QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kantor, L. S. Articles by Lin, B.-H. Search for Related Content PubMed PubMed Citation Articles by Kantor, L. S. Articles by Lin, B.-H.

---

Supplement

Choose a Variety of Grains Daily, Especially Whole Grains: A Challenge for Consumers¹

Diet, Safety and Health Economics Branch, Economic Research Service, U.S. Department of Agriculture, Washington, DC 20036

²To whom correspondence should be addressed. E-mail: Lkantor{at}ers.usda.gov.

	ABSTRACT

TOP ABSTRACT INTRODUCTION History of the grains... METHODS OF ASSESSMENT SURVEILLANCE STRATEGIES FOR IMPROVEMENT REFERENCES

 
The 2000 edition of Nutrition and Your Health: Dietary Guidelines for Americans is the first to include a specific guideline for grain foods, separate from fruits and vegetables, and recognize the unique health benefits of whole grains. This paper describes and evaluates major tools for assessing intakes of total grains and whole grains, reviews current data on who consumes grain foods and where, and describes individual- and market-level factors that may influence grain consumption. Aggregate food supply data show that U.S. consumers have increased their intake of grain foods from record low levels in the 1970s, but consumption of whole-grain foods remains low. Data on individual intakes show that consumption of total grains was above the recommended 6 serving minimum in 1994–1996, but consumption of whole grains was only one third of the 3 daily servings many nutritionists recommend. Increased intake of whole-grain foods may be limited by a lack of consumer awareness of the health benefits of whole grains, difficulty in identifying whole-grain foods in the marketplace, higher prices for some whole-grain foods, consumer perceptions of inferior taste and palatability, and lack of familiarity with preparation methods. In July 1999, the U.S. Food and Drug Administration authorized a health claim that should both make it easier for consumers to identify and select whole-grain foods and have a positive effect on the availability of these foods in the marketplace.

KEY WORDS: • whole grains • grains • CSFII • food supply • DHKS

	INTRODUCTION

TOP ABSTRACT INTRODUCTION History of the grains... METHODS OF ASSESSMENT SURVEILLANCE STRATEGIES FOR IMPROVEMENT REFERENCES

 
Grain products, along with fruits and vegetables, form the base of a healthy diet. Grains provide complex carbohydrates (starches), an important source of food energy, fiber and key vitamins and minerals, such as folate. Folate is a B vitamin that reduces the risk of some serious types of birth defects and may help protect against coronary heart disease and certain cancers (1) .

Whole grains differ from refined grains in the amount of vitamins, minerals, fiber and other protective substances they provide, and different whole-grain foods differ in nutrient content. Refined grains are low in fiber and in the protective substances that accompany fiber. Eating plenty of fiber-containing foods, such as whole grains (and also many fruits and vegetables) promotes proper bowel function (1) .

The 2000 edition of Nutrition and Your Health: Dietary Guidelines for Americans, for the first time, includes a specific guideline for grain foods, separate from fruits and vegetables, and recognizes the unique health benefits of whole grains. These guidelines suggest a minimum of 6 servings of grain products per day, depending on energy intake, and several servings of whole grains (1) .

	History of the grains guideline

TOP ABSTRACT INTRODUCTION History of the grains... METHODS OF ASSESSMENT SURVEILLANCE STRATEGIES FOR IMPROVEMENT REFERENCES

 
The grains component of the Dietary Guidelines has evolved over time to reflect a changing scientific research base and to simplify and clarify consumer educational messages. The early guidelines reflected an emerging scientific consensus on the relationships between excess consumption of energy, fat, cholesterol, sodium and sugars and chronic disease (2) . The 1980 and 1985 guideline statement was "Eat Foods with Adequate Starch and Fiber" (3 ,4) . The accompanying guideline text emphasized increased consumption of foods high in starch and fiber, i.e., whole-grain breads and cereals, enriched grains, fruits, vegetables, and dry beans and peas, primarily to support energy needs as consumers reduced their intake of fats and sugars and to help add dietary fiber to the diet (5) .

In 1980, emerging research linked fiber intake to "reduced symptoms of chronic constipation, diverticulitis and some types of irritable bowel" (3) . By 1985, the recognition that different types of foods contained different types of fiber with different chemical structures and biological effects led to an increased emphasis on consuming a variety of fiber-rich foods (6) .

The revised wording of the 1990 guideline statement, "Choose a Diet with Plenty of Vegetables, Fruits, and Grain Products," shifted the emphasis from consumption of food components such as starch and fiber to specific categories of foods that contained these components, such as fruits, vegetables and grain products (7) . The purpose was to make it easier for consumers to identify healthful food products and to shift the educational message away from starch, which was viewed negatively by many consumers as fattening (8) . With "increased evidence that some of the benefit from a high fiber diet may be from foods providing the fiber, not from fiber alone," consumers were advised that it was best to "get fiber from food rather than supplements. Excessive use of fiber supplements is associated with a greater risk for intestinal problems and lower absorption of some minerals" (8) .

The 1990 Dietary Guidelines were also the first to quantify the minimum number of servings of grains and other foods that people should eat for good health. These quantitative recommendations grew out of the 1985 development of a food guidance system by the USDA intended to help consumers integrate the dietary guidelines into their daily food choices by suggesting the numbers of servings to eat from five major food groups (5) . The revised guidance system was published as the Food Guide Pyramid in 1992 (9) . Although the 1990 Dietary Guidelines recommended that most consumers include 6–11 grain servings daily, depending on calorie intake, they stopped short of quantifying a recommended number of servings of whole grains, recommending only that consumers include "several" servings daily.

In 1995, the guideline statement was reworded to "Choose a Diet with Plenty of Grain Products, Vegetables, and Fruits" to reflect the positioning of grain products at the base of the Pyramid and their role as the largest source of energy in the diet (10 ,11) . The 1995 Dietary Guidelines highlighted the most recent scientific evidence linking components in grains, fruits and vegetables, in addition to fiber and complex carbohydrates, to reduced risk of heart disease and some cancers. In 2000, the guideline statement was reworded to "Choose a Variety of Grains Daily, Especially Whole Grains" (1) .

