Should You Eat Grains?

It is likely you will have seen or heard the debate about whether we should eat grains and more particularly wheat, either in the media or elsewhere.

This has produced a very polarised debate within the health and fitness industry.

So, are they essential foods, which should form the foundation of a healthy and nutritious diet, or are they evil packages of carbs and toxins that make you fat and inflame your body?

On the grains side, we have many advocates of vegetarianism, veganism and macrobiotic diets.

On the anti-grains side, we have the paleo movement, followers of the Atkins diet, the release of books like ‘Wheat Belly’, and others, that argue that we shouldn’t eat grains because our ancient ancestors didn’t and that we can’t digest them properly.

Couple that with the increased awareness of Celiac disease and the apparent rise in gluten or wheat intolerance and we have many in the population who now fear gluten in their foods.

So, when we talk about grains, what are we talking about?

Grains are classed as the seeds of grasses, that have been a food source for many centuries for people all over the world. In this country, we are familiar with wheat, rice, oats, corn, barley, buckwheat and rye, but there are lots of lesser-known grains such as triticale, quinoa, teff, amaranth, sorghum, millet, spelt and kamut.

Those who are supporters of the Paleo diet argue that they are relatively new addition to our diet, however, there is evidence that humans have eaten grains for millions of years in some shape or form. The hunter-gatherer period of history ended when we learned to cultivate grains.

Grains provide a wide variety of nutrients, including vitamins, minerals, fibre and phytonutrients.

Most of these nutrients, however are mostly only present in whole grains.

Much of the grain based food we eat isn’t whole grain though, but are grains in a refined form, where they are milled and have the bran and germ removed. These refined grains provide all the carbohydrates, but have little of the original nutrient content.

Products that contain refined grains often have extra fat and salt to make them more palatable. This makes them tastier and easy to eat, but less filling. This makes them easy to overeat and can contribute to increased weight gain and chronic disease.

So considering all these factors it is best to minimise your consumption of refined grains.

Are whole grains any healthier?

Opponents of grain consumption argue that grains cause systemic inflammation, intestinal damage, obesity, and other conditions. However, what does the scientific evidence that has looked at grain consumption say?

Those studies used by opponents of grains that have concluded that grains cause inflammation were not particularly well carried out and have shown little evidence of cause and effect. Other studies which look at the patterns, causes, and effects of health and disease conditions in defined populations (epidemiological) have suggested whole grain intake that actually reduces levels of inflammation.

These were not controlled studies and so the results only suggest correlations. There hasn’t been one controlled study that points to the consumption of whole grains leading to increased inflammation within the body.

There is a view that inflammation is the root of all health problems, and that all health problems can be traced back to your diet and the health of your gut. However, there is no real evidence for this.

Food sensitivities can cause inflammation, which may or may not lead to disease, but it is currently believed that inflammation is a result of already existing disease and that it exacerbates conditions that are already present.

Therefore, it is believed that inflammation probably does not cause most diseases, even those with an inflammatory component.

Another argument put forward by those that are anti-grain is that it causes intestinal damage since they contain ‘anti-nutrients’ and other compounds that interfere with your absorption of minerals.

Those studies that have investigated this theory, found that eating various amounts of whole wheat flour, wheat bran, and/or oat bran had no significant effects on absorption or blood levels of major minerals like calcium, zinc, or iron.

According to the current evidence, I would suggest that unless you were eating excessive levels of whole grains then the absorption of minerals and health of your gut will not be adversely affected.

Whole grains, especially wheat, rye and barley contain a protein called gluten, which creates the elasticity present in flour when things like bread are made.

Intolerance to gluten does exist and is the main trigger in Celiac disease. Those affected by this disease do suffer inflammation, particularly in the gut, making it more permeable (meaning it allows increased passage of toxins and nutrients to and from the gut), and inhibits proper digestion.

