Whole grain intake and its cross-sectional association with obesity, insulin resistance, inflammation, diabetes and subclinical CVD: The MESA Study

We examined the relationship between whole grain intake and obesity, insulin resistance, inflammation, diabetes and subclinical CVD using baseline data from the Multi-Ethnic Study of Atherosclerosis. Whole grain intake was measured by a 127-item FFQ in 5496 men and women free of CHD and previously known diabetes. Mean whole grain intake was 0.5 (sd 0.5) servings per d; biochemical measures reflect fasting levels. After adjustment for demographic and health behaviour variables, mean differences for the highest quintile of whole grain intake minus the lowest quintile of intake were 0.6 kg/m2 for BMI, 0.36 mg/l for C-reactive protein, 0.82 micromol/l for homocysteine, 0.15 mU/l*mmol/l for homeostasis model assessment (HOMA), 0.48 mU/l for serum insulin, 2.0 mg/dl for glucose and 5.7 % for prevalence of newly diagnosed impaired fasting glucose (glucose >or= 100 mg/dl or diabetes medication). These differences represent 11-13 % of a standard deviation of BMI, HOMA, glucose and impaired fasting glucose, but 23 %, 52 % and 80 % of a standard deviation of homocysteine, C-reactive protein and insulin, respectively. An inverse association between whole grains and urine albumin excretion was suggested but retained statistical significance after adjustment only in Chinese and Hispanic participants. No associations were observed between whole grain intake and two subclinical disease measures: carotid intima-media thickness and coronary artery calcification. Concordant with previous research, whole grain intake was inversely associated with obesity, insulin resistance, inflammation and elevated fasting glucose or newly diagnosed diabetes. Counter to hypothesis, however, whole grain intake was unrelated to subclinical CVD.     

Dietary intake and food sources of whole grains among US children and adolescents: data from the 1994-1996 Continuing Survey of Food Intakes by Individuals

OBJECTIVE: This study characterizes whole grain consumption among a nationally representative sample of US children and adolescents. DESIGN: Data used in this study were collected as part of the 1994-1996 US Department of Agriculture Continuing Survey of Food Intakes by Individuals (CSFII). SUBJECTS/SETTING: CSFII was designed to obtain a nationally representative sample of noninstitutionalized persons of all ages residing in the United States. Analyses reported in this article are limited to participants aged 2 to 18 years with two days of dietary recall data (n=4,802). Foods reported in the survey were quantified in servings as defined by the Food Guide Pyramid using the US Department of Agriculture Pyramid Servings Database, which contains reference data for each food reported in CSFII in servings per 100 g for 30 Pyramid food groups, including whole grain and total grain. STATISTICAL ANALYSES: Means, frequencies, and logistic regression analyses were conducted as appropriate. RESULTS: Average whole grain intake ranged from 0.8 servings per day for preschool-aged children to 1.0 servings per day for adolescents. Ready-to-eat cereals, corn and other chips, and yeast breads were found to be the major food sources of whole grains accounting for 30.9%, 21.7%, and 18.1% of whole grain intake respectively among those aged two to 18 years. APPLICATIONS/CONCLUSIONS: Given the apparent low level of whole grain intake among most children and adolescents in the United States, interventions are needed to increase intake of whole-grain foods.     

Body mass index mediates the association between meat intake and insulin sensitivity