The 2000 Dietary Guidelines mark a departure from previous editions in three key ways, i.e., they establish a guideline for grain products separate from that for fruits and vegetables, place a new emphasis on variety in grain consumption and, for the first time, specifically mention whole grains in the guideline statement (12) . The 2000 Dietary Guidelines Advisory Committee cited three objectives in creating separate guidelines for grains and for fruits and vegetables: "... it increases attention to grains as distinct from vegetables and fruits, it simplifies the message, and it helps make clear that there are distinct advantages of the two broad categories of plant foods" (12) . The Committee also recognized that the average compliance of U.S. consumers with minimum serving recommendations differed for grains, vegetables and fruits.

To reflect the fact that "the health benefits of grains are now more correctly linked with the consumption of plenty of whole grains," the Committee incorporated a phrase about whole grains into the guideline statement but did not specify the exact number of servings that should be consumed (12) . The Committee cited two reasons for the new emphasis on whole grains, i.e., very low intake of whole grains in the United States and new scientific evidence showing the unique health benefits of whole grains. The Committee said, "Recent research has found that people who consume higher amounts of whole grains have a low risk for cardiovascular disease, and possibly some forms of cancer, than do people who have a low intake of whole grains. This apparently beneficial association of a dietary pattern higher in whole grains is related to factors distinct from their fiber content" (12) .

This paper describes and evaluates major tools for assessing progress toward meeting minimum serving recommendations for total grains and whole grains, presents baseline data on who consumes grain foods and where, describes changes in total grain and whole-grain consumption patterns over time, and describes individual- and market-level factors that might influence grain consumption.

	METHODS OF ASSESSMENT

TOP ABSTRACT INTRODUCTION History of the grains... METHODS OF ASSESSMENT SURVEILLANCE STRATEGIES FOR IMPROVEMENT REFERENCES

 
This section discusses major data sources that are available to measure compliance with the 2000 Dietary Guidelines statement for grains.

Continuing Survey of Food Intakes by Individuals

The Continuing Survey of Food Intakes by Individuals (CSFII)³ is a nationally representative survey that measures foods eaten by individuals (13 ,14) . The most recent CSFII, conducted in 1994–1996 provides data for individuals of all ages on their food and nutrient intakes over two nonconsecutive days (15) . A separate survey on children’s food intake was conducted in 1998 and is not discussed in this paper. In addition to food intake data, demographic information, such as household size, income, race, age and gender, and health-related information, such as smoking and exercise habits are available for each individual. The demographic information is particularly valuable because it can be used to identify the types of people most likely to meet dietary recommendations on the basis of social and demographic characteristics and can help researchers to assess dietary status among population subgroups (13) .

Dietary intakes were collected by trained interviewers in respondents’ homes on two nonconsecutive days using a 24-h multiple-pass recall method. The survey design called for separating the d-1 and d-2 interviews by 3–10 d, and conducting each on a different day of the week. Sampling weights were applied to the data to provide national probability estimates adjusted for differential rates of selection and nonresponse (16) .

Interviewers used standardized probes to obtain complete descriptions of types and amounts of foods eaten by respondents. For grain foods, these standardized probes made it possible to assign each reported food to a food code and associated recipe that represented the proportion of whole-grain ingredients it contained (16) . When a food contained some whole-grain and some non-whole-grain ingredients, the recipe was used to determine the fraction of the grain servings from each.

The CSFII Pyramid Servings Database, first released for public use in 1997, uses recipes, intended to be typical of foods eaten in the United States, to separate food mixtures, such as a grilled cheese sandwich, into their component parts, such as bread and cheese, and tabulate each part with the appropriate food group. Gram weights are then transformed into the number of servings as defined by the Food Guide Pyramid. (17) .

The Pyramid Servings Database contains servings/100 g for each food reported in the 1994–1996 CSFII from 30 food groups and subgroups of which three are grain, i.e., total grain, whole grain and non-whole grain. Definitions of grain serving sizes were based on the Food Guide Pyramid and accompanying educational materials. Examples of one grain serving include 1 slice of bread, 1/2 of a hamburger roll, English muffin, bagel, or large croissant, 1 tortilla, 1 oz. of ready-to-eat breakfast cereal or 1/2 cup of cooked rice or pasta (9) .

USDA nutrient data laboratory specialists classified all grain ingredients reported in the 1994–1996 CSFII as whole grain or non-whole grain. A detailed list of the 29 food ingredients included in the whole-grain servings total is available in Cleveland et al. (16) . Some grain ingredients that are not whole grains, such as oat bran and wheat bran, were also counted as whole-grain servings if they had a high fiber content because a major objective of the whole-grain recommendation is to promote adequate fiber consumption.

    Limitations of food intake surveys. Numerous studies have suggested that food intake surveys such as the CSFII, which collect food consumption data through food recalls or food records over short periods of time, are subject to underreporting of consumption when measured in terms of energy intake (18 19 20 21 22 23 24 25) . Although improved probing methods in the 1994–1996 CSFII may have reduced underreporting compared with previous surveys, food intake surveys, and hence the dietary assessments on which they are based, probably reflect a lower limit on actual food intake. Consequently, these assessments may also tend to understate the number of Food Guide Pyramid servings actually consumed by individuals, at least for some food groups.

The number of persons meeting a serving recommendation can vary depending on the use of 1-d vs. multiple-day intakes, especially when intakes are at the very high or low end of recommended levels (26) . Additional research is required on appropriate methods for determining usual intakes from food intake surveys.

The CSFII excludes people such as migrants and homeless persons who do not have a fixed mailing address or telephone. Also excluded are military personnel living on bases in the United States and overseas, and people living in institutions (e.g., long-term care facilities and prisons). Although samples for the CSFII include ethnic subgroups such as Asian Americans, Pacific Islanders and American Indians, sample sizes for these groups are typically small and may not be sufficient to allow valid analysis by subgroup (27) .

Food Supply Data (FSD)

The Economic Research Service (ERS) of the USDA annually calculates the amount of food available for human consumption in the United States by tracking flows of several hundred individual agricultural commodities through domestic marketing channels (28) . For most commodity categories, the available food supply is calculated as the sum of annual domestic production, beginning inventories and imports minus exports, industrial nonfood uses, farm uses (seed and feed), and end-of-year inventories.

Grain commodities are an exception. Grain supplies for human use are measured directly or estimated statistically. For example, wheat and rye flour supplies are measured directly in terms of 100-lb sacks of flour produced, as reported in the quarterly Flour Milling Census (29) . For all commodities in the FSD, per capita consumption is usually calculated by dividing the available food supply by the total U.S. population on July 1 of a given year.

