Over the last year couple of years, and notably just a few days ago, a series of studies have hit the media touting the virtues of whole grains as opposed to refined grains. Not wanting to miss a hot marketing trend, the mainstream food companies and supermarkets have roled out a plethora of brand new whole grain options -- or announced their intentions to do so. My goodness, even Count Chocula cereal now comes in a whole grain version. So, are whole grains really better? Yes, that's obviously a dumb question. Of course they are, but…
There's more to the story than meets the eye. Unfortunately, all of the studies so far focus on the trees and not the forest. They focus on single issues such as "whole grains and cancer" or "whole grains and heart disease." Where are the studies that focus on "whole grains and overall health?" The results might surprise. On top of that, the media stories reporting on the studies, in an attempt to simplify them for public consumption, drift even further away from the big picture. The net result is that along the way, the true story of grains -- both good and bad -- gets lost in a barrage of sensationalized sound bites. In the next two issues of this newsletter, we're going to look at the entire forest as it were. In this issue, however, we're going to focus on the positive studies on whole grains and look at all of the good things that are said about them. We'll wait for the next issue to wander deeper into the forest and explore those things not revealed in the studies so we can get a better sense of the big picture.
Before we begin, however, we probably need to touch briefly on the difference between whole grains and refined grains so that we understand what the studies are actually comparing.
Refined grains versus whole grains
The difference between refined grains and whole grains is actually quite extreme, with refined grains being significantly modified from their whole grain starting points. Primarily, this modification involves the mechanical removal of the bran and the germ, either through grinding or selective sifting. In addition, the refining process can include mixing, bleaching, and even adding potassium bromate, a known carcinogen. (Note: potassium bromate is sometimes added to flour to improve its ability to help bread loaves rise. However, it has been banned from use in food products in Europe, the United Kingdom, Canada, and most other countries because of its known carcinogenic qualities.( 1, 2, 3, 4) Not surprisingly, it has not been banned in the United States -- although California does require a warning label when bromated flour is used.)
Why then is grain refined and adulterated?
The bran (the fiber of the grain) is removed primarily for aesthetic reasons -- to make the grain flour look whiter, prettier, and cook with a lighter texture. The germ, on the other hand is removed to extend shelf life. The germ is the "heart" of the cereal kernel (the embryo of the seed) and is a concentrated source of essential nutrients including a number of vitamins and minerals. But most importantly, it contains key oils such as Vitamin E and the essential fatty acids, which explains why it is removed -- to prevent the refined grain from turning rancid and spoiling.
With the differences now in mind, let's take a look at some of the studies that explore the impact those differences have.
Whole grains and heart disease
On October 22, the Archives of Internal Medicine published a study that "a higher intake of whole grain breakfast cereals is associated with a lower risk of heart failure." The study evaluated the association between whole grain breakfast cereal intake and the incidence of heart failure among 21,376 participants over a span of almost 20 years. The study adjusted for age, smoking, alcohol consumption, vegetable consumption, use of multivitamins, exercise, and a history of heart disease -- and then evaluated the incidence of heart disease between those who consumed whole grain breakfast cereals and those who did not. During follow-up 1,018 of the participants experienced heart failure. These failures broke down as follows:
- 362 of 6,995 participants who did not eat any cereal
- 237 of 4,987 of those who ate one serving or less per week
- 230 of 5,227 of those who ate two to six servings per week
- 189 of 4,167 of those who ate seven or more servings per week.
As I mentioned above, based on this data, the study concluded that a higher intake of whole grain breakfast cereals is associated with a lower risk of heart failure. The study's authors surmised that this association might be due to the beneficial effects of whole grains on heart failure risk factors such as hypertension, heart attack, diabetes, and obesity.
According to the background information associated with the study, "The lifetime risk of heart failure is estimated at 20 percent (one in five) for both men and women aged 40 years." Eating whole grain foods significantly modifies that risk. The regular consumption of whole grain cereals, as revealed in the study, may reduce that risk by a stunning 50%.
Chalk one up for whole grain cereals.
Whole grains and diabetes
Several studies have shown that the intake of whole grains is inversely associated with the risk of diabetes.
In a study published last year in the American Journal of Clinical Nutrition (AJCN), researchers from the Harvard School of Public Health published the results of an investigation of the diet records and blood samples of nearly 1,000 healthy middle-aged adults. They measured levels of insulin and hemoglobin A1C as well as homocysteine and cholesterol levels. Data showed a lower risk of diabetes and heart disease in people eating a diet high in whole grains.
Another study published in the American Journal of Clinical Nutrition just one month prior to the above study demonstrated that whole grain intake is inversely associated with metabolic syndrome and mortality in older adults. In fact, the results showed a "significant" inverse trend between whole grain intake and metabolic syndrome, not to mention mortality from cardiovascular disease, independent of demographic, lifestyle, and dietary factors.
