February 2008
Healthy
Refinements: Kids’ Diets Get a Whole Grain Boost
By Sharon Palmer, RD
Today’s Dietitian
Vol. 10 No. 2 P. 46
The whole grain message is getting through,
and schools and even restaurants are doing their part to help
ingrain it into parents’ and children’s minds.
White bread and refined breakfast cereal have
been staple grain foods for kids for decades, but there’s
new hope for whole grains. That’s because some parents
are starting to realize that whole grains are healthier for
their children. According to the Report on Healthy and Organic
Foods 2006, only a label indicating no added sugar is a more
attractive attribute than one touting whole grains when consumers
select foods for children. When asked about the specific benefits
of the top functional foods, 72% of consumers associated whole
grains with benefits related to cardiovascular disease, and
86% associated fiber and whole grains with intestinal health,
according to the 2007 International Food Information Council’s
Consumer Attitudes Toward Functional Foods/Foods for Health
survey.
Consumers now have a positive attitude about
getting their families to feast on whole grains and are actively
seeking them. This may explain why food manufacturers have jumped
at the chance to plaster the whole grain message all over children's
favorite foods—from Trix breakfast cereal to Kraft Macaroni
& Cheese. More products are bragging about their whole grain
content, further propping up the health halo that whole grains
now proudly wear.
New product launches of foods making a whole
grain claim have grown sharply since 2000. According to the
Mintel Global New Products Database, in 2006 nearly 10 times
as many new whole grain products were introduced as in 2000.
Government and leading health organizations can take credit
for getting the whole grains party started. After the release
of the 2005 Dietary Guidelines for Americans, the average shopper
purchased approximately 15% more whole grain products. Restaurants
have further helped promote whole grains that kids can sink
their teeth into—from whole grain burritos to whole grain
pizza. While taste—the king in consumer decision making—was
once a barrier to increasing whole grain consumption, it may
no longer be.
A Healthy Habit for
Children
A body of scientific evidence about the health benefits of whole
grains has been mounting. Though there is a dearth of data correlating
whole grain consumption in children with chronic disease prevention
later in life, experts believe that introducing whole grains
early can build healthy eating behaviors that can have positive
effects for a lifetime.
“Whole grains are more nutrient dense;
they have a variety of phytochemicals and antioxidants. Three
servings of whole grains per day can significantly reduce the
risk for heart disease, certain types of cancer, and diabetes,”
says Leonard F. Marquart, PhD, RD, assistant professor at the
University of Minnesota’s department of food science and
nutrition, who believes that whole grains can be a piece of
the puzzle in addressing concerns of pediatric obesity and related
diseases. “Whole grains have a filling effect. Those that
consume more whole grains have a lower BMI [body mass index]
and gain less weight over time. When you make changes, a lot
of impact comes through kids vs. waiting later on,” adds
Marquart.
The pediatric obesity epidemic may be fueled
by an increase in refined carbohydrates, according to Alan Greene,
MD, FAAP, pediatrician and assistant clinical professor at Stanford
University School of Medicine in California, who presented at
the Getting Whole Grains to 3 International Conference in January
2006. “Heart disease risk factors include elevated blood
pressure, elevated blood glucose, elevated triglycerides, decreased
HDL [high-density lipoprotein] cholesterol, and increased waist
size. Two thirds of Americans had one or more of these risk
factors by the age of 18. One eighth of them have full-blown
metabolic syndrome,” says Greene.
According to autopsy results, atherosclerosis
may begin developing as early as the first decade of life. In
a University of California, Los Angeles study, boys and girls
at varying levels of fitness and adiposity without documented
atherosclerosis were placed on a high-fiber, low-fat, low-cholesterol
diet (which included lots of fruits, vegetables, and whole grains)
at the Pritikin two-week residential program, where food was
provided ad lib and exercise was performed daily for up to 2.5
hours per day. After the two-week period, significant reductions
in BMI, total cholesterol, and triglycerides were observed.