ERS has developed new methods to adjust the FSD for losses and express the data in terms of Food Guide Pyramid–based servings (30) . This allows researchers to gain a more complete understanding of U.S. dietary patterns by comparing food supply servings at the national level with estimates generated at the individual level by food intake surveys. The Center for Nutrition Policy and Promotion of the USDA annually calculates the amounts per capita per day of food energy and 24 nutrients and food components in the U.S. food supply (31) . This series also provides information about nutrient contributions from the major food groups, including grains.

    Limitations of FSD. Because FSD measure commodity supplies as they move through marketing channels for domestic consumption, the data typically overstate the amount of food actually consumed by humans by capturing substantial quantities of nonedible food portions lost to human use through waste and spoilage in the home and marketing system (32) . The series also includes unknown quantities of grains used as ingredients in manufactured foods that are exported, such as ready-to-eat breakfast cereals (30) . As a result of this and other "overcounting," the average energy provided by the food supply is well above that required to meet the energy needs of the U.S. population (33) . However, the conversion of the FSD to Pyramid-based servings overcomes many of these limitations by adjusting the data for waste, spoilage and other losses.

For most commodities, the amount of food available for consumption is an aggregate measure defined at the basic commodity level. Final product forms and marketing channels are not usually known, and little or no data exist on supplies of further processed products. For example, relatively good data are available for food ingredients such as flour and canned tomatoes, but not for foods as usually eaten, such as bread or lasagne. As a result, the FSD cannot be used to assess distributions of consumption by the U.S. population or population subgroups. However, because the data are not collected directly from consumers, they provide an independent basis for examining food consumption in the U.S., separate from food intake data. If waste and other losses in the system are relatively constant over time, FSD also provide an independent measure of changes in food consumption trends.

FSD are available for nine aggregate grain categories: white flour and whole-wheat flour; semolina durum flour (used to manufacture pasta); rye flour; rice; corn flour and meal; corn hominy and grits; cornstarch; oat products, including rolled oats, ready-to-eat oat cereals, oat flour and oat bran; and barley products, including barley flour, pearl barley, and barley malt and malt extract used in food processing.

Estimates for wheat flour and rye flour, which accounted for 75 and 0.3% of total grain foods, respectively, in the 1998 FSD, are among the most accurate estimates in the FSD. By law, millers must report their flour production to the Federal government. However, food supply estimates for other grain products, including rice, corn, oats and barley, are considerably less reliable than estimates for wheat and rye flours (34) .

Except for rye flour, oat and barley products, which are mainly whole grain, the FSD does not identify the whole-grain share of the available grain supply. Moreover, it excludes wheat foods not manufactured directly from wheat flour or bulgur, i.e., it excludes wheat bran, wheat germ, wheat berries and products manufactured directly from these items, such as Wheaties (cooked, flattened, toasted wheat berries), Shredded Wheat, Puffed Wheat and All-Bran breakfast cereals and Triscuit crackers. Similarly, it excludes whole-grain foods made directly from field corn (e.g., Tostito and Dorrito brand corn tortilla chips), corn bran (used in some breakfast cereals) and popcorn. The FSD also excludes many less frequently consumed whole grains such as amaranth, buckwheat, millet, kamut, quinoa, spelt and triticale, as well as flours milled from these grains.

Using periodic data from the U.S. Census of Manufacturers (29) and other information, ERS has attempted to estimate the amount of whole-wheat flour, field corn and corn bran available in the food supply. However, the Census of Manufacturers data are available only every 5 y (in years ending in 2 and 7), and the release of data is subject to disclosure rules to protect the identity of individual firms. The magnitude of the disclosure problem grew in the 1997 data set because increased concentration in the food processing industry has reduced the number of firms reporting data for any single food commodity. Given these limitations, the future usefulness of the Census series for assessing national supplies of whole grains and other foods is in doubt.

Diet and Health Knowledge Survey (DHKS)

From a nutrition policy perspective, the role of nutrition information is of special interest because it is the most amenable to modification. To understand the role of nutrition information, it is necessary to have data linking consumers’ knowledge, attitudes and beliefs to their food and nutrient intake. Such data were provided for the first time on a nationwide basis by the DHKS conducted as a companion survey along with the 1989–1991 CSFII (14) . The CSFII-DHKS survey was fielded again with the 1994–1996 CSFII (15) .

The DHKS was conducted as a telephone follow-up to the CSFII. One DHKS respondent was randomly selected from each household from among eligible CSFII sample persons 20 y old who had provided 1 d of dietary intake. In 1994–1996, 5765 households provided complete DHKS data for a response rate of 74%. The DHKS respondents were asked a series of questions about their attitudes, knowledge and beliefs about nutrition and healthy eating. Among other matters, the questions were governed by a need for data on knowledge and attitudes about the Dietary Guidelines for Americans. The 1994–1996 DHKS had two questions directly related to the grains group:⁴ 1) Serving Knowledge: How many servings from the Bread, Cereal, Rice, and Pasta Group would you say a person of your age and sex should eat each day for good health? and 2) Dietary Attitude: To you personally, is it very important, somewhat important, not too important, or not at all important to choose a diet with plenty of breads, cereals, rice and pasta?

Supermarket scanner data

Supermarket scanner data can be used to evaluate the size and growth of the market for whole-grain and non-whole-grain foods, and to compare the price of whole-grain foods to refined versions of the same product. Supermarket scanner data are compiled and distributed by a number of private firms around the country. The data used in this paper are provided by Information Resources (35) . The database contains weekly retail scanner information from samples of supermarkets, drug and mass-merchandising stores across the United States with at least $2 million in annual sales, statistically selected to be representative of retail stores nationwide.

    Limitations of supermarket scanner data. Supermarket scanner data exclude sales of nonscannable food items such as fresh produce, fresh meats, items sold in bulk, or items prepared or packaged at the store (such as bakery and deli items, and luncheon meats and cheese sliced in the store). Food sales from stores with <$2 million in annual sales, such as smaller grocery stores, convenience stores, and most health food and specialty stores also are excluded. These exclusions could be particularly important for assessment of whole-grain product sales.

Limitations of assessment tools and outstanding issues

In addition to the limitations of major assessment tools discussed above, this paper identifies a number of other barriers that may affect assessment of the population’s grain and whole-grain intakes.

