Whole Grains and cereal health benefit, living longer by Ray Sahelian, M.D.
November 15 2016

Those who eat the whole grains have a lower risk of heart disease, stroke and diabetes, not to mention better colon health. The reasons for the health benefits aren't hard to fathom. Whole grains include not just the starchy interior of a kernel, but also the fibrous bran that surrounds it, together with the vitamin- and mineral-rich germ (or seed). In contrast, fluffy white refined flour the kind in most cakes, cookies and crackers has the highly nutritious bran and germ stripped away.

Whole grains include unprocessed whole or cracked wheat, corn, cornmeal, brown rice, oatmeal and whole oats, barley, quinoa, sorghum, spelt and whole rye. Other examples are grains and flours made from the following: amaranth, buckwheat, bulgur, emmer, farro, grano (lightly pearled wheat), millet, triticale, wheat berries and wild rice. You can also find whole grain pasta in health food stores, along with whole grain bread. My favorite whole grain product is sprouted whole multi grain bread. See also cereal for more info.

Whole grains or foods made from them contain all the essential parts and naturally occurring nutrients of the entire grain seed. The outer skin of the seed is the B vitamin-, antioxidant- and fiber-rich bran; the germ (or embryo) holds the protein, minerals and healthy fats; and the endosperm (the main part of the grain between the bran and the germ) has the proteins, carbohydrates and smaller quantities of vitamins and minerals. The bran and germ contain 25 percent of the protein in whole grains and many nutrients. When highly processed, these valuable nutrients and proteins are lost (not to mention healthful fiber).

Have variety in your diet
Rather than consuming wheat all the time, consider alternatives:
Oats can be eaten for breakfast once or twice a week.
   Allergies are very rare. Ann Allergy Asthma Immunol. 2013. Anaphylactic reaction to dietary oats.
Bulgur, which is chewy and soft, can be used in tabouli and similar recipes.
Buckwheat, which is easy to prepare and is similar to rice.
Millet, which cooks quickly and has a mild flavor.
Quinoa, which is rich in protein and magnesium, appears to be acceptable to those with celiac disease.
Rice - germinated brown rice ingestion has the greatest impact on increasing antioxidant enzyme activity and vitamin E level and on reducing lipid peroxidation. Furthermore, germinated brown rice diet can also reduce the level of hepatic enzymes. Therefore, minimize the use of white rice in favor of GBR.
Salba grain is a great whole food source of Omega 3 fatty acids and fiber found in nature.
Spelt, which has a nutty flavor, is easy to digest and is rich in protein. You can bake with spelt flour in place of flour from wheat.

Food Nutr Res. Feb 4 2014. The HEALTHGRAIN definition of 'whole grain'. Most cereal products, like white bread, pasta, and biscuits, are based on flour after removal of bran and germ, the two parts of grain kernels containing most of the dietary fibre and other bioactive components. In the past decade, consumers have been rediscovering whole grain-based products and the number of wholegrain products has increased rapidly. In most countries in Europe and worldwide, however, no legally endorsed definition of wholegrain flour and products exists. Current definitions are often incomplete, lacking descriptions of the included grains and the permitted flour manufacturing processes. The consortium of the HEALTHGRAIN EU project (FP6-514008, 2005-2010) identified the need for developing a definition of whole grain with the following scope: 1) more comprehensive than current definitions in most EU countries; 2) one definition for Europe - when possible equal to definitions outside Europe; 3) reflecting current industrial practices for production of flours and consumer products; 4) useful in the context of nutritional guidelines and for labelling purposes. The definition was developed in a range of discussion meetings and consultations and was launched in 2010 at the end of the HEALTHGRAIN project. The grains included are specified: a wide range of cereal grains from the Poaceae family, and the pseudo-cereals amaranth, buckwheat, quinoa, and wild rice. The definition also describes manufacturing processes allowed for producing wholegrain flours. This paper compares the HEALTHGRAIN definition with previous definitions, provides more comprehensive explanations than in the definition itself regarding the inclusion of specific grains, and sets out the permitted flour manufacturing processes.

FDA definition
FDA defines whole grains as cereal grains such as barley, corn, rice, oats or wheat that consist of the intact, ground, cracked or flaked fruit of the grain. Products such as pizza crust could only be labeled as "whole grain" or "whole wheat" when the crust is made entirely from grain or wheat. Using the term multi-grain or seven-grain doesn't necessarily mean that a product contains whole grains. Providing a standard definition would help consumers select whole-grain products that are consistent with dietary guidelines. The popularity of whole grains has soared in recent years after scientific studies showed they may help prevent cardiovascular disease, high blood pressure and diabetes.

