Guidelines Dietary - Eat For Health

2.3.2 The evidence for consuming ‘grain (cereal) foods, mostly wholegrain and/orhigh cereal fibre varieties’The evidence for the association of grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties,with reduced risk of cardiovascular disease, type 2 diabetes and excess weight gain has strengthened since the2003 edition of the dietary guidelines.The literature is difficult to interpret because studies use varied definitions of ‘wholegrain’. FSANZ applies theterm to products that use every part of the grain (cereal) including the outer layers, bran and germ even if theseparts are separated during processing and regardless of whether the grain (cereal) is in one piece or milled intosmaller pieces. 441 In the literature review for these Guidelines, the most commonly used definition was found tobe that of Jacobs et al 1998, 442 who defined wholegrain foods as those containing 25% or more of wholegrains.Other studies have included bran cereals as part of the definition of wholegrain and others only examined certaintypes of grain (cereal) food such as oats.Table 2.7: Evidence statements for consuming ‘grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties’Evidence statementGradeGuideline 2Consumption of cereal foods (especially wholegrains and those with fibre from oats or barley) is associated with a reduced riskof cardiovascular disease in adults.Consumption of one to three serves per day of wholegrain cereals is associated with a reduced risk of cardiovascular disease.Consumption of cereal foods (especially three serves a day of wholegrains) is associated with reduced risk of type 2 diabetesConsumption of three to five serves per day of cereal foods (mainly wholegrain) is associated with a reduced risk of weight gain.Consumption of one to three serves per day of cereals high in fibre is associated with reduced risk of colorectal cancer in adults.BBBBCNotes: Grades – A: convincing association, B: probable association, C: suggestive associationIncludes evidence statements and gradings from the Evidence Report (literature from years 2002–2009). Does not include evidence fromother sources, such as the 2003 edition of the dietary guidelines (in which individual studies were classified according to their design aslevel I, II or III but overall grades for relationships were not derived), although these sources have been used to inform these Guidelines.Grade C evidence statements showing no association and all Grade D statements can be found in Appendix E.Cardiovascular disease, type 2 diabetes and excess weight• Cardiovascular disease: There is evidence of a probable association between the consumption of grain (cereal)foods (especially wholegrains and those with fibre from oats or barley) and a reduced risk of cardiovasculardisease in adults (Grade B; Evidence Report, Section 6.3). 226,443-458 Almost all the high level trials were conductedwith oats, with the evidence of beneficial lowering of levels of LDL and total cholesterol levels. The protectiveeffect was noted with between one to three serves per day of wholegrain foods (predominantly oats).• Type 2 diabetes: There is evidence of a probable association between the consumption of grain (cereal) foods(especially wholegrains) and reduced risk of type 2 diabetes (Grade B; Evidence Report, Section 6.7). 445,457,459-466The evidence supports three serves per day of wholegrain foods conferring between 21% and 42% reductionin risk of type 2 diabetes.• Excess weight: There is evidence of a probable association between consumption of three to five serves perday of grain (cereal) foods (mainly wholegrain) and reduced risk of weight gain (Grade B; Evidence Report,Section 6.6). 215,220-229Enjoy a wide variety of nutritious foodsNational Health and Medical Research Council45