    Guidelines lack quantitative standard for whole grains. The most important barrier to accurate assessment of compliance with the new grains guidelines is that the 2000 Dietary Guidelines do not provide a quantitative standard for whole-grain intake. According to the 2000 Dietary Guidelines Advisory Committee report, "The committee considered whether or not increasing the intake of whole grains at the expense of enriched, folate-fortified refined grains would decrease the intake of some micronutrients (e.g., iron, folate, zinc) to undesirably low levels. Analyses of dietary patterns using 1994–96 CSFII composites show that substituting three servings of whole grains for three servings of enriched, folate-fortified refined grains would not adversely affect nutrient intake levels" (12) .

But neither the text nor the guidelines statement of the 2000 Dietary Guidelines specify the number of whole-grain servings that consumers should eat each day. However, a number of public and private organizations have recommended that at least three daily grain servings should come from whole grains.

The three-serving recommendation for whole grains first appeared in the USDA 1985 food guidance system, the precursor to the Food Guide Pyramid. In developing the research base for the food guide, one half of the minimum 6 daily servings from the grain group was assumed to come from the whole-grain subgroup (5) . The intent was to increase consumption of dietary fiber and key vitamins and minerals available in greater quantities in whole-grain foods. In 1994, the 3-serving recommendation for whole grains was operationalized in the development of a " 3 Are Key" consumer education slogan by the American Dietetic Association (36) .

In January 2000, the U.S. Department of Health and Human Services integrated the 3-serving recommendation into the national nutrition objectives for 2010, which for the first time included an objective specifically targeting whole-grain intake. The objective reads: Increase the proportion of persons aged 2 y and older who consume at least 6 daily servings of grain products, with at least 3 being whole grains from 7% to at least 50% by 2010 (37 ,38) .

The new emphasis on variety in grain consumption in the 2000 Dietary Guidelines also presents an assessment challenge. The text of the guidelines recommends that consumers "Eat foods made from a variety of whole grains—such as whole wheat, brown rice, oats, and whole corn—every day" (10) Theoretically, because whole-grain ingredients have been identified in the CSFII Pyramid Servings Database (16) , this data set could be used to look at the distribution of whole-grain ingredients, such as whole corn, across daily grain servings. However, such research has not yet been undertaken and the 2000 Dietary Guidelines do not provide a quantitative standard against which such an assessment of variety could be measured.

    Few labeling standards for whole grains. Assessment of whole-grain intakes is also hampered by the variety of terms used to describe whole-grain foods (39) . Labeling of whole-grain ingredients is often unclear and inconsistent. As a result, many consumers are unable to correctly identify whole-grain foods in the marketplace or accurately report consumption of whole-grain foods in food intake surveys (39 ,40) .

Some foods, such as brown rice or whole wheat spaghetti, may be fairly easily identified by consumers as whole-grain foods, but processed products with multiple ingredients, such as breads, crackers and other baked goods, may cause confusion. For example, breads labeled "multigrain," "nine-grain" or "made with whole grain" may contain some whole-grain ingredients, but typically are made primarily with enriched wheat flour and do not offer the same fiber and other health benefits available from products made mostly from whole grain (40) . Also, many consumers mistakenly believe that a dark or brown color, such as that found in pumpernickel and rye breads, denotes a whole-grain product, when, in fact, these breads are made mostly with enriched wheat flour and caramel or other added coloring.

Adding to the confusion, some products, such as barley and oatmeal, are always whole grain, but others that are usually refined are sometimes marketed in a whole-grain form. For example, Food Guide Pyramid educational materials list bagels, cornmeal and flour tortillas as non-whole-grain or refined products, but these products are sometimes available in the marketplace in whole-grain form such as whole-wheat bagels, whole-wheat flour tortillas and whole-grain cornmeal.

Because Americans eat away from home more often, they are likely to find it more difficult to identify correctly the whole-grain content of foods they consume. When eating out, consumers are less likely to know about the ingredients, preparation methods and nutritional quality of foods purchased, especially for foods they may not be used to preparing themselves (41) . This makes it harder to assess reported food intakes.

To help consumers select whole-grain foods, the text of the 2000 Dietary Guidelines includes an educational box that directs consumers to purchase products that name a whole-grain ingredient first on the ingredient label. It states, "Choose foods that name one of the following ingredients first on the label’s ingredient list—brown rice, bulgur (cracked wheat), graham flour, whole-grain corn, oatmeal, popcorn, pearl barley, whole oats, whole rye, or whole wheat" (1) . However, the lack of consistent ingredient labeling for whole-grain foods may make it difficult for consumers using this method to identify whole-grain foods correctly. For example, a sampling of ingredient labels for corn tortilla chips (a whole-grain food) at a supermarket in suburban Maryland found three different terms used to describe the grain ingredient, depending on the manufacturer and brand name, whole corn, corn and stone ground corn.

In July 1999, the Food and Drug Administration authorized a health claim that may make it easier for consumers to identify whole-grain foods. The claim reads, "Diets rich in whole-grain foods and other plant foods and low in total fat, saturated fat, and cholesterol, may help reduce the risk of heart disease and certain cancers." To qualify for the health claim, a food must contain at least 51% whole-grain ingredients by weight per reference amount customarily consumed, be low in fat and meet other general requirements for health claims (42) .

	SURVEILLANCE

TOP ABSTRACT INTRODUCTION History of the grains... METHODS OF ASSESSMENT SURVEILLANCE STRATEGIES FOR IMPROVEMENT REFERENCES

 
Individual grain intakes/trends over time: the CSFII

Assessment of individual grain intakes relative to Food Guide Pyramid recommendations has been reported elsewhere, in terms of means for 1989–1991 and 1994–1996 using the CSFII (17 ,43) . Whole-grain and non-whole-grain servings for adults 20 y old and food sources of whole- and non-whole-grain servings are available using the 1994–1996 CSFII (16) . The age-adjusted share of persons who consumed 6 grain servings/d and the age-adjusted share of persons who consumed 3 servings of whole-grain foods/d have also been reported (37 ,38) . Servings data for whole- and non-whole-grain foods for 1994–1996 are also available on the Internet (44) .

