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Sound Science

To set the stage for the sound science that forms the foundation of the Grains for LIFE campaign, the Grain Foods Foundation conducted an exhaustive literature review of more than 700 abstracts and articles published in medical literature from January 1999 through July 2004.

The Clinical Advisory Board examined the findings of the literature review and found consensus in virtually all specialties analyzed – including nutrition, sports medicine, basic science, primary care, endocrinology, internal medicine, oncology, gastroenterology, cardiology, psychology, pediatrics, obstetrics and gynecology, public health and epidemiology – that grain-based foods, including bread and rolls, provide myriad benefits in achieving and maintaining optimal health and wellness.

GRAIN FOODS AND DIETARY CARBOHYDRATES
A STRATEGIC ANALYSIS OF THE MEDICAL LITERATURE, 1999-2004

EXECUTIVE SUMMARY

Objective
To determine current trends in the scientific messages being disseminated to various medical specialties about grain foods and dietary carbohydrates as a first step to educate the public about the benefits of grain foods and dietary carbohydrates and help provide clarity and correct misinformation.

Methods

  • A comprehensive search and review of on-line abstracts retrieved from PubMed and from relevant medical meetings from January 1, 1999 to July 1, 2004
  • 1,032 abstracts retrieved (995 from PubMed and 37 from medical meetings) and imported into database; 724 deemed relevant and included in analysis

Findings

  • The number of published articles about grain foods and dietary carbohydrates has been gradually increasing since 1999
  • Overall, the articles were more favorable to the consumption of grain foods and dietary carbohydrates than unfavorable (53% favorable, 12% unfavorable, 13% with both favorable and unfavorable aspects, and 20% neutral or not applicable)
  • Nutrition was by far the most common specialty to which articles were targeted (41% of articles)
  • 151 different journals carried articles on grain foods and/or dietary carbohydrates; 16% of articles appeared in the American Journal of Clinical Nutrition, the top-ranked nutrition journal and the official journal of The American Society for Clinical Nutrition
  • Major specialties most favorable to grain foods and carbohydrates: Primary Care (67% favorable articles), Basic Science (63%)
  • Major specialties least favorable to grain foods and carbohydrates: Cardiology (19% unfavorable articles), Endocrinology (17%), Internal Medicine (17%)
  • Messages were categorized into 35 major groups; the most frequent messages as follows:
    • Exercise increases need for carbohydrates and carbohydrates improve physical/athletic performance
    • Many Americans make poor food choices
    • Grain-based carbohydrates are not the cause of obesity
    • Whole grains or grain products may reduce risk of mortality and chronic disease
    • Carbohydrates are part of a healthy diet
    • Grain products are healthy foods; they are good sources of vitamins, minerals, fiber and other healthy components
  • Major messages differed predictably by specialty, however none discounted the importance of a well balanced diet that includes grain-based foods.

Summary
In summary, the bulk of the scientific evidence and discussion is favorable to including grain foods and carbohydrates as a major food source. Primary care physicians receive and disseminate the most favorable messages with respect to grain foods and dietary carbohydrates, and Basic Science articles support their stance. Cardiologists and Internists receive and disseminate the most negative messages. The specialty with the most publications related to grain foods and dietary carbohydrates is Nutrition. On the other hand, some influential specialties like Ob/Gyn and Nursing publish infrequently on the topic, suggesting an unmet need for basic nutrition information among these constituencies.

Further Readings

Grain Foods and Gylcemic Index References

Scientific Literature Review Full Report (PDF)

Gaesser, GA. Carbohydrate Quantity and Quality in Relation to Body Mass Index. Journal of the American Dietetic Association. 2007; 107: 1768-1780.

Franz MJ, Bantle JP, Beebe CA et al. Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications. Diabetes Care. Jan. 2002; 25 (1): 148-198.

Foster-Powell K, Holt SHA, Brand-Miller JC. International table of glycemic index and glycemic load values: 2002.
American Journal of Clinical Nutrition. 2002; 76 (1): 556.

Mayer-Davis EJ, Dhawan A, Liese AD, Teff K, Schulz M. Towards understanding of glycaemic index and glycaemic load in habitual diet: associations with measures of glycaemia in the Insulin Resistance Atherosclerosis Study. British Journal of Nutrition. 2006; 95: 397-405.

Yang, Q, Botto LD, Erickson JD, Berry RJ, Sambell C, Johansen H, Friedman JM. Improvement in Stroke Morality in Canada and The United States, 1990-2002. Circulation. 2006; 113: 1335-1343.

Yang, Q, Botto LD, Erickson JD, Berry RJ, Sambell C, Johansen H, Friedman JM. Improvement in Stroke Morality in Canada and The United States, 1990-2002. Circulation. 2006; 113: 1271.

Smith, AP. Breakfast cereal consumption and subjective reports of health. International Journal of Food Sciences and Nutrition. 1999; 50: 445-449.

Hays NP, Starling RD, Sullivan DH, Fluckey JD, Coker RH, Williams RH, Evans WJ. Effects of an Ad Libitum, High Carbohydrate Diet and Aerobic Exercise Training on Insulin Action and Muscle Metabolism in Older Men and Women. Journal of Gerontology. 2006; 61A (3): 299–304.

Rampersaud GC, Pereia MA, Girard BL, Adams J, Metzl JD. Breakfast Habits, Nutritional Status, Body Weight, and Academic Performance in Children and Adolescents. Journal of the American Dietetic Association. 2005; 105: 743-760.

Gilbertson HR, Brand-Miller JC, Thorburn AW, Evans S, Chondros P, Werther GA. The Effect of Flexible Low Glycemic Index Dietary Advice Versus Measured Carbohydrate Exchange Diets on Glycemic Control in Children With Type 1 Diabetes. Diabetes Care. 2001; 24: 1137.

McKeown NM, Meigs JB, Liu S, Saltzman E, Wilson PWF, Jacques PF. Carbohydrate Nutrition, Insulin Resistance, and the Prevalence of the Metabolic Syndrome in the Framingham Offspring Cohort. Diabetes Care. 2004; 27: 238-546.

Sheard NF, Clark NG, Brand-Miller JC, Franz MJ, Pi-Sunyer FX, Mayer-Davis E, Kulkarni K, Geil P. Dietary Carbohydrate (Amount and Type) in the Prevention and Management of Diabetes. Diabetes Care. 2004; 27: 2266-2271.

Liese AD, Schulz M, Fang F, Wolever T, D'Agostino RB, Sparks KC, Mayer-Davis EJ. Dietary Glycemic Index and Glycemic Load, Carbohydrate and Fiber Intake, and Measures of Insulin Sensitivity, Secretion, and Adiposity in the Insulin Resistance Atherosclerosis Study. Diabetes Care. 2005; 28: 2832-2838.