Public Health Nutrition Editorial Highlight: ‘Evaluating the ≤10:1 wholegrain criterion in identifying nutrient quality and health implications of UK breads and breakfast cereals’ by Authors: Bahar Ghodsian and Angela M Madden

The benefits associated with eating wholegrain ingredients are well-established and include reducing the risk of cardiovascular disease (CVD), type 2 diabetes and many cancers. However, wholegrain intake in the UK remains low with 45% of the population eating less than one serving per day and 18% eating none over a four-day period.  A public health initiative is clearly needed to substitute foods containing whole grains for those containing significant amounts of refined grains in order to improve health, save resources and reduce total and CVD-related mortality.

A significant obstacle to a successful public health initiative is the absence of a national and international definition of a wholegrain food. The UK Institute of Grocery Distribution recommend that a food should have at least 8g of wholegrain ingredients per serving to be called whole grain. However, this recommendation is non-binding and the content of other nutrients are not specified in relation to this resulting in some foods, currently described as wholegrain, also having high levels of sugar or fat. There is international recognition of this problem with bodies such as the UK Scientific Advisory Committee on Nutrition and the US Dietary Guidelines Technical Advisory Committee calling for the development and implementation of a definition of wholegrain foods.

In 2013, researchers in Boston, USA, compared five different criteria to identify which represented the healthiest American wholegrain-based foods. They found that foods with a carbohydrate:fibre ratio <10:1 contained the least sugar, sodium and trans-fats. Following on from these findings, our recent research has evaluated the nutrient quality of breads and breakfast cereals sold in the UK with a <10:1 carbohydrate:fibre ratio. A total of 162 breads and 266 breakfast cereals sold at the four major UK supermarkets were identified as meeting this criterion and their nutritional quality was compared with the Food Standards Agency traffic light system. Breads which met the <10:1 criterion typically contained medium fat, low saturated fat, low sugar and medium salt. Breakfast cereals typically contained medium fat, low saturated fat, high sugar and low salt. However, one important limitation of the criterion was its inability to distinguish between foods that met the criterion due to their wholegrain ingredients and those that met it due to the added fibre contained in other ingredient such as fruit, nuts and seeds.

Based upon these results, we concluded that the <10:1 approach helps to identify wholegrain foods that are likely to be healthier and this criterion could be used in public health messages and supplement the front-of-pack traffic light labelling currently in use.

The full article ‘Evaluating the ≤10:1 wholegrain criterion in identifying nutrient quality and health implications of UK breads and breakfast cereals’ in Public Health Nutrition is available to download for free until 11th February 2018.

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