Wholegrain cereals and bread: A duet of the Mediterranean diet for the prevention of chronic diseases

1Department of Biochemistry and Molecular Biology II, Centre for Biomedical Research (CIB), Institute of Nutrition and Food Technology, University of Granada, Avda. del Conocimiento s/n, 18100 Armilla, Granada, Spain.
Public Health Nutrition (Impact Factor: 2.68). 12/2011; 14(12A):2316-22. DOI: 10.1017/S1368980011002576
Source: PubMed

ABSTRACT

The promotion of healthy lifestyles is one of the major goals of governments and international agencies all over the world. Wholegrain cereals are rich in nutrients and many phytochemical compounds, with recognised benefits for health, including dietary fibre, a number of phenolic compounds, lignans, vitamins and minerals and other bioactive components. The aim of the present work is to review the fundamental studies that support the consumption of wholegrain cereals and bread to prevent chronic diseases.
Descriptive review considering human studies.
Subjects included in randomised intervention trials and cohort studies from different countries published up to 2010.
Several studies show consistently that subjects who ingest three or more portions of foods per day based on wholegrain cereals have a 20-30 % lower risk of CVD than subjects who ingest low quantities of cereals. This level of protection is not observed with the ingestion of refined cereals, these being even higher than with the intake of fruit and vegetables. Likewise, high intake of wholegrain cereals and their products, such as whole-wheat bread, is associated with a 20-30 % reduction in the risk of type 2 diabetes. Finally, protection against the risk of colorectal cancer and polyps, other cancers of the digestive tract, cancers related to hormones and pancreatic cancer has been associated with the regular consumption of wholegrain cereals and derived products.
The regular intake of wholegrain cereals can contribute to reduction of risk factors related to non-communicable chronic diseases.

