Whole grains

Fiber is important for the elderly to help prevent constipation and improve quality of life, and yet many older adults are falling short on fiber. In this study, 681 dietitians working in long-term (elderly) care answered questionnaires exploring barriers to whole grain consumption for older adults. Overall, 89.5% of dietitians reported that they would like to serve more whole grains. Twenty seven percent of dietitians reported that cost was a barrier to serving whole grains in long term care, and yet 75% of dietitians report that their patients need fiber supplements, averaging upwards of $11-20 a month per patient. Given that whole grains are a natural source of fiber, whole grains may be able to offset some of the cost of fiber supplementation. Other factors influencing the decision to purchase whole grains included dietary needs (such as special considerations for kidney disease), existing food contracts, nutritional content, and acceptance by residents.
Journal of Nutrition in Gerontology and Geriatrics. 2017 Oct-Dec;36(4):178-188. (Coffman CA et al.)

As global life expectancy grows, dementia is an increasing concern. Healthy eating patterns like the Mediterranean Diet are thought to help decrease the risk of such diseases. Researchers recently analyzed the diets of 1,865 Greek adults over the age of 64 as part of The Hellenic Longitudinal Investigation of Ageing and Diet (HELIAD) study. The researchers concluded that closer adherence to the Mediterranean Diet may be associated with improved cognitive performance—particularly memory—and lower dementia rates. Fish and whole grains in particular were singled out for their association with cognitive benefits.
PLOS One. 2017 August 1. 12(8): e0182048. (Anastasiou CA et al.)

Cholecystectomy, or the removal of the gallbladder, is a common treatment for gallstones, which affect 10-15% of the adult population. Some studies suggest that foods typical of the Western diet (high in calories, cholesterol, etc.) may increase the risk of gallstone disease. Researchers analyzed whether a healthful diet, like the Mediterranean diet, could potentially prevent cholecystectomy in a group of 64,052 French women. They found that those more closely following the Mediterranean diet had a lower risk of cholecystectomy. Specifically, a higher intake of legumes, fruit, vegetable oil, and whole grain bread was associated with a lower cholecystectomy risk, and a higher intake of ham was associated with a higher risk.
American Journal of Gastroenterology. 25 July 2017. [Epub ahead of print.] (Barré A et al.)

Wholesome plant foods are the foundation of a healthy diet, but not all “vegetarian” foods are equally nutritious. To see how different variations of plant-based diets relate to the risk of developing coronary heart disease (when plaque builds and hardens in the heart’s major blood vessels and decreases blood flow), researchers analyzed data detailing what more than 200,000 people ate over 20 years and separated people into three versions of plant based diets: overall plant-based diet (includes all plant foods and some animal foods), healthful plant-based diet (includes healthy plant foods like whole grains, fruits, and vegetables), and unhealthful plant-based diet (includes sugar-sweetened drinks and refined grains). Not surprisingly, they found that the second choice – eating fewer animal foods and more healthy plant foods – was linked with a lower risk of developing coronary heart disease, while eating more animal foods and more unhealthy plant foods was linked with an increased chance of developing coronary heart disease.
Journal of the American College of Cardiology. 2017 July; 70(4):411-422. (Satija et al.)

While there is no one-size-fits-all weight loss plan that works for everyone, it seems that a low Glycemic Load or low carbohydrate diet makes little difference for most people who don’t have diabetes (or pre-diabetes). Researchers analyzed data from 3 different experiments (high Glycemic load vs low Glycemic Load, lots of whole grains vs few whole grains, and low fat vs. low carbohydrate) and noted whether the weight change differed between people with insulin sensitivity issues (such as diabetes or pre-diabetes). Eating a high Glycemic Load diet resulted in significantly more weight gain in people whose bodies don’t respond well to insulin (the hormone that helps control blood sugar), compared to those without insulin sensitivity issues. Similarly, people with insulin sensitivity problems lost more weight on a New Nordic Diet (high in whole grains) or a high-fat, low-carbohydrate diet. However, people without diabetes or pre-diabetes lost more weight on a high-carbohydrate, low-fat diet.  
American Journal of Clinical Nutrition. 2017 July 5. [Epub ahead of print.] (Hjorth MF et al.)

