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.
