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Are Whole Grains Healthy Or Bad For You?

By Charlie Seltzer, MD / February 20, 2016

Grain-bashing and anti-wheat sentiments seem to be all the rage these days. It’s not much of an exaggeration to say some people think grains are the cause of all of society’s ills.

In this article, we will examine both sides of the argument, who is making the arguments, what the evidence says and finally, why it doesn’t matter in the real world.

The USDA defines grains as: “Any food made from wheat, rice, oats, cornmeal, barley or other cereal grains.” Examples are bread, pasta, oatmeal, breakfast cereals, tortillas and grits. Whole grains contain all parts of the kernel, including the bran, germ and endosperm. Refined grains undergo a process that removes the bran and the germ.

Grains Are Bad For You – The Anti-Grain Argument

Here are a few of the arguments the anti-grain camp make, though the list of grains’ purported evils is much more extensive:

  1. Grains were not regularly consumed for most of human history. Therefore, humans lack the ability to digest and utilize grains, essentially making them a toxin.

    Note: It is true that grains were not consumed for the vast majority of human history. However, evolution is constant, and it is completely reasonable to believe that humans have indeed evolved mechanisms over the past 10,000 years to digest wheat and grains, and that’s assuming humans weren’t able to digest them in the first place, a claim which also has no evidence behind it.

  2. Gluten, a protein component of grains, causes adverse reactions in the majority of people, ranging from water retention, weight gain, fatigue, and memory issues, to severe, chronic illnesses like heart disease and cancer.

    Note: Celiac disease, a condition in which the body views gluten as an “invader” and fights it with its immune system, is becoming significantly more common. (The reason for this is unknown.) Celiac disease is diagnosed by removing a tiny portion of intestine and looking at it under the microscope. Additionally, certain blood tests can reflect Celiac.1

    However, a growing number of experts believe that certain individuals can have sensitivity to gluten without having actual Celiac Disease. For example, Alessio Fasano, MD, who heads the Center for Celiac Research at the University of Maryland, has concluded through his research that around 18,000,000 Americans (between 5 and 6%) have some degree of gluten sensitivity. On the other side of the argument, research from the Columbia University Celiac Disease Center found rates much lower, around 0.55%. Once again, research has been inconclusive and until biologic markers are found that can diagnosis the disorder, the true prevalence will not be known. Still, if you think you may be sensitive to gluten, then by all means try a gluten free diet and see how your body responds.

  3. Grains cause a massive spike in insulin leading to diabetes and obesity.

    Note: The processing of grains, which removes what many believe to be the “healthy” part of the grain, yields a product which elicits a much greater insulin response. Whole grains, on the other hand, cause significantly less insulin release. Furthermore, while excess insulin certainly promotes fat storage, fat gain occurs when more calories are consumed than expended. Spikes in insulin can temporarily trigger fat accumulation, but in the setting of an overall calorie deficit, this will quickly be reversed and the net effect will be fat loss.

  4. Grains contain a chemical called Phytic acid, which binds to minerals such as calcium, leaching them from the GI tract and contributing to bone weakness and osteoporosis.

    Note: A large research study examined this hypothesis and concluded that Phytic acid does not affect bone density or markers of calcium absorption.2

  5. Grains contain “antinutrients, which are plant-based defense mechanisms that interfere with digestion and allow the absorption of toxic materials into the bloodstream.

    Note: While antinutrients can certainly be detrimental to good health, there is evidence that certain antinutrients actually have health promoting properties. For instance, phytic acid, lectins, phenolic compounds, amylase inhibitors and saponins have been shown to reduce the blood glucose and insulin responses to starchy foods. In addition, phytic acid, phenolics, saponins, protease inhibitors, phytoestrogens and lignans have been related to reduced cancer risks.3

    When traditional cultures consumed grains, they were always soaked or fermented first, and/or allowed to sprout (or grow), which in theory makes them more digestible and increases nutrients.4Again however, there is conflicting evidence. Some research has shown sprouted grains have no greater nutrition than unsprouted.5

Grains Are Healthy – The Pro-Grain Argument

  1. Whole grains contain an abundance of nutrients and fiber which contribute to a healthy, balanced diet.
  2. Whole grain intake promotes satiety, or the feeling of fullness, making it easier to consume fewer calories and maintain a healthy weight.6
  3. Research clearly shows that diets high in whole grains decrease risk of diabetes, heart disease, certain cancers and high blood pressure.78
  4. There is no evidence that diets containing gluten do harm to people without Celiac Disease.
  5. Research suggests that people who consume diets high in whole grains tend to have healthier weights and gain less weight over time than those who don’t.910

You can see that the claims are often completely contradictory.

