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Validation of a short food frequency questionnaire to assess consumption of cereal foods, fruit and vegetables in Chinese Singaporeans.

OBJECTIVE: To assess the ability of a 16-item food frequency questionnaire (FFQ) to measure consumption of cereal foods, fruit and vegetables in Chinese Singaporeans. DESIGN: Subjects completed the questionnaire twice, at the beginning and end of a six-week period during which they also provided three 24 h diet recalls. Estimates of intake from the questionnaire were compared with those from diet recalls. SUBJECTS: Subjects were recruited from a range of occupational groups through random sampling across divisions in the headquarters of the Singapore Ministry of Health. Of the 81 subjects initially recruited, three failed to complete the diet recalls, one was excluded due to changes in diet, and seven did not return the second questionnaire. RESULTS: Mean difference in food group consumption estimated by the two methods did not differ significantly from zero for fruit (0.00 serving, s.d.=0.54, 95% CI= -0.13, +0.12, P=0.95) or vegetables (-0.05, s.d.=0.29, 95% CI= -0.12, +0.02, P=0.13). For cereal foods, the mean difference was small, but significantly different from zero only in women (-0.32 servings, s.d. = 0.92, 95% CI = -0.59, -0.06, P=0.02). At an individual level, cereal food intake as measured by the FFQ may be 37% below or 59% above the diet recall values; and values for total fruit and vegetables may be half or double the recall values. Among subjects whose intake was classified into the lowest quartiles by diet recalls, 78% and 94% respectively, fell into the lowest two questionnaire quartiles for cereal foods, and total fruit and vegetables. The ability of the questionnaire to predict those having inadequate intake based on recall data was more than 90% for the three food groups. CONCLUSION: The short questionnaire cannot replace the three-day recalls in intake assessment for individuals, but it could be used to screen for low consumers in intervention programmes, to assess mean food group intake in population groups, and to rank individuals into broad categories of food group intake.

Adult↗

Effect of consumption of a ready-to-eat breakfast cereal containing inulin on the intestinal milieu and blood lipids in healthy male volunteers.

OBJECTIVE: To investigate the effect of a breakfast cereal containing inulin on blood lipids and colonic ecosystem in normolipidemic young men. SETTING: Department of Food Science and Microbiology,University of Milan, Italy. SUBJECTS: Twelve healthy male volunteers, age 23.3 +/- 0.5 y, body mass index (BMI) 25.7 +/- 1.2 kg/m2 (mean +/- s.e.m.). INTERVENTIONS: Subjects consumed daily, for three periods of four weeks, 50 g of a rice-based ready-to-eat cereal (placebo) and the same cereal containing 18% inulin (test) in substitution of their habitual breakfast, then returned to the habitual diet (wash-out). They followed no other dietary restrictions. RESULTS: No changes in body weight, dietary habits, faecal and bile acid output, faecal short-chain fatty acid (SCFA) and faecal pH, were observed at the end of each period, whereas plasma total cholesterol and triacylglycerols significantly decreased at the end of test period by 7.9 +/- 5.4 (P < 0.05) and 21.2 +/- 7.8% (P < 0.005) respectively. Meal glucose tolerance test (MTT) resulted in the same incremental area under the curve for both cereals (IAUC test 124 +/- 35; placebo 118 +/- 33 mmol x min/l, ns). Inulin markedly enhanced breath H2 excretion (IAUC test 280 +/- 40; placebo 78 +/- 26 ppm x h, P < 0.005), as well as faecal concentration of L-lactate. Total facultative anaerobes significantly decreased after test, and bifidobacteria increased after correction for total anaerobes (P < 0.05). Changes in blood lipids were negatively correlated with bifidobacteria counts and positively with secondary bile acid excretion (P < 0.05). CONCLUSIONS: Inulin seems to have a lipid lowering potential in normolipidemic men possibly mediated by mechanisms related to colonic fermentation.

Adult↗

Cholesterol-lowering effects of plant sterol esters differ in milk, yoghurt, bread and cereal.