Can an apple a day keep the grim-reaper away – at least for a while? To find out how diet relates to mortality, researchers analyzed the diets of 47,994 women and 25,745 men. They used scores from the Alternate Healthy Eating Index, the Alternate Mediterranean Diet, and the Dietary Approaches to Stop Hypertension (DASH) diet to determine diet quality. They found that a 20-percentile increase in any of these three diet-quality scores was associated with a reduced risk of death from any cause. Specifically, a 20-percentile increase in diet-quality score was associated with a 25% reduced risk of death from cardiovascular disease when assessed by the Alternate Healthy Eating Index, 7% when assessed by the Mediterranean Diet score, and 4% when assessed by the DASH score. Overall, a healthful diet full of whole grains, vegetables, fruit, and fish is linked with a longer life.
New England Journal of Medicine. 3 July 2017;377(2):143-153. (Sotos-Prieto M et al.)

Whole grains are thought to help prevent type 2 diabetes, but researchers want to learn more about this protective effect. In a review of 14 randomized controlled studies, scientists found that whole grain foods led to better post-meal blood sugar management than refined grain foods. However, the medium- and long-term effects (6 weeks or more) on fasting blood sugar were not significantly different between whole grain and refined grain meals. 
Nutrients. 2017 Jul 19;9(7). pii: E769. (Marventano S et al.)

Even in Italy, workers are starting to opt for unhealthy Western food choices, in place of traditional Mediterranean meals. To combat this trend, researchers in Italy piloted a health program within worksite cafeterias of a large industrial corporation. Handouts, posters, and other promotional material decorated the cafeteria to encourage consumption of healthy foods like vegetables and whole grains. Nutritionists also worked with the food service staff to modify recipes to make them healthier. At the end of the pilot, after analyzing food choices from 738 employees (half office workers, half plant workers) there was a higher purchase rate of dishes based on whole grains, legumes, fish, and poultry and a lower purchase rate of dishes based on refined grains, red meats, eggs and cheese. This trend persisted up to three years after the intervention. There was also better adherence to the national Italian recommendations for saturated fat, cholesterol, sugars and fiber after the study. The authors conclude that this could be a good model for other workplace nutrition programs, especially given that it cost the employer very little, and did not take up too much of the foodservice employees’ time.
International Journal of Food Sciences and Nutrition. 2017 Jun;69(1):117-124. (Vitale M et al.)

Foods that moms choose during pregnancy may have an impact on their children’s health down the line. In a study of more than 500 mother-child pairs in Denmark, in which all of the moms were diagnosed with gestational diabetes (diabetes during pregnancy), Harvard researchers found that substituting 1 serving of refined grains per day with whole grains in the mom’s diet during pregnancy was associated with a 10% lower risk of the child being overweight or obese at age 7. They also found that eating more than 4.3 servings of refined grains per day during pregnancy was linked with nearly double the risk of children becoming overweight or obese at age 7 compared to those who ate fewer than 1.8 servings of refined grains per day. These results were especially strong in kids who were breastfed for less than 6 months.
American Journal of Clinical Nutrition. 2017 June 7. [Epub ahead of print.] (Zhu Y et al.)

Unless you have celiac disease, you might want to rethink that gluten-free diet. In a study of more than 100,000 US adults without celiac disease, followed for more than 25 years, researchers found that eating gluten was not related to heart disease risk. In fact, the researchers caution that avoiding gluten may result in eating fewer whole grain foods, which may in turn pose a risk for heart disease.
BMJ. 2017 May 2;357:j1892. (Lebwohl B et al.)