The purpose of this study was to examine the possible inverse relationship between total meat intake and processed meat intake and insulin sensitivity as mediated by body mass index (BMI). The Quantitative Insulin Sensitivity Check Index (QUICKI) was used to assess participants’ insulin sensitivity: decreased insulin sensitivity indicated at a score of <0.36. Cross-sectional data were used from Visit 1 of the Atherosclerosis Risk in Communities (ARIC) cohort. Mediation analysis was conducted using the PROCESS macro for SPSS. The mean BMI was 27.3 ± 5.0 kg/m², total meat intake was 1.76 ± 0.89 servings per day, processed meat intake was 0.44 ± 0.46 servings per day, and the mean QUICKI score was 0.34 ± 0.039. This suggested decreased insulin sensitivity was prevalent in this population. As hypothesized and previously shown, both total meat intake and processed meat were inversely and significantly associated with insulin sensitivity after adjusting for key covariates including BMI. In mediation analysis, the significant inverse direct association model between total meat and QUICKI was -0.0017 (95% CI: -0.0026, -0.0008). BMI had a significant indirect association with QUICKI of -0.0028 (95% CI: -0.0033, -0.0023) which accounted for 62% of the association between total meat intake and insulin sensitivity. In the processed meat intake and QUICKI mediation model, BMI accounted for a significant 43% of the relationship. Our results suggest that the association between total meat and processed meat intake and insulin sensitivity is mediated by BMI.     

Relation of leptin to insulin resistance syndrome in children

OBJECTIVES: To examine the relation of leptin to insulin resistance, as measured by euglycemic insulin clamp, and insulin resistance syndrome factors in thin and heavy children. RESEARCH METHODS AND PROCEDURES: Anthropometrics, insulin, blood pressure, and leptin were measured in 342 11- to 14-year-old children (189 boys, 153 girls, 272 white, 70 black). Insulin sensitivity (M) was determined by milligrams glucose uptake per kilogram per minute and expressed as M/lean body mass (Mlbm). Children were divided by median BMI (boys = 20.5 kg/m(2); girls = 21.4 kg/m(2)) into below-median (thin) and above-median (heavy) groups. Correlation coefficients between log-leptin and components of insulin resistance syndrome were adjusted for Tanner stage, gender, and race. RESULTS: BMI was related to leptin in boys (r = 0.70, p < 0.001) and girls (r = 0.75, p < 0.001). Leptin was higher in girls than boys (32.6 vs. 12.3 ng/mL, p = 0.0001). Leptin levels increased in girls and decreased in boys during puberty, paralleling the changes in body fat. Leptin was significantly correlated with insulin, Mlbm, triglycerides, and blood pressure in heavy children and only with insulin in thin children. After adjustment for body fat, the correlations remained significant for insulin and Mlbm in heavy children and with insulin in thin children. DISCUSSION: Significant associations were found between leptin and insulin resistance in children, and these associations were attenuated by adjustment for adiposity. These findings at age 13 likely have long-term consequences in the development of the obesity-insulin resistance-related cardiovascular risk profile.     

Sugar-added beverages and adolescent weight change

OBJECTIVE: The increase in consumption of sugar-added beverages over recent decades may be partly responsible for the obesity epidemic among U.S. adolescents. Our aim was to evaluate the relationship between BMI changes and intakes of sugar-added beverages, milk, fruit juices, and diet soda. RESEARCH METHODS AND PROCEDURES: Our prospective cohort study included >10,000 boys and girls participating in the U.S. Growing Up Today Study. The participants were 9 to 14 years old in 1996 and completed questionnaires in 1996, 1997, and 1998. We analyzed change in BMI (kilograms per meter squared) over two 1-year periods among children who completed annual food frequency questionnaires assessing typical past year intakes. We studied beverage intakes during the year corresponding to each BMI change, and in separate models, we studied 1-year changes in beverage intakes, adjusting for prior year intakes. Models included all beverages simultaneously; further models adjusted for total energy intake. RESULTS: Consumption of sugar-added beverages was associated with small BMI gains during the corresponding year (boys: +0.03 kg/m2 per daily serving, p = 0.04; girls: +0.02 kg/m2, p = 0.096). In models not assuming a linear dose-response trend, girls who drank 1 serving/d of sugar-added beverages gained more weight (+0.068, p = 0.02) than girls drinking none, as did girls drinking 2 servings/d (+0.09, p = 0.06) or 3+ servings/d (+0.08, p = 0.06). Analyses of year-to-year change in beverage intakes provided generally similar findings; boys who increased consumption of sugar-added beverages from the prior year experienced weight gain (+0.04 kg/m2 per additional daily serving, p = 0.01). Children who increased intakes by 2 or more servings/d from the prior year gained weight (boys: +0.14, p = 0.01; girls +0.10, p = 0.046). Further adjusting our models for total energy intake substantially reduced the estimated effects, which were no longer significant. DISCUSSION: Consumption of sugar-added beverages may contribute to weight gain among adolescents, probably due to their contribution to total energy intake, because adjustment for calories greatly attenuated the estimated associations.     

