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Wheat Foods Council, Parker, Colorado
Address reprint requests to: Judi Adams, President, Wheat Foods Council, 10841 S. Crossroads Drive, Ste. 105, Parker, CO 80138
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ABSTRACT |
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 TOP ABSTRACT INTRODUCTIONBACKGROUNDWHY THE SHORTFALL?POSSIBLE SOLUTIONS FOR...CONCLUSIONREFERENCES |
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Key words: whole grains, Continuing Survey of Food Intakes by Individuals (CSFII), folate, hard white wheat
Key teaching points:
• Health professionals must understand the benefits of these foods so that they can effectively communicate and influence consumers to incorporate more whole grains into their diets.
• Health professionals and food manufacturers must help consumers identify whole grain products and offer convenient, practical ways for adding them into the diet.
• The food industry and health professionals should use the recently approved FDA whole grain health claim as a tool for educating the public about the benefits of whole grain foods.
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INTRODUCTION |
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TOPABSTRACTINTRODUCTIONBACKGROUNDWHY THE SHORTFALL?POSSIBLE SOLUTIONS FOR...CONCLUSIONREFERENCES |
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As much as advice has changed over the years, it also has stayed the same—as is evidenced in the writings of this anonymous author:
• 2000 BC—Here, eat this root.
• 1000 AD—That root is heathen. Here, say this prayer.
• 1850 AD—That prayer is superstition. Here, drink this potion.
• 1940 AD—That potion is snake oil. Here, swallow this pill.
• 1985 AD—That pill is ineffective. Here, take this antibiotic.
• 2000 AD—That antibiotic doesn’t work anymore. Here, eat this root.
Regardless of nutritional advances over the past century, it appears our ancestors had it right all along. Eating whole grains is a valuable part of a healthful diet. Current science is showing exactly how valuable.
Whole Grain Attributes
We consider the benefits of whole grains to be indisputable. In the 1970’s, fiber was recognized as a food component that could prevent constipation and cancer [1]. In more recent years, it’s been determined that whole grains are more than just fiber. Recent research has found that some of the vitamins and minerals, along with newly discovered phytochemicals and phytoestrogens in whole grains, have a beneficial effect on health. Whole grain intake is positively associated with enhancing insulin sensitivity [2], better weight control management [3], prevention of heart disease [4] and cancer [5]. Eating a diet rich in folic acid—found abundantly in regular and fortified whole grain products—helps prevent neural tube birth defects [6] and lowers homocysteine levels in the blood, which in turn may reduce the risk of heart disease [7]. Preliminary studies suggest folic acid may even have a role in protection against cancer.
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BACKGROUND |
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TOPABSTRACTINTRODUCTIONBACKGROUNDWHY THE SHORTFALL?POSSIBLE SOLUTIONS FOR...CONCLUSIONREFERENCES |
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Several studies have reported that 20 to 30 grams of fiber a day, much of it coming from whole grain foods, has significantly lowered the risk of heart attacks and heart disease. The Nurses Health Study which has followed more than 75,000 women for 10 years found that those who ate two to three servings of whole grains a day had about half the risk of heart disease as women who ate almost no whole grain foods. Jacobs, et al. recently found that as little as one whole grain serving a day could decrease the risk of heart disease in women [4].
Actual Dietary Intake of Whole Grains
A study, conducted by Market Research Corporation of America (MRCA) from 1990 to 1992, discovered that most Americans failed to consume even one whole-grain food per day [12]. According to the USDA Continuing Survey of Food Intakes by Individuals, 1994–96 [13], white individuals over the age of two consume only 1.1 servings of whole grain foods per day. Blacks over the age of two consume even less, 0.7 servings, and Mexican Americans of the same age consume 0.8 servings. Interestingly, adult white males seem to be better at eating whole grains than females, 1.2 servings, as compared to 0.9 for adult white females 20 and over. Black adult males also consume more servings per day (0.7) when compared to black adult females (0.6). On the other hand, adult Mexican American females and males eat the same amount, 0.6 servings per day.
When it comes to age-related consumption numbers, there are differences between whites, blacks and Mexican Americans. White males and females over the age of 60 consume more whole grains daily than any other age group; males 1.3 servings, females 1.0 servings. Blacks, on the other hand, consume more as children than at any other age, 1.0 servings for males between the ages of two and five and 0.8 servings for females of the same age. The difference for Mexican American males is not as noticeable. Boys between the ages of two and 20 consume the same amount, 0.8 servings, while Mexican American female teenagers (ages 12 to 19) consume 1.2 servings of whole grains a day.
