How “Whole” are Your Grains?
One of my main inspirations for creating nutrition content and for pursuing a future career in the dietetics field is the fact that there are many topics where the scientific data is very clear, yet people are incredibly confused. Grains, and carbohydrates more broadly, are great example.
So in a world that villainizes carbs, what do the data have to say about grains? Read on for guidance on how to navigate the complicated world of grains: why they are beneficial for your health, how to incorporate them into your diet, and how to choose the best “whole grain” products for your health.
What is a “whole grain”?
Not all grains are created equal. Most studies demonstrating health benefits of grain consumption refer to whole grain consumption. So before we dive in to the scientific literature, let’s define the term “whole grain.”
A whole grain kernel consists of three primary components: the endosperm, the bran, and the germ. The bran is a protective outer layer of the grain, and it contains fiber, as well as B vitamins, minerals, antioxidants, and phytochemicals. The germ lies beneath the bran and contains more B vitamins, antioxidants, and phytochemicals, as well as vitamin E and healthy fats. The endosperm is primarily carbohydrate and protein with only small amounts of vitamins and minerals. When a grain is “refined,” it retains just the starchy, carbohydrate-rich endosperm, with the nutritious bran and germ removed during the milling process.
When consuming refined grains, not only do you miss out on the potential nutrients, but your body responds to the grain differently with those components removed, as revealed by the scientific data in the next section.
Whole grains & your health: the data
The body of literature investigating the effects of whole grain consumption on population health is vast. When so many individual research studies exist, it allows researchers to conduct meta-analyses. A meta-analysis looks at all available high-quality research of a similar type and lumps all that data together in one analysis. It allows researchers to look at what the body of scientific literature on a topic reveals as a whole, including a far greater number and diversity of study participants than any individual study.
Our Top Killers
One such meta-analysis was published in 2016 investigating the relationship between whole grain consumption and relative risk for numerous chronic health conditions, including the two top killers in the western world, cardiovascular disease and cancer. The study compiled and collectively analyzed data from 45 studies. They found that consuming three servings of whole grains per day (one serving was equivalent to one slice of whole grain bread) reduced risk of disease and death. Here are some of the specific findings:
Coronary heart disease: 19% risk reduction
Stroke: 12% risk reduction
Cardiovascular disease: 22% risk reduction
Cancer mortality: 15% risk reduction
Death by any cause: 17% risk reduction
Many of these risks showed continued reduction with additional servings of whole grains, up to about seven servings per day. Notably, there was no evidence of risk reduction from total grain consumption or refined grain consumption. It is the “whole” that counts!
Type 2 Diabetes
An earlier meta-analysis, published in 2013, investigated the effects of whole grain and refined grain consumption on risk of developing type 2 (insulin resistant) diabetes. That study found that the same modest intake of three servings per day reduced type 2 diabetes risk by 32%!
Both these meta-analyses looked at studies that tracked whole grain intake in a large number of individuals over a long period of time to see which individuals developed various diseases. They are a powerful tool in nutrition research, but they don’t always tell us the direct result of an intervention. What would happen to me today if I increased my whole grain intake? To answer those questions, we turn to randomized controlled trials, which allow researchers to assess the effects of an intervention in comparison to a control group on an outcome of interest. Let’s take a look at a couple of those:
Weight, Inflammation, & Gut Health
A 2017 study compared the effects of a diet consisting of primarily refined grain to a diet consisting of primarily whole grain over an 8-week intervention period on markers of inflammation and gut health in 50 individuals at risk for metabolic conditions. With grain type as the only directed dietary change, they found a significant reduction in weight and markers of systemic inflammation. The weight loss was related to an inadvertent reduction in calorie consumption, likely because whole grain products are naturally more filling! Read the study here.
Another study published in the same year investigated the impact of swapping whole grains for refined grains for six weeks in 81 healthy adults. They found that the whole grain group had increased stool size and frequencies (thought to be part of the mechanism by which whole grain intake reduces colon cancer risk), as well as an increase is measured short-chain fatty acid production. Short-chain fatty acids are a group of molecules produced by healthy gut microbes that have a host of positive effects throughout the body. Other biomarkers measured in this study showed evidence of modest benefits to the gut microbiome health, immune function, and inflammation. Check out the data here.