In addition, reduction in insulin levels in conjunction with
decrements in leptin, a hormone thought to be connected to appetite,
were discovered.1
Recent research is also exploring whole grain’s
potential benefits for healthier carotid arteries and blood
pressure levels and reducing the risk of asthma, inflammatory
disease, colorectal cancer, gum disease, and tooth loss. In
a study published in the December 2006 issue of Thorax,
researchers from the Dutch National Institute of Public Health
and the Environment found that children who ate whole grains
were 54% less likely to develop asthma and 45% less likely to
develop wheezing than children who did not eat whole grains.2
According to the 2005 Dietary Guidelines for
Americans, all age groups should consume at least one half of
their grains as whole grains. MyPyramid recommends 1.5 whole
grain servings for females and males aged 2 to 3; two for females
and 2.5 for males aged 4 to 8; and three for females and males
aged 9 to 13. The American Heart Association recommends eating
foods with whole grain listed as the first ingredient on the
label and to make at least one half of daily grain servings
whole grain. Across the globe, similar recommendations are made
for consumers. One serving of whole grain is one slice of 100%
whole grain bread, 1 cup of 100% whole grain cereal, or 1/2
cup of 100% whole grain hot cereal, cooked pasta, rice, or other
grain. For food products containing whole grains, 16 grams or
more of whole grain ingredients counts as a full serving.
Tempting Children to
Dig Whole Grains
While plenty of food manufacturers offer tasty solutions for
whole grain needs, children still have a long way to go to meet
current recommendations. Recent surveys suggest that children
eat roughly one to less than one serving of whole grains per
day. Adults are warming up to chefs whipping up whole grain
creations such as faro risotto, barley-stuffed zucchini, and
squid with quinoa, but different tactics are needed to tempt
kids.
Jesse Cool, food author and chef/owner of the
California restaurants Flea St. Café, JZ Cool Eatery,
and Cool Café, believes that it all starts with parents
teaching their children to eat whole grains. At the whole grains
conference, Cool emphasized that “we need to change the
way that parents and adults feed kids. My job is to get them
to eat whole grains by imitating junk foods, such as whole wheat
burritos, whole grain pasta with meat sauce, sandwiches with
whole grains, whole grain crust on pizza, and brown rice pancakes.”
“For some kids, the appearance of whole
grains, since they are brown, don’t look so good. If you
use white whole wheat or barley flour, it appears more refined.
It looks more like what they are used to. The acceptance with
this is greater than bread products made with red whole wheat
flour that looks darker,” says Terri Burgess-Champoux,
PhD, RD, LD, a postdoctoral fellow in the Adolescent Health
Training Program at the University of Minnesota. Burgess-Champoux
studied the acceptance of whole grains in a school-based project
for her dissertation.
Many whole grain products can capture a child’s
attention and taste buds. Whole grain ingredients can make an
appearance in favorites foods such as breakfast cereals, pretzels,
pitas, pastas, pizzas, tacos, wraps, cookies, sandwiches, bagels,
burgers, granola bars, waffles, pancakes, graham crackers, soups,
corn bread, chips, and popcorn.
The ABCs of Whole Grains
Schools may be the perfect setting to encourage children to
eat more whole grains. “There are 30 million kids getting
school lunches every day. You have a captive audience whereby
to introduce whole grains in a context unlike other situations,”
says Marquart, who led a research project on whole grain consumption
in schools.
Marquart reports that the key issues in getting
children to become whole grain fans include making them familiar
with whole grains, increasing availability, and creating a natural
transition. Marquart’s research team found success using
white whole wheat flour in foods because it is lighter in color,
easier to mix in foods, and tolerated better by children and
it allows for a transition to whole grains. The study project
was performed in first through sixth grades at Hopkins School
District in Minnesota, which served approximately 550 lunches
per day. Using pizza with a 50/50 blend of white whole wheat
flour and refined red wheat flour providing 16 grams of whole
grains per serving, the researchers studied plate waste. They
found, on average, that the children ate 75% of the pizza. In
addition, dinner rolls and breadsticks made with white whole
wheat flour were found to be as acceptable to the children as
those made with refined flour.
In a second project led by Marquart in the same
district, children were fed whole grain products as part of
the classroom curriculum that also included family involvement.
Whole grain foods were substituted on the menu, and meal intake
was observed. It was found that whole grain consumption increased
by one serving when it was served for lunch in items such as
pizza, pasta, tortillas, buns, and rolls. Burgess-Champoux,
who also worked on the research project, reports, “We
wanted to make connections between the school and home. Parents
are very important; you have to really work on engaging them.”
Some innovative methods used to involve parents included weekly
newsletters, parent-child activities such as word searches,
bakery and grocery tours, and a Whole Grain Day that included
cooking and food samples, T-shirt giveaways, and a whole grain
quiz bowl.
