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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.

The perception that food affects our health has increased over the past fifty years in industrialised Western countries. The notion of "healthy food" has become ubiquitous in medical, political, and media discourse as well as in the discourses of the lay population. This study seeks to understand the social representations of "healthy food" of Brazilian, Spanish and French dietitians and young laywomen. A qualitative and comparative methodology based on 131 individual semi-structured interviews was set up. According to the analysis of the discourses, the notion of "healthy food" is ambivalent and polysemic. Scientific-nutritional rationality is not the only way to think about "healthy food". Two main ways of categorising "healthy foods" are observed in the three countries. They are based on eating analysis criteria that referred to diverse value systems and different scientific, symbolic and moral rationalities: on the one hand, a physiological, nutritional and functional conception, and on the other, an "eco-ideological" conception that took into account production, culture and distribution methods. Though dietitians have a greater technical knowledge of nutrients and metabolic processes than laywomen, professionals and young laywomen, mainly within the same nationality, shared similar discourses concerning the notion of "healthy food", revealing patterns that differentiate each nationality. Taking together, the results reveal that although medical-nutritional discourses are disseminated internationally, discourses on "healthy food" are constructed taking into account social, cultural, symbolic and moral dimensions. These discourses are linked to a historical and sociocultural context., Competing Interests: Declaration of competing interest The authors also declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020. Published by Elsevier Ltd.)