Whole-grain intake and insulin sensitivity: the Insulin Resistance Atherosclerosis Study

BACKGROUND: Increased intake of whole-grain foods has been related to a reduced risk of developing diabetes and heart disease. One underlying pathway for this relation may be increased insulin sensitivity. OBJECTIVE: We assessed the relation between dietary intake of whole grain-containing foods and insulin sensitivity (S(I)). DESIGN: We evaluated data from the Insulin Resistance Atherosclerosis Study (IRAS Exam I, 1992-1994). Usual dietary intakes in 978 middle-aged adults with normal (67%) or impaired (33%) glucose tolerance were ascertained by using an interviewer-administered, validated food-frequency questionnaire. Whole-grain intake (servings per day) was derived from dark breads and high-fiber and cooked cereals. S(I) was assessed by minimal model analyses of the frequently sampled intravenous-glucose-tolerance test. Fasting insulin was measured by using a radioimmunoassay. We modeled the relation of whole-grain intake to log(S(I) + 1) and to log(insulin) by using multivariable linear regression. RESULTS: On average, IRAS participants consumed 0.8 servings of whole grains/d. Whole-grain intake was significantly associated with S(I) (beta = 0.082, P = 0.0005) and insulin (beta = -0.0646, P = 0.019) after adjustment for demographics, total energy intake and expenditure, smoking, and family history of diabetes. The addition of body mass index and waist circumference attenuated but did not explain the association with S(I). The addition of fiber and magnesium resulted in a nonsignificant association that is consistent with the hypothesis that these constituents account for some of the effect of whole grains on S(I). CONCLUSION: Higher intakes of whole grains were associated with increases in insulin sensitivity.     

Dietary energy density and successful weight loss maintenance

Research shows a positive relationship between dietary energy density (ED) and body mass index (BMI), but dietary ED of weight loss maintainers is unknown. This preliminary investigation was a secondary data analysis that compared self-reported dietary ED and food group servings consumed in overweight adults (OW: BMI=27-45kg/m(2)), normal weight adults (NW: BMI=19-24.9 kg/m(2)), and weight loss maintainers (WLM: current BMI=19-24.9kg/m(2) [lost≥10% of maximum body weight and maintained loss for ≥5years]) participating in 2 studies, with data collected from July 2006 to March 2007. Three 24-h phone dietary recalls from 287 participants (OW=97, NW=85, WLM=105) assessed self-reported dietary intake. ED (kcal/g) was calculated by three methods (food+all beverages except water [F+AB], food+caloric beverages [F+CB], and food only [FO]). Differences in self-reported consumption of dietary ED, food group servings, energy, grams of food/beverages, fat, and fiber were assessed using one-way MANCOVA, adjusting for age, sex, and weekly energy expenditure from self-reported physical activity. ED, calculated by all three methods, was significantly lower in WLM than in NW or OW (FO: WLM=1.39±0.45kcal/g; NW=1.60±0.43 kcal/g; OW=1.83±0.42 kcal/g). Self-reported daily servings of vegetables and whole grains consumed were significantly higher in WLM compared to NW and OW (vegetables: WLM=4.9±3.1 servings/day; NW=3.9±2.0 servings/day; OW=3.4±1.7 servings/day; whole grains: WLM=2.2±1.8 servings/day; NW=1.4±1.2 servings/day; OW=1.3±1.3 servings/day). WLM self-reported consuming significantly less energy from fat and more fiber than the other two groups. Self-reported energy intake per day was significantly lower in WLM than OW, and WLM self-reported consuming significantly more grams of food/beverages per day than OW. These preliminary findings suggest that consuming a diet lower in ED, characterized by greater intake of vegetables and whole grains, may aid with weight loss maintenance and should be further tested in prospective randomized controlled trials.     