Metabolic syndrome
Older adults who regularly eat whole grains like high-fiber cereals and cooked oatmeal may be less likely to develop a cluster of conditions that raise the risk of heart attack and stroke. Researchers found that among 535 adults between 60 and 98 years old, those who ate more whole-grain foods were less likely to develop a group of risk factors known as metabolic syndrome x or to die of cardiovascular disease over the next 12 to 15 years. All of the study subjects underwent a physical exam, completed a 3-day food diary to track their eating habits, and provided information on other lifestyle habits such as exercise, smoking and drinking. Overall, the researchers found that men and women with the highest whole-grain intake -- typically three servings a day -- were less than half as likely to have metabolic syndrome as their peers who consumed less than one serving of whole grains per day. Similarly, whole-grain eaters were about half as likely to die from cardiovascular disease over the next 12 to 15 years. Men and women who ate more whole grains also tended to have lower blood sugar levels and to weigh less than those who favored refined grains. American Journal of Clinical Nutrition, January 2006.
    Americans should bulk up on whole grains like oatmeal, barley and brown rice to help lower their risk of clogged arteries, heart attacks and strokes.

Diabetes
Diets rich in whole grains can lower the risk of diabetes and heart disease. Such diets would include bran, whole wheat, fruit and vegetables. Higher intake of whole grains is associated with higher levels of physical activity, greater fruit and vegetable intake, less smoking and lower consumption of alcohol and saturated and monounsaturated fats. While there appears to be a lowered risk of diabetes and heart disease among individuals who consume higher levels of whole grains, the mechanism for how this works is unclear. Whole grains are a rich source of fiber, minerals, vitamins and antioxidants.
   The type of fiber found in whole grains and many vegetables -- called insoluble fiber -- may help prevent diabetes by improving the body's use of the blood-sugar-regulating hormone insulin. Since a decline in insulin sensitivity precedes type 2 diabetes, people may help lower their diabetes risk by getting more insoluble fiber. There are two main types of fiber -- soluble and insoluble. Soluble fiber dissolves in water to form a gel-like material, and it's believed to lower cholesterol and blood sugar. Foods like oatmeal and beans, as well as apples, berries and certain other fruits are high in soluble fiber. Insoluble fiber does not dissolve, passing through the digestive system largely intact. It's been unclear why, in some studies, diets high in insoluble fiber have been linked to lower diabetes risk.

Among rice lovers, people who eat brown rice or other whole grains seem to have a lower risk of developing diabetes than those who eat white rice. Archives of Internal Medicine, June 14, 2010.

Heart disease
A diet high in whole grains may lower a person's likelihood of developing diabetes and heart disease.

Am J Clin Nutr. 2016 . Intake of whole grains is associated with lower risk of myocardial infarction: the Danish Diet, Cancer and Health Cohort. High intake of whole grains has been associated with lower risk of coronary heart disease.

Among more than 900 healthy men and women, those who reported consuming the most whole grains had lower levels of cholesterol and various markers of heart disease. Healthy men and women who report the highest intake of whole grains had levels of homocysteine, a blood protein that has been tied to heart disease and stroke, that were lower than those who reported consuming the least amount of whole grains.  Apart from the better cholesterol and blood sugar levels, levels of insulin and C-peptide, a marker of insulin production, were also 14 percent lower in the high whole-grain consumers, the researchers report. Furthermore, concentrations of leptin, a hormone that generally reflects body fat levels, were lower among the whole-grain eaters than among their counterparts. Source: American Journal of Clinical Nutrition, February 2006.

Blood pressure
Diets with increases whole-grain foods, high in soluble or insoluble fiber, are associated with a reduction in blood pressure in individuals with slightly elevated cholesterol.

Eating lots of whole grains reduces high blood pressure. In a study published in the American Journal of Clinical Nutrition September 2009, men with the highest whole-grain consumption were 19 percent less likely to develop high blood pressure than men who ate the least amount of whole grains. While refining grains removes their outer coating, whole grains retain their bran and germ, so they are richer in many nutrients.

Longevity, living longer, lifespan
A 2015 study from the Harvard School of Public Health shows that each average daily serving of whole grains lowers a person's risk of dying from heart disease by 9 percent and lowers the overall risk of dying from anything by 5 percent over a quarter-century. That's even taking into account that whole grain lovers tend to do other healthy stuff, too. The benefits probably come from the bran, that fibrous coating that processing takes off of whole wheat and brown rice, the researchers write in the American Medical Association's journal JAMA Internal Medicine.

Pancreatic cancer
Medicine (Baltimore). 2016. Whole Grain Intake Reduces Pancreatic Cancer Risk: A Meta-Analysis of Observational Studies. Mounting evidence from epidemiology studies suggests that whole grain intake may reduce pancreatic cancer risk, but convincing evidence is scarce. We conducted a meta-analysis to assess the association between whole grain intake and pancreatic cancer risk. A high intake of whole grains was associated with a reduced risk of pancreatic cancer.