Who Believes Grains Are Bad For You?

On one hand, there are well-respected and knowledgeable PhDs, medical doctors and dietitians who believe that grain consumption is detrimental to health. In researching the anti-grain argument on the web, however, it became very clear that many of the websites bashing grains were personal blogs and group web pages run by people with little to no scientific background or training. This doesn’t discredit them automatically, but brings up an interesting point. I found that scientific support of their conclusions was either lacking, or taken from bits and pieces of different research papers (mostly out of context) and combining it with theory.

Who Believes Grains Are Healthy?

This group of people was made up mostly of physicians, epidemiologists (people who study the patterns, causes and effects of health and disease conditions in defined populations) and researchers. Cites and sources espousing the benefits of grains include the Mayo Clinic, Centers of Disease Control and Prevention, National Institutes of Health, and the Harvard School of Public Health. Their stance is backed by large volumes of peer-reviewed literature, including huge review studies examining thousands and thousands of people. Could all of these establishments be misguided or part of a larger conspiracy as the anti-grainers would have you believe?

It is not out of the realm of possibility, and certainly it is possible that the research doesn’t tell the whole story. Take fat, for example. Until relatively recently, the traditional medical establishment viewed dietary fat as the cause a host of diseases and encouraged people to essentially avoid it at all costs. This turned out to be inaccurate, so it is important to look at the bigger picture and take all research with a grain of salt.

So, Should You Eat Grains?

Let’s look at this in the real world, using a patient of mine to illustrate my point. I saw a woman who underwent extensive allergy testing. She came into my office with a list of 32 foods she was “allergic to.” One of them was garlic. She explained that she had been eating garlic her entire life without noticing any negative consequences. After getting the results, she completely eliminated garlic from her diet for 30 days and noticed no change in anything.

She asked if she could start eating it again. I said yes. And here is the problem with tests like that- just because you are technically “allergic” to something may or may not have any real-world relevance. If a food turns up positive but you suffer no ill effects from consuming it, then what does eliminating it do? On the other hand, if eating a particular food makes you feel sluggish or sick, or makes you retain water, are you going to continue eating it because your allergy test came up negative for that food? I hope not.

Recommendations:

What do you think? Are grains healthy, or bad for you?

Show 10 References

  1. These include: EMA (Immunoglobulin A anti-endomysium antibodies); AGA (IgA anti-gliadin antibodies); DGP (Deamidated gliadin peptide antibody); tTGA (IgA anti-tissue transglutaminase)
  2. Fenton TR, Lyon AW, Eliasziw M, Tough SC, Hanley DA. Meta-analysis of the effect of the acid-ash hypothesis of osteoporosis on calcium balance.J Bone Miner Res. 2009;24(11):1835-40.
  3. http://www.sciencedirect.com/science/article/pii/096399699390069U. Accessed June 28, 2013.
  4. http://www.westonaprice.org/food-features/be-kind-to-your-grains
  5. Lorenz K. Cereal sprouts: composition, nutritive value, food applications. Crit Rev Food Sci Nutr. 1980;13(4):353-85.
  6. Samra RA, Anderson GH. Insoluble cereal fiber reduces appetite and short-term food intake and glycemic response to food consumed 75 min later by healthy men. Am J Clin Nutr. 2007;86(4):972-9.
  7. Pereira MA, Jacobs DR, Pins JJ, et al. Effect of whole grains on insulin sensitivity in overweight hyperinsulinemic adults. Am J Clin Nutr. 2002;75(5):848-55.
  8. Jensen MK, Koh-banerjee P, Hu FB, et al. Intakes of whole grains, bran, and germ and the risk of coronary heart disease in men. Am J Clin Nutr. 2004;80(6):1492-9.
  9. Liu S, Willett WC, Manson JE, Hu FB, Rosner B, Colditz G. Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle-aged women. Am J Clin Nutr. 2003;78(5):920-7.
  10. Mckeown NM, Meigs JB, Liu S, Wilson PW, Jacques PF. Whole-grain intake is favorably associated with metabolic risk factors for type 2 diabetes and cardiovascular disease in the Framingham Offspring Study. Am J Clin Nutr. 2002;76(2):390-8.

