Educate Your Brain About Whole Grain
By Lauren Swann, MS, RD, LDN
Today’s Dietitian
Vol. 8 No. 6 P. 36

When it comes to whole grains, misinformation abounds—even among some dietitians.

According to the 2005 Dietary Guidelines, daily consumption of whole grains can reduce the risk of several chronic diseases and may help with weight maintenance. Most notably, the benefits remain after adjusting for fiber or bran. “The No. 1 cause of obesity is refined carbohydrates,” said Alan Greene, MD, FAAP, pediatrician and assistant clinical professor, Stanford Medical School, at the Oldways “Getting Whole Grains to 3” conference held in January in Orlando, Fla. “When you remove the germ and bran, you remove more than half of vitamins B1, B2, B3, B5, B6, and E, folic acid, calcium, phosphorus, copper, iron, magnesium, zinc, fiber, and complex phytonutrients.”

Milling removes the outer layers of the grain—most of the bran and some of the germ—minimizing rancidity. This refinement process became common during the 20th century with widespread economical technology advancements, leading the way for white flour to be the cheapest and most widely produced. Vitamin and mineral deficiency diseases such as beriberi (from lack of thiamine) and pellagra (from inadequate niacin) arose and grew dramatically, prompting nutrient enrichment and fortification to ultimately become common practices. This is in ironic contrast to an emerging contemporary dilemma: While all grain servings can be whole grain, the 2005 Dietary Guidelines also recommend including some folate-fortified whole grain choices.

What Makes a Grain Whole?
Oldways, the Boston-based nonprofit food issues think tank, along with the Whole Grains Council (WGC), a non-profit consortium of industry, scientists, and chefs working to increase consumption of whole grains for better health, cited findings from a 2005 Minneapolis “Whole Grains & Health” conference that even many health professionals don’t understand whole grains. Forty percent of RDs could not identify common whole grain foods and 61% believed whole grains were the same as bran or fiber. The WGC/Knorr-Lipton Sides 2005 survey results show that 28% of consumers don’t know what makes whole grain products different from refined products.

The 2005 Dietary Guidelines define whole grain as the entire grain seed or kernel made of three components: the bran, germ, and endosperm, which must be in nearly the same relative proportions as the original grain if cracked, crushed, or flaked. In February, the FDA issued draft guidance for industry comment regarding use of the term whole grain in labeling. The USDA has also published Interim Policy Guidance for whole grain claims on meat and poultry products.

Sizing Up a Serving
The USDA defines “a grain serving” as “the grams of grain product containing 16 grams of flour”—approximately 1 ounce (28 grams) for many prepared foods. For example, bread, which tends to be approximately 40% moisture, contains roughly 11 grams of water and 1 gram of additional nongrain ingredients in a typical 1-ounce slice. A slice made entirely from whole grain flour would therefore contain approximately 16 grams, or one serving (see Table 1: “One Whole Grain Ounce-Equivalent”).

The Dietary Guidelines recommend three or more ounce-equivalents of whole grain products daily—roughly one half of one’s grains should be whole. However, this ounce-equivalent approach works reliably only with products made entirely from whole grains because some popular new breads are made with a mixture of refined and whole wheat flour with as little as 4 grams of whole grain in each 1-ounce slice. Feedback from media representatives also reveals that “make half your grains whole” is a confusing message, and one of the WGC’s initiatives is to help the media produce accurate stories about whole grains.

To counter rampant abuse, help make it quick and easy for consumers to locate whole grains, and encourage manufacturers to create delicious new products, the WGC launched its Whole Grain Stamp in January 2005, a black and gold graphic for use only on products that provide at least one half of a “Pyramid serving” of whole grains. Oldways believes that if consumers choose products with the stamp for all six of their grain servings, they’re guaranteed to reach or exceed the recommended minimum of 48 grams per day of whole grains.

The WGC now has 106 members, including industry leaders, with nearly 600 products using the stamp. Endorsed by Oprah Winfrey and featured in Parade magazine, the stamp was recently revised to state the number of grams of whole grain ingredients included in each serving of a product. This “score” on all stamped products will enable consumers to compare products more readily.

“Previously, our top rating of ‘Excellent Source’ denoted at least 16 grams—a full Pyramid serving—of whole grain content,” said Cynthia Harriman, director of food and nutrition strategies for Oldways and the WGC. “But some products have twice that level of whole grain content or more. Now, consumers can decide just what level of whole grain content best suits their taste.”