These are only a handful of studies, but they demonstrate the vast positive impacts of whole grain consumption on our immediate and long term health. Perhaps you have heard claims to the contrary on social media by those portraying all grains as inflammatory or poor for health. It is difficult to reconcile those claims with the vast body of existing scientific literature showing the positive impact of whole grain consumption on inflammatory markers in the short term and disease outcomes over decades. Be wary of people citing individual studies without an attempt to look at data within the context of the whole body of scientific evidence.
A note about gluten
Addressing the topic of gluten warrants more than a paragraph within this post. For now, I will link to a resource that I find very informative on this issue. If you are curious to learn more on this topic, I recommend you start with this Podcast - Zoe Science & Nutrition: Should you worry about gluten?
Diversity matters, too
The two randomized controlled studies described above both hypothesize that gut microbiome biodiversity likely would have improved more with greater grain diversity, not just whole grain consumption. Different grains contain different fiber and phytonutrient profiles, with the potential to cause flourishing of different gut bacterial species. This assertion is supported by preliminary findings published from the American Gut Project. Rob Knight and his team found that individuals consuming 30 or more unique plants per week had more favorable gut microbiome profiles when compared with those who consume 10 or less; that is, they had more of the species that researchers have identified as health-promoting and anti-inflammatory. Read the full-text article here.
Whole grains are a great way to add plant diversity to your diet. There is a whole world of grains out there perfect for breakfast, lunch, or dinner. Read on to learn some ways to push your comfort zone with whole grains.
I’m sold! Where do I start?
Swapping grain products is a great place to start improving the quality of your diet in a significant way. Here are some suggestions.
Swap your flour
If you bake or use flour regularly, try subbing in whole wheat or a different whole grain flour. If you don’t typically use whole wheat flour, I recommend starting slow and replacing just part of the flour. My favorite place to experiment with different flour is in pancakes, a weekend staple in my house. I typically use whole wheat flour for pancakes, but enjoy occasionally subbing in other flours. I recommend Yummy Toddler Food’s Pancake Recipes for the whole family, even if your family does not include a toddler!
Some flours to try: Whole Wheat, Buckwheat, Rye, Spelt, or Oat
Rethink your rice
Most families have a meal in their regular rotation that involves rice. For us, it is stir fry, fajita bowls, fried rice, and Cajun red bean & rice to name a few. This is an easy place to start incorporating whole grains. If you typically use white rice, try subbing for brown rice. You can make this a gradual switch as well, mixing brown and white together. Brown and white rice do have different cooking times, so it is best to cook the two separately and then mix together. If you are new to brown rice, try different types until you find one that you prefer. For us, brown jasmine rice is now our go to (we love Trader Joe’s brand).
You can also think beyond brown rice. Applying a principle we discussed in my turmeric post (the colors are the nutrients!), you may accurately predict that black rice has even more antioxidants than brown rice! Wild rice and quinoa are also easy substitutes.
Try a grain salad
A great way to incorporate a brand new grain into your diet is in a grain salad. Either add a grain to green salad, or look up a grain salad recipe to try. Farro, quinoa, barley, and buckwheat all work well for this. Searching “grain salad” on Google yields a treasure trove of yummy, satiating lunch options that you can eat all week long. I will also often add leftover grains from a dinner meal to a green salad to give it a nutritional boost and create a more filling lunch.
Mix up your breakfast oatmeal
If oatmeal is not in your breakfast rotation, give it a try! Oats have many levels of processing. The least processed form is called oat groats, which take the longest to cook. Steel cut oats are the full oat groat chopped into smaller pieces. Old fashioned rolled oats is the next most processed form, followed by instant oats. Despite the differing level of processing, these are all whole grains, because none of the nutritional components are removed. However, evidence demonstrates that grains that are more intact have a powerful effect on weight control, satiety, blood sugar, and gut health. If you currently use quick oats or instant oatmeal packages, try swapping those out for old fashioned rolled oats, or give steel cut oats a try! Rolled oats can still be cooked pretty quickly on the stove or in the microwave. Using a pressure cooker to batch-cook steel cut oats is my go-to method.
