WASHINGTON - Flour-based foods such as bread, cereal and pasta are the source of roughly half of iron consumption in the US, and proposed changes to the Dietary Guidelines for Americans (DGA) for 2025-2030 may reduce adequate intake of this important nutrient, according to the grain chain.
Providing an additional perspective on potential health impacts from potential changes to the DGA's grain-based food recommendations, the Grain Chain proposed that staple grains could help address nutrient intake deficiencies and promote health equity , according to members of the Grain Chain.
The November 20 letter to Subcommittee 3 of the Dietary Guidelines Advisory Committee (DGAC) addresses the work of the DGAC Food Pattern Modeling & Data Analysis, addressing their discussion of basic carbohydrates. It follows a letter to the committee submitted by the Grain Foods Foundation on November 15.
Several key points raised during the September 11-12 subcommittee meeting speak directly to the health benefits of eating grains, according to the Grain Chain. Of particular interest to the subcommittee, for example, is the prevalence of diet-related chronic health conditions such as obesity, coronary heart disease, diabetes and colorectal cancer - "all conditions for which grain consumption has been found to reduce the risk," de Grain said Ketting.
The group cited a recent multinational cohort study published in The Lancet which concluded that the consumption of foods such as bread and cereals, sometimes characterized as 'ultra-processed', should not be associated with the risk of cancer or cardiometabolic diseases, adding that the products should be recommended for consumption.
The DGAC subcommittee focuses on the prevalence of nutrient deficiencies in typical American diets, a problem exacerbated by deficiencies in grain consumption, Grain Chain members said. The letter cited that the grain food category is a major contributor of dietary fiber, folic acid, iron and magnesium, "showing how grains help offset nutrient deficiencies."
Yet a majority of Americans do not meet the DGA recommendations for grain intake, especially for whole grains, despite grains being "core elements" of previous editions of the DGA, as well as the 2020-2025 guidelines, according to the Grain Chain.
The Grain Chain's comments also focused on elements raised in the GFF letter. Common concerns between the two groups in their comments included the risk that replacing whole and/or fortified grains with starchy vegetables and legumes could lead to nutrient deficiencies.
The Grain Chain stated that "Americans do not consume enough fiber, and only 6% of people age 1 year and older meet recommended levels of dietary fiber intake," noting that nearly 40% of dietary fiber is consumed through fortified cereals.
Both groups place particular emphasis on the risks to pregnant women and their babies of dietary changes that would reduce intake of essential nutrients such as iron and folic acid.
The Grain Chain letter states that about half of iron consumption in the U.S. comes from bread, cereal, pasta and other foods made with enriched and whole wheat flours, and that these foods "critically supply folic acid."
The Grain Chain said that "the fortification of folic acid in certain grain products has contributed to the significant reduction of neural tube defects.
"Additionally, iron deficiency anemia during pregnancy is associated with having a low birth weight infant and postpartum depression, and severe iron deficiency during pregnancy may increase the risk of preterm birth (delivery before 37 weeks of gestation)," the letter said. "Hispanic mothers are still at the highest risk of having a baby with an NTD (neural tube birth defect). Compared to 31% of non-Hispanic white women, only 13% of Hispanic women consumed folic acid. Additionally, research shows that those who follow a low-carb diet are 30% more likely to have a child with anencephaly or spina bifida.
"While the DGAC examines every scientific question with a health equity lens, it is important to consider how NTDs affect specific racial and ethnic groups and how dietary guidelines, including recommendations to consume fortified grains, can address nutrient deficiencies among certain populations."
The Grain Chain finds it encouraging that the DGAC is focusing on establishing a definition for enrichment. Members emphasized "the importance of having a definition to ensure Americans get the nutrients they need."
Despite the benefits of fortified grain consumption, grain foods are still incorrectly "considered 'ultra-processed' by some classification systems," according to members of the Grain Chain. uniquely positioned to do.
"The DGAC should consider how the grain food group not only contributes to a nutritious diet and nutrient adequacy, but also how to encourage the consumption of more grain foods, including foods that are fortified, not less, to improve health and nutrition to improve," they said.
The DGAC should also be aware of the implications of their recommendations for low-income families, the Grain Chain said, citing recent USDA data that estimates 44.2 million people in the United States are facing hunger.
"Additionally, 13.4 million children lived in food insecure households, an increase of 44.6% from 2021," the letter said. "Food insecurity was also higher for female-headed single-parent households, as well as for Black and Hispanic households. These statistics are a sobering reminder that all Americans should have access to affordable, nutritious food options, like grains. Grain foods are affordable, versatile and accessible, making them an ideal, nutritious choice for all Americans."
Groups that signed the letter included the American Bakers Association, AIB International, the Cereals and Grains Association, the Independent Bakers Association, the National Association of Wheat Growers, the National Pasta Association, the North American Millers' Association, the Retail Bakers of America, the USA Rice Federation and the Wheat Foods Council.
Flour-based foods such as bread are responsible for approximately 50% of dietary iron intake in the United States