OBJECTIVE: To measure the relative effects of each of four phytosterol ester-enriched low-fat foods (bread, breakfast cereal, milk and yoghurt) on serum lipids, plasma phytosterols and carotenoids. DESIGN: : Three research centres undertook a randomised, incomplete crossover, single-blind study consisting of four treatment periods of 3 weeks each, one of which was a control period. Each sterol-enriched test food provided 1.6 g/day of phytosterols as sterol esters. SETTING: General Community. SUBJECTS: In all 58, free-living men and women with mean age (s.d.) 54 (8) y, moderately elevated plasma total cholesterol 6.2 (0.7) mmol/l and body mass index 26.2 (3.0) kg/m(2). MAIN OUTCOME MEASURES: Serum lipids, plasma phytosterols and carotenoids. RESULTS: Serum total and LDL cholesterol levels were significantly lowered by consumption of phytosterol-enriched foods: milk (8.7 and 15.9%) and yoghurt (5.6 and 8.6%). Serum LDL cholesterol levels fell significantly by 6.5% with bread and 5.4% with cereal. They were both significantly less efficacious than sterol-enriched milk (P<0.001). Plasma sitosterol increased by 17-23% and campesterol by 48-52% with phytosterol-enriched milk and bread. Lipid-adjusted beta-carotene was lowered by 5-10% by sterols in bread and milk, respectively. CONCLUSIONS: This is the first study to demonstrate that cholesterol-lowering effects of plant sterol esters may differ according to the food matrix. Plant sterols in low-fat milk was almost three times more effective than in bread and cereal. Despite phytosterol-enriched cereal products resulting in lower serum cholesterol reductions compared to sterol-enriched milk, the detection of similar changes in plasma phytosterols demonstrated that such products still delivered and released phytosterols to the gut.

Adult↗

Changes in thiamin intake and blood levels in young, overweight/obese women following hypocaloric diets based on the increased relative consumption of cereals or vegetables.

OBJECTIVE: To analyse the changes in thiamin intake and blood levels of young, overweight/obese women following slightly hypocaloric diets based on the increased relative consumption of foods whose intakes were most removed from the ideal: cereals and vegetables. DESIGN: The women were randomly assigned to one of two slightly hypocaloric diets: diet V, in which the consumption of vegetables was increased, or diet C, in which the consumption of cereals (especially breakfast cereals) was increased. SUBJECTS: The study subjects were 67 young women with a body mass index of 24-35 kg/m2. INTERVENTIONS: Dietetic, anthropometrics and biochemical data were collected at the start of the study and again at 2 and 6 weeks. RESULTS: The reduction in energy intake was similar in both groups. However, diet C subjects lost significantly more weight. Blood thiamin concentration was higher in group C women than in group V women at 2 and 6 weeks. Compared to initial values, group C subjects showed a higher blood thiamin level at 2 weeks. The highest blood thiamin levels seen in group C women may have been due to their greater thiamin intake, their higher thiamin dietetic density, and a higher thiamin/carbohydrates ratio at both week 2 and 6 of the intervention period. CONCLUSIONS: Increasing the relative consumption of breakfast cereals within the context of a slightly hypocaloric diet can help in weight control and improve thiamine intake and blood levels.

Adult↗

Inverse association between intake of cereal fiber and risk of gastric cardia cancer.

BACKGROUND & AIMS: Recent data show that salivary nitrites form carcinogenic nitrosamines, especially at the gastric cardia. Wheat fiber has been shown to neutralize such mutagen formation. Our aim was to evaluate the association between dietary fiber and cancers of the esophageal and gastric cardia. METHODS: We examined data from a large-scale population-based case-control study of risk factors for adenocarcinoma of the gastric cardia and esophagus and squamous cell carcinoma of the esophagus. RESULTS: We found a strong dose-dependent inverse association between total dietary fiber intake and risk of gastric cardia adenocarcinoma, which was driven mainly by intake of cereal fiber. The odds ratio among individuals in the highest quartile of cereal fiber intake compared with the lowest was 0.3 (95% confidence interval, 0.2-0.5; P trend < 0.0001). High intake of cereal fiber was also associated with a moderately decreased risk of esophageal adenocarcinoma, but no linear dose-risk trend was observed. There was no association between dietary fiber and esophageal squamous cell carcinoma. CONCLUSIONS: High intake of cereal fiber may significantly lower the risk of gastric cardia cancer.

