Whole Grains

Whole grains are a healthy addition to almost any
diet.  In varying amounts, they provide healthy
proteins, carbohydrates, fats, and micronutrients.  
As a bonus, whole grain oats help reduce blood fats
(LDL cholesterol, triglycerides, etc).  This ability to
lower LDL without changing HDL is believed to result
from the viscous beta-glucan fibers in oats.  The
effect of other whole grains on blood fats is much
less than oats or there is a lack of studies
demonstrating their effect on cholesterol.  In the
case of barley and rye, both are high in viscous
fibers however, insufficient studies are available to
make a determination.

Whole grains offer a nutritious package that
includes three parts: bran, germ, and endosperm.  
The bran is a fiber-rich outer layer that supplies
vitamins, minerals, antioxidants, and
phytochemicals.  At the core, the germ contains
healthy fats along with more vitamins,
phytochemicals, and antioxidants.  The interior part,
called the endosperm, contains carbohydrates,
proteins, and small amounts of vitamins and
minerals. In contrast with whole grains, most refined
grains contain only the starchy endosperm part.

Each part of the whole grain is important for health.   
The fiber in the grains bran helps food move
through the digestive tract and slows the breakdown
of starch into glucose.  This in turn helps maintain
steady blood sugar without sharp spikes.  And, as
previously mentioned, fiber helps to lower
cholesterol.  Fiber may also help prevent heart
attacks or strokes by preventing the formation of
small blood clots.  In other parts of the grain, the
abundance of essential vitamins, minerals, and
phytochemicals provide nutrients that are also
believed to help protect against some cancers.

Unfortunately, the invention of industrialized roller
mills in the late 19th century changed the way grains
were processed and along with it the diet habits of
most people.  The ability to easily remove the germ
(fat content) greatly extended the grains’ shelf-life.  
What was left had much lower nutritional quality and
a much higher glycemic index.  In exchange for
fluffier bread and cake the average person gained
weight and has poorer health.  Although it was only
a partial solution to the nutritional deficiencies of
milled grains, in the 1940s some nutrients lost in
processing were added back to flour.

Due to the research showing health benefits derived
from whole grains and detrimental effect from
refined grains, it’s important to read food labels for
their whole grain content.  The best way to know if a
product has a significant amount of whole grains is
to check the label to determine if the first or second
ingredient is a whole grain. A better strategy is to
buy only bulk packaged whole grains and cook them
at home.  Cooking a pot of whole grain cereals for
the coming week is a handy way to compliment any
meal including a lunch you take to work or school.

Take care when choosing foods labeled as whole
grains. “Whole grain” is often a marketing ploy.  It
seems that each time a new food is declared
nutritious, unscrupulous food companies use the
new food as camouflage for their unhealthy
products.  In the case of products marketed as
whole grains, many are actually foods high in salt,
added fats, and sugar.  Even food sold as ‘high in
fiber’ is suspect since that leaves in question
whether the rest of the grain was discarded or
included.

While an occasional refined grain treat may have no
noticeable health effect, making low quality grains a
part of your routine diet over many years can have
detrimental health effects.  As nutrition research has
accumulated, it has become clear that the quality of
carbohydrates eaten is important.  Results from a
wide range of studies show a connection between
whole grains and better health.

• Studies have linked whole grain consumption with
fewer deaths from inflammatory and infectious
causes including rheumatoid arthritis, gout, asthma,
ulcerative colitis, Crohn’s disease, and
neurodegenerative diseases. Compared with women
who rarely or never ate whole-grain foods, those
who had at least two or more servings a day were
30% less likely to have died from an inflammation-
related condition over a 17-year period.

• An analysis of over 786,000 individuals found that
people who ate 70 grams/day of whole grains had a
22% lower risk of total mortality, a 23% lower risk of
cardiovascular disease mortality, and a 20% lower
risk of cancer mortality when compared with those
who ate little or no whole grains.

