Grains: The “Whole” Truth

  • Grains contain carbohydrates, fiber, vitamins and other nutrients and are an important part of a healthy diet.
  • Some incorrectly label all carbohydrates as bad and unknowingly avoid important nutritional benefits of whole grains.
  • Chose whole grains and avoid processed or refined grains which lack the healthy elements of whole grains. Increased consumption of refined or processed grains can contribute to weight gain and an increased likelihood of prediabetes and diabetes.


Grains, also known as cereals, are members of the grass (Gramineae) family of plants and produce a fruit, which is commonly referred to as a kernel, grain, or berry. A “whole” grain product according to the Food and Drug Administration (FDA) refers to the seed of a plant which contains all components of grain: the  bran (fiber), endosperm (carbohydrates) and germ (the embryo) in the proportions one would expect to see in an intact grain. Examples of whole grains include whole wheat  flour, bulgur (cracked wheat), oatmeal, whole cornmeal, and brown rice. According to a 2006 FDA report a food product must contain at least 51 percent of whole grains by weight to be labeled “whole grain”.

Don’t be fooled

It is often confusing when trying to purchase a whole grain product and this is particularly challenging with bread. A multi-grain bread, for instance, sounds appealing when you are trying to cut down on those starches that can spike blood sugar and add inches to your waist but beware.

Your favorite multi-grain bread may not actually be a whole-grain product. Look carefully for the first ingredient in the listed ingredients of your multigrain product and if the first one is enriched flour, not whole wheat flour, all you can be sure of is that it’s made with more than one type of grain and the product is not a whole grain bread. To make matters worse, many multi-grain labels use confusing terms such as “stone-ground” or even “100% wheat” so don’t be led astray. Remember, the ingredients are listed in proportional order so that if the first ingredients is not whole grain -but enriched flour, stone-ground, or made of 100% wheat -the product is not a whole grain product.

Look for the word “whole” such as whole wheat or whole grain and disregard the misleading words such as multi-grain, stone-ground or even 100% wheat.

Other whole grains when consumed in a form that includes the bran, germ and endosperm include: barley, buckwheat, corn, including corn meal, millet, oats, brown rice, rye, sorghum, tiff, triticale and different types of wheat: spelt, emmer, farro, einkorn, Kamut, durum, and forms like bulgur, cracked wheat and  wheat berry.

  • Compared with intact whole grains processed or refined grains will have lower fiber and nutrient levels — with only the residual least nutritious endosperm component left. Refined grains are more likely to trigger weight gain, inflammation and blood-sugar imbalances and act more like sugar with a higher glycemic index than whole grains. The glycemic index (GI) is a way of measuring how food influences blood sugar. Whole grain products have a lower glycemic index than refined grain meals. Avoidance of a high glycemic carbohydrates in favor of a diet rich in whole grains would be expected to reduce the risk for cardiovascular disease, diabetes and obesity. Some examples of refined grain products are: white flour, de-germed cornmeal, white bread, white rice.

Refining wheat to create white flour is a process that strips away more than half of wheat’s B vitamins, 90 percent of the vitamin E, and virtually all of the fiber. Similarly finely ground grain is more likely to cause a spike in insulin and blood sugar levels. Whole grains unlike refined grains are also associated with lower total cholesterol, low-density lipoprotein cholesterol (LDL), triglycerides, and insulin levels. In addition to traditional whole grains one can also consider pseudograins (ancient grains) that share similar health benefits.

Health outcomes with whole grains

  • Better digestive health from the fiber in whole grains helps prevent intestinal disease such as constipation, diverticular disease and colon cancer.
  • Prevention of diabetes is possible with increased whole grains consumption (consider brown rice simply substituted for white rice). An 18 year study of more than 160,000 women showed a 30% lower rate of new type 2 diabetes with an average of 2-3 servings of whole grains a day compared to those who rarely ate refined grains (Arch Intern Med. 2010; 170:961-9). In another study whole grain, bran, and germ intake lowered the risk of type 2 diabetes (PLoS Med. 2007; 4:e261).
  • Improved cardiovascular health was demonstrated in the Harvard-based Nurses’ Health Study, that compared women who ate 2 to 3 servings per week of whole-grain products (mostly bread and breakfast cereals) to those who ate less than 1 serving. After 10 years a 30 percent lower rate of major cardiovascular events including heart attack or heart disease death was found in the whole grain group  (American Journal of Clinical Nutrition. 1999; 70:412-9). Another study considered an extensive analysis of 7 studies (this is called a meta-analysis) that looked at whole grain consumption and found those who ate 2.5 or more servings of whole-grain foods a day compared with those who ate less than 2 servings a week showed a 21% lower rate of heart attack, stroke, or coronary bypass or angioplasty/ stent procedure rate (Nutr Metab Cardiovasc Dis. 2007).

Pseudo grains

Pseudograins are not true grains and unlike grains are derived from broad leaf plants. They are an excellent source for a nutrient-dense and gluten-free equivalent to whole grains that are ideal for people with food allergies or intolerances and the more than 50% of Americans with prediabetes or diabetes. Pseudograins are metabolically similar to whole grains and are a healthy alternative to processed (refined) grains. Examples of pseudograins include the following: amaranth, quinoa, wild rice, and buckwheat. They are also known as ancient, heritage or heirloom grains since their cultivation and use dates back many thousands of years.

  • Amaranth was a highly valued nutrition staple in Aztec culture nearly 8,000 years ago. Amaranth is an excellent source of high-quality protein, fiber, calcium, magnesium, iron, copper, and phytosterols.
  • Quinoa considered “sacred” by the Incas is considered by many the “super grain” and contains all eight essential amino acids, making quinoa a complete protein food. It can contain up to 50% more protein than common grains. Quinoa is a healthy food choice and an easy-to-prepare substitute to white rice and can make a healthy breakfast alternative to oatmeal.


Carbohydrates come in may forms and details (found on labels) are important. Grains are carbohydrates but too often they are highly processed and are missing all health promoting grain constituents: the bran (fiber), the germ and endosperm. Wheat germ, bran cereals, and multigrain breads for example are often misconstrued as whole grain produces but are not. Consider pseudograins -with very similar metabolic effects to whole grains but without gluten.