And prior to these two studies, several large-scale trials had already been published showing similar results. One example would be the study involving 4,300 middle-aged Finns also published in the AJCN, in the March 2003 issue, that found that people eating the highest amounts of whole grains were 35 percent less likely to develop diabetes. Another example would be the Health Professionals Follow-up Study of 43,000 male health professionals published in September 2002 that found that those who consumed the most whole grains were 42 percent less likely to develop diabetes.
The bottom line is that consumption of whole grains has been shown to reduce diabetes versus "normal" diets that either have no grain consumption or refined grain consumption. (Note: these results may, however, be a bit more ambiguous than they first appear, but we'll have to wait until our next issue before we get into that issue. Suffice it to say that the definition of a "normal" diet is open to interpretation.)
Whole grains and cancer
Because of the wide range of anti-cancer ingredients they contain, diets high in whole grains may decrease cancer risk in general, and specifically the growth rate of breast cancer, via several simultaneous, synergistic pathways. In fact, there have been numerous studies that have found that whole grain intake may reduce the incidence of cancer in general. Most notably, a meta-analysis of 40 case-control studies published in Nutrition and Cancer in 1998 examined 20 different types of cancer and found that those people with high whole grain intakes had an overall risk of cancer that was 34% lower than those who consumed low levels of whole grain food. And finally, a study published in 2005 in the British Journal of Cancer tracked more than 61,000 Swedish women for 15 years and found that those who consumed more than 4.5 servings of whole grain foods daily had a 35% lower risk of colon cancer than those who consumed less than 1.5 servings of whole grains daily.
The healing power of whole grains
So how do whole grains accomplish these healing miracles? What is contained in the bran and germ that has been removed from refined grains that makes such a difference? Keep in mind that most of the following beneficial components are not found in refined grains unless they have been added back in limited amounts, using synthetic versions, after the fact. In any case, the key components found in whole grains that make them what they are include:
- Certainly fiber is at the top of the list, but as we shall see, not all grains are equal here -- some having more beneficial fibers than others.
- Vitamins and minerals are basic nutrients found in grains.
- Antioxidants that inhibit oxidation of cells, cell walls, and even DNA are major whole grain components.
- Lignans, which are naturally occurring compounds in grains that have both estrogenic and anti-estrogenic activity, may provide protection against several types of cancer including breast, uterine cancer, and prostate cancer.
- Other phytochemicals such as sterols, saponins, phenolic compounds, and sulfur-containing compounds may provide additional benefits.
The mix of nutrients above will vary widely from grain to grain. Some nutrients are particular to only one grain. Some allergenic elements such as gluten may be present in several grains, but not in others. The bottom line is that saying that all grains are the same is like saying all people are the same -- theoretically true, but in practical terms: absurd.
If whole grains are healthier, why do we use refined grains?
As stated above, it all comes down to aesthetics and economics.
- Refined grain flour is "whiter," "prettier" than whole grain flour, and aesthetically more appealing.
- Refined flour bakes lighter in texture because it has no bran.
- Refined flour doesn't spoil because all the beneficial oils have been removed, which means it lasts far longer on the grocer's shelf than products made with whole grain flours. Again, economically more profitable.
- Refined flour is "enriched" to put back a small amount of the nutrients lost in refining.
- And the manufacturers of refined flour products are now actually adding back the fiber (albeit, sawdust in some cases) and essential fatty acids (the hot new functional food additive) which were removed in the refining process to improve their products' nutritional profiles. When you think about it, this is pure insanity.
- We pay extra to have the grains refined.
- We pay extra again to have manufacturers put back a pale imitation of what they removed in the first place.
- We pay to have these manufacturers produce ads that tell us white is black and black is white -- that these "modified" grains are actually "enriched" and healthier for us.
- We pay extra in medical bills and funerals as we reap the ill health these enhanced products produce for us.
And for years, we've bought it all hook line and sinker. Now manufacturers are unleashing the scientific study/media machine to tell us that their "brand new" whole grain versions will lead us into the Promised Land of optimum health -- and we again believe. Ahh! If only it were that simple.
This is probably a good stopping point. We've discussed the differences between whole and refined grains and explored some of the wonderful and true -- as far as it goes -- benefits of whole grains. The problem, unfortunately, lies in what has not been said -- either in the different studies, or in the media reports on those studies. In the next issue of the newsletter we'll pick up with a discussion of those problems and address questions relating to:
- The different types of fiber in grains and why those differences matter.
- How different grains affect body pH.
- Why the manner in which whole grains are processed and cooked matters, and why the temperature they're cooked at makes a difference.
- When whole grain is not actually whole grain.
- Phytates -- the good and bad.
- Long chain carbohydrates versus ultra-long chain carbohydrates.
- Highly allergenic versus hypoallergenic grains
- The other phytochemicals that matter.
- The differences in how grains are grown and why it matters.
- Organic versus non-organic.
- And what about no-grain diets.
PS: In case there's any question to this point in our discussion -- yes, in general, if you're going to eat grains, whole grains are significantly healthier than refined grains. But there's more to come.
Until next issue.
Read more about healthy grains with part 2 of this whole grain health newsletter series.