Currently, schools are not required to serve
whole grains, as regulations indicate grains may be enriched
or whole. In a 2004 communication to child nutrition programs
in all states, the USDA encouraged school food authorities to
investigate the availability of whole grain products when developing
product specifications and making their procurement plans. Schools
participating in the school meals program are encouraged to
consider purchasing and offering whole grains and improving
nutritional well-being. Although all government nutrition programs
are required to be consistent with the Dietary Guidelines, the
National School Lunch Program regulations trail behind the release
of the most recent guidelines. Regulations are anticipated to
be updated to conform with the Dietary Guidelines.
Some schools are stepping up to the plate to
offer whole grains. The School Nutrition Association 2007 Trends
Report found that increasing availability of whole grain products
is the most commonly reported effort in place in school districts
across the nation. Approximately 85% of districts implementing
specific food and nutrition policies report an increase in availability
of whole grain products. The HealthierUS Schools Challenge is
a voluntary USDA program offering recognition to schools that
improve overall nutrition. They grant Silver Award status to
schools that serve whole grains three times per week and Gold
Award status to schools that serve whole grain all five days.
Foods qualifying as whole grain must be formulated with at least
51% of their grain as whole grain.
Many schools are promoting whole grains in the
cafeteria, as well as through newsletters, buttons, posters,
games, magnets, stickers, and decorations. Alaska Gateway School
District in Tok, Alaska, uses whole grain buns. Operators at
Clymer Central School Cafeteria in New York are finding success
using white whole wheat bread for their peanut butter and jelly
sandwiches and whole grain buns for their sub sandwiches. When
the Chappaqua Central School district in Westchester County,
N.Y., mandated that their schools offer whole wheat alternatives,
the foodservice director tempted kids with products such as
white rice mixed with brown rice, whole wheat spaghetti intertwined
with the standard kind, and sandwiches made from one slice of
white bread and one slice of wheat.
Restaurants Dishing
Up Whole Grains
Restaurants are also helping expose kids to whole grains—an
important step since American families are eating away from
home more often. The Whole Grains Council’s program, Just
Ask for Whole Grains, encourages consumers to ask for whole
grain options at their favorite eating establishments with the
goal that every restaurant provide at least one whole grain
option on the menu. Many restaurants are ponying up to the challenge
and offering kid-friendly whole grain fare. Atlanta Bread Company
uses whole grain bread for sandwiches, McDonald’s features
a Premium Chicken Sandwich with a whole grain bun, TGI Friday’s
serves turkey burgers on whole wheat buns, Denny’s offers
whole grain bagels, Taco Time utilizes a whole wheat tortilla,
and Olive Garden serves whole grain pasta—just to name
a few. P.F. Chang’s won the Whole Grains Council’s
2007 Challenge for serving 10 million pounds of brown rice over
the year, reporting that 45% of their diners choose it over
white rice.
And the whole grains message doesn’t stop
there; it is woven into health promotion campaigns for many
cities and states. Head Start; Women, Infants, and Children;
and after-school programs are teaching kids about whole grains.
Even day care providers are encouraging kids to eat whole grains.
Dietitians are relying on whole grains in working with kids
with special nutritional needs. At Camp Sweet Freedom, a day
camp for children who use insulin, and Camp Strongheart, a camp
for overweight children, in Kannapolis, N.C., instructors include
whole grain cooking lessons and taste challenges to incorporate
this key message. National Nutrition Month has also become a
time for whole grain education to shine.
“If we can get kids to accept whole grains
at a young age, this behavior can reach into adulthood,”
says Burgess-Champoux. “We have to offer these foods multiple
times at frequent exposures. It’s not only at school;
these changes need to also occur [in] the home environment.”
— Sharon Palmer, RD, is a contributing
editor at Today’s Dietitian and a freelance
food and nutrition writer in southern California.
References
1. Roberts C, Chen A, Barnard R. Effect of a short-term diet
and exercise intervention in youth on atherosclerotic risk factors.
Atherosclerosis. 2007;191(1):98-106.
2. Tabak C, Wijga AH, de Meer G, et al. Diet
and asthma in Dutch school children (ISAAC-2). Thorax.
2006;61(12):1048-1053.
Whole Grain Recipes
Whole Wheat Veggie Pizzas
Courtesy of HSC Cafeterias, Whole Grains Challenge
Winner
Serves: Nine 7-inch pizzas
2 cups whole wheat flour
2 cups all-purpose flour
1/2 cup dry oats
1 T + 11/2 tsp active dry yeast
1/4 tsp salt
2 tsp honey
11/2 cups warm water
Mix 1 cup each white and whole wheat flour,
oats, yeast, and salt. Heat water to 125°F, then add honey.