Adenocarcinoma↗

Effect of soy-based breakfast cereal on blood lipids and oxidized low-density lipoprotein.

Consumption of soy protein may reduce the risk of cardiovascular disease both through reduction in serum lipids and by the antioxidant properties of protein-associated soy isoflavones. However, the effect that processing required for the manufacture of breakfast cereals may have on the lipid lowering and antioxidant activities of soy has not been studied. We have therefore assessed the health benefits of soy incorporation into breakfast cereals. Twenty-five hyperlipidemic men and women took soy (providing 36 g/d soy protein and 168 mg/d isoflavones) and control breakfast cereals, each for 3 weeks in a randomized crossover study with a 2-week washout period between treatments. Fasting blood samples were obtained pretreatment and at weeks 2 and 3 of each treatment. No significant difference was seen in serum lipids between treatments at week 3 apart from a 3.8% +/- 1.5% higher apolipoprotein A-1 level on control versus soy (P = .021). However, oxidized low-density lipoprotein (LDL) was reduced on the test compared with the control both as total dienes in LDL and as the ratio of conjugated dienes to cholesterol in the LDL fraction by 9.2% +/- 4.3% (P = .042) and 8.7% +/- 4.2% (P = .050), respectively. High isoflavone intakes in soy breakfast cereals may decrease the risk of cardiovascular disease by reducing oxidized LDL, while having no significant effect on the absolute concentration of LDL cholesterol.

Adult↗

Glycaemic index of cereal products explained by their content of rapidly and slowly available glucose.

Elucidating the role of carbohydrate quality in human nutrition requires a greater understanding of how the physico-chemical characteristics of foods relate to their physiological properties. It was hypothesised that rapidly available glucose (RAG) and slowly available glucose (SAG), in vitro measures describing the rate of glucose release from foods, are the main determinants of glycaemic index (GI) and insulinaemic index (II) for cereal products. Twenty-three products (five breakfast cereals, six bakery products and crackers, and twelve biscuits) had their GI and II values determined, and were characterised by their fat, protein, starch and sugar contents, with the carbohydrate fraction further divided into total fructose, RAG, SAG and resistant starch. Relationships between these characteristics and GI and II values were investigated by regression analysis. The cereal products had a range of GI (28-93) and II (61-115) values, which were positively correlated (r(2)) 0.22, P<0.001). The biscuit group, which had the highest SAG content (8.6 (SD 3.7) g per portion) due to the presence of ungelatinised starch, was found to have the lowest GI value (51 (SD 14)). There was no significant association between GI and either starch or sugar, while RAG was positively (r(2)) 0.54, P<0.001) and SAG was negatively (r(2)) 0.63, P<0.001) correlated with GI. Fat was correlated with GI (r(2)) 0.52, P<0.001), and combined SAG and fat accounted for 73.1% of the variance in GI, with SAG as the dominant variable. RAG and protein together contributed equally in accounting for 45.0 % of the variance in II. In conclusion, the GI and II values of the cereal products investigated can be explained by the RAG and SAG contents. A high SAG content identifies low-GI foods that are rich in slowly released carbohydrates for which health benefits have been proposed.

Dietary Carbohydrates↗

Trichothecenes, ochratoxin A and zearalenone contamination and fusarium infection in Finnish cereal samples in 1998.

