Horizons #53 – Swapping to whole grain could save Australia billions

08 June, 2021

Guest author: Dr Sara Grafenauer, Accredited Practising Dietitian and Managing Director of the Grains & Legumes Nutrition Council (GLNC).

Australia could make healthcare savings of more than $1.4 billion annually in the prevention of heart disease (CVD) and type 2 diabetes, simply by swapping just three serves a day of refined grain foods to whole grains.

The remarkable health benefits associated with eating more whole grain foods are well-known.

Eating three serves of whole grains daily can reduce the risk of heart disease by 13 per cent and type 2 diabetes by 32 per cent.

What has been less understood – until now – are the enormous potential economic benefits associated with these health outcomes.

GLNC has just released research that shows Australia could make healthcare savings of more than $1.4 billion annually in the prevention of heart disease (CVD) and type 2 diabetes, simply by swapping just three serves a day of refined grain foods to whole grains. (1)

This is the first research to quantify healthcare savings associated with meeting the 48g Daily Target Intake for whole grains in Australia. The new findings were made by investigators from GLNC and an expert from Kuwait University, and were published in the international journal Nutrients.

The researchers calculated the savings in healthcare costs and lost productivity associated with reductions in heart disease and type 2 diabetes from increased consumption of whole grains – both major health issues in Australia.

The calculations utilise data from

  • the Australian Institute of Health and Welfare for the costs of care and the productivity losses; (2)
  • the National Nutrition and Physical Activity Survey (2011-12) for the consumption data; (3) and
  • two meta-analyses which have determined the risk reduction in CVD and Type 2 Diabetes. (4,5)
  • These findings could have substantial implications for policy makers and provide strong evidence for further strengthening messaging regarding whole grains in the national dietary guidelines.

Given we know diets low in whole grain are the second leading dietary risk factor for disease and death in Australia, the outcomes of this study highlight the need for dietary change. This new finding highlights the significant potential impact on disease prevention and endorses the need for greater promotion of whole grains in dietary guidelines and front-of-pack labelling tools, such as the Health Star Rating.

The most recent data shows only 27 per cent of Australians meet the recommended 48g per day Daily Target Intake (DTI). (3)

If 50 per cent were to meet the DTI, Australia could save $734 million annually and more than $1.4 billion could be saved if all Australians could reach this target.

The published paper provides further details on the discounted cost savings over the next 20 years – as $1 spent today is worth less in the future, providing even greater impetus to act sooner than later.

As in other parts of the world, Australians fall short of many of the suggested dietary targets included in national dietary guidelines. However, three whole grain servings can be easily achieved by swapping grain foods, rather than adding to the energy density of the diet.

The good news is many Australians are already halfway there in meeting their whole grain daily target of 48 grams, or three serves of 16 grams each.

By focusing on whole grain breakfast cereals and wholemeal bread – the two largest sources of whole grain for Australians – target levels for whole grains could be achieved with minimal change to regular eating habits. A simple swap to a whole grain option could have a powerful impact on individual health, as well as the Australian economy.

Grains and grain-based foods are a key food category in dietary recommendations, as they provide 60 per cent of global energy intake (6) along with a range of important nutrients and dietary fibre.

Since 1979 the Australian Dietary Guidelines (ADG) have promoted whole grain choices, with the current guidelines pointing to “mostly” whole grain and/or high cereal fibre varieties/ (7) Examples suggested in the ADGs are breads, cereals, rice, pasta, noodles, polenta, couscous, crackers, oats, quinoa and barley, while recommending that two-thirds of total daily grain intake is whole grain.

While the DTI is 48g for Australians over the age of nine, the most recent National Nutrition and Physical Activity Survey (NNPAS) found the median daily whole grain intake was 21g in adults, (3) leaving a gap of 27g per day between current and target consumption.

These results are a timely reminder of the importance of whole grains in a healthy diet in the lead up to Whole Grain Week on 21-27 June. A range of resources are available to help encourage increased whole grain consumption, including a video showing how to swap out refined grains for whole grains, an e-Book with easy-to-make whole grain recipes and a searchable whole grain product database.

References

  1. Abdullah, M.M.H.; Hughes, J.; Grafenauer, S. Healthcare Cost Savings Associated with Increased Whole Grain Consumption among Australian Adults. Nutrients 2021, 13, doi:10.3390/nu13061855.
  2. Australian Institute of Health Welfare. Disease Expenditure in Australia. Available online: https://www.aihw.gov.au/reports/health-welfare-expenditure/disease-expenditure-australia (accessed on 4 June 2021).
  3. Galea, L.; Beck, E.; Probst, Y.; Cashman, C. Whole grain intake of Australians estimates from a cross-sectional analysis of dietary intake data from the 2011-13 Australian Health Survey. Public Health Nutrition 2017, 20, 2166-2172, doi:10.1017/S1368980017001082.
  4. Aune, D.; Keum, N.; Giovannucci, E.; Fadnes, L.T.; Boffetta, P.; Greenwood, D.C.; Tonstad, S.; Vatten, L.J.; Riboli, E.; Norat, T. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ 2016, 353, i2716, doi:10.1136/bmj.i2716.
  5. Aune, D.; Norat, T.; Romundstad, P.; Vatten, L.J. Whole grain and refined grain consumption and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies. Eur J Epidemiol 2013, 28, 845-858, doi:10.1007/s10654-013-9852-5.
  6. Food and Agriculture Organisation of the United Nations. Staple foods: What do people eat? Rome, Italy, 2019.
  7. National Health and Medical Research Council; 2013. Australian Dietary Guidelines: Providing the scientific evidence for healthier Australian diets. Available online: https://www.nhmrc.gov.au/_files_nhmrc/file/publications/n55_australian_dietary_guidelines1.pdf (accessed on 4 June 2021).

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Expert grains industry analysis and commentary from AEGIC’s Economics and Market Insight Team on a range of big-picture topics that affect Australia’s export grains sector.

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