Branching out from oatmeal is also a great way to add grain diversity. You can use leftover brown rice to create a brown rice porridge Just add cinnamon, milk of choice, dates, fruit, nuts, seed, or whatever you have on hand. Don’t knock it until you’ve tried it! Teff, amaranth, and buckwheat are other grains that make great breakfast porridge.
A more accessible approach may be a store-bought hot cereal. Bob’s Red Mill makes a 10 Grain Hot Cereal - hard to think of a better way to add grain diversity than consuming that many varieties as your first meal of the day!
Check your bread
Perhaps you have been eating whole wheat bread for years. Let’s turn over the loaf and see whether your whole wheat bread is as “whole” as you think. There are few grocery aisles more frustrating to navigate than the bread aisle. It is rife with health claims and misleading advertising. Right now, I have a loaf of bread in my pantry labeled “100% whole wheat”, and it is not a 100% whole grain product. Annoying! With a few simple tools, you can look past the health claims and figure out which product is the closest to a truly whole grain bread.
Check the ingredients list. If the first word on the ingredients list is not “whole”, than it definitely is not a whole wheat product. For a truly 100% whole grain bread, every type of flour listed in the ingredients list should explicitly state “whole.”
Check the nutrition facts. Look at the total grams of carbohydrate relative to the grams of fiber. The lower the ratio between total carbs and fiber, the less refined the bread. If you recall, fiber is one of the nutritious components removed when grains are refined; therefore, the more fiber left in the product, the more whole grain the bread. Dr. Michael Greger, author of How Not to Die and founder of NutritionFacts.org, suggests looking for a ratio of no more than 5:1. In my local supermarkets (my options are slim), this ratio is difficult, if not impossible to find. Even if you can’t find the perfect whole grain bread, this method can help compare available options.
Check the added sugar. This does not tell us how whole grain the product is, but it is another important metric to consider in choosing your bread. I personally prefer to consume my added sugar in delicious sweet treats, not in my bread!
Here are a few things that can’t tell you how healthy a loaf of bread is:
The color. Check the ingredients list and you may find that your wheat bread contains artificial coloring to make it appear healthier. Raisin juice is often used this way. Don’t be fooled by bread with a tan!
Seeds. Seeds are incredibly nutritious and a great addition to a loaf of bread, but the presence of seeds alone can’t tell you whether you are consuming a whole grain bread product.
Health claims. Labels like “wheat”, “whole wheat”, “100% whole wheat”, and “multigrain” can be misleading, and don’t guarantee that a bread is truly whole grain. Turn the loaf over and look for yourself!
The healthiest bread is probably a 100% whole grain sourdough loaf. This is not easy to come by and is difficult to find in stores, so shoot for the best product given the tips addressed above that fits your budget and satisfies your palate. “Healthy” is a continuum, so feel free to let go of perfection.
Balance is best
I hope that you feel confident that whole grains are a nutritious component of a balanced diet and that you feel inspired to make some healthy swaps or try a brand new grain. However, take courage in knowing that the health benefits described earlier exhibit a dose-response relationship; the more servings you add, the more health benefits you get, and the first few servings show the most potent benefit. Even swapping just one or two servings of refined grains per day with whole grains will have significant health benefits.
In our house, not all of our grains are whole. There are factors that drive some of our food choices other than just health. For example, when we make burritos, or our go-to crunch wrap copy cat recipe, we choose white flour tortillas. Although sometimes we choose whole grain pasta, other times we stick with the refined version. And occasionally, we favor white rice because it is faster to cook or just tastes better with a meal. It is okay to choose foods just because they are your preference, they make a meal more satisfying, or because it will help increase your consumption of other healthful foods. Understanding the role a food plays in your diet, even if that role isn’t nutrition, is incredibly empowering.