The total dietary intake of adolescents is a concern among most health professionals. According to a study by Levine and Guthrie [14], that concern is warranted. This age group does not consume an adequate number of servings of grains, vegetables, fruits and dairy foods. Wilson et al. showed that while many adolescents actually met the required grain servings, the average number of whole grain servings was far from the goal—1.0 servings a day for males and 0.9 for females.
Income levels also seem to affect the number of whole grain servings Americans choose [13]. Those individuals under 131 percent of poverty consume only 0.7 servings daily, while those at 131 to 350 percent of poverty consume 1.0 servings daily, and those over 350 percent of poverty eat 1.1 servings per day.
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WHY THE SHORTFALL? |
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TOPABSTRACTINTRODUCTIONBACKGROUNDWHY THE SHORTFALL?POSSIBLE SOLUTIONS FOR...CONCLUSIONREFERENCES |
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Case histories and other studies show that a high percentage of Americans act upon nutrition beliefs if they are given a compelling reason to do so. In 1998, the International Food Information Council (IFIC) [17] conducted a telephone survey of 1,000 individuals over the age of 18. According to their findings, 95 percent of consumers agreed that "... certain foods may reduce the risk of certain diseases." Fifty-three percent act on that belief and eat specific foods for their particular health benefits.
When asked which foods may reduce the risk of disease, consumers mentioned the following: broccoli (21%), other fruit (20%), oranges/orange juice (13%), other vegetables (11%), carrots (10%), fish/fish oil (10%), garlic (10%), green, leafy vegetables (9%) and milk (8%). Fiber came in at seven percent—whole grains were never mentioned. Twenty-two percent of respondents linked fiber to colon cancer, but they made no link between colon cancer and whole grains. Only 10 percent associated fiber and whole grains with a lower risk for heart disease.
In 1999, IFIC held focus groups in Boston, Massachusetts, Columbus, Ohio, and Los Angeles, California [18]. When asked to name "hot" functional foods or nutrients, the following were mentioned: calcium, cranberry juice, fiber, fish oil/omega-3 fatty acids, folic acid, garlic, green vegetables, oat bran, soy, tomato sauce/lycopene. Whole grains did not make the top 10 list, but two of their components, oat bran and fiber, did.
Health professionals appear to lack an understanding of the value of whole grains and exactly what constitutes a whole grain food. A 1998 self-administered survey of dietitians [19] found that 61 percent thought the benefits of eating bran and fiber were the same as eating whole grains. A phone survey of military food service specialists a few years ago found that 90 percent of them believed they were serving whole-grain bread at their facility. In reality, only 22 percent were [20].
In 1998, a graduate student at the University of Nevada conducted research to determine attitudes among low-income adolescents towards consuming more whole grains, fruits, vegetables and dairy products [21]. Seven focus groups were done with 34 students, 50 percent of whom were female. The mean age of the children was 12.4 years.
Of the food groups discussed, participants were least familiar with whole grain foods. When asked about specific beneficial nutrients from whole grains, fiber was mentioned, as was the perception that these foods were "lower in calories" and might be beneficial for people who want to lose weight. Surprisingly, "good taste" was also cited as a reason to eat whole grains, as was the potential for better school performance (e.g., "I think they’re healthy because they help your brain work better.").
According to the focus groups, foods that compete with whole grains in the diet include white bread and other refined grain products such as cakes, cookies, pastries and pies. The participants offered strategies for increasing whole grain consumption, such as improving taste. Sweetening whole grain foods was favored, as was moistening them with milk or water. Serving whole grain foods instead of other snack foods or sweets was also suggested. Participants felt that telling people that whole grain foods are good for them or that they taste good might also encourage individuals to eat more. When asked what would make it easier to consume more whole grains, one participant replied, "if they can make oatmeal taste more like ice cream." Also, whole grains would be more readily eaten if these foods were easier to prepare, if the children knew how to prepare them or if they were prepared for them more often. The author was quick to point out that her findings may not be representative of all consumers because of the size and composition of this group.
In the fall of 1998, seven focus groups were sponsored by the Oklahoma Center for Advancement of Science and Technology [23] to investigate women’s attitudes toward folate-containing foods. Fifty-seven women, ages 18 to 44, participated. When asked, "Why do you eat grain foods," they offered six reasons: 1) grains are a traditional part of the meal; 2) they taste good; 3) they are filling, 4) convenient, 5) inexpensive and 6) readily available.
When asked what limits them from adding more grain foods to the diet, participants said they were trying to control their weight and they felt they already chose an adequate number of servings. Time and money were mentioned as obstacles to eating nutritiously.