Table 1 shows mean daily intakes of whole-grain and non-whole-grain servings per day by socioeconomic characteristics, urbanization level and geographic region for 1989–1991 and 1994–1996. In 1994–1996, all individuals 2 y old consumed an average of 6.8 grain servings/d, nearly a full serving above the 6-serving minimum recommended in the Food Guide Pyramid. Of the 6.8 total grain servings consumed on average in 1994–1996, only one was whole grain. Those with incomes between 0 and 130% of the poverty line (the income threshold for the Food Stamp Program) and individuals with less than a high school education had whole-grain intakes 40% below those in the highest income and education groups. Whole-grain consumption among Hispanics and non-Hispanic African-Americans was about half that of non-Hispanic Caucasians.

The percentage of the population meeting minimum recommended intakes for total grains and whole grains in 1989–1991 and 1994–1996 is shown in Table 2 . Day 1 of intake for both surveys was used to facilitate comparisons; however, a single day’s consumption may not be representative of usual intakes. In 1994–1996, half of the population 2 y old consumed 6 servings of grain foods, whereas just 10% consumed 3 whole-grain servings. Two thirds of the population 2 y old consumed <1 serving of whole grains. Although the share of the population consuming 6 total grain servings increased from 42% in 1989–1991, the share consuming 3 servings of whole grains was virtually unchanged.

In 1994–1996, about two thirds of total grain and non-whole-grain servings were obtained from "at home" sources, which is about the same share of total food energy. Fewer than 15% of whole-grain servings were obtained away from home, which is less than half the share of total food energy obtained away from home. Restaurants and fast food establishments, which accounted for nearly 20% of total food energy, were the source of <6% of total whole-grain servings.

Trends in the per capita food supply

Per capita food supplies of flour and cereal products reached 195 lb in 1998 from an all time low of 133 lb in 1972 (Table 4 ). Four fifths of this increase occurred since 1980, the period following the release of the first Dietary Guidelines for Americans. The 1980 Dietary Guidelines encouraged consumers to "select foods which are good sources of fiber and starch such as whole-grain breads, cereals, fruit, vegetables, beans, peas, and nuts" (3) . The expansion in supplies reflected strong consumer demand for new bread varieties and in-store bakery items, and grain-based snack foods, as well as increasing sales of fast-food products made with buns, doughs and tortillas (33) . Yet this consumption is far below the 300 lb consumed per person in 1909.

Americans also consumed much more rye flour, buckwheat flour and barley products in 1909 than did their 1997 counterparts. This explains in large part why contributions from the grain products group of several key nutrients found in whole-grain products, such as vitamin E, magnesium and copper, are much greater in the 1909 FSD than in the 1997 FSD (Table 5 ). However, as noted in "Limitations of Food Supply Data," some whole-grain products consumed by Americans in 1997 are excluded from the 1997 FSD and, thus, from the FSD per capita nutrient series. In contrast, the 1909 FSD likely reflects the total grain food supply of 1909.

Figure 1 presents the grains group serving knowledge of U.S. adults based on the 1994–1996 DHKS. Serving knowledge responses were grouped into 3 categories: 0–2, 3–5 and 6. Only 7% of the adults reported the correct number of grain servings within the recommended 6–11 serving range, whereas nearly half (48%) reported 0–2 as the number of servings to be consumed daily for good health.⁵ The 7% correct response is, however, a considerable improvement from a 1990–1991 analysis of the DHKS that found a 1% correct response rate for the grains group (48) .⁶ The relative improvement may be due to the popularization of the Food Guide Pyramid during the intervening years.

View larger version (58K): [in this window] [in a new window]   Figure 1. Servings knowledge: how many servings from the bread, cereal, rice, and pasta group would you say a person of your age and sex should eat each day for good health? 0–2, 48.4%; 3–5, 44.3%; 6, 7.2%.

View larger version (44K): [in this window] [in a new window]   Figure 2. Dietary attitude: to you personally, is it very important, somewhat important, not too important, or not at all important to choose a diet with plenty of breads, cereals, rice, and pasta? Not important, 25.2%; somewhat important, 42.8%; very important, 31.8%.

In addition to knowledge and attitudes, the price and availability of goods in the marketplace also affect consumer behavior. Consumers’ ability to increase the quantity and variety of whole-grain products consumed may be limited by the lack of availability and/or higher prices of whole-grain foods in conventional supermarkets. A 1996 study by ERS found that nutritionally improved versions of the same food product, such as those lower in fat or sodium or higher in fiber were 2-94% more expensive than "regular" versions of the same product (50) .

Supermarket scanner data were used to estimate volume sales (pounds) and average prices for nine grain product categories: fresh bread and rolls; flour; flour tortillas; rice, cereal grains; pasta (spaghetti, macaroni, fettuccine and rigatoni); ready-to-eat breakfast cereals; and ready-to-cook breakfast cereals. Within each category, products were defined as whole-grain or non-whole-grain on the basis of information provided on the product label as captured by the scanner data. Products that had a mix of whole-grain and non-whole-grain ingredients were the most difficult to classify.

Fresh breads and rolls, tortillas and pasta, except spaghetti, were classified as whole grain if their product label said "whole grain" or "whole wheat." The whole-grain spaghetti category reflects a greater diversity of varieties and includes whole-wheat and whole-grain types as well as those made from buckwheat flour, bran and brown rice. Whole-grain classifications for ready-to-eat and ready-to-cook breakfast cereals and the rest of the products included in this analysis are listed in the footnotes to Table 12 .

Several factors may account for these price differences. Some of the observed price differentials are likely associated with a premium charged on "healthfood" products (50) . Other price differences may be associated with higher production costs. For example, bakers add more gluten to whole-wheat bread to increase palatability and taste (51) . Moreover, many whole-grain products on the market are produced organically by small producers who may have higher production and marketing costs. In addition, whole-grain products tend to spoil quickly, leading to a shorter shelf life relative to refined grain products.

	STRATEGIES FOR IMPROVEMENT

TOP ABSTRACT INTRODUCTION History of the grains... METHODS OF ASSESSMENT SURVEILLANCE STRATEGIES FOR IMPROVEMENT REFERENCES

 
The combination of data presented in this paper shows that U.S. consumers have increased their intake of grain foods from record low levels in the 1970s, but consumption of whole-grain foods remains low. Although average consumption of total grains was above the recommended 6 serving minimum in 1994–96, consumption of whole grains was only one third of the 3 daily serving target many nutritionists recommend. In addition, consumption of all grain foods was below recommended levels for many socioeconomic and demographic subgroups, particularly non-Hispanic African-Americans and those with incomes at or near the poverty level. With only 7% of consumers aware that they should be consuming 6–11 total grain servings and several servings of whole grains daily, opportunities exist for the development of new methods for educating the public about the health benefits of eating grains, especially whole grains.