This can cause conditions such as diarrhoea, nutrient deficiencies, osteoporosis and even cancer, and this means sufferers must completely remove gluten form their diet. However, the disease is still not well understood and isn’t straightforward to diagnose.

The incidence of the disease is still fairly small and figures have estimated that around 0.3-1.2 percent of the population suffer from Celiac disease. It has been speculated that between 10 and 20 percent of the population may suffer some other form of gluten intolerance, which can result in some of the same symptoms (bloating, pain, diarrhoea) without the same level of intestinal damage or biological markers of Celiac disease.

However, there is little concrete evidence of the existence or extent of gluten intolerance.

So unless you have been diagnosed with Celiac disease, there is little evidence to support eliminating gluten from your diet. If you haven’t been diagnosed and still feel you don’t tolerate gluten, then you can adopt an elimination diet and judge how you feel after eliminating it.

People whether they are actually gluten intolerant or not, should also be wary of consuming too many gluten-free products as these are often packed with extra sugar and fat to make them more palatable and substitute for the removed gluten.

Otherwise, if you feel that eating grains doesn’t cause you any intestinal issues and you are happy with your current body composition, then whole grains can form part of your healthy diet. As with everything else don’t go overboard though.

If you don’t have Celiac disease and haven’t been diagnosed with an intolerance, but still feel you suffer from some of the symptoms associated with these conditions (pain, bloating and gas), then there is now a suggestion that the issue may be related to FODMAPs (oligo-saccharides, di-saccharides, mono-saccharides and polyols).

These are carbs that are found in some grains, but also in dairy, vegetables, fruits and other foods. It appears that some people don’t break these down or absorb them properly. This then leads them to draw water into the gut and these are then fermented by the gut’s bacteria, but instead of producing methane, they produce hydrogen and cause all the undesirable symptoms I mentioned above.

Again, the extent of this problem is far from conclusive, but again you can experiment using the elimination diet with foods you feel may be causing you problems.

There are some within health and fitness industry who argue that mass consumption of carbs and in particular, grains have led to the current obesity crisis in the western world.

Is that true?

Well the research has mostly been of the epidemiological variety, which as we have discussed before only produces correlations rather than cause and effect. However, the evidence from these has shown a positive relationship between higher whole grain consumption and lower body weight.

Those trials which have been controlled have produced less consistent results. These have produced results that suggest that whole grains don’t lead to better fat loss, but conversely, they also didn’t show that they lead to weight gain either.

Those who consume high grain diets, predominantly those on plant-based diets, do not have a higher incidence of being overweight or obese.

While all the above evidence is not absolutely conclusive, it is likely the data would show if there were some trends and correlations between grain consumption and weight gain (other than overconsumption).

There is a real distinction here though between whole grains and refined grains. Whole grains have many more benefits. They are high in fibre (improves gut health), are digested slower (improves blood sugar management, is higher in vitamins and minerals and improves satiety.

Processed refined grains have almost none of these benefits. It is difficult to avoid refined grains as they are used in so many food products, but it is certainly prudent to limit their intake.

So, firstly, are whole grains crucial for health, and secondly, are they essential in your diet?

The answer is no, in the sense that you could survive without any particular food group, but they can form part of a healthy diet. So, I would reject the notion that grains are bad for your health, but I would also reject the notion that they are superfoods too. The answer as with most issues in nutrition, usually lies somewhere in the middle.

Grains are difficult to avoid in the western world. They are used in many of the products we find in our supermarkets, restaurants, fast food joints and in children’s school meals. As a society, we consume them in massive quantities, but if you tolerate them well, then you can happily include them in your diet.

I will finish with a quote from the dietician and nutritionist Brian St. Pierre which sums up the context in which grains should be put.

“In reality, foods are often a mixture of both good and bad outcomes, depending on what the diet as a whole looks like, the amount of food X or food Y being eaten, and the person who’s eating them.”

It’s about finding the foods that work for you and the proportions you should eat them in.