The occurrences and concentrations of trichothecenes, ochratoxin A and zearalenone in Finnish cereal samples are presented in this study. Furthermore, injections by moulds, especially Fusarium contamination of grains in the same samples, are reported. In total 68 cereal samples, including 43 rye, 4 wheat, 15 barley and 6 oats samples, were collected after a cool and very rainy growing season in 1998. A gas chromatograph combined with a mass spectrometric detector was used for determination of seven different trichothecenes. A high performance liquid chromatograph with a fluorescence detector was used for ochratoxin A and zearalenone determination. For the identification of moulds, the grain samples were incubated and the moulds were isolated and identified by microscopy. The analytical methods were validated for mycotoxin analysis and they were found to be adequately reliable and sensitive. Heavy rainfalls in the summer and autumn of 1998 caused abundant Fusarium mould infection in Finnish cereals, particularly in rye. Fusarium avenaceum was the most common Fusarium species found in cereals. However, the mycotoxin concentrations were very low and only deoxynivalenol, nivalenol and HT-2 toxin were detected. Deoxynivalenol was detected in 54 samples in the concentration range 5-111 microg/kg. Nivalenol and HT-2 toxin were detected in three and two samples, respectively, in the concentration range 10-20 microg/kg.

Chromatography, Gas↗

Investigation of the herbicide glyphosate and the plant growth regulators chlormequat and mepiquat in cereals produced in Denmark.

An LC-MS/MS method for analysing glyphosate and aminomethylphosphonic acid (AMPA) in cereals was developed. The method is based on extraction with water and detection of the ions from the fragmentation m/z 170-->88 (glyphosate) and m/z 112-->30 (AMPA), using electrospray interface in the positive mode. Investigation from the harvests of 1998 and 1999 showed residues of glyphosate and/or its degradation product AMPA in more than half of the cereal samples produced in Denmark. The average concentration of glyphosate in 46 samples from the 1999 harvest was 0.11 mg/kg compared with 0.08 mg/kg for the 1998 harvest (n = 49). Thus, the figures were well below the maximum residue limit (MRL) and no violations were observed. The plant growth regulators chlormequat and/or mepiquat were investigated in cereals from the Danish harvest of 1999 where 83% of the samples contained chlormequat (n = 46) compared with 87% of the samples from the 1997 harvest (n = 52). The average concentration of chlormequat in 1999 was 0.32 mg/kg compared with 0.23 mg/kg in 1997. At 2.9 mg/kg, one sample of wheat bran was exceeding the MRL of 2 mg/kg for wheat. The intakes of the pesticides through the diet of cereals were estimated to comprise 0.04% of the acceptable daily intake (ADI) for glyphosate and 1% of the ADI for chlormequat for an adult Dane.

Chlormequat↗

Effect of rice cereal feedings on bone mineralization and calcium homeostasis in cow milk formula fed infants.

OBJECTIVE: We conducted a prospective randomized, single-blinded clinical trial to test the hypothesis that intake of formula plus cereals between the ages of 16 and 26 weeks postnatally (as compared to formula alone) would lead to lower bone mineral content (BMC), higher parathyroid hormone (PTH) concentration, lower serum calcium (Ca), magnesium (Mg) and osteocalcin (OC); and increased continuous night sleep. METHODS: At 16 weeks postnatally, 41 healthy, term infants were randomized to formula alone or formula and cereal. RESULTS: We found no significant differences in growth or sleep pattern, nor in BMC between groups. Serum PTH concentration was significantly increased in the cereal group at 26 weeks. CONCLUSION: We speculate that the increase in PTH is due to relative Ca deficiency or is responsive to increased phosphate load in the cereal group.

Animals↗

Antioxidant content of whole grain breakfast cereals, fruits and vegetables.

BACKGROUND: Considerable scientific evidence suggests that whole grains, as commonly consumed in the United States and Europe, reduce risk for chronic disease including cancer and heart disease. Whole grains provide a wide range of nutrients and phytochemicals that may work synergistically to optimize human health. Fruits and vegetables provide protection against age related diseases. It is believed their high content of antioxidant compounds is key to such protection. OBJECTIVE: This research compares the antioxidant activity of whole grain, ready-to-eat (RTE) breakfast cereals to that of fruits and vegetables. METHOD: Antioxidant activity was determined by dispersing finely ground samples in a 50% aqueous methanol solution of the stable free radical 2,2-diphenyl-1-picrylhydrazyl (DPPH). DPPH, which forms a deep purple solution, reacts with antioxidants and color loss at 515 nm correlates to antioxidant content, which is expressed as Trolox equivalents/100 grams (TE). RESULTS: Whole grain breakfast cereals analyzed in this study contained from 2,200-3,500 TE. By comparison, fruits generally ranged from 600-1,700 TE, with a high of 2,200 TE for red plums. Berries averaged 3,700 TE and. vegetables averaged 450 TE with a high of 1,400 TE for red cabbage. A 41 gram average serving of RTE breakfast cereal provides 1,120 TE, while an average 85 gram serving of vegetables or fruits provides 380 and 1,020 TE, respectively. CONCLUSION: Whole grain breakfast cereals, fruits and vegetables are all important dietary sources of antioxidants.

