A very consequential study for enriched grains

by Josh Sosland
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Josh Sosland
Milling and baking reached an important milestone in late July with publication of the study showing positive nutrition profiles and health benefits for consumers of flour-based foods.

To understand the importance of the study funded by the Grain Foods Foundation, a look at recent history is helpful. It was nearly three years ago at the 2013 International Baking Industry Exposition that Glenn Gaesser, Ph.D., chairman of the Grain Foods Foundation’s scientific advisory committee, made a perplexing observation. He briefly summerized findings from a comprehensive scientific literature review aimed at evaluating whether studies looking at the healthfulness of grain-based foods yielded positive top-line conclusions (grains are good for you) or negative assessments (they should be avoided). Looking at over 1,200 studies spanning many years, a team led by Dr. Gaesser considered the impact of grains on areas of health ranging from cardiology and nutrition to pediatrics and vascular health.

The surprise was not in the results, which showed that 72% of the studies generated positive conclusions, and only 12% reflected criticisms directed at grain-based foods. The surprise shared by Dr. Gaesser was the nearly complete absence of research specifically looking into the healthfulness of enriched grain foods, in contrast to the plethora of research on whole grains. Astonishingly, the scientific community had essentially ignored what for decades has been the largest source of energy and a range of other nutrients in the U.S. diet. Yet, even as researchers have spent untold millions studying whole grains and other foods, fundamental questions about the healthfulness of the grain-based foods Americans actually consume in measureable quantities every day have been neglected. Questions like, are people who consume enriched grains more prone to obesity or chronic disease than those who avoid grains? Are people who consume enriched grains getting enough vitamins and minerals? Are people who consume enriched grains healthy?

The lack of such data presented a thorny challenge to the grain-based foods industry and specifically the Grain Foods Foundation. From the time it was established by the grain-based foods industry, the G.F.F. has been committed to disseminating information about the healthfulness of grain-based foods solidly grounded in science. While the Foundation’s scientific advisory committee has been able to tout the well-documented benefits of whole grains, they have been challenged when trying to make definitive statements specifically about enriched grain products encompassing most (90 per cent plus) of what the industry produces and the public consumes. In the face of endlessly blistering barrages of baseless criticisms about grain-based foods, the advisory committee has been poorly armed when it comes to the kind of research most needed. Sources like the U.S. Department of Agriculture offer plenty of data indicating grains are the principal source of many important nutrients like iron and folate, but in scientific debates it is peer-reviewed scientific studies that are the coin of the realm. The information hole the industry has faced is gaping.

Against that backdrop, the study published in the July issue of Food and Nutrition Sciences represents the long-sought first major step forward. As a data source, the researchers probed figures in “What We Eat in America,” encompassing statistics from the National Health and Nutrition Examination Survey (NHANES), statistics gathered through the Centers for Disease Control and Prevention in collaboration with the U.S. Department of Agriculture. Widely used by research professionals, this information is collected annually by in-person assessments of thousands of individuals, asking each to recall all foods and beverages consumed in the last 24 hours. The subjects then are assessed for markers of health like body mass index, cholesterol and waist circumference.

Trying to isolate whether eating specific grain-based foods is associated with positive or negative health outcomes, the researchers filtered from the universe of 30,000 clusters of individuals who either ate a diverse mix of grain-based foods each day (about 30 per cent of the subjects); concentrated their consumption of grain-based foods on one category of products, such as bread, cereal or even sweets (groups accounting for between 4 and 23 per cent of the subjects); or consumed little or no grain-based foods (about 6 per cent). The sweeping look generated what on balance must be viewed as a highly welcome outcome:

“Overall, while some grain food patterns were associated with elevated sodium and added sugar, the present data also support that several grain food patterns can serve as part of a healthy dietary food pattern that accounts for 2015 Dietary Guidelines recommendations to reduce total fat, saturated fat and added sugar consumption, while concurrently increasing intake of shortfall nutrients and/or nutrients of concern, including iron, magnesium, dietary  fiber, vitamin D, potassium and B vitamins.”

Even subjects who reported consuming more cakes, cookies and pies (4.6 per cent of the group) than recommended fared just as well as the no grains group as measured by body mass index and other key health markers.

To the grain-based foods industry, the healthfulness of flour-based foods and enrichment had been celebrated for decades in the nutrition community and viewed as “settled science,” making the need for a study such as this baffling. In fact, for far too long the study of the nutritional merits of baked foods has been neglected science. The G.F.F. study represents a crucial first step toward building a body of evidence demonstrating the unparalleled public health contribution of grain-based foods as they are actually consumed in the real world. The road toward such an objective is a long one and will require a commitment to conducting further research and for grain-based foods to raise its collective voice to press for studies to be conducted without industry sponsorship or funding. But the stakes for the industry and for public health could hardly be greater. 
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