Individual-level behavior changes

Increased intake of whole-grain foods may be limited by a number of factors, including lack of consumer awareness of their health benefits, difficulty in identifying whole grains in the marketplace, consumer perceptions of inferior taste and palatability, and lack of familiarity with preparation methods (16 ,40 ,51) . The recently authorized health claim for whole-grain foods should make it easier for consumers to identify and select whole-grain foods and is likely to have a positive effect on the availability in the marketplace of products that meet these criteria.

Consumers also require sufficient knowledge and information to motivate them to change consumption habits. For most consumers, meeting the whole-grain guideline may require substantial shifts in shopping and consumption habits, especially for the two thirds of U.S. consumers who are currently consuming <1 whole-grain serving/d.

System-level changes

The successful adoption of the 2000 Dietary Guidelines for grains also requires that consumers have access to sufficient quantities of grain foods at prices that they can afford and in forms that will meet standards for taste, palatability and convenience (52) . This will be a particular challenge in the away-from-home sector in which consumption of whole grains is well below total food energy obtained at eating places.

With an increased share of meals eaten away from home, and <15% of total whole-grain servings consumed in the away-from-home food market, meeting the whole-grain guideline will require a sizeable shift in the integration of such foods into the away-from-home sector. Agriculture producers and grain millers also could be affected as consumers demand larger quantities of whole-grain foods (52 ,53) .

Supermarket scanner data show that many whole-grain products, including breads, breakfast cereals, brown rice and tortilla chips, are widely available in conventional supermarkets. However, whole grains still make up a tiny share of total grain food sales. This is consistent with data from the CSFII that show low intakes of whole-grain foods by all population groups. Consumers’ ability to add variety to their whole-grain choices may be limited by the lack of availability and/or higher prices of many whole-grain foods in the marketplace. Furthermore, in many parts of the country, foods such as whole-grain pastas, whole wheat couscous and tortillas, and lesser-known grains such as bulgur or quinoa, may be available only at ethnic, health food or other specialty stores, or through the Internet or mail order (40) . This may be a particular issue for low-income consumers in central cities and sparsely populated rural areas where food stores and product choices are often more limited (54 55 56) .

Additional research and methods are required to improve our capacity to make an accurate assessment of our nation’s progress toward meeting Federal dietary recommendations for grain foods. These include developing an improved understanding of the differences between the number of grain servings provided by the CSFII and FSD, integrating a quantitative standard for whole-grain intake into the Dietary Guidelines, and increasing consistency among researchers, food manufacturers and food retailers in defining, describing and labeling whole-grain foods. The addition of questions to the DHKS that measure consumer’s knowledge about whole-grain foods could be particularly useful in tracking the success of educational efforts regarding that part of the guideline.

	FOOTNOTES

 
¹ Published as a supplement to The Journal of Nutrition. The publication of this supplement was sponsored by the National Cancer Institute, National Institutes of Health, Bethesda, MD. The guest editor for this publication was Susan M. Krebs-Smith, NCI, NIH, Bethesda, MD.

³ Abbreviations used: CSFII, Continuing Survey of Food Intake by Individuals; DHKS, Diet and Health Knowledge Survey; ERS, Economic Research Service; FSD, Food Supply Data.

⁴ A third question about dietary beliefs deals indirectly with some foods in the grain group: please tell me if you strongly agree, somewhat agree, somewhat disagree, or strongly disagree with the statement: starchy foods, like breads, potatoes and rice, make people fat. This question is less relevant to the revised dietary guidelines than the other two questions.

⁵ The 7% (n = 328) includes two respondents who answered >11 servings.

⁶ The food groups serving knowledge questions were not asked in 1989. In the 1989–1991 DHKS, the household respondent was the main meal planner/preparer. When the 1994–1994 sample is restricted to the main meal planner/preparer, 7.9% reported the correct number of grain servings.

	REFERENCES

TOP ABSTRACT INTRODUCTION History of the grains... METHODS OF ASSESSMENT SURVEILLANCE STRATEGIES FOR IMPROVEMENT REFERENCES

 

1. U.S. Department of Agriculture, U.S. Department of Health and Human Services (2000) Nutrition and Your Health: Dietary Guidelines for Americans, 2000, 5th ed. Home and Garden Bull. 232, U.S. Government Printing Office, Washington, DC.

2. Davis, C. & Saltos, E. (1999) Dietary recommendations and how they have changed over time In: America’s Eating Habits: Changes and Consequences (Frazao, E., ed.). Economic Research Service, U.S. Department of Agriculture, AIB-750.

3. U.S. Department of Agriculture, U.S. Department of Health and Human Services (1980) Nutrition and Your Health: Dietary Guidelines for Americans, 1st ed. Home and Garden Bull. 232, U.S. Government Printing Office, Washington, DC.

4. U.S. Department of Agriculture, U.S. Department of Health and Human Services (1985) Nutrition and Your Health: Dietary Guidelines for Americans, 2nd ed. Home and Garden Bull. 232, U.S. Government Printing Office, Washington, DC.

5. Cronin F. J., Shaw A. M., Krebs-Smith S. M., Marsland P. M., Light L. Developing the Food Guidance System for "Better Eating for Better Health," A Nutrition Course for Adults 1985 U.S. Department of Agriculture Human Nutrition Information Service. Administrative Report no. 377.

6. U.S. Department of Agriculture, Human Nutrition Information Service, Dietary Guidelines Advisory Committee (1985) Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, to the Secretary of Health and Human Services and the Secretary of Agriculture.

7. U.S. Department of Agriculture, U.S. Department of Health and Human Services. (1990) Nutrition and Your Health: Dietary Guidelines for Americans, 3rd ed. Home and Garden Bull. 232, U.S. Government Printing Office, Washington, DC.

8. U.S. Department of Agriculture, Human Nutrition Information Service, Dietary Guidelines Advisory Committee (1990) Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans 1990, to the Secretary of Health and Human Services and the Secretary of Agriculture.

9. U.S. Department of Agriculture, U.S. Department of Health and Human Services (1992) The Food Guide Pyramid. Home and Garden Bull. 252, U.S. Government Printing Office, Washington, DC.