Gaps in Getting Enough Whole Grains
Twenty-seven percent of RDs thought Americans, in general, eat enough whole grains. Yet, the WGC survey found that 68% of Americans are unaware that they should receive at least three daily servings of whole grains, and 71% of consumers think they get enough whole grains, when in fact only approximately 10% get the recommended three servings per day. Only 5% of American adults eat one half of their grains as whole grains; 81% eat one quarter or less of their grains as whole grains.

To reduce health risks, however, 58% of consumers would eat whole grains. “Sixty-four percent are trying to get more whole grains,” said Joe Derochowski, director of business development, National Eating Trends, The NPD Group, Inc., drawing from its 20th survey of America’s eating habits. “Trends are driven by taste, money, ease, and being new,” he said. “While 90% of consumers heard about whole grains and think they know, they also think of them as ‘brown,’ ‘wheat,’ ‘multi,’ ‘taste bad,’ and ‘for adults only’,” he said. “Hard to cook” and “takes too long” are also commonly heard comments from consumers.

Yet, whole grain rice and ready-to-eat cereal food purchases experienced a significant sales spike following the release of the 2005 Dietary Guidelines. A ConAgra study found that 76% of consumers believe whole grains are important for their health, 42% think taste is most important in choosing a product, and 24% believe nutrition is most important.

“Consumers are buying but don’t know why,” said Christiane Paul, marketing director, Knorr-Lipton Sides with Whole Grains, Unilever. “So education is the backbone of the campaign.” Further research revealed that 64% of consumers agreed “a lot” and 28% agreed “a little” when asked whether they think whole grains taste good. After the group was educated about the health benefits of whole grains, their perceptions improved even further, with 79% agreeing strongly and 20% agreeing a little that whole grains taste good.

“Whole grain information and news needs to be included within other articles and diet plans. Recipes can’t take long,” said Delia Hammock, RD, nutrition director, Good Housekeeping. Jane Andrews, MS, RD, corporate nutritionist, Wegmans Food Markets, Inc., highlighted their focus as “making less healthy more healthy; making healthy more convenient.” To get their families to eat healthier, “90% admit to culinary subterfuge,” said Paul, citing findings that 73% spice with herbs and 57% sneak vegetables in a side dish. Culinarians are confronting challenges for adjusting recipes and menus from refined to whole as well. “Chefs and cooks are still learning how to balance white flour and wheat flour for the right texture and functionality,” said Jesse Cool, chef/owner of Flea St. Café, JZ Cool Eatery, and Cool Café.

The Dietary Guidelines Advisory Committee strongly recommended “transition foods” that contain both whole and refined grains as the most promising way to increase consumption of whole grains, stating: “In practice, when a person selects a mixed grain bread or cereal, he [or she] gets both a whole grain portion and an enriched grain portion. Because of the desirable baking properties of enriched flour, these mixed grain products are often appealing to consumers who do not choose to eat 100% whole grains.… While many are not entirely whole grains, they provide some whole grains in the diets of those who might not otherwise select any. This approach allows these mixed products to fit readily into a person’s food choices.”

At the “Getting Whole Grains to 3” conference, 40 leading food manufacturers worked together with physicians and healthy eating advocates to develop an action plan to make whole grains even more widespread. Intended approaches include menu plans to “assemble” meals—not necessarily recipes—so consumers can choose from “out of the box,” “heat and eat,” or “quick cooking” to learn about whole grain foods that match their lifestyle.

Whole Grain Schooling
Addressing the need for efforts to increase whole grain consumption among children from approximately one serving to three servings per day, Terri Burgess-Champoux, MS, RD, LD, from the University of Minnesota, reported on a school-based study to encourage kids to eat more whole grains. “Sampling increases acceptability, and parents are influential role models for children,” she said. The model included interventional lessons and activities on what a whole grain is, how whole grains are labeled, why they are healthy, and how to include them and utilized parent newsletters, bakery tours, grocery store “treasure hunts,” and a “Whole Grain Day” at Mill City Museum. This resulted in increased knowledge, home availability, and adequacy of whole grains for adults with children ultimately accepting a variety of whole grain products in a school cafeteria environment and a significant increase of one whole grain serving per day.