Gradually add water to dry mixture. Mix for two minutes. Add
remaining flour, mixing well after each addition. Knead dough
for 10 minutes. Spray with Pam. Cover. Let rise in warm place
until double. Punch down. Divide into equal parts. Roll and
place in 7-inch pizza pans. Cover and let rise in warm place
approximately 45 minutes.
Sauce and Toppings:
1 cup + 2 T pizza sauce
2 tsp minced garlic
1/4 cup fresh basil leaves, trimmed and chopped
11/2 cups spinach leaves, stems trimmed
1 cup + 2 T broccoli flowerets
1/2 cup + 1 T carrots, grated
1 cup + 2 T green peppers, diced
1 cup + 2 T fresh tomatoes, diced
21/4 cups part-skim mozzarella cheese
Mix pizza sauce with minced garlic and fresh
basil. Top each dough with:
2 T pizza sauce
Spinach leaves
2 T broccoli flowerets
1 T carrots, grated
2 T green peppers
2 T fresh tomatoes, diced
1/4 cup part-skim mozzarella cheese
Bake in hot oven (375°F convection; 425°F
conventional) approximately 10 minutes.
Nutrient Analysis
Calories: 326 Protein: 16 g; Carbs: 53 g; Total
Fat: 6 g;
Sat Fat: 3 g; Trans Fat: 0 g; Cholesterol: 18 mg; Sodium: 372
mg; Fiber: 7 g
Italian Pasta Salad
Courtesy of Colorado Springs School District, Whole
Grains Challenge Winner
Serves: Fifty 2-ounce servings
2 pounds multigrain penne pasta, cooked
13/4 cups + 2 T canned olives, sliced and drained
121/2 ounces pepperoni, sliced
3/4 cup + 1 T Italian salad dressing
Cook pasta according to package directions and
drain well. Add sliced olives, sliced pepperoni, and Italian
dressing to cooked pasta and toss to combine. Chill and serve.
Nutrient Analysis
Calories: 118; Protein: 4 g; Carbs: 15 g; Total Fat: 5 g; Sat
Fat: 1 g; Trans Fat: 0 g
Cholesterol: 8 mg; Sodium: 237 mg; Fiber: 2 g
Kids’ Turkey Meatloaf With Whole
Grain
Courtesy of Jesse Cool, Flea Street Café
Serves: 8
1 yellow onion
2 carrots, peeled
2 stalks celery
3 whole eggs, beaten
1 cup tomato ketchup
11/2 T dry Italian seasoning
1 T salt
1/2 tsp ground black pepper
2 pounds ground dark turkey meat
11/2 cups cooked bulgur
Preheat oven to 375°F. In a food processor
or by hand, grate the onion, carrot, and celery and scrape into
a large bowl. Add the eggs, 2/3 cup of the ketchup, the Italian
seasoning, salt, and pepper. Add the ground meat and bulgur
and mix thoroughly. Put the meatloaf in a baking pan and form
into a loaf. Spread remaining ketchup on top of the meatloaf.
Bake in the oven for approximately 45 minutes or until internal
temperature when tested with a thermometer is 150°F.
Nutrient Analysis
Calories: 269; Protein: 24 g; Carbs: 18 g; Total
Fat: 11 g; Sat Fat: 3 g; Trans Fat: 0 g; Cholesterol: 170 mg;
Sodium: 1,367 mg; Fiber: 3 g
Optimum Power Organic Whole Grain Cookies
Courtesy of Nature’s Path Foods
1 cup butter or margarine
13/4 cup organic brown sugar
2 eggs
2 tsp vanilla
11/2 cups organic unbleached wheat flour
1 tsp baking soda
2 cups quick organic oats
2 cups Nature’s Path Optimum
1/2 cup dried cranberries
Preheat oven to 350°F. Cream butter/margarine
and sugar until fluffy. Add eggs (or egg substitute) and vanilla.
In a separate bowl, mix remaining ingredients. Add these to
the butter mixture. Spoon drops of dough onto an ungreased cookie
sheet. Bake for 10 to 12 minutes.
Nutrient Analysis
Based on 60 cookies
Calories: 67; Protein: 1 g; Carbs: 9 g; Total
Fat: 4 g; Sat Fat: 2 g; Trans Fat: 0 g; Cholesterol: 15 mg;
Sodium: 32 mg; Fiber: 1 g