Path analysis of metabolic syndrome components in black versus white children, adolescents, and adults: the Bogalusa Heart Study

PURPOSE: Examine the complex relationships among metabolic syndrome components in black and white individuals by growth periods. METHODS: Path analyses of metabolic syndrome components were performed on 8203 black and white healthy subjects (64.3% white and 47.9% male) comprising children (4-11 years), adolescents (12-18 years), and adults (19-44 years). RESULTS: The direct effect of body mass index (BMI) on fasting insulin levels was greatest among all the paths for each age group in both races. In general, path coefficients were greater in whites than in blacks except for the age-mean arterial pressure (MAP) path and greater in children and adults than in adolescents. The direct age effect on MAP was greater in black versus white adults (p = 0.010 for race difference). Whites showed greater direct effects of BMI on MAP in children (p = 0.007), adolescents (p = 0.090), and adults (p = 0.022); BMI on insulin in adolescents (p < 0.001); BMI on triglycerides in children (p = 0.003); and insulin on triglycerides in adults (p < 0.001). A race difference in the effect of BMI on fasting glucose was noted among adolescents (p = 0.048). CONCLUSIONS: The black-white differences in the relationships of obesity and insulin resistance measures to other components may account for the lower prevalence of metabolic syndrome in the black population.     

Whole-grain intake is associated with body mass index in college students

OBJECTIVE: To measure whole-grain intake in college students and determine the association with body mass index (BMI). DESIGN: Cross-sectional convenience sample of college students enrolled in an introductory nutrition course. SETTING: Large state university. PARTICIPANTS: 159 college students, mean age: 19.9. MAIN OUTCOME MEASURES: Intake of whole grains, refined grains, calories, and fiber from food records; BMI determined from height and weight measurements. ANALYSIS: Analysis of variance with linear contrasts; participants grouped by BMI category (P<.05). RESULTS: Average intake of cereal grains was 5.4 servings per day, of which whole-grain intake accounted for an average of 0.7 servings per day. Whole-grain intake was significantly higher in normal weight students than in overweight and obese students (based on BMI). CONCLUSIONS AND IMPLICATIONS: The low intake of whole grains in this population of college students indicates the need for interventions aiming to increase whole-grain intake to the recommended minimum of 3 servings per day. College students who are concerned about their body weight may be motivated to increase their intake of whole-grain foods; however, their intake of whole grains is likely to be influenced by the availability of these food items in campus dining halls and other locations around the college campus.     

Relationship between whole-grain intake, chronic disease risk indicators, and weight status among adolescents in the National Health and Nutrition Examination Survey, 1999-2004

BackgroundAlthough whole-grain intake has been associated with improved chronic disease risk factors and weight status in adults, similar studies are limited among adolescents.ObjectiveTo determine the relationship among chronic disease risk factors, weight status, and whole-grain intake among adolescents (aged 12 to 19 years) by sex.DesignAnalysis of the relationship between dietary, anthropometric, and chronic disease risk factors/laboratory measures and whole-grain intake groups (none, low [>0 to ≤0.5 oz equivalents/day], high [>0.5 oz equivalents/day]) among US adolescents (based on cross-sectional data from the National Health and Nutrition Examination Survey, 1999-2004).Participants/settingData from 4,928 adolescents (2,495 boys, 2,433 girls) collected in person at home and mobile examination centers.Main outcome variablesAdjusted least-squares means for dietary, anthropometric, and chronic disease risk factors/laboratory measures by whole-grain intake groups.Statistical analyses performedOutcome variables were examined in separate multiple linear regression models with categories of whole-grain intake as the independent variable, adjusted for demographic characteristics, smoking, physical activity, and food group/energy intake.ResultsFewer than one third consumed >0.5 whole grain ounce equivalents per day. Higher whole-grain intake was associated with lower refined-grain and higher carbohydrate, fiber, folate, and energy intakes. Higher whole-grain intake was associated with lower body mass index and waist, thigh, and arm circumferences among boys only but not on further adjustment for food group intake. In models adjusted for food group intake, higher whole-grain intake was associated with lower fasting insulin levels and higher serum and red blood cell folate levels for boys and girls, with lower C-peptide concentrations for girls and lower homocysteine concentrations for boys.ConclusionsWhole-grain intake was not associated with body mass index after adjusting for food group intake but was related to positive nutrient profiles and chronic disease risk factors, which supports current recommendations to promote greater intake of whole grains among adolescents.     

