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Opportunities for diet quality improvement: the potential role of staple grain foods

Lookup NU author(s): Emeritus Professor Chris SealORCiD



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Cambridge University Press, 2021.

For re-use rights please refer to the publisher's terms and conditions.


Objective: Given the high disease burden associated with the low intake of whole grains, modelling studies that estimate the impact of dietary strategies to increase more healthful grain foods consumption are essential to inform evidence-based and culturally-specific policies. This study investigated the potential nutritional impact of replacing staple grain foods with more healthful options.Design: Based on the 2015 Health Survey of São Paulo, a cross-sectional, population-based study, we modelled the substitution of white rice and white bread with brown rice and whole-wheat bread. Outcomes included changes in more healthful grain foods, energy, and nutrient intakes.Setting: Urban area of São Paulo, Brazil.Participants: Participants aged over 12 years who completed a semi-structured questionnaire and one 24-h recall (n=1741).Results: The substitution of all white rice and white bread with brown rice and whole-wheat bread, respectively, would result in more than 5% increases in zinc (+9.1%), calcium (+9.3%), vitamin E (+18.8%), dietary fibre (+27.0%), and magnesium (+52.9%) intake, while more than a 5% decrease would be seen for total carbohydrate (-6.1%), folate (-6.6%), available carbohydrate (-8.5%), iron (-8.6%), vitamin B6 (-12.5%), vitamin B2 (-17.4%), and vitamin B1 (-20.7%). A substantial increase in the amount of more healthful grain foods consumed would be seen (10g/d to 220g/d), or from 4% to 69% of total grain intake.Conclusions: Replacing white rice and white bread with their whole-grain versions has the potential to improve diet quality, suggesting they are prime targets for policy actions aiming at increasing intake of more healthful grain foods.

Publication metadata

Author(s): Fontanelli MdM, Martinez-Arroyo A, Sales CH, Seal CJ, Fisberg RM

Publication type: Article

Publication status: Published

Journal: Public Health Nutrition

Year: 2021

Volume: 24

Issue: 18

Pages: 6145-6156

Online publication date: 12/04/2021

Acceptance date: 04/04/2021

Date deposited: 12/04/2021

ISSN (print): 1368-9800

ISSN (electronic): 1475-2727

Publisher: Cambridge University Press


DOI: 10.1017/S1368980021001531


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