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People Ate More Whole Grains at Restaurants in 2015/2106 vs 2003/2004

Healthy menu items are seemingly easier to find at restaurants than they were ten years ago, but are people actually eating these dishes? To find out, researchers analyzed the nutritional content of fast-food and full-service restaurant dishes eaten by 35,015 adults between 2003 and 2016. Although the overall diet quality remained poor for both fast-food and full-service restaurant meals eaten by the participants, there are a few promising signs of progress. Notably, whole grains eaten at restaurants increased from 0.22 to 0.49 servings per day in full-service restaurants, and 0.08 to 0.31 servings in fast food restaurants. There were also slight increases in nut/seed/legume intake at fast food restaurants, as well as slight decreases in soda consumption at full-service restaurants and saturated fat and sodium consumption at fast food restaurants. Unfortunately, over this time period, people also at fewer fruits and vegetables at both types of restaurants, and the nutritional disparities between different racial and ethnic demographic groups persisted and, in some cases, worsened.
Journal of Nutrition. 2020 Jan 29. pii: nxz299. doi: 10.1093/jn/nxz299. [Epub ahead of print] (Liu J et al.)

When it Comes to Low-Carb vs Low-Fat Diets, Quality is More Important than Quantity

While some headlines focus on the supposed benefits of choosing a low-carb or a low-fat diet, the smarter dietary move is to focus on overall diet quality, and let the numbers fall where they may. In this study, researchers analyzed the food choices of 37,233 US adults, then followed them for years to see if diet impacted risk of death. Neither low-carb nor low-fat diets were linked with death. However, when differentiating between healthy and unhealthy diets, both unhealthy low-carb and low-fat diets were linked with increased mortality risk over the study period, while healthy low-carb and low-fat diets were both linked with lower risk of mortality over the study period. Therefore, it seems that the amount of fat or carbs is less important than the quality of fat or carbs.
JAMA Internal Medicine. 2020 Jan 21. doi: 10.1001/jamainternmed.2019.6980. [Epub ahead of print] (Shan Z et al.)

Kids with Celiac Disease Tend to Eat Less Fiber, More Saturated Fat on Gluten-Free Diet

Lifelong adherence to a gluten-free diet is a medical necessity for people with celiac disease. However, extra care must be taken to ensure that a gluten-free diet is nutritionally balanced. In this study, researchers analyzed the diets of 120 children with celiac disease who had been eating a gluten-free diet for at least 2 years, along with 100 age-and-gender-matched healthy children who didn’t avoid gluten. Those on a gluten-free diet ate significantly more saturated fat (contributing to 12.8% vs 8.8% of total calories) and significantly less fiber (12.6 g vs 15 g) daily than those not on a gluten-free diet.
Nutrients. 2020 Jan 4;12(1). pii: E143. doi: 10.3390/nu12010143.(Lionetti E et al.)

Improving Diet Could Save $301 per Person per Year in Healthcare Costs

Eating a healthy, well-balanced diet is known to help prevent numerous chronic diseases, so it’s no surprise that eating healthier can reduce healthcare costs, too. In this study, researchers analyzed U.S. eating habits against dietary recommendations, and then calculated the cardiometabolic disease burden (heart diseases, stroke, type 2 diabetes) attributable to not meeting specific dietary guidelines. From there, they were able to calculate the costs associated with not meeting specific dietary recommendations. They found that diet-related healthcare costs were $301 per person annually (or $50.4 billion total) for cardiometabolic diseases alone. Specifically, the per-person annual cardiometabolic cost of not eating enough nuts & seeds was $81, seafood omega-3 fats was $76, vegetables and legumes was $60, fruits was $57, and whole grains was $45.
PLoS Medicine. 2019 Dec 17;16(12):e1002981. doi: 10.1371/journal.pmed.1002981. eCollection 2019 Dec. (Jardim TV et al.)

Whole Grain Breads with Larger Particle Size / Less Processing Linked with Healthier Blood Sugar Control

In a small study, researchers assigned 15 people to four different types of 100% whole grain bread and measured their blood sugar responses (using iAUC, post-meal glucose, and 3-hour glucose). One bread was made with 100% stone ground flour, one was made with 100% roller milled flour, one was made with 50% roller milled flour and 50% cracked whole wheat, and one was made with 40% roller milled flour, 30% intact whole wheat, and 30% cracked whole wheat — although all breads were 100% whole grain. Among the roller milled breads, they found that the larger the particle sizes in the bread (intact whole wheat > cracked whole wheat > roller milled wheat), the gentler the impact on blood sugar. Interestingly, the blood sugar response of the stoneground bread (as measured by iAUC) was better than the 50% cracked wheat / 50% roller milled bread, but not quite as good as the 40% roller milled / 30% intact whole wheat / cracked whole wheat bread.
Diabetes Care. 2019 Nov 19. pii: dc191466. doi: 10.2337/dc19-1466. (Reynolds AN et al.)

Healthy Diet Linked with Improvement in Depression in Young Adults

A balanced diet can go a long way towards nourishing our bodies, our brains, and our feelings. In this study, 76 young adults (ages 17-35) with symptoms of depression were randomly assigned to either continue their typical diet or eat a healthier diet with whole grains, fruits, vegetables, nuts, lean protein, and fish for 3 weeks. After the study period, those eating the healthier diet had significantly lower self-reported depression symptoms than the control group, and some of the beneficial results were maintained 3 months after the study as well.
PLoS One. 2019 Oct 9;14(10):e0222768. doi: 10.1371/journal.pone.0222768. (Francis HM et al.)