Fruit and vegetable intakes are an independent predictor of bone size in early pubertal children

BACKGROUND: Adequate intakes of fruit and vegetables are recommended for optimum health in children. OBJECTIVE: The objective of this study was to determine whether consuming fruit and vegetables >3 times per day is beneficial to bone mass in children. DESIGN: Fifty-six white females (Tanner stage 2) recorded dietary intake on 3 independent days. The numbers of servings of fruit and vegetables were recorded for each day and tallied, and the subjects were divided into 2 consumption groups for analysis (low consumption: <3 servings/d, n = 22; high consumption: > or = 3 servings/d, n = 34). Bone area and the bone mineral content of the whole body and radius were assessed by using dual-energy X-ray absorptiometry. Radioimmunoassays measured serum parathyroid hormone and 25-hydroxyvitamin D. Twenty-four-hour urine samples were assessed for calcium, sodium, and creatinine. RESULTS: After adjustment for age, body mass index, and physical activity, those children who reported consuming > or = 3 servings fruit and vegetables/d had more bone area of the whole body (6.0%; P = 0.03) and radius (8.3%; P = 0.03), lower urinary calcium excretion (2.6 +/- 0.2 compared with 1.8 +/- 0.3 mg/kg; P = 0.04), and lower parathyroid hormone (19.6 +/- 1.9 compared with 25.0 +/- 1.6 pg/mL; P = 0.01) than did those children who reported consuming <3 servings fruit and vegetables/d. CONCLUSIONS: High fruit and vegetable intakes have beneficial effects on the bone area of the radius and whole body in early pubertal girls. The lower urinary calcium output associated with higher fruit and vegetable intakes may be a modulating factor.     

Binge eating symptoms, diet composition and metabolic characteristics of obese children and adolescents

This study aimed to determine the occurrence of symptoms of binge eating (BE) among children and adolescents seeking treatment for their obesity, as well as to evaluate their diet composition and metabolic characteristics. The Binge Eating Scale (BES) was answered by 128 children and adolescents (10.77+/-2.04 years, BMI 29.15+/-4.98 kg/m2, BMI Z score 2.28+/-0.46, 53.91% pubescent), who were classified into two subgroups--binge eaters (score greater than or equal to 18 points) and non-binge eaters (score lower than 18 points). Anthropometric data, body composition and Tanner stages were collected and dietary evaluation conducted. Blood pressure was determined, and glucose, lipid profile and insulin assays were performed. Insulin resistance was determined using HOMA-IR. BE symptoms were present in 39.06% of patients. Carbohydrate intake in diet composition was significantly higher among binge eaters. Children with BE did not demonstrate significant dissimilar metabolic characteristics when compared to their counterparts without BE. Therefore, BE seems to be a prevalent problem among children and adolescents seeking help for their obesity. When associated with obesity, this eating behaviour can influence macronutrient consumption through increased carbohydrate intake. Further research would be valuable to verify the reproducibility of these findings.     

Prospective study of cured meats consumption and risk of chronic obstructive pulmonary disease in men