10. U.S. Department of Agriculture, U.S. Department of Health and Human Services (1995) Nutrition and Your Health: Dietary Guidelines for Americans, 4th ed. Home and Garden Bull. 232, U.S. Government Printing Office, Washington, DC.

11. U.S. Department of Agriculture, Agriculture Research Service, Dietary Guidelines Advisory Committee (1995) Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans 1995, to the Secretary of Health and Human Services and the Secretary of Agriculture.

12. U.S. Department of Agriculture, Agriculture Research Service (2000) Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2000, to the Secretary of Health and Human Services and the Secretary of Agriculture.

13. Tippett, K. S., & Cypel, Y. S., eds. (1998) Design and Operation:The Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey, 1994–96. NRS Report no 96-1. U.S. Department of Agriculture, Agricultural Research Service.

14. U.S. Department of Agriculture, Agriculture Research Service, Beltsville Human Nutrition Research Center, Food Surveys Research Group (1996) 1989–91 Continuing Survey of Food Intakes by Individuals and Diet and Health Knowledge Survey. CD-ROM. National Technical Information Service accession number PB96–501747. U.S. Department of Agriculture, Riverdale, MD.

15. U.S. Department of Agriculture, Agriculture Research Service. Beltsville Human Nutrition Research Center, Food Surveys Research Group (2000) 1994–96 and 1998 Continuing Survey of Food Intakes by Individuals and Diet and Health Knowledge Survey. CD-ROM. National Technical Information Service accession number PB2000–500027. U.S. Department of Agriculture, Riverdale, MD.

16. Cleveland L. E., Moshfegh A., Albertson A., Goldman J. Dietary intake of whole grains. J. Am. Coll. Nutr. 2000;19:331S-338S[Abstract/Free Full Text]

17. Cleveland L. E., Cook D. A., Krebs-Smith S. M., Friday J. A method for assessing food intakes in terms of food guidance based servings. Am. J. Clin. Nutr. 1997;65(suppl):1245S-1263S

18. Black A. E., Goldberg G. R., Jebb S. A., Livingstone M.B.E., Cole T. J., Prentice A. M. Critical evaluation of energy intake data using fundamental principles of energy physiology. Eur. J. Clin. Nutr. 1991;45:583-599[Medline]

19. Bingham S. A. The use of 24-h urine samples and energy expenditure to validate dietary assessments. Am. J. Clin. Nutr. 1994;59(suppl.):227S-231S[Abstract/Free Full Text]

20. Johnson R. K., Goran M. I., Poehlman E. T. Correlates of over and underreporting of energy intake in healthy older men and women. Am. J. Clin. Nutr. 1994;59:1286-1290[Abstract/Free Full Text]

21. Briefel R. R., McDowel M. A., Alaimo K., Caughman C. R., Bischof A. L., Carroll M. D., Johnson C. L. Total energy intake of the U.S. population: the third National Health and Nutrition Examination Survey 1988–91. Am. J. Clin. Nutr. 1995;62(suppl.):1072S-1080S[Abstract/Free Full Text]

22. Briefiel R. R., Sempos C. T., McDowell M. A., Chien S.C.-, Y. & Alaimo K. Dietary methods research in the third National Health and Nutrition Examination Survey: underreporting of energy intake. Am. J. Clin. Nutr. 1997;65(suppl.):1203S-1209S[Abstract/Free Full Text]

23. Kiesges R. C., Eck L. H., and Ray L. W. Who underreports dietary intake in a dietary recall?. Evidence from the Second National Health and Nutrition Examination Survey. J. Consult. Clin. Psychol. 1995;63:438-444

24. Riddick H Assessment of energy intakes in the U.S. population, 1989–91. Fam. Econ. Nutr. Rev. 1996;94:21-32

25. Krebs-Smith S .M., Graubard B. I., Kahle L. L., Subar A. F., Cleveland L. E., Ballard-Barbash R. Low energy reporters vs others: a comparison of reported food intakes. Eur. J. Clin. Nutr. 2000;54:281-287[Medline]

26. Krebs-Smith S. M. Choose beverages and foods to moderate your intake of sugars: measurement requires quantification. J. Nutr. 2001;131:527S-535S[Abstract/Free Full Text]

27. Federation of American Societies for Experimental Biology, Life Sciences Research Office. Prepared for the Interagency Board for Nutrition Monitoring and Related Research (1995) Third Report on Nutrition Monitoring in the United States: Volume 1. U.S. Government Printing Office, Washington, DC, 365 pp.

28. Putnam, J. J. & Allshouse, J. (1999). Food Consumption, Prices, and Expenditures, 1970-97. U.S. Department of Agriculture, Economic Research Service, SB-965.

29. U.S. Department of Commerce, U.S. Census Bureau (1999) 1997 Economic Census, Manufacturing Industry Series, Flour Milling, EC97M-3112A.

30. Kantor, L. S. (1998) A Dietary Assessment of the U.S. Food Supply:Comparing Per Capita Food Consumption with Food Guide Pyramid Serving Recommendations, U.S. Department of Agriculture, Economic Research Service, AER-772.

31. Gerrior, S. & Bente, L. (1997) Nutrient Content of the U.S. Food Supply, 1909–94. U.S. Department of Agriculture, Center for Nutrition Policy and Promotion, Home Economics Research Report 53.

32. Kantor L. S., Lipton K., Manchester A., Oliveira V. Estimating and addressing America’s food loss. Food Rev 1997;20:1-12

33. Putnam J. U.S. food supply providing more food and calories. Food Rev 1999;22:2-12

34. Putnam, J. J. & Allshouse, J. (2001) Food Consumption, Prices, and Expenditures, 1970–99, U.S. Department of Agriculture, Economic Research Service (in press).

35. Information Resources, Inc. (2000) InfoScan. Scanner-based tracking data, 1995–1999.

36. National Center for Nutrition and Dietetics (1994) Nutrition Fact Sheet, Whole-Grain Goodness 3 Are Key. J. Am. Diet. Assoc. 94, inside back page.

37. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion (2001) Healthy People 2010: Objectives for Improving Health. U.S. Government Printing Office, Washington, DC (in press).

38. U.S. Department of Health and Human Services, Public Health Service. Office of Disease Prevention and Health Promotion (2001) Tracking Healthy People 2010. U.S. Government Printing Office, Washington, DC (in press).