The Food Marketing Institute and Prevention Magazine [24] team up annually to conduct a consumer survey titled "Shopping for Health." The 1999 survey found 21 percent of respondents had sought information in the past month on how to find whole grain products and 43 percent had sought ways to increase fiber intake. The more mature shopper (54 and over) was more likely than the younger shopper to want information on fiber (52% vs. 39%) and whole grains (28% vs. 18%). The primary source of information for both groups was grocery store personnel. Dietitians or nutritionists placed second and the Internet, third. Individuals most likely to seek information on fiber and whole grains were classified as "Progressive Self-Care" shoppers—people who place a great deal of importance on selecting healthy foods, along with herbal and natural remedies.
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POSSIBLE SOLUTIONS FOR OVERCOMING BARRIERS—INDUSTRY OPPORTUNITIES |
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TOPABSTRACTINTRODUCTIONBACKGROUNDWHY THE SHORTFALL?POSSIBLE SOLUTIONS FOR...CONCLUSIONREFERENCES |
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Some professionals and consumers do not select whole grain foods because they have trouble in recognizing which foods offer whole grain ingredients.
Identifying Whole Grains
There are two ways that industry can help people find foods containing whole grains. One way is to use a flag or banner on products that predominately comprise whole grains. Another approach is to promote the benefits of whole grains through the recent, FDA-approved, health claim: "A diet rich in whole-grain foods and other plant foods and low in total fat, saturated fat and cholesterol may reduce the risk of heart disease and some cancers." These strategies remove the guesswork of whether or not a product is considered a whole grain food, and in the case of the health claim, its presence gives shoppers a strong incentive for choosing a whole grain product. Consumer research and past examples have proven that communicating the benefits of eating certain foods, including whole grain foods, increases consumption of them. For example, effective health professional and consumer campaigns promoting the claim "Soluble fiber from whole grain oat foods can help reduce cholesterol (when included in a diet low in saturated fat and cholesterol)" increased sales and consumption of whole grain oat products like oatmeal and Cheerios.
The new whole grain claim provides many opportunities for food manufacturers to promote a broad range of whole grain foods including cereals, breads, crackers and pasta.
Specifics on the Claim
The whole grain claim has been approved through a new process. It is based on the authoritative statements provision of the FDA Modernization Act of 1997. This process allows for a claim to be made if it is based on a published authoritative statement, which is currently in effect about the relationship between a nutrient and a disease or health related condition. The statement must come from a scientific body of the U.S. government with official responsibility for public health or human nutrition research. The whole grain claim is based on a statement from Diet and Health: Implications for Reducing Chronic Disease Risk (National Research Council, 1989). It was approved in July as a result of a claims notification submitted to the FDA by General Mills.
The notification defines "whole grain food" as a food containing 51 percent or more whole grain ingredients by weight per reference serving. It also stipulates that the food contain a minimum of 16 grams per serving and meet the other qualifications outlined in the claim. Compliance with the claim is determined by measuring the fiber level in the product. Because wheat is the predominate grain consumed in the U.S. diet, the level of fiber found in wheat is used as the reference level. These requirements allow a wide array of whole grain foods to qualify for the claim, including whole-grain breads and rolls, whole-grain hot or ready-to-eat cereals, crackers and whole-grain pasta.
Other Point-of-Purchase Strategies
The 1999 Shopping for Health survey [24] discovered that 90 percent of shoppers would "definitely" or "probably" use nutrition information posted right next to a product. Eighty-two percent would use pamphlets, and 70 percent would read a grocery store newsletter. This reiterates the many opportunities manufacturers have to connect with customers and influence their food selections. Packaging, shelf-talkers and recipe tear pads near foods can also communicate pertinent messages.
Improving Taste
Even if consumers understand the benefits of whole grains and are able to readily recognize them, they will not eat whole grain foods if they do not taste good. Whole-grain cereals appear to be well accepted; however, opinions vary on the palatability of whole-grain breads. Dryness and bitterness of whole grain products have been mentioned in various focus group discussions [21,23].
The industry is capable of making softer, moister whole grain products, and, in fact, many currently on the market meet that standard. Consumers need to be encouraged to try different foods until they find some which suit their tastes.
Recipes for whole-wheat French toast, meat loaf with whole grain crackers, whole wheat bread pudding and other creative ideas can be promoted to the consumer for tasty ways to increase whole grain consumption. In addition, adding whole grains such as wheat kernels, barley, oats, brown rice, amaranth and quinoa to casseroles, chili, soups and stews is an easy and convenient way to increase whole grain consumption.