Cured meats are high in nitrites. Nitrites generate reactive nitrogen species that may cause damage to the lung. The objective is to assess the relation between frequent consumption of cured meats and the risk of newly diagnosed chronic obstructive pulmonary disease (COPD). Between 1986 and 1998, the authors identified 111 self-reported cases of newly diagnosed COPD among 42,915 men from the Health Professionals Follow-up Study. The cumulative average intake of cured meats consumption (processed meats, bacon, hot dogs) was calculated from food frequency questionnaires administrated in 1986, 1990, and 1994 and divided according to servings per week (never/almost never, <1 serving/week, 1-3 servings/week, 4-6 servings/week, at least once/day). After adjustment for age, smoking status, pack-years, pack-years squared, energy intake, race/ethnicity, US region, body mass index, and physical activity, the consumption of cured meats was positively associated with the risk of newly diagnosed COPD (for highest vs. lowest intake: relative risk = 2.64, 95% confidence interval: 1.39, 5.00; p(trend) = 0.002). In contrast to these findings, the consumption of cured meats was not associated with the risk of adult-onset asthma. These data suggest that cured meat may worsen the adverse effects of smoking on risk of COPD.     

The association of whole grain consumption with incident type 2 diabetes: the Women's Health Initiative Observational Study

PurposeWhole grains may offer protection from diabetes by decreasing energy intake, preventing weight gain, and direct effects on insulin resistance. This study examined associations of whole and refined grains with incident type 2 diabetes (T2D) ascertained by self-reported medication use in a cohort of postmenopausal women.MethodsWe included 72,215 women free of diabetes at baseline from the Women's Health Initiative Observational Study. Whole grain consumption was categorized as 0, less than 0.5, 0.5 to 1.0, 1.0 to less than 1.5, 1.5 to less than 2.0, and 2.0 or more servings per day. Proportional hazards regression was performed to estimate hazard ratios (HR) and 95% confidence intervals adjusting for potential confounders.ResultsThere were 3465 cases of incident T2D over median follow-up of 7.9 years. Adjusted for age and energy intake per day, successively increasing categories of whole grain consumption were associated with statistically significant reduced risk of incident T2D (HRs, 1.00, 0.83, 0.73, 0.69, 0.61, and 0.57; P for trend < 0.0001). Results were attenuated after adjustment for confounders and other dietary components. The reduction in risk of T2D was greater among nonsmokers and those who maintained their weight within 5 pounds with higher consumption of whole grains than smokers and women who gained more weight.ConclusionsThis large, prospective study found an inverse dose–response relationship between whole grain consumption and incident T2D in postmenopausal women.     

Popcorn consumption and dietary and physiological parameters of US children and adults: analysis of the National Health and Nutrition Examination Survey (NHANES) 1999-2002 dietary survey data

Popcorn is a whole-grain food/snack that is included among foods recommended in the 2005 Dietary Guidelines for Americans and MyPyramid to increase whole-grain consumption. The purpose of the present study was to use 1999-2002 National Health and Nutrition Examination Survey 24-hour dietary recall data to determine the average popcorn intake among Americans, and whether popcorn consumers exhibited different dietary intake patterns or physiological biomarkers of cardiovascular disease compared with popcorn nonconsumers. Mean intake among consumers of popcorn was 38.8 g/day. Compared with nonconsumers, popcorn consumers had approximately 250% higher (P<0.01) intake of whole grains (2.5 vs 0.70 servings/day) and approximately 22% higher (P<0.01) intake of fiber (18.1 vs 14.9 g/day). Small but significant differences (P<0.01) were also observed for intake of carbohydrate, magnesium (higher intake in popcorn consumers), protein, niacin, and folate (lower intake in popcorn consumers). In addition, popcorn consumers had a greater (P<0.01) intake of total grains and consumed fewer meat servings. Popcorn consumption was associated with increased intake of whole grains, dietary fiber, and certain other nutrients.     

Whole-Grain Intake in Middle School Students Achieves Dietary Guidelines for Americans and MyPlate Recommendations when Provided as Commercially Available Foods: A Randomized Trial