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27 Comments

  • Meghan says:

    Thanks for this article. I appreciate the work you did to uncover the truth behind a complicated issue. I am hearing the anti-grain sentiment everywhere so it is helpful to hear a reasonable even-handed overview. I have a couple of questions if you have time.

    1. You wrote that "There is no evidence that diets containing gluten do harm to people without Celiac Disease." By this, do you mean that you found no respectable research to conclude this or that there is actual evidence from reputable sources that gluten does not harm non-celiac people?

    2. When you say that grains promote satiety, why is it that some people might find that they increase hunger as you say toward the end of the article? (possibly another article topic?) ;)

    Thanks again!!
    M

    • Charlie Seltzer, MD says:

      Hello Meghan-
      1. That point was listed under the "Pro Grain Argument." There IS evidence that gluten can cause harm but according to grain advocates the evidence is "not good." As with most things, the research on this is open to a certain degree of interpretation. I happen to believe that gluten can be detrimental to health in certain people who do not have Celiac disease.

      2. People react differently to different foods, and one person may experience increased hunger when eating grains while another may not. That conclusion comes from studies and as we know studies of populations are frequently not applicable to individuals.

      I hope this helps. I know these answers are less than definitive.

  • Sara Keenan says:

    Thanks for the article Charlie,

    In the last year working with you I have hardly eaten grains, but not intentionally. Needing 1400 calories per day including 100 grams of protein meant most of my calories came from lean meats, fruits and veggies just so I could squeeze in the needed food to hit those targets and eat a pile of something, not a tiny bit. There was no room left over for grains and I haven't missed them. I do believe that the lack of grains (not a pasta dish, rice dish, no potato and no bread) for a year made the 100 pounds fall right off me. For satiety I used water or other zero calorie liquids. 32-60 oz of water or Power-Ade Zero will make the empty stomach feel full anytime of day or night so no need for grains to do that. Had my first bite of rice pilaf (that came with salmon and veggies at a restaurant) on over a year last week and it seemed completely unneeded. The meat and veggies felt like the most satisfying, but that may just be conditioning after a year without.

  • Brian says:

    This is a good and timely article given all of the conflicting views floating around, and this both-sides type of evaluation is what I love about your site. My mother has full blow celiac disease that she's lived with her whole life and she has become quite learned on the subject. One thing your article doesn't mention is how long to try a dietary elimination for. When my daughter tested positive for gluten allergy, the allergist said to take her off for 30 days before making a decision. My mom, who's lived with it her whole life, said it can take multiple months for your digestive system to stabilize and heal. Is there a rule of thumb for dietary eliminations, insofar as how long you need to let it run before deciding whether it's making any difference?

    • Charlie Seltzer, MD says:

      Recommendations vary from 1-2 weeks for children up to 4+ weeks for adults. There doesn't appear to be a clear answer, but I think if you are not seeing any changes at all after 4 weeks, then continuing is not likely to have a positive effect. Again, though, every one is different. If you are seeing even minor changes for the better after 4 weeks, it makes sense to continue as long as changes for the better occur. If you decide to reintroduce, pay careful attention to negative changes and use common sense from there. I hope this helps.

