Do Refined Grains Have a Place in a Healthy Dietary Pattern: Perspectives from an Expert Panel Consensus Meeting

Overall Findings of the Expert Panel Discussion:

  1. Whole grains and refined grains can make meaningful nutrient contributions to dietary patterns.
  2. Whole and refined grain foods contribute nutrient density.
  3. Fortification and enrichment of grains remain vital in delivering nutrient adequacy in the American diet.
  4. There is inconclusive scientific evidence that refined grain foods are linked to overweight and obesity.
  5. Gaps exist in the scientific literature with regard to grain foods and health.

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Consensus Statement Overall Findings

Consensus statements derived from an expert panel roundtable event:

  1. Grain foods make meaningful nutrient contributions to US dietary patterns. In particular, both whole and refined grain foods can play a role in helping deliver shortfall nutrients to the American population.
  2. Grain foods are meaningful contributors of nutrient density in the American diet in both children and adults, with particular emphasis on ready-to-eat cereals, breads, rolls, and tortillas.
  3. Grain foods can contribute nutrient adequacy in the US diet of children and adults.
  4. Currently with US typical dietary patterns, a large percentage of children and adults are not meeting recommendations set forth by authoritative dietary guidance. Removing portions or all of certain whole and refined grain foods from the diet can further exacerbate nutrient inadequacies in US children and adults.
  5. Removing refined grains from the diet results in more children and adults falling below recommendations for shortfall nutrients as identified by the 2015–2020 Dietary Guidelines for Americans.
  6. Available scientific evidence from observational studies does not support the notion that refined grain consumption is linked to increased risk of overweight and obesity.
  7. Limiting consumption of indulgent refined grains, due to contributions of calories, added sugar, sodium, and saturated fat, is necessary within dietary patterns.
  8. Evolving dietary guidance needs to evaluate emerging grain research to address the nutritional relevance of certain refined grain foods within dietary patterns.
  9. The current categorization of refined grain foods may need further delineation, particularly because current evidence suggests differences in nutrient contribution from breads and cereals in comparison to indulgent grain foods such as cakes, cookies, and pies.
  10. Future research should consider distinguishing different types of refined grain foods with the goal of potentially creating an additional classification of grains that goes beyond the terms “whole” and “refined”. For example, dietary pattern–focused research needs to separate refined grains (i.e., breads and cereals from cakes, cookies, and pies) when assessing nutrient intake, diet quality, and health-related outcomes.
  11. Future research should consider repeating currently available analyses with epidemiological-based databases other than NHANES. For example, the expert panel recommends conducting analyses using large cohorts, including the Nurses’ Health Study and Health Professional Follow-Up Study, in which refined grains are further distinguished (i.e., refined grain categories need to differentiate between breads and cereals and cakes, cookies, pies, etc.).

Supporting Research Studies

Several grain dietary patterns are associated with better diet quality and improved shortfall nutrient intakes in US children and adolescents: a study focusing on the 2015–2020 Dietary Guidelines for Americans

February 2017 / Nutrition Journal Papanikolaou Y, et al.  The study identified the most commonly consumed grain food patterns in US children and adolescents (2–18 years-old; N = 8,367) relative to those not consuming grains and compared diet quality and nutrient intakes, with focus on 2015–2020 DGA shortfall nutrients.

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Certain Grain Foods Can Be Meaningful Contributors to Nutrient Density in the Diets of U.S. Children and Adolescents: Data from the National Health and Nutrition Examination Survey, 2009–2012

February 2017 / Nutrients Papanikolaou Y, et al.  The current analyses showed that certain grain foods, in particular breads, rolls and tortillas, ready-to-eat cereals and quick breads and bread products, are meaningful contributors of folate, iron, thiamin, niacin and dietary fiber, a nutrient of public health concern as outlined by the 2015–2020 DGA.

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Grain Foods Are Contributors of Nutrient Density for American Adults and Help Close Nutrient Recommendation Gaps: Data from the National Health and Nutrition Examination Survey, 2009–2012

August 2017 / Nutrients Papanikolaou Y, et al.  In this study, researchers looked closely at what American adults are eating – or not – to contribute to the growing issue of shortfall nutrients. Shortfall nutrients are very important nutrients – defined by the 2015 DGA Committee – that, when under-consumed, cause public health concerns.

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Grains Contribute Shortfall Nutrients and Nutrient Density to Older US Adults: Data from NHANES, 2011–2014

April 2018 / Nutrients Yanni Papanikolaou and Victor L. Fulgoni III  Previous data demonstrate grain foods contribute shortfall nutrients to the diet of U.S. adults. The 2015–2020 Dietary Guidelines for Americans have identified several shortfall nutrients in the U.S. population, including fiber, folate, and iron (women only).

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Perspective: Refined Grains and Health: Genuine Risk or Guilt by Association?

Glenn A. Gaesser, PhD Extensive analyses of the existing body of published studies show that refined grain consumption is not associated with any of the chronic diseases to which it usually is attributed. This study illustrates that current dietary recommendations to reduce refined grain consumption conflict with the substantial body of published scientific evidence.

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Perspective: Whole and Refined Grains and Health—Evidence Supporting “Make Half Your Grains Whole”

November 2019 / Advances in Nutrition Julie Miller Jones, Carlos Guzmán García, Hans J Braun Review indicates positive health impacts from diverse diets that include not more than 50% carbohydrates and the right mix of grain-based foods. Grain-based foods — both whole-grain and refined, from which the bran has been removed — are a key part of healthy diets, according to a study published in the science journal Advances in Nutrition.

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