In accordance with the 2010 Dietary Guidelines for Americans, at least half of total grain intake should be whole grains. Adolescents are currently not consuming the recommended daily intake of whole grains. Research is needed to determine whether whole grains are acceptable to adolescents and whether changing their food environment to include whole-grain foods will improve intake. The aim of this study was to determine the effect of providing refined-grain or whole-grain foods to adolescents, with encouragement to eat three different grain-based foods per day, on total grain and whole-grain intakes. Middle school students (n=83; aged 11 to 15 years) were randomly assigned to either refined-grain or whole-grain foods for 6 weeks. Participants and their families were provided with weekly grains (eg, bread, pasta, and cereals), and participants were provided grain snacks at school. Intake of grains in ounce equivalents (oz eq) was determined through eight baseline and intervention targeted 24-hour diet recalls. Participants consumed 1.1±1.3 oz eq (mean±standard deviation) of whole grains at baseline, out of 5.3±2.4 oz eq of total grains. During intervention, whole-grain intake increased in the whole-grain group (0.9±1.0 to 3.9±1.8 oz eq/day), whereas those in the refined-grain group reduced whole-grain intake (1.3±1.6 to 0.3±0.3 oz eq/day; P<0.002, group by time period interaction). Total grain intake achieved was 6.4±2.1 oz eq/day and did not differ across intervention groups. Providing adolescents with whole-grain foods in their school and home environments was an effective means of achieving recommendations.     

Dietary intake of whole and refined grain breakfast cereals and weight gain in men

OBJECTIVE: Prospective studies have suggested that substituting whole grain for refined grain products may lower the risk of overweight and obesity. Breakfast cereal intake is a major source of whole and refined grains and has also been associated with having a lower BMI. The aim of this study was to prospectively assess the association between whole and refined grain breakfast cereal intakes and risk of overweight (BMI >or= 25 kg/m(2)) and weight gain. RESEARCH METHODS AND PROCEDURES: We examined 17,881 U.S. male physicians 40 to 84 years of age in 1982 who were free of cardiovascular disease, diabetes mellitus, and cancer at baseline and reported measures of breakfast cereal intake, weight, and height. RESULTS: Over 8 and 13 years of follow-up, respectively, men who consumed breakfast cereal, regardless of type, consistently weighed less than those who consumed breakfast cereals less often (p value for trend = 0.01). Whole and refined grain breakfast cereal intake was inversely associated with body weight gain over 8 years, after adjustment for age, smoking, baseline BMI, alcohol intake, physical activity, hypertension, high cholesterol, and use of multivitamins. Compared with men who rarely or never consumed breakfast cereals, those who consumed >or=1 serving/d of breakfast cereals were 22% and 12% less likely to become overweight during follow-up periods of 8 and 13 years (relative risk, 0.78 and 0.88; 95% confidence interval, 0.67 to 0.91 and 0.76 to 1.00, respectively). DISCUSSION: BMI and weight gain were inversely associated with intake of breakfast cereals, independently of other risk factors.     

Whole-Grain Intake Correlates among Adolescents and Young Adults: Findings from Project EAT

Background

National survey data indicate few adolescents or young adults consume whole grains in the amount recommended to prevent chronic disease and maintain a healthful weight. Interventions are needed to address this gap; however, little is known about what modifiable factors influence whole-grain intake among youth.

Objective

This study aimed to identify socioenvironmental, personal, and behavioral correlates of whole-grain intake among adolescents and young adults.

Design

Data for this cross-sectional analysis were drawn from Project EAT (Eating Among Teens)-II, the second wave of a population-based study in Minnesota. Mailed surveys and food frequency questionnaires were completed by male (44.8%) and female (55.2%) participants in 2003-2004, including 792 adolescents (mean age=17.2 years) and 1,686 young adults (mean age=20.5 years). Linear regression models adjusted for demographic characteristics were used to identify factors associated with energy-adjusted daily intake of whole grains.

Results

Mean daily intake of whole grains was lower than recommended among adolescents (males: 0.59±0.04 servings, females: 0.61±0.04 servings) and young adults (males: 0.68±0.03 servings, females: 0.58±0.03 servings). Home availability of whole-grain bread, self-efficacy to consume ≥3 daily servings of whole grains, and preference for the taste of whole-grain bread were positively associated with whole-grain intake during adolescence and young adulthood across sex. Conversely, fast-food intake was associated with lower intake of whole grains among adolescents and young adults of both sexes. The factors examined in this study explained 28% to 34% of variance in whole-grain intake across sex and the two age groups.