  • Kristin says:

    Interesting article. I was recently diagnosed with an autoimmune disorder - apparently a rather common issue amongst women. The individual I am working with wants me to follow a Paleo AIP protocol. I don't eat many grains anymore anyhow for the reasons Marc and Scott mention, but it is crazy hard trying to live 100% AIP Paleo (esp since I am not a big fan of meat. Love my veggies at least :) ). That and I am not showing any gastrointestinal issues (she still thinks I, at minimum, need off of gluten). Though sensitivities are touched on in the above article, I would be curious as to if indeed there is a connection between autoimmune issues and gluten sensitivity. Dr. Seltzer are you familiar with this, or did you come across this in your research?

    • Charlie Seltzer, MD says:

      Kristin-
      There does appear to be a connection between autoimmune disorders and gluten intolerance. A number of patients in my practice suffer from thyroid disease and gluten sensitivity.
      There is a well-researched connection between Celiac and Hashimoto's Thyroiditis (an autoimmune thyroid disease). I came across a number of research papers which demonstrated a reduction or disappearance of antibodies against the thyroid after following a gluten free diet.

      • Kristin says:

        Thank you for the response - and for the above information on elimination diets (though other than weight issues, I tend to be pretty asymptomatic anyhow). It is Hashimoto’s Thyroiditis I was diagnosed with actually (hopefully nothing else!). Looks like I would best be off gluten then (please no correlations with dairy! LOL) I assume those articles are up on Pub Med?

  • Marian Cerny says:

    I'm not entirely against grains, but I do think you should avoid insulin spikes in general most of the time. Refined or not, you should definitely not base your diet around grains.

    I'm also a little concerned about phytic acid and the other anti-nutrients, so I limit them as much as I can. I eat a piece of white bread from time to time, but it's always a part of a massive meal.

    In general, I think people are better off without grains than with them.

    • Charlie Seltzer, MD says:

      I agree with that. I do think that insulin spikes can be beneficial around intense workouts but only in people with no evidence of insulin resistance. It is also important to remember that protein can cause significant release of insulin as well, as can the ingestion of certain amino acids like leucine. This generally acts to lower blood sugar, and at least in animal models, can reduce the risk of developing diabetes.

  • Dave says:

    As with many things you can always find a scientist who backs you up - especially if you fund their research so imho Charlie's advice about trying it yourself is the only way to go.

    I read a blog posting which described the symptoms of gluten intolerance and realized that a) I had most of them; and b) I had previously assumed they were all just stress related and that my excess body fat was due to lack of exercise. I decided to try it out.

    I gave up gluten and lost 45 lbs out of 225 lbs over the next four months, cleared up minor skin and nasal allergies, slept better and had massively higher energy levels even without any additional exercise. I had a 25 year old pair of levi's that i couldn't wear any more because they were so baggy they looked like they belonged to my big brother!

    The trick is to give up _all_ gluten for _at least 30 days_. I stopped eating bread, pasta, cakes, biscuits and also avoided the less obvious problem foods like soy sauce and Colmans English mustard (read the labels - I had no idea either). Don't bother with gluten free stuff - they tend to be stuffed with sugar. Just stick to non-processed foods like meat, fish, fruit and veg. There are plenty of paleo websites out there with how-tos and hundreds of recipes.

    And dont forget wine, whisky, wagyu and 85% dark chocolate are all gluten free :)

  • johnny moore says:

    i go with Ezekiel Bread only. Can't go wrong with it... Great article by the way.

  • Arista says:

    This is a great article, thank you for being unbiased and citing your sources, that can be hard to come by! I have a couple questions if you have the time,

    You state that "While antinutrients can certainly be detrimental to good health, there is evidence that certain antinutrients actually have health promoting properties," then go on to explain the benefits of antinutrients. I am curious about the first part of that statement, that antinutrients can be detrimental to good health. How so are they detrimental and would you say that the benefits outweight the detriments?

    Also, I am on a gluten-free diet. I had problems with my skin, took gluten out of my diet, noticed no change, then when I tried to reintroduce it reacted with severe GI problems. I was wondering, how strict of a gluten-free diet is necessary? By consuming trace amounts of gluten found in things such as soy sauce or other condiments, if I have no negative GI effects am I still somehow harming my body?

    Thanks again for the informing article!