Allergy symptoms and allergies
Introducing cereals into the diet of babies before the age of 6 months does not increase the likelihood that they'll become allergic to wheat. In fact, a delay seems to raise the risk.

Whole grain cereals  and weight loss
High-fiber whole grain cereals may help dieters lose weight while making gains in some nutrients. In a six-month study of 180 overweight adults, whole-grain cereals helped people lose weight while boosting their consumption of fiber, magnesium and vitamin B-6. Their intake of these nutrients was higher than that of dieters who cut calories but did not eat whole-grain cereal. The implication is that fiber-rich cereals can help people cut calories while maintaining or improving the quality of their diet. The study, which received funding from Kraft Foods, Inc., was published in the Journal of the American Dietetic Association.

Avena sativa and cholesterol
Effect of Avena Sativa (oat bran) enriched diet on the atherogenic lipid profile in patients with an increased coronary heart disease risk. A controlled randomized lifestyle intervention study.
Ann Nutrition Metabolism. 2003.
We performed a randomized, controlled, parallel-group, single-centre study in which 1,994 patients from the Wehrawald Hospital were screened and 235 met the criteria male gender, hypercholesterolemia, and overweight. All patients in the Hospital took part in a 4-week standardized inpatient lifestyle health program consisting of dietary intervention, increased physical activity, and health education. Caloric restriction, fat modification, and avena sativa bran supplementation were part of the nutritional regimen within the lifestyle health program. Ninety-nine patients were randomized to a fat-modified diet with caloric restriction and a daily intake of 35-50 grams avena sativa bran and 136 patients to a fat-modified, oat bran-free diet with caloric restriction. The most significant decreases in total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B were found with the combination of the fat-modified and avena sativa enriched food. Added to a fat-modified diet, oat bran within a practical range of intake significantly reduces total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B.

Celiac patients and avena sativa
Adult celiac patients do tolerate large amounts of oats.
Eur J Clinical Nutrition. 2003.
The aim of the present study was to investigate whether adult patients with celiac disease in remission could include large amounts of oats in their daily gluten-free diet for an extended period of time without adverse effects. Twenty adult celiac patients in remission included large amounts of uncontaminated rolled avena sativa in their daily diet for a prolonged period. No adverse effects of a large intake were seen in small bowel histology, serology nor in nutritional status in the 15 subjects who completed the whole study period. The median intake of oats was 93 g/day and the compliance to the avena sativa diet was found to be good. Examinations of the patients after drop-out did not show any deterioration in small bowel histology or nutritional status nor raised levels of antibodies. Results from this study indicate that adult patients with celiac disease in remission can include large amounts of controlled wheat-free rolled oats for an extended period of time without adverse effects.

Salvia
Salba is a whole grain developed from Salvia hispanica L. and produced by Salba Corporation, Buenos Aires, Argentina. Salvia grain is a rich source of fibre, omega-3 fatty acids, calcium, magnesium, iron, and antioxidants.

Barley Bran Rice Bran Barley Flour Soy Flour Blanched Almond Flour Soy Protein Isolate Brown Rice Flour Vital Wheat Glutan Buckwheat Wheat Bran Corn Bran Wheat Germ Flaxmeal Wheat Grass Malted Barley Wheat Soy Isolate Oat Bran Whey Protein Oat Fiber White Corn Flour Polydextrose White Corn Meal Potato Flour White Rice Flour Potato Starch Yellow Corn Flour Red Flour Yellow Corn Meal Red Wheat Bran.

Inquiries
 I read that whole grains aren't as healthy as once thought. Can you please suggest any grains that don't rapidly break down into sugar?
    When consumed in moderate amounts as part of a healthy diet, these foods are a healthy addition to one's overall food intake. It is best to consume small amounts of several types rather than a high amount of one or two.

I am a 68 year old male with a history of cardiovascular disease and colon polyps. I have read with great interest and appreciation your articles on whole grain health benefits. I have now been presented by my support group with a drastically conflicting point of view regarding the health benefits of grains. They say grains have been shown to be very atherogenic, plaque-causing and severe irritants to the fragile endothelium of coronary arteries. They say they can cause gut irritation as well; to produce celiac disease, Crohn's Disease, diverticulitis. Please share your thoughts.
   Except in those who have specific GI problems (such as Celiac patients), studies in general have shown benefits of whole grains, when ingested in reasonable amounts and in a wide variety, as part of a diet that includes a variety of other foods as listed on this page. Many cultures have based their diets predominantly on grains and the people who live in those countries do not seem to have an excess health issues.