Conclusions

The findings suggest nutrition interventions should address the availability of whole-grain foods in homes and restaurants. In addition, young people should be provided with opportunities to taste a variety of whole-grain foods to enhance taste preferences and self-efficacy to consume whole-grain products.     

Vegetable Consumption Is Linked to Decreased Visceral and Liver Fat and Improved Insulin Resistance in Overweight Latino Youth

There are limited data on the influence of vegetable consumption on adiposity and metabolic health, specifically nonstarchy vegetables and vegetables that are dark green and deep orange/yellow (also known as nutrient-rich vegetables). Our study examines the relationship between vegetable intake and adiposity, liver fat, and insulin dynamics in overweight Latino youth. This cross-sectional study of 175 overweight (body mass index ≥85th percentile) Latino youth (aged 8 to 18 years), with data collected during 2006-2011, included the following: dietary intake via multiple 24-hour recalls, total body fat via dual-energy x-ray absorptiometry, adipose tissue distribution and liver fat via magnetic resonance imaging, and insulin dynamics via frequently sampled intravenous glucose tolerance test. Linear regression and analysis of covariance were used for analysis, with the following a priori covariates: age, sex, energy intake, and total body fat. Participants who consumed the most nonstarchy vegetables (mean intake=1.7±1.0 servings/day) compared with the least (mean intake=0.1±0.1 servings/day) had 44% less liver fat (10.0%±8.5% vs 5.6%±8.7%; P=0.01). Nutrient-rich vegetable intake was positively correlated with insulin sensitivity (r=0.19; P=0.03). Consumers of nutrient-rich vegetables (mean intake=0.3±0.4 servings/day [n=107]), compared with nonconsumers (n=68), had 31% increased insulin sensitivity (1.6±1.6 vs 2.1±1.3×10^–4/min/μU/mL; P=0.03) and 17% less visceral adipose tissue (2.3±0.9 vs 1.9±0.7 L; P=0.01). Consumption of specific vegetable types by overweight Latino youth is associated with positive metabolic outcomes, including reduced visceral and liver fat and risk factors for type 2 diabetes, even when consumed in small quantities. These may be relevant targets for interventions.     

Ten-Year Trends in Fiber and Whole Grain Intakes and Food Sources for the United States Population: National Health and Nutrition Examination Survey 2001–2010

Current U.S. dietary guidance includes recommendations to increase intakes of both dietary fiber and whole grain (WG). This study examines fiber and WG intakes, food sources and trends from 2001 to 2010 based on National Health and Nutrition Examination Survey (NHANES) data for children/adolescents (n = 14,973) and adults (n = 24,809). Mean fiber intake for children/adolescents was 13.2 (±0.1) g/day. Mean fiber intake for adults 19–50 years (y) was 16.1 (±0.2) g/day and for adults 51+ was 16.1 (±0.2) g/day. There were significant increases in fiber intake from 2001–2010 for children/adolescents and for adults 51+ y. Mean WG intake for children/adolescents was 0.52 (±0.01) oz eq/day. Mean WG intake for adults 19–50 y was 0.61 (±0.02) oz eq/day and for adults 51+ 0.86 (±0.02) oz eq/day. There were no significant changes in WG intake for any age group from 2001–2010. The main food groups contributing to dietary fiber intake for children/adolescents were vegetables (16.6%), grain mixtures (16.3%), other foods (15.8%) and fruits (11.3%). For adults 19+ y, the main sources of dietary fiber were vegetables (22.6%), other foods (14.3%), grain mixtures (12.0%) and fruits (11.1%). Major WG sources for children/adolescents included ready-to-eat cereals (RTEC) (31%), yeast breads/rolls (21%) and crackers and salty grain snacks (21%). The main sources of WG for adults 19+ were yeast breads/rolls (27%), RTEC (23%) and pastas/cooked cereals/rice (21%). Recommending cereals, breads and grain mixtures with higher contents of both dietary fiber and WG, along with consumer education, could increase intakes among the United States (U.S.) population.