American Diet Slowly Gets a Tiny Bit Better, Still Needs Improvement

The standard American diet is infamous for its high levels of refined carbs, sugar, and saturated fats. To see if nutrition initiatives are taking hold, researchers analyzed the diets of 43,996 U.S. adults in 1999 and then again in 2016. Over this time period, people got 1.23% more calories from high quality carbs (whole grains), 0.38% more calories from plant protein, 0.65% more calories from polyunsaturated fats, and 3.25% fewer calories from low quality carbohydrates (sugar and refined grains). Unfortunately, calories from saturated fat increased by 0.36%, and the general diet is still far from ideal, with 42% of calories still coming from low quality carbs, and saturated fat remaining above 10% of energy intake.
JAMA. 2019 Sep 24;322(12):1178-1187. doi: 10.1001/jama.2019.13771.(Shan Z et al.)

Sourdough Fermentation Methods Improve Quality of Partially Whole Wheat Pasta

Swapping out some of the white flour for whole wheat flour in pasta is a simple way for manufacturers to bump up the nutritional quality of their products. But researchers wonder if different whole wheat pasta formulations might be better than others. In this study, researchers compared the nutritional and sensory (taste, acceptability, etc.) characteristics on two types of partially (28.5%) whole wheat fresh pasta: in one, the whole wheat flour was fermented (essentially a sourdough starter) and in the other, the whole wheat flour was not fermented. The fermented pasta showed a higher content of free essential amino acids and phenolic compounds, lower phytic acid content, and higher antioxidant activity. In consumer testing in a group of 54 people, the fermented pasta was rated higher for overall acceptability (taste, texture, and flavor). Interestingly, when people were told about the use of sourdough fermentation in the pasta, the acceptability ratings were even higher, reflective of the growing appetite for functional foods.
Foods. 2019 Sep 18;8(9). pii: E422. doi: 10.3390/foods8090422. (Fois S et al.)

Whole-Food Plant-Based Diet Linked with Weight Loss, Healthier Gut Microbiome

Researchers randomly assigned 148 overweight and obese adults to a low-fat vegan diet, or to continue their usual diet for 16 weeks. Those in the vegan group lost about a pound per week, and also lost a significant amount of body fat. Additionally, the vegan group (who ate lots of legumes, fruits, vegetables, and nuts) also had higher levels of beneficial bacteriodetes in their gut. This may partially explain some of the health benefits of plant-based diets, because people with diabetes, insulin resistance, and inflammation tend to have low levels of bacteriodetes. (Note that findings presented at meetings are considered preliminary until published in a peer-reviewed journal.)
Presentation at European Association for the Study of Diabetes 2019 Annual Meeting. Barcelona, Spain. September 17, 2019.

Going Gluten-Free Does Not Improve Digestive Symptoms in Healthy Volunteers

If you don’t have a medically-diagnosed problem with gluten, is there any benefit to going gluten-free? New research suggests not. In this study, scientists randomly assigned 28 people without medical problems with gluten to a gluten-free diet or a gluten-containing diet for 2 weeks. The gluten-containing diet did not generate any symptoms (diarrhea, reflux, constipation, fatigue, etc.) in these healthy volunteers. They concluded that because a gluten-free diet is often less healthy than a typical diet, “there is possibly clinical justification in actively discouraging people from starting it if they have no diagnosable sensitivity.”
Gastroenterology. 2019 September;157:881-883. doi: 10.1053/j.gastro.2019.05.015. (Croall ID et al.)

Millet-based Lunches Improve Health in Indian Children

Millet is a whole grain that has a rich history throughout India. However, in recent times, millet has been displaced by refined grains like white rice. In this study, researchers introduced millet-based lunches at 2 schools in Karnataka, India, and then compared the health outcomes of those 136 students to 102 students at 2 schools who ate their regular fortified rice-based lunches for 3 months. Those in the millet group significantly improved stunting (an important measure of growth and development) and BMI, while the rice group did not. Additionally, all of the millet meals had high acceptability, with the most popular ones being finger millet ildi (a steam cooked fermented savory cake), little and pearl millet bisi belle bath (a millet-lentil hot meal), and upma (a pearl and little millet-vegetable meal).
Nutrients. 2019 Sep 3;11(9). pii: E2077. doi: 10.3390/nu11092077.(Anitha S et al.)

AMERICANS CAN CORRECTLY CATEGORIZE MOST FOODS AS WHOLE GRAIN OR REFINED GRAIN

In this study, researchers asked 169 low-income adults to look at 11 foods in their original packaging and determine if each was a whole grain or a refined grain. The majority of participants (7 out of 10) correctly identified 4 out of 5 of the whole grain products as whole grain, and nearly as many (6 out of 10) participants correctly identified 5 out of the 6 refined grain products. Specifically, 9/10 people correctly identified whole grain bread, 8/10 correctly identified whole grain crackers & whole grain cereal, and 7/10 correctly identified oatmeal as a whole grain, while popcorn tripped most people up (with only 3/10 people correctly identifying it as a whole grain food). Similarly, 8/10 correctly identified refined crackers, 7/10 correctly identified refined macaroni and tortillas, and 6/10 correctly identified refined bread and cereal, while white rice was tricky for people (with only 4/10 correctly identifying it as a refined grain). Based on interviews with a subset of 60 of the participants, the researchers found that helping people more clearly identify whole grains on the package, and reducing the cost (or perceived cost) of whole grain foods may help increase whole grain consumption in low-income adults.
Current Developments in Nutrition. 2019 May 16;3(7):nzz064. doi: 10.1093/cdn/nzz064. (Chea M et al.)

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