Healthful grain foods consumption by São Paulo residents: a 12-year analysis and future trends

Public Health Nutr. 2021 Jul;24(10):2987-2997. doi: 10.1017/S1368980020001342. Epub 2020 Jul 1.


Objective: Understanding trends in grain consumption is essential to tackle the low consumption of healthful grain foods. This study aimed to evaluate trends and determinants of grain foods meeting the ≤10:1 carbohydrate:fibre ratio (≤10:1 ratio) in Brazil and to estimate this intake for the next years.

Design: Three editions of the cross-sectional, population-based study Health Survey of São Paulo (2003, 2008 and 2015).

Setting: Urban area of São Paulo, Brazil.

Participants: The sample included 5801 participants aged 12 years or more.

Results: A growing trend in the intake of these foods (0·9 percentage of energy (%E) in 2003 to 1·5 %E in 2015) was observed. Also, the proportion of the population consuming at least one grain food meeting the ≤10:1 ratio increased from 8·7 % in 2003 to 15·8 % in 2015, and 20·3 % of the population would be consuming some kind of healthful grain food by 2030. Sociodemographic factors associated with the consumption of grain foods meeting the ≤10:1 ratio changed according to study edition, but overall, older individuals (+79 %), females (+28 %), those with higher education (+138 %) and higher family income (+135 %) were more likely to consume grain foods meeting the ratio, whereas participants who self-reported black, brown or indigenous ethnicity were less likely to consume these foods (-30 %).

Conclusions: There was a growing trend to consume grain foods meeting the ≤10:1 ratio from 2003 to 2015, but this consumption continues to be far from recommended levels. Intersectoral changes are urgently needed in order to increase the intake of healthful grain foods.

Keywords: Brazil; Carbohydrates; Diet surveys; Dietary fibre; Socio-economic factors; Wholegrain cereal.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brazil
  • Cross-Sectional Studies
  • Dietary Fiber
  • Edible Grain*
  • Foods, Specialized*
  • Humans


  • Dietary Fiber