• Eating whole grains instead of refined grains
substantially lowers low-density lipoprotein (LDL, the
bad cholesterol), triglycerides, and insulin levels.
• In the Harvard-based Nurses’ Health Study, women
who ate 2 to 3 servings of whole-grain products
each day were 30% less likely to have a heart attack
or die from heart disease over a 10-year period
than women who ate less than 1 serving per week.
• A meta-analysis of seven major studies showed
that cardiovascular disease (heart attack, stroke, or
the need for a procedure to bypass or open a
clogged artery) was 21% less likely in people who
ate 2.5 or more servings of whole-grain foods a day
compared with those who ate less than 2 servings a
week.
• In a study of more than 160,000 women whose
health and dietary habits were followed for up to 18
years, those who averaged 2 to 3 servings of whole
grains a day were 30% less likely to have developed
type 2 diabetes than those who rarely ate whole
grains.
• A study of more than 72,000 postmenopausal
women without diabetes at the start of the study
found that the higher the intake of whole grains, the
greater the risk reduction of type 2 diabetes. A 43%
reduced risk was found in women eating the highest
amount of whole grains (2 or more servings daily) as
compared with those who ate no whole grains.
• A review of four large population studies showed a
protective effect of whole grains from colorectal
cancer, with a cumulative risk reduction of 21%.

If considering a change in diet that includes more
whole grains, here are a few points to consider.
While gluten can cause side effects in some people,
such as those with celiac disease, most people can
and have eaten gluten most of their lives without
any adverse reaction.  For further information on
gluten and health, see: “Gluten: A Benefit or Harm
to the Body?”

The blood-lipid lowering effects of whole grains are
smaller than those achieved with medications.  
Nevertheless, the effects are considered clinically
relevant. This is particularly true of whole-grain
oats.  In combination with a change to a plant-based
whole food diet, many find they need less
medication or no longer need medications to
regulate lipids. While other whole grains offer
excellent health benefits, the evidence for lowering
lipids is not their notable advantage.

You may wonder which whole grain provides the
best overall health benefits.  For heart health, oats
may be the best.  Otherwise, it would be a tough call
given that each whole grain has certain strengths.  
For example, of the twelve most popular grains, oats
rank seventh place for total fiber, third place for total
nutrients, and second place for protein.  In contrast,
corn rates last for nutrients and tenth place for fiber
and protein. You could do worse.  White rice ranks
even lower but then it’s not a whole grain.  To do
better, make whole grains part of your diet.  If
having difficulty choosing the right one I’ll offer a
suggestion.  The one you prefer and are willing to
eat every day is the best one for you.

Still pondering which whole grain is the most
nutritious?  Well, for those with an urge to compare
grains, the table below offers one approach.  For
purposes of calculating a relative nutrient rating, the
grains received one point for each of the following
nutrients: protein, fiber, iron, zinc, folic acid, vitamin
E, riboflavin, niacin, thiamin, and calcium.  

 
  Relative Amount of Nutrients per Grain
(1 is highest amount, 12 is lowest amount)

      Nutrients           Fiber in grams     Protein in grams
 (See formula)         per serving             per serving
 __________________________________________
1        Amaranth                Barley                         Amaranth
2        Rye                          Amaranth                   Oats
3        Oats                         Whole wheat            Rye
4        Wild rice                  Rye                            Wild rice
5        Millet                        Buckwheat                Millet
6        Barley                      Millet                          Quinoa
7        Quinoa                    Oats                           Barley
8        Buckwheat             Wild Rice                   Whole wheat
9        Whole wheat          Quinoa                      Buckwheat
10      Brown rice             Corn                           Corn
11      White rice              Brown Rice                Brown Rice
12      Corn                        White Rice                White Rice


The unique distribution of micronutrients in each
whole grain further complicates answering the
question, which grain is best.


Top Five Grains For Selected Micronutrients

Folic Acid       Calcium        Iron             Zinc
Millet            Amaranth     Quinoa         Wild Rice
Wild Rice     Quinoa         Amaranth     Rye
Rye              Oats             Oat               Amaranth
Amaranth     Barley       Enriched Rice  Oats
Oats             Rye              Millet             Quinoa

While you may feel better by knowing you have a
whole grain that rates high in these micronutrient
categories, the more important consideration is that
the whole is greater than the sum of the parts.  
For that reason, both brown rice and whole kernel
corn rank high as nutritious foods when part of a
balanced diet composed of plant-based whole foods.


 Nancy Neighbors, MD
  Huntsville, Alabama