Dietitians’ Attitudes and Understanding of the Promotion of Grains, Whole Grains, and Ultra-Processed Foods

Abstract

NOVA is a food-classification system based on four levels of processing, from minimally processed to ultra-processed foods (UPFs). Whole-grain-containing commercial breads and ready-to-eat breakfast cereals are considered ultra-processed within NOVA, despite being considered core foods in the Australian Dietary Guidelines. These food categories contribute the greatest quantities of whole grain in the Australian diet, although consumption is less than half of the 48 g/day daily target intake. Dietitians are key to disseminating messages about nutrition and health; therefore, an accurate understanding of whole grains and the effects of processing is critical to avoid the unnecessary exclusion of nutritionally beneficial foods. The aim was to utilise an online structured questionnaire to investigate dietitians’ attitudes to the promotion of grains and whole grains and understand their level of knowledge about and attitudes towards NOVA and the classification of specific whole-grain foods. Whole-grain foods were perceived positively and are regularly promoted in dietetic practice (n = 150). The dietitians tended not to consider whole-grain breads and ready-to-eat breakfast cereals as excessively processed, although most generally agreed with the classification system based on the extent of processing. If dietitians intend to incorporate NOVA and concepts of UPFs in their counselling advice, the anomalies regarding the categorisation of whole-grain choices and optimum intakes should be addressed.