Antioxidants↗

Effects of a cereal rich in soluble fiber on body composition and dietary compliance during consumption of a hypocaloric diet.

OBJECTIVES: To investigate the effects of oats, a cereal rich in soluble fiber, on body composition changes and dietary compliance during consumption of a weight loss diet. METHODS: Subjects were 41 healthy men and women aged 18 to 78 years. Weight maintenance energy requirements were established over two weeks during consumption of a control diet with low soluble fiber content. Subjects then consumed a hypocaloric diet for six weeks, either consuming a low soluble fiber control diet or a diet containing 45 g/1000 kcal rolled oats, a whole grain cereal rich in soluble fiber (mean energy deficit -895+/-18 kcal/day relative to weight maintenance energy requirements). Changes in body fat and fat-free mass were determined by underwater weighing, and dietary compliance was assessed using the urinary osmolar excretion rate technique. In a final phase of the study, subjects ate ad libitum for six months, and changes in body weight and composition were monitored. RESULTS: There was no significant effect of the oat-containing diet on body weight or composition changes during the hypocaloric regimen or in the subsequent ad libitum period. In addition, fecal energy excretion was not significantly different between groups. However, there were non-significant trends indicating reduced hunger in the oat group compared to controls (frequency of hunger 2.5+/-0.5 vs. 3.6+/-0.4, P=0.1). In addition, fewer oat subjects were non-compliant (four versus seven subjects dropped out or had urinary osmolar excretions greater than 130% of values predicted from dietary intake), but again the difference was not significant. CONCLUSIONS: These results suggest that use of a cereal rich in soluble fiber in a closely monitored hypocaloric feeding regimen does not improve weight loss or dietary compliance. Further studies are needed to examine the possibility that cereals containing soluble fiber may have effects on hunger and dietary compliance that could be important in less tightly controlled protocols than the one described here.

Adult↗

Extraction of cereal prolamins and their toxicity in coeliac disease.

Simple extraction of prolamins from cereal flour using 70% aqueous ethanol leads to co-extraction of lipids and other secondary products. Treatment of the crude extract with an excess of pure ethanol resulted in the removal of the majority of these compounds. Prolamin extracts obtained following ethanol precipitation showed little difference to products of more complex, multi stage, selective extractions, when compared using MALDI-TOF mass spectrometry. Toxicity tests on enzymic digests of ethanol-precipitated prolamins from coeliac-toxic cereals, coeliac-non-toxic cereals and oats were carried out using a rat liver lysosome assay. The prolamins from the ethanol-precipitated extracts showed greater activity than those extracted using only 70% ethanol for extraction. As the ethanol precipitation method is simple and provides a prolamin extract of sufficient purity for further evaluation, this procedure has been adopted as an alternative to more tedious procedures for preparation of cereal prolamins.

Animals↗

Growth, hemoglobin, cholesterol, and blood pressure observed in rats fed common breakfast cereals.

Most of the common breakfast cereals tested were unable to support growth or promote health in young rats that consumed these products as their only food. An anemia, accompanied by fatty liver and large concentrations of iron stored in the liver, was observed with cereals having the lowest protein content. Some cereals produced a marked elevation of systolic blood pressure at certain times. Low cholesterol levels were invariably associated with fatty livers, whereas high cholesterol levels seemed to be associated with hypertension at the 45-day period. When only the ready-to-eat cereals were considered, there was a positive correlation between the dietary zinc/copper ratio and the plasma cholesterol concentration.