    • Charlie Seltzer, MD says:

      Antinutrients are thought to interfere with the absorption of other nutrients. To answer your questions honestly, I just don't know. I would like to see more research before I comment definitively.

      As far as miniscule amounts of gluten harming your body, again I don't know for sure, but if you forced me to answer I would say it is fine. The stress you would put yourself under trying to eliminate 100% of gluten from your diet would likely more than offset any minor benefit you would get from it. In the big picture, if you feel well, are able to maintain a healthy body composition eating the way you do and have no overt symptoms stemming from your nutritional plan, I think it is reasonable to stick with it.

      I hope this helps and thanks for reading my article.

  • Quinton says:

    Hello, Me and my wife have started doing a Perfect health diet approach to Eating, A basic paleo template that includes high safe fats and proteins, omega 3s with an allownce of dairy and Potatoes. we've seen Great weight loss results and we feel much better. Altho i do have to concede we were drinking sodas and Eating allot of processed boxed food before this. so anythings better then that.

    But I'm still hung up on grains and soy. The Saturated fats argument was understandable, and the turn around to the original idea of it being benign if not healthy and stable fat is refreshing to hear, also the boycott of industrial seed oils seems to be a no brainer. (I Digress)

    Never before have I seen so many polarized data sets and opinions over this subject of grains and soy.

    My wife and I have never had many issues with them before. Other then some bloating after eating a whole loaf of bread by itself. But the horrors of lectins and insulin spikes, Omega 6 Increases (which allot of things are to blame for that) and antinutriants you hear about from the paleo crowd are hard to ignore. and quite demonizing. I Just want to stay within the margins and Not be Sick.

    Im starting to feel like everything in moderation is the way to go. Staying away from Boxed freezer food and eating based on a whole foods, close to source Diet, (maybe being a little light on grains) and just not Adding More to the hormonal storm by Stressing over subjects like these.

    What do you think on that take? safe?

    • Marc Perry, CSCS, CPT says:

      @Quinton - I couldn't agree more on your stance. I think stressing about food can literally lead to eating disorders. That's why I'm so hesitant to recommend the paleo diet because while philosophically I agree with it, I think it's extremely impractical for most people and just too difficult to sustain. My opinion is eat foods that are whole foods and that make you feel good. Eating whole foods is hard enough for most people! If you eat grains, dairy, or beans, and you feel great, so be it. There are too many examples of healthy people who eat these demonized foods and live very, very long lives. Just today, a story came out about a man who may be 123 years old, the oldest person on record. Whether or not he is, apparently barley is a staple of his diet, and he used to eat beans as well => Bolivia Records: Aymara Herder Is 123 Years Old. Also consider the Japanese who eat a lot of noodles and rice and have very long life expectancy!

  • Carbless says:

    1. Westerners/Asians have a much easier time digesting grains than say a native american.. probably through evolution.

    3. Growth hormone and insulin are opposites and when 1 is higher than other is lower. Consuming any kind of carbohydrate increases insulin levels. Insulin spikes for short periods of time for example after a workout are desirable but a steady intake slowly digesting in your stomach is counter productive for most.

    4. Phytic acids attaches to important minerals and flushes them out through the GI track... does anyone even need more information than this?

    5. Anti nutrients can lower blood sugar and reduce insulin response to starchy foods? So what! Is blood sugar a bad thing? Well put it this way... if it's a bad thing you will get a much bigger rise by eating a food composed of majority carbohydrate than any lowering effect the anti nutrients will have. So what is the point here? Eat food full of sugar and add poison so that you can slightly lower the level of sugar that goes to your blood?

    Oh and the reduced cancer risk is iron-mediated colon cancer risk. Not quite the same.

    The "pros"

    1. Contains nutrients and fiber... so does broccoli.. more and better quality nutrients.

    2. It makes you full? Wow.. I guess if it makes you feel like you've eaten you don't need to eat anything else.

    3. Diets high in whole grains reduce risk of diabetes? And? This is not cause and effect. Diets with 0 whole grains at all can be tailored to show the same thing.

    4. Yet people without celiac disease are popping up everywhere with gluten sensitivity.

    5. Is this not the exact same point as no. 2?

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