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    • "The major aim is to reduce calorific intake and hence reduce the incidence of obesity, which should in turn reduce the incidence of obesity-related diseases. Also, the consumption of low glycaemic index (low GI) cereal foods has been more directly associated with prevention and alleviation of type 2 diabetes[12]. This review firstly briefly examines how starch is digested in cereal foods and the importance of the degree and rate of digestion, and measurement of the resulting glycaemic response. "
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    ABSTRACT: One cause of obesity and related diseases like type-2 diabetes is overconsumption of cereal foods with readily available carbohydrates, resulting in hyperglycaemia and ultimately insulin resistance. A strategy to combat this is to modulate glycaemic response through starchy cereal foods that have low glycaemic index (GI) because their starch is less available to digestion. In cereals, many factors can limit accessibility of amylase to the starch. Of these, intact pieces of endosperm, high levels of oat or barley β-glucan and high amylose starch are probably the most important. Starch accessibility in cereal foods is also greatly affected by processing. Heat-moisture thermal processing at low moisture above glass transition temperature, but below gelatinization temperature is probably the most effective processing technology to reduce starch availability. Formation of starch-lipid complexes also appears promising. Whole grain (milled whole kernel) cereal foods are intrinsically low GI but may have a long-term role in preventing obesity and type 2 diabetes through their phytochemicals, particularly polyphenols. A novel approach is to structure starchy cereal foods to deliver their carbohydrate at the distal end of the gastrointestinal tract to trigger the ileal and colonic brakes feedback systems so as to enhance satiety and hence decrease energy intake.
    No preview · Article · Nov 2014 · Starch - Starke
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    • "Plant foods are the main source of nutrients such as slow-release carbohydrate and fiber, vegetable protein, beneficial minerals, antioxidant vitamins, and polyphenols that contribute to an optimal nutrition, satiety, and maintenance of a balanced diet. The group of cereals is found in the main meals, preferably consumed as whole grains, emphasizing the importance of a high fiber content in the diet [1, 3, 36]. In our study, greater fiber intake in MeDiet groups may be related to lower dietary GL and GI. "
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    ABSTRACT: Objective. To compare the one year effect of two dietary interventions with MeDiet on GL and GI in the PREDIMED trial. Methods. Participants were older subjects at high risk for cardiovascular disease. This analysis included 2866 nondiabetic subjects. Diet was assessed with a validated 137-item food frequency questionnaire (FFQ). The GI of each FFQ item was assigned by a 5-step methodology using the International Tables of GI and GL Values. Generalized linear models were fitted to assess the relationship between the intervention group and dietary GL and GI at one year of follow-up, using control group as reference. Results. Multivariate-adjusted models showed an inverse association between GL and MeDiet + extra virgin olive oil (EVOO) group: 𝛽 = −8.52 (95% CI: −10.83 to −6.20) and MeDiet + Nuts group: 𝛽 = −10.34 (95% CI: −12.69 to −8.00), when comparing with control group. Regarding GI, 𝛽 = −0.93 (95% CI: −1.38 to −0.49) for MeDiet + EVOO, 𝛽 = −1.06 (95% CI: −1.51 to −0.62) for MeDiet + Nuts when comparing with control group. Conclusion. Dietary intervention with MeDiet supplemented with EVOO or nuts lowers dietary GL and GI.
    Full-text · Article · Sep 2014 · Journal of nutrition and metabolism
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    • "In response to the growing burden of non-communicable diseases (NCDs), the World Health Organization (WHO) recommends a reduced intake of fat, sugar and salt, and a higher intake of fruits, vegetables, whole grains and nuts, while maintaining energy balance and healthy weight [1]. The vegetarian diet [2,3], among others such as the Dietary Approaches to Stop Hypertension (DASH), Mediterranean and Japanese diets, may offer benefits for reducing risk of NCDs [2,4]. Evidence on the health benefits of a vegetarian diet from long-term cohort studies in the West, such as EPIC-OXFORD and the Adventist Health study II, show positive cardiovascular, cancer, mental health and overall mortality effects [5-9]. "
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    ABSTRACT: Background The cardiovascular and other health benefits and potential harms of protein and micronutrient deficiency of vegetarian diets continue to be debated. Methods Study participants included urban migrants, their rural siblings and urban residents (n = 6555, mean age - 40.9 yrs) of the Indian Migration Study from Lucknow, Nagpur, Hyderabad and Bangalore. Information on diet (validated interviewer-administered semi-quantitative food frequency questionnaire), tobacco, alcohol, physical activity, medical histories, as well as blood pressure, fasting blood and anthropometric measurements were collected. Nutrient databases were used to calculate nutrient content of regional recipes. Vegetarians ate no eggs, fish, poultry and meat. Using multivariate linear regression with robust standard error model, we compared the macro- and micro-nutrient profile of vegetarian and non-vegetarian diets. Results Vegetarians, (32.8% of the population), consumed greater amounts of legumes, vegetables, roots and tubers, dairy and sugar, while non-vegetarians had a greater intake of cereals, fruits, spices, salt (p < 0.01), fats and oils. Vegetarians had a higher socioeconomic status, and were less likely to smoke, drink alcohol (p < 0.0001) and engage in less physical activity (p = 0.04). On multivariate analysis, vegetarians consumed more carbohydrates (β = 7.0 g/day (95% CI: 9.9 to 4.0), p < 0.0001), vitamin C (β = 8.7 mg/day (95% CI: 4.3 to13.0), p < 0.0001) and folate (β = 8.0 mcg/day (95% CI: 3.3 to 12.7), p = 0.001) and lower levels of fat (β = −1.6 g/day (95% CI: −0.62 to −2.7), p = 0.002), protein (β = −6.4 g/day (95% CI: −5.8 to −7.0), p < 0.0001), vitamin B12 (β = −1.4 mcg/day (95% CI: −1.2 to −1.5), p < 0.0001) and zinc (β = −0.6 mg/day (95% CI: −0.4 to −0.7), p < 0.0001). Conclusion Overall, Indian vegetarian diets were found to be adequate to sustain nutritional demands according to recommended dietary allowances with less fat. Lower vitamin B12 bio-availability remains a concern and requires exploration of acceptable dietary sources for vegetarians.
    Full-text · Article · Jun 2014 · Nutrition Journal
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