Why is whole grain better is a complex subject as it affects many systems in the body from spiking blood glucose to beneficial metabolites like serotonin from the microbiome in the colon.
And the gluten controversy must be squarely faced.
True stone ground wholemeal, so called "wholegrain" and cake flour.
There is a massive body of research now revealing how refined grains contribute to obesity, type 2 diabetes and heart disease; new work has also clearly shown that they play a major role in causing dry age-related macular degeneration too, the chief cause of blindness in persons over fifty.
Over five million Americans are needlessly blind, and many more partially sighted; all because of cake flour.
In theory, 'whole grain' should mean the flour contains the bran, germ and endosperm in the exact same proportions as found in the original kernel. In practice, it hardly exists because the oils are rapidly oxidised once the shell is cracked. So what is to be done?
Whole grains are better because they help decrease weight and body mass index. There are numerous reasons for this.
Firstly, whole grains promote satiety, meaning we are less likely to feel the need to snack, usually on refined carbs. Stomach contents are released more slowly, slowing the unlocking of glucose from the starch for absorption in the small intestine, and thus into the blood stream.
Secondly, more calories are excreted in the faeces of those on a high fibre diet. And thirdly we then benefit from a higher resting metabolic rate; we consume more calories when not active than those enjoying the refined grains used for making bread, cookies and most breakfast cereals.
Put bluntly, those who eat whole grains are less fat; or, those who enjoy refined carbohydrates are far more likely to be obese.
"The calories in corn flakes, refined white bread and rice, and potatoes is 100% glucose."
- Dr Dariush Mozaffarian, MD, PhD
New potatoes are the exception, by the way, if you can get them. That is why we grow them, and never buy them from cold storage.
Restriction of calories has proved largely unsuccessful in promoting weight loss; simply changing to whole grains and oddly adding healthy fats to your food has proved far more effective. It is all about constantly feeling hungry when dieting.
Type 2 diabetes mellitus (T2DM) is the most common metabolic disease worldwide. Currently there are over 400 million cases, and the prevalence is predicted to increase by 50 percent by 2040.
Lifestyle interventions including a change to whole grains, and daily exercise, particularly immediately after a starchy meal, presents the best initial strategy to prevent and treat T2DM.
Strictly excluding all refined carbohydrate as is used in the various ketogenic diets is the next step; and for those who are unstable diabetics, restricting all starches to less than 50g per day, and perhaps even less.
The raised blood glucose of diabetes results in profound inflammation of the capillaries and larger vessels, and consequent cardiovascular disease. Then there is consequent raised blood pressure and insulin resistance. Together these are known as metabolic syndrome.
It is no coincidence that cardiovascular disease is the number one cause of death. Simply replacing a refined starch with a whole grain is the simplest effective strategy to change all of this.
Actually there is nothing simple about it; it means foregoing all supermarket bread, or baking your own.
Regrettably, since the oils in 100% flour go rancid very quickly after milling, virtually all bread is made from grains that have been refined to one degree or another.
There is a big fat lie in legislation worldwide regarding bread; bakers are allowed to call it whole grain provided that not more than 40% of the content has been removed, notably the fibre and germ. Supermarket bread is a major cause of obesity, diabetes and cardiovascular disease.
If you love bread there is only one solution. Mill your own flour and bake a loaf, unless you can find a bakery that does that; there are extremely few.
It takes but five minutes to mix the ingredients for our low GI bread, including milling the wheat.
The fibre in whole grains go a long way to alleviating constipation, though in my case it is not enough. I have a lazy colon and have had since childhood.
Over and above the insoluble fibre making whole grains better, I personally have to have soluble fibre too on a daily basis; that means fruit and greens at least twice a day. Then I have no difficulty whatsoever. The malignant colorectal tumours associated with constipation are horrific.
Researchers working at the Tufts' Friedman School of Nutrition state that there is strong data showing that those who consume high GI foods with subsequent rapid digestion of the starches in refined grains are at a higher risk of