Animals↗

Studies on the solubility of Ca, Mg, Zn, and Cu in cereal products.

In vitro studies were carried out on a range of cereal products of differing phytate content in order to examine the likely release and fate of the Ca, Mg, Cu, and Zn present in cereals on passing through the stomach and small intestine. The Ca, Mg, Cu, and Zn was released by extraction with HCl (pH = 1) for 0.5 h. The addition of HCO-3 to pH 7 caused varying levels of precipitation ranging from 100% for Zn in high phytate cereals to 0% for Ca and Mg in low phytate cereals. Extracted Cu was not precipitated. The addition of the organic ligands EDTA and citric acid prevented precipitation and it is postulated that naturally occurring soluble ligands are an important controlling factor in determining the bioavailability of essential minerals.

Biological Availability↗

Iron fortification of infant cereals: a proposal for the use of ferrous fumarate or ferrous succinate.

Hemoglobin-repletion tests in rats, organoleptic studies, and iron-absorption studies in humans were used to search for Fe sources with high bioavailability that could be added to infant cereals as alternatives to the Fe compounds currently used for fortification. From rat and organoleptic studies on 11 alternative Fe sources, ferrous fumarate, ferrous succinate, and ferric saccharate were selected as the most suitable for infant-cereal fortification and, by use of radioactive labels, absorption of those compounds from fortified cereal was measured in adult human volunteers. There was no difference in absorption between ferrous fumarate and ferrous sulfate whereas the values for ferrous succinate, ferrous saccharate (10% Fe), and ferric pyrophosphate were 92%, 74%, and 39% of the ferrous sulfate values, respectively. We conclude that ferrous fumarate and ferrous succinate are highly available Fe sources in man that can be used to fortify infant cereals without causing fat oxidation or discoloration.

Absorption↗

Measurement of zinc bioavailability from beef and a ready-to-eat high-fiber breakfast cereal in humans: application of a whole-gut lavage technique.

We measured zinc absorption in humans from two different foods, using a whole-gut lavage technique. Healthy adults (n = 8) were given test foods containing approximately 4 mg (61.2 mumol) Zn as either beef or a high-fiber, ready-to-eat breakfast cereal. Basal zinc loss in the gut was measured after giving only 200 mL water alone after an overnight fast. Mean polyethylene glycol (PEG) recovery, a nonabsorbable fecal marker, was 95 +/- 2% (mean +/- SE). There was no significant difference of PEG recoveries with the various treatments. True absorption of zinc was 11.0 +/- 5.4 mumol (716.3 +/- 355.9 micrograms) for breakfast cereal and 34.8 +/- 3.5 mumol (2274.1 +/- 230.2 micrograms) for beef. Fractional zinc absorption was significantly lower for breakfast cereal compared with beef, 14.7 +/- 6.7% vs 55.1 +/- 4.6%, respectively. Our findings demonstrate that zinc absorption can be measured in humans from single foods containing a physiological dose of zinc by using the whole-gut lavage absorption technique and that zinc bioavailability from beef is about fourfold greater than from a high-fiber breakfast cereal.

Adult↗

Lipid profiles after the daily consumption of an oat-based cereal: a controlled crossover trial.

Water-soluble fiber has been reported to reduce serum cholesterol and consequently, oat bran, which has a high soluble-fiber content, has been recommended as part of a lipid-lowering diet. However, a recent small study of 20 volunteers with low mean serum cholesterol concentrations (4.8 mmol/L) demonstrated no lipid-lowering effect of oat bran. The present study investigated 64 volunteers with cholesterol concentrations much more typical of the UK population (6 mmol/L). Subjects were randomly allocated to receive either a normal-sized helping of an oat-based cereal or a cereal containing no oats for 4 wk and then crossed over to the alternative regimen for a further 4 wk. Small (2.23% and 4.55%) but significant (P < 0.04 and P < 0.05) reductions in total and low-density-lipoprotein cholesterol, respectively, were observed in association with the consumption of oat-based cereal. These data support the view that consumption of oat-based cereals may well contribute usefully to a lipid-lowering diet.

Cholesterol, HDL↗