Reducing the prevalence of fat-rich, energy-dense diets is a public health priority. The present parallel-designed randomised study compared three interventions aimed to increase intakes of low-fat starchy foods and to reduce fat intakes among 589 individuals from 169 families in the Family Food and Health Project (FFHP). Intervention A was education only, intervention B provided ‘cook and eat’ sessions only, whereas intervention C included personalised goal setting, ‘cook and eat’ and education. Diet was assessed at baseline (T0) and at 3 months (T1), 6 months (T2) and 18 months (T3) post-intervention. Retention rates were 75 % at T1, 63 % at T2 and 40 % at T3. ANCOVA (baseline intake as covariate) was assessed between intervention differences at T1, T2 and T3. At T1, individuals in intervention C consumed less fat (P = 0·02) and more total carbohydrate (P = 0·001), starch (P = 0·04) vitamin C (P = 0·002) and NSP (P = 0·01) than those in intervention A. Whereas similar dietary intakes were reported across interventions at T2, participants in intervention C had less energy-dense diets that contained more NSP and vitamin C at T3 than intervention A (P < 0·0001, P = 0·002 and P = 0·01, respectively). Across all intervention groups, the more socially deprived participants in the FFHP (n 119) consumed less fat (P = 0·01) and more total carbohydrate (P = 0·02) at T2 than the least socially deprived (n 240). These data demonstrate the importance of personalised goal setting to translate knowledge and practical cooking skills into healthier food choices, suggesting that low-fat starchy food-focused interventions may be effective in reducing fat intake.

Nutritional recommendations call for balanced, diversified consumption of starchy foods and increased whole-grain food intake. Their efficiency may depend on sociodemographic and socioeconomic factors, for which little information is available. The aim of the present study was to investigate the relationship between sociodemographic and socioeconomic characteristics and starchy food consumption in a large general population of French adults. Dietary intake was assessed using at least six 24-h dietary records collected, during a 2-year period, from 4574 men and women aged 45–60 years who participated in the Supplémentation en VItamines Minéraux et AntioXydants cohort study in 1995–7. Compliance with the recommendation ( ≥ 3 and < 6 servings/d), non-consumption of whole-grain products, variety and daily cost were compared across sociodemographic and socioeconomic categories using logistic regression and covariance analyses. About 55 % of subjects complied with the starchy food recommendation, with little variation across sociodemographic characteristics. Consumption of whole-grain products was less likely in men (P = 0·001), in subjects with a lower education level (P-trend = 0·01) and in those belonging to intermediate occupational categories (P = 0·02). The variety of starchy food intake increased with education level (P-trend = 0·0002) and was lowest for manual workers (P = 0·03). The proportion of daily food cost spent on starchy foods decreased with occupational category (P < 0·0001), and was higher in rural areas (P = 0·0004). The starchy food budget spent on potatoes decreased with the educational level (P-trend = 0·007), whereas it increased for rice and unsweetened breakfast cereals (P-trend = 0·001 for both). Public recommendations concerning starchy food variety and whole-grain intake should specifically target subjects with a lower education level and/or occupational category.

In the UK, starch contributes up to 25 % of energy intake in adults (). The present study investigated the acute response to a starchy meal on whole-body glucose metabolism and assessed insulin sensitivity in men compared with women. Low insulin sensitivity has been postulated to pre-dispose individuals to a cluster of associated abnormalities known to increase the risk of CHD. Metabolic responses to a 13C-labelled meal were determined in conjunction with a primed continuous infusion of D-[6,6-2H]glucose in groups of healthy age- and BMI-matched men and women. Peripheral plasma glucose disposal (Gd) was computed using non-steady state kinetics in a single compartment model, simultaneously with determination of whole-body net glucose oxidation by indirect calorimetry. Insulin sensitivity was derived using cumulative Gd as the dependent variable, and time and the integrated insulin concentration as independent variables. The female group had the higher fractional rate of glucose appearance in plasma from starch (P=0·019) immediately after ingestion. Females also had a higher rate of plasma Gd and a significantly higher insulin-dependent Gd (6·8 v. 5·6 μg glucose/(min.kg) per pmol insulin, P<0·05) compared with the males. A smaller absolute pool of endogenous glucose in females allowed the rate of exogenous 13CO2 production to be significantly higher in the females (P=0·007) corresponding also to a significantly higher (P<0·05) carbohydrate oxidation rate obtained by indirect calorimetry. The present study suggests that during the ingestion of a starchy meal, females exhibit higher glucose flux and greater whole-body insulin sensitivity than males.

To gain an understanding of UK consumer attitudes and beliefs regarding starchy foods and their dietary role, a questionnaire based on the theory of planned behaviour was developed and sent out to a UK consumer sample (n 800). The content focused on attitudes and beliefs towards starchy foods, perceived barriers towards increasing their intake (e.g. cost, habit, social influences), perceptions of personal and recommended starchy food intake, intention to increase starchy food intakes in the future and socio-demographic information. Responses (n 414) indicated that consumers have highly divergent attitudes and beliefs regarding starchy foods. These foods are seen as nutritious and good for one's health, but also as high in energy and not helping to control weight, and the overall intention to increase starchy food intake was extremely low. Possible barriers towards increasing starchy food intake were the perceptions that personal starchy food intakes were already high, beliefs that starchy food intakes should be reduced to achieve a healthier diet, and the view that personal starchy food intakes did not need to be changed any further, because (depending on attitude) individual's intakes had already been increased or reduced. The model including attitude and subjective norm had the best fit for predicting reported intention to increase starchy food consumption, with attitude being the strongest contributor. Addition of the factor ‘family's liking of starchy foods’ significantly improved the model. For reported starch intake, the model including attitude had the best fit, and addition of other factors did not improve the model. These findings indicate that health promotion strategies aimed at increasing complex carbohydrate intakes should take these perceptions into consideration; however, further work is required to examine how these potential barriers can best be addressed in practice.