WASHINGTON — Flour-based foods such as bread, cereals and pasta are the source of roughly half of US iron consumption, and proposed changes the 2025-2030 Dietary Guidelines for Americans (DGA) should not imperil adequate intake of this important nutrient, according to the Grain Chain.
Bringing additional perspective on possible health ramifications from potential changes to grain-based food recommendations in the DGA, the Grain Chain proposed that staple grains could help to remediate nutrient intake shortfalls and promote health equity, according to members of the Grain Chain.
The Nov. 20 letter to the Dietary Guidelines Advisory Committee (DGAC) subcommittee 3 addresses the work of the DGAC Food Pattern Modeling & Data Analysis, homing in on their discussion of staple carbohydrates. It follows a letter to the committee submitted Nov. 15 by the Grain Foods Foundation.
Several key points raised during the subcommittee’s Sept. 11-12 meeting speak directly to the health advantages of eating grains, according to the Grain Chain. For instance, of great concern to the subcommittee is the prevalence of nutrition-related chronic health conditions like obesity, coronary heart disease, diabetes, and colorectal cancer — “all conditions that grain consumption has been found to lower the risk of,” the Grain Chain said.
The group cited a recent multinational cohort study published in The Lancet, which concluded consumption of foods like bread and cereals, sometimes characterized as “ultra-processed,” was not to be associated with the risk of cancer or cardiometabolic diseases, adding that the products should be recommended for consumption.
The DGAC subcommittee is focusing on the prevalence of nutrient deficiencies in typical American diets, a problem exacerbated by shortfalls in grain consumption, members of the Grain Chain said. The letter cited that the grain food category is a leading contributor of dietary fiber, dietary folate, iron and magnesium, “showcasing how grains help in meeting shortfall nutrients.”
Yet a majority of Americans do not meet DGA recommendations for grain intake, particularly for whole grains, despite grains being “core elements” of past editions of the DGA, as well as the 2020-2025 guidelines, noted the Grain Chain.
The Grain Chain comments also focused on elements addressed by the GFF’s letter. Common concerns between the two groups in their comments included the risk that replacing whole and/or enriched grains with starchy vegetables and pulses could result in nutrient shortfalls.
The Grain Chain stated that “Americans are not consuming enough fiber, and only 6% of people aged 1 year and older meet recommended levels of dietary fiber intake,” noting that nearly 40% of dietary fiber is consumed through enriched grains.
Both groups put particular emphasis on risks to pregnant women and their babies of dietary shifts that would reduce intake of vital nutrients like iron and folic acid.
The Grain Chain letter stated that about half of US iron consumption is comprised of bread, cereals, pasta, and other foods made with enriched and whole wheat flour, and that these foods “provide critical folic acid.”
The Grain Chain said that “the fortification of folic acid in certain grain foods has contributed to the significant reduction of neural tube defects.
“Additionally, iron deficiency anemia during pregnancy is associated with having a low-birth-weight baby and postpartum depression, and severe iron deficiency during pregnancy can increase the risk of premature birth (delivery before 37 weeks of pregnancy),” the letter said. “Hispanic mothers continue to be at the highest risk for 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 carbohydrate-restricted diet are 30% more likely to have an infant with anencephaly or spina bifida.
“As the DGAC examines each scientific question with a health equity lens, it is important to consider how NTDs impact specific racial and ethnic groups and how dietary guidance, including the recommendations to consume enriched grains, can address nutrient shortfalls among certain populations.”
The Grain Chain is encouraged that the DGAC is focusing on establishing a definition for fortification. Members stressed “the importance of having a definition to ensuring Americans obtain the necessary nutrients.”
Despite the benefits of fortified grain consumption, grain foods are nonetheless unjustly “deemed ‘ultra-processed’ by some classification systems,” according to members of the Grain Chain, which could interfere with efforts to bridge nutrient gaps, which they suggest grain foods are uniquely positioned to do.
“The DGAC must consider how the grains food group not only contributes to a nutritious dietary pattern and nutrient adequacy, but also how to encourage consumption of more grain foods, including those that have been fortified, not less, to improve health and nutrition,” they said.
The DGAC also should be mindful of the implications of their recommendations on low-income families, the Grain Chain said, citing recent USDA data estimating that 44.2 million people in the United States struggle with hunger.
“In addition, 13.4 million children lived in households that experienced food insecurity, which is up 44.6% from 2021,” the letter said. “Rates of food insecurity were also higher for single-parent households headed by women as well as for Black and Latinx 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 signing the letter were 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 account for about 50% of dietary iron intake in the United States