39. Slavin J, Marquart L., Jacobs D., Jr Consumption of whole-grain foods and decreased risk of cancer: proposed mechanisms. Cereal Foods World 2000;45:54-58

40. Liebman, B. (1997) The Whole Grain Guide. Nutrition Action Health Letter. Center for Science in the Public Interest. March 1–11, Washington, DC.

41. Lin, B.-H., Guthrie, J. & Frazao, E. (1999) Away-From-Home Foods Increasingly Important to Quality of American Diet. U.S. Department of Agriculture, Economic Research Service, AIB-749.

42. U.S. Food and Drug Administration (1999) Whole-Grain Foods Authoritative Statement Claim Notification. Docket 99P-2209, Washington, DC.

43. Moshfegh, A. J., Cleveland, L. E., Goldman, J. D., & LaComb, R. R. (2001) Grain intakes in the United States. Nutr. Today (in press).

44. U.S. Department of Agriculture, Agriculture Research Service, Food Surveys Research Group [Online.]. <http://www.barc.usda.gov/bhnrc/foodsurvey/Products9496.htm#anchor164107.

45. Lin, B.-H., Guthrie, J. & Frazao, E. (1998) Popularity of dining out presents barrier to dietary improvements. Food Rev. May-Aug: 3–10.

46. Lin B.-H., Guthrie J., Frazao E. Quality of children’s diets at and away from home: 1994–96. Food Rev. Jan-Apr 1999;:2-10

47. Gerrior, S. & Bente, L. (2001) Nutrient Content of the U.S. Food Supply, 1909–1999. U.S. Department of Agriculture, Center for Nutrition Policy and Promotion (in press).

48. Guthrie J. F., Fulton L. H. Relationship of knowledge of food group servings recommendations to food group consumption. Fam. Econ. Nutr. Rev. 1995;8:2-17

49. Guthrie J. F., Derby B. Changes in consumers’ knowledge of food guide recommendations, 1990–91 versus 1994–95. Fam. Econ. Nutr. Rev. 1998;11:42-48

50. Frazao, E., Allshouse, J.(1996) Size and Growth of the Nutritionally Improved Foods Market. U.S. Department of Agriculture, Economic Research Service. AIB-723.

51. Adams J. F., Engstrom A. Dietary intake of whole grain vs. recommendations. Cereal Foods World 2000;45:75-78

52. McNamara P. E., Ranney C. K., Kantor L. S., Krebs-Smith S. M. The gap between food intakes and the pyramid recommendations: measurement and food system ramifications. Food Policy 1999;24:117-133

53. Young, C. E. & Kantor, L. S. (1999) Moving Toward the Food Guide Pyramid:Implications for U.S. Agriculture, Economic Research Service, U.S. Department of Agriculture, AER-779.

54. Kaufman, P. K., MacDonald, J. M., Lutz, S. M., Smallwood, D. M. (1997) Do the Poor Pay More for Food? Item Selection and Price Differences Affect Low-Income Household Food Costs. U.S. Department of Agriculture, Economic Research Service, AER-759.

55. Kaufman P. K. Rural poor have less access to supermarkets, large grocery stores. Rural Dev. Perspect. 1999;13:19-25

56. Mantovani, R. E., Daft, L., Macaluso, T., Welsh, J. & Hoffman. K. (1997) Authorized Food Retailer Characteristics Study: Technical Report IV (Authorized Food Retailers’ Characteristics and Access Study). U.S. Department of Agriculture, Food and Consumer Service, Office of Analysis and Evaluation.

This article has been cited by other articles:

				D. L. Paineau, F. Beaufils, A. Boulier, D.-A. Cassuto, J. Chwalow, P. Combris, C. Couet, B. Jouret, L. Lafay, M. Laville, et al. Family Dietary Coaching to Improve Nutritional Intakes and Body Weight Control: A Randomized Controlled Trial Arch Pediatr Adolesc Med, January 1, 2008; 162(1): 34 - 43. [Abstract] [Full Text] [PDF]

				V. S Malik and F. B Hu Dietary prevention of atherosclerosis: go with whole grains Am. J. Clinical Nutrition, June 1, 2007; 85(6): 1444 - 1445. [Full Text] [PDF]

				A.-M. Linko-Parvinen, R. Landberg, M. J. Tikkanen, H. Adlercreutz, and J. L. Penalvo Alkylresorcinols from Whole-Grain Wheat and Rye Are Transported in Human Plasma Lipoproteins J. Nutr., May 1, 2007; 137(5): 1137 - 1142. [Abstract] [Full Text] [PDF]

				M. K Jensen, P. Koh-Banerjee, M. Franz, L. Sampson, M. Gronbaek, and E. B Rimm Whole grains, bran, and germ in relation to homocysteine and markers of glycemic control, lipids, and inflammation 1 Am. J. Clinical Nutrition, February 1, 2006; 83(2): 275 - 283. [Abstract] [Full Text] [PDF]

				P. Koh-Banerjee, M. Franz, L. Sampson, S. Liu, D. R Jacobs Jr, D. Spiegelman, W. Willett, and E. Rimm Changes in whole-grain, bran, and cereal fiber consumption in relation to 8-y weight gain among men Am. J. Clinical Nutrition, November 1, 2004; 80(5): 1237 - 1245. [Abstract] [Full Text] [PDF]

				A. D Liese, A. K Roach, K. C Sparks, L. Marquart, R. B D'Agostino Jr, and E. J Mayer-Davis Whole-grain intake and insulin sensitivity: the Insulin Resistance Atherosclerosis Study Am. J. Clinical Nutrition, November 1, 2003; 78(5): 965 - 971. [Abstract] [Full Text] [PDF]

				A. B. Ross, A. Kamal-Eldin, E. A. Lundin, J.-X. Zhang, G. Hallmans, and P. Aman Cereal Alkylresorcinols Are Absorbed by Humans J. Nutr., July 1, 2003; 133(7): 2222 - 2224. [Abstract] [Full Text] [PDF]

				J. M. Jones, M. Reicks, J. Adams, G. Fulcher, G. Weaver, M. Kanter, and L. Marquart The Importance of Promoting a Whole Grain Foods Message J. Am. Coll. Nutr., August 1, 2002; 21(4): 293 - 297. [Abstract] [Full Text] [PDF]

This Article Abstract Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kantor, L. S. Articles by Lin, B.-H. Search for Related Content PubMed PubMed Citation Articles by Kantor, L. S. Articles by Lin, B.-H.