In recent years, dietitians and public health advocates have focused their attention on raising awareness of the health consequences of consuming too many sugar-sweetened beverages (SSBs) including soda, energy drinks, coffee beverages and juice. The attention is deserved, as these products are essentially liquid sugar and contribute more added sugar to our diets than any other food category. However, an examination of data on overall dietary intake reveals that SSBs are not the top food consumed each day by Americans.
The No. 1 source of daily calories in the diet is not soda, but rather grain-based desserts. Birthday and holiday treats have now taken precedent as everyday food items. Our second largest source of calories is from yeast bread, commonly consisting of refined white wheat flour. According to nutrition writer Kevin Klatt, "only .9 ounces of the estimated 7.5 ounces [of grain] consumed per day are whole grains -- not even close to the modest recommendation of consuming at least 3 ounces of whole grains per day." Aside from dessert and bread, we eat a variety of foods heavy in refined grains, such as pizza, tortillas and pasta.
Public health advocates could argue that our low consumption of whole grains is worse than our low consumption of fruits and vegetables. The gold standard dietary survey, National Health and Nutrition Examination Survey (NHANES), which examines dietary intake across the country, demonstrates that Americans consume 59 percent of the recommended amount of vegetables and 42 percent of fruits. In contrast, we consume only 15 percent of the recommended amount of whole grains. Currently, we are over-consuming refined grains by eating 100 percent more than our recommended limit.
The standard American diet, which delivers approximately 50 percent of calories from refined grains has been demonstrated to negatively affect health in the following ways: less satiety after meals; increased inflammation; increase risk of Type 2 diabetes; and increase in triglycerides after consumption. Although refined grains have been shown to be detrimental, they are often overlooked in nutrition education materials and policy decisions.
One important reason for our high consumption of refined carbohydrates is convenience; most prepared food items, such as frozen lasagna, pizza or boxed macaroni and cheese, contain them. These products have the characteristics consumers look for in a food product: convenience, affordability and shelf stability. Due to income, taste preferences and time restraints, many families depend on these meals as staples.
The problem of consuming too many refined grains can be addressed in part by upgrading to higher quality carbohydrates. Studies have shown that kids are warming up to the taste of whole grains, especially when they are presented in a fun manner. But focusing solely on purchasing whole grains can lead average consumers to misleading, unhealthy choices. Simply searching for the word "whole" as the first ingredient is an acceptable approach to some foods. However, while products like Reese's Puffs cereal, Coco Puffs, and sugary granola bars are technically whole grains, they contain very little fiber and added sugar. Additionally, focusing only on the added sugar content of processed foods could lead consumers to believe that items consisting of highly refined carbohydrates, such as Corn Flakes, are healthy since they do not contain added sugar.
Despite the grim picture painted above, there is reason for hope. Nutritional scientists have begun to define the characteristics a high quality carbohydrate should possess. Dr. Dariush Mozaffarian of Tufts University and Dr. Rebecca Mozaffarian from Harvard School of Public Health have created a four criteria index to define the qualities. A high quality carbohydrate should have high fiber content, be an intact grain (minimally processed), have a low glycemic response (i.e. how much your blood sugar rises after consumption) and be a solid food product.
These researchers recommend the simple method of assessing the grams of carbohydrate to the grams of fiber on the nutrition facts label. They consider a high quality carbohydrate to be a product with a 5:1 carb to fiber ratio. A good product is 10:1 and a poor carbohydrate is anything above 10:1.
For example, one serving of Reese's Puffs cereal has approximately 22 grams of carbohydrates to 1 gram of fiber. So the ratio for this product would be 22:1. A popular item in kids' lunch boxes, Sunbelt Bakery granola bars, have a 19:1 ratio for carbs to fiber.
Comparing these foods to healthier options, one serving of steel cut oats has 29 grams of carbohydrates to 5 grams of fiber, putting it at around 6:1 ratio. KIND Vanilla Almond granola bars have 14 grams of carbohydrates and 5 grams of fiber, a 2.8:1 ratio.
To start improving your health, try to eat around half of your carbohydrates from the high quality category (5:1 or less than 10:1 varieties) and gradually increase the amount over time. Although the guidance is not perfect, it can make shopping for bread, cereals, granola bars and crackers a much easier task.