Abstract

Objective: Given the high disease burden associated with the low intake of whole grains, modelling studies that estimate the impact of dietary strategies to increase more healthful grain foods consumption are essential to inform evidence-based and culturally specific policies. The current study investigated the potential nutritional impact of replacing staple grain foods with more healthful options. Design: Based on the 2015 Health Survey of Sao Paulo, a cross-sectional, population-based study, we modelled the substitution of white rice and white bread with brown rice and whole-wheat bread. Outcomes included changes in more healthful grain foods, energy and nutrient intakes. Setting: Urban area of Sao Paulo, Brazil. Participants: Participants aged over 12 years who completed a semi-structured questionnaire and one 24-h recall (n 1741). Results: The substitution of all white rice and white bread with brown rice and whole-wheat bread, respectively, would result in more than 5 % increases in Zn (+9 center dot 1 %), Ca (+9 center dot 3 %), vitamin E (+18 center dot 8 %), dietary fibre (+27 center dot 0 %) and Mg (+52 center dot 9 %) intake, while more than a 5 % decrease would be seen for total carbohydrate (-6 center dot 1 %), folate (-6 center dot 6 %), available carbohydrate (-8 center dot 5 %), Fe (-8 center dot 6 %), vitamin B-6 (-12 center dot 5 %), vitamin B-2 (-17 center dot 4 %), and vitamin B-1 (-20 center dot 7 %). A substantial increase in the amount of more healthful grain foods consumed would be seen (10 g/d to 220 g/d, or from 4 % to 69 % of total grain intake). Conclusions: Replacing white rice and white bread with their whole-grain versions has the potential to improve diet quality, suggesting they are prime targets for policy actions aiming at increasing intake of more healthful grain foods.