Oldways plans a continued school information exchange Web site about successful menu additions and food companies to match school lunch planners with manufacturers who can provide delicious, affordable whole grain options to schools.

Workplace Dining
“Employees are most likely to look for healthier options at lunch so they can ‘splurge’ at dinner,” said Deanne S. Brandstetter, MBA, RD, CDN, director of nutrition for Compass Group, The Americas Division. “Cooking classes for chefs on purchasing and preparing whole grains, menu options for all meal components, and recipe contests educate and entice chefs and staff,” she said. Their “Whole Grains All Day Long – Hot Cereal Bar” featuring desserts, stuffings and accompaniments, legume vegetarian entrees, baked goods, and salads led to many recipe requests. “Customers say they have never thought of having bulgur or cornmeal as hot cereal. We sell 5 gallons of cornmeal porridge and 2 gallons of bulgur or another whole grain hot cereal each day in addition to oatmeal,” said Rick Low, executive chef.

Educating and enticing customers with cooking demonstrations, showing them how to use different grains in recipes, offering historical origin information—during Spanish colonization of South America, the Incas were once banned from growing quinoa—sampling, tastings, having retail product available for purchase, and coupons are all effective approaches. Gradual introductions paired with familiar foods, displays of raw and cooked products, “how-to-cook” instructions for a variety of grains, recipes, special promotions, and partnering with vendors for chef seminars and new ideas has worked well.

From Stores to Homes
Wegmans Food Markets has a whole grain wellness key, shelf talkers, and a menu magazine including recipes prepared in less than 30 minutes. “There are lots of great whole grain stories to sell,” said Andrews, noting that all benefits, not only antioxidants or lignans, should be stressed with visual examples, such as “Digest this! 30 feet of healthy whole grain interaction.”

Michigan-based Meijer Supercenters in the Midwest put out a monthly brochure featuring advertised products and have in-store healthy living keys, shelf talkers, and special sections. Chefs demo meal planning with ideas that use top food items in quick preparation. “We need to develop how to stock pantries with whole grains,” said Shari Steinbach, MS, RD, corporate dietitian and healthy living advisor.

Oldways is working with several national grocery chains, gathering information on resources that would best help them educate consumers, and plans to create a kit of graphics and whole grain references for supermarkets.

Keeping it Whole While Out and About
Forty-seven percent of the food dollar is spent on food away from home. “Taste rules,” reported Sheila Cohn, RD, LD, director of nutrition policy, National Restaurant Association. “Two out of three consumers agree that their favorite restaurant foods provide flavor and taste sensations that cannot easily be duplicated in their home kitchen. Value is also important to the consumer. If healthy products are more expensive than standard fare, they may not be willing to purchase them in the restaurants.” The National Restaurant Association has found that recipe contests generate excitement and allow talent to create new product ideas.

“Seventy percent of restaurant customers customize,” said Sue Moore, director of product development, BAMA Foods. “So we need to ask in restaurants,” Harriman concurred. Many restaurants now offer whole grains, and Oldways plans a Web site program to help diners find such places locally.

Whole Grains in Healthcare
Deane Bussiere, executive chef, Dominican Hospital, Santa Cruz, Calif., recommends changing patient menus by starting with whole grain breads for all sandwiches and rolls. “We use whole wheat bread for all patient sandwiches unless dietary restrictions require otherwise,” said Bussiere, who asserted that many recipes can be written to utilize whole wheat pastas and brown, black, and red rice. “Selling these grains takes flavorful preparations using spices, herbs, and bold flavors to make them appealing. Make it look good with bright colors and garnishing,” he said.

As for the future of any comprehensive whole grains campaign, Eric Hentges, PhD, executive director, Center for Nutrition Policy and Promotion, USDA, announced, “We need to establish consistent methods for defining and measuring whole grains; refine an evidence base; establish public health recommendations; and study related health benefits and consumption patterns.”

— Lauren Swann, MS, RD, LDN, runs Concept Nutrition, Inc., a Bensalem, Pa., consulting business specializing in food and dietary supplement labeling and regulatory issues, marketing communications and freelance writing, and cultural and ethnic foodways.

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Web Site Resources
FDA Draft Guidance for Comment

USDA Interim Policy

Whole Grains Council