Eating whole grain foods away from home may present a bigger challenge, as many restaurants offer little on the menu in terms of whole grains. When ordering breakfast, those eating out might choose a whole grain ready-to-eat or cooked breakfast cereal or ask for one if there is none listed on the menu. Whole-grain bagels and whole-wheat toast are excellent choices. At lunch, a sandwich on whole-wheat bread, a whole-grain bagel, pita or bun might be ordered. A whole-grain salad such as tabouli made from bulgur or a soup containing whole grain ingredients, such as barley or quinoa, might be available. At dinner, whole-grain breads in the breadbasket should be selected, the menu might be checked for whole grain side dishes or for mixed dishes containing a whole-grain component.
A relatively new variety of wheat, hard white wheat, is being grown, primarily in Kansas and Idaho. It may offer more whole-grain options. Hard white wheat has sufficient gluten quality and quantity to make bread products, in contrast to other white, milled wheat flour, which is usually used for cakes, pastries, cookies and Asian noodles. When ground into whole-wheat flour, hard white wheat can be a much milder tasting product than the usual hard red wheat grown in the U.S. Whole-wheat cakes have been successfully made from hard white wheat flour. They look and taste very similar to cakes made from the traditional refined soft white wheat flour. As the demand for this product grows, more bushels will be produced, and its availability will expand.
Cost Concerns
According to the Shopping for Health survey, 28 to 63 percent of shoppers feel "it costs more to eat healthful foods" [24]. Whole grain cereals and crackers do not appear to cost more than non-whole grain cereals and crackers. Whole grain breads and pasta, however, do. According to one major milling company, whole-wheat flour and white flour are sold at more or less the same price, but processing whole-wheat flour into bread is often a more expensive procedure because of the necessary addition of gluten for a texture and volume. Fortunately, consumers concerned about cost should still be able to eat three servings of whole grain foods a day relatively inexpensively. A large bowl of whole-grain, ready-to-eat or hot cereal, six to eight whole grain crackers, plus a slice of whole grain bread or a small whole grain bagel or a whole-wheat tortilla fill the quota.
Time Constraints
Time does not have to be an obstacle to eating whole grain foods. For example, it does not take more time to eat a bowl of whole-grain cereal than non-whole grain cereal or a slice of whole-grain bread instead of white bread. There are several whole-grain hot cereals on the market that take no longer than three minutes in the microwave. Certain whole grains such as whole-wheat kernels, need to be cooked about 15 to 20 minutes before they can be eaten. But since they are usually used in soups and stews, which have to be simmered for about the same amount of time, they can be added in at the start of meal preparation and be ready when the rest of the meal is done. Brown rice takes longer to cook than white rice, but it can be partially cooked ahead of time and refrigerated for last minute meals. Instant brown rice is also available in most grocery stores.
The food industry needs to be challenged to offer a wider variety of whole-wheat toaster waffles, good tasting low-fat whole grain muffins, whole grain children’s cereals, frozen whole grain pizza and other creative new products.
Product Availability
Other than consumers in small rural towns, just about anyone should be able to find whole grain products readily available in grocery stores. Changes in product labeling will make it easier to identify the scope of foods from which one can choose. As the demand increases, the American food manufacturer will find new ways to include whole grains in more products.
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CONCLUSION |
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TOPABSTRACTINTRODUCTIONBACKGROUNDWHY THE SHORTFALL?POSSIBLE SOLUTIONS FOR...CONCLUSIONREFERENCES |
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We can make the whole grain message as relevant to consumers as other successful nutrition campaigns have done, including those impressing the consumer with the importance of eating fruits and vegetables. It will take a creative, consistent and concerted effort on the part of industry and health professionals to educate the public on the benefits of eating whole grain foods. As more and more research demonstrates the influence of whole grains on health, it becomes clear that it is an effort worth making.
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REFERENCES |
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TOPABSTRACTINTRODUCTIONBACKGROUNDWHY THE SHORTFALL?POSSIBLE SOLUTIONS FOR...CONCLUSIONREFERENCES |
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This article has been cited by other articles:
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  P. Koh-Banerjee, M. Franz, L. Sampson, S. Liu, D. R Jacobs Jr, D. Spiegelman, W. Willett, and E. Rimm Changes in whole-grain, bran, and cereal fiber consumption in relation to 8-y weight gain among men Am. J. Clinical Nutrition, November 1, 2004; 80(5): 1237 - 1245. [Abstract] [Full Text] [PDF]
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 L. Marquart, D. R. Jacobs Jr, and J. L. Slavin Whole Grains and Health: An Overview J. Am. Coll. Nutr., June 1, 2000; 19(90003): 289S - 290. [Full Text] [PDF]
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