title: Whole-grain dietary recommendations: the need for a unified global approach.
abstract: Increased whole-grain (WG) consumption reduces the risk of CVD, type 2 diabetes and some cancers, is related to reduced body weight and weight gain and is related to improved intestinal health. Definitions of 'WG' and 'WG food' are proposed and used in some countries but are not consistent. Many countries promote WG consumption, but the emphasis given and the messages used vary. We surveyed dietary recommendations of fifty-three countries for mentions of WG to assess the extent, rationale and diversity in emphasis and wording of any recommendations. If present, recommendations were classified as either 'primary', where the recommendation was specific for WG, or 'secondary', where recommendations were made in order to achieve another (primary) target, most often dietary fibre intake. In total, 127 organisations were screened, including government, non-governmental organisations, charities and professional bodies, the WHO and European Food Safety Authority, of which forty-nine including WHO provide a WG intake recommendation. Recommendations ranged from 'specific' with specified target amounts (e.g. x g WG/d), 'semi-quantitative' where intake was linked to intake of cereal/carbohydrate foods with proportions of WG suggested (e.g. x servings of cereals of which y servings should be WG) to 'non-specific' based on 'eating more' WG or 'choosing WG where possible'. This lack of a harmonised message may result in confusion for the consumer, lessen the impact of public health messages and pose barriers to trade in the food industry. A science-based consensus or expert opinion on WG recommendations is needed, with a global reach to guide public health decision making and increase WG consumption globally.
authors.affiliation: 1School of Agriculture,Food & Rural Development,Human Nutrition Research Centre,Newcastle University,Newcastle upon Tyne,NE1 7RU,UK.
authors.forename: Chris J
authors.identifier: 0000-0001-6313-6691
authors.initials: CJ
authors.lastname: Seal
authors.affiliation: 2UCD Institute of Food and Health,UCD,Belfield,Dublin 4,Ireland.
authors.forename: Anne P
authors.initials: AP
authors.lastname: Nugent
authors.affiliation: 3TES Nutrihealth Strategic Consultancy,46 Jalan SS22/32,47400 Petaling Jaya,Selangor D.E.,Malaysia.
authors.forename: E-Siong
authors.initials: ES
authors.lastname: Tee
authors.affiliation: 4Thielecke Consultancy,Bettenstrasse 60a,4123 Allschwill,Switzerland.
authors.forename: Frank
authors.initials: F
authors.lastname: Thielecke
mesh_terms: D004043:Dietary Fiber / Q000008:administration & dosage; D002149:Energy Intake; D005247:Feeding Behavior; D014943:Global Health; D006801:Humans; D018673:Nutrition Policy; D011634:Public Health; D064167:Recommended Dietary Allowances; D000067348:Whole Grains
keywords: Dietary recommendations; EFSA European Food Safety Authority; FBDG food-based dietary guidelines; Global recommendations; Whole grain; Whole-grain intakes