Public Health Nutrition

Hot topic – Childhood Obesity

Whole grain consumption is inversely associated with BMI Z-score in rural school-aged children

Silvina F Choumenkovitcha1 c1, Nicola M McKeowna2, Alison Tovara1, Raymond R Hyatta3, Vivica I Kraaka4 p1, Alia V Hastingsa1, Julia Bloom Herzoga1 and Christina D Economosa1

a1 John Hancock Research Center on Physical Activity, Nutrition, and Obesity Prevention, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA

a2 Jean Mayer–USDA HNRCA at Tufts University, Boston, MA, USA

a3 School of Medicine, Tufts University, Boston, MA, USA

a4 US Programs, Save the Children, Washington, DC, USA


Objective To examine the relationship between intake of whole grains and BMI Z-score in rural children.

Design General linear models and logistic regression were used to examine the cross-sectional associations between whole grain intake and BMI Z-score, prevalence and odds ratios of overweight and obesity. Dietary intake was assessed using the Block Food Screener for ages 2–17 years. Children were classified into three categories according to servings of whole grain intake: <1·0 serving/d, 1·0–1·5 servings/d and >1·5 servings/d.

Setting The CHANGE (Creating Healthy, Active and Nurturing Growing-up Environments) study, an obesity prevention intervention in elementary schools in eight rural US communities in California, Mississippi, Kentucky and South Carolina.

Subjects Seven hundred and ninety-two children attending 3rd–6th grade.

Results After adjusting for age, sex, race/ethnicity, physical activity and state of residence, whole grain intake was inversely associated with BMI Z-score (0·90 v. 0·61 in the lowest v. the highest whole grain intake category; P trend = 0·01). Children who consumed >1·5 servings of whole grains/d had a 40 % lower risk of being obese (OR = 0·60; 95 % CI 0·38, 0·95, P = 0·02) compared with children who consumed <1·0 serving/d. Further adjustment for potential dietary predictors of body weight (fruit, vegetable and dairy intakes) did not change the observed associations.

Conclusions Increasing the intake of whole grains as part of an overall healthy lifestyle may be beneficial for children to achieve and maintain a healthy weight.

(Received September 27 2011)

(Revised April 18 2012)

(Accepted June 17 2012)

(Online publication August 16 2012)


  • Obesity;
  • Children;
  • Whole grains;
  • BMI


c1 Corresponding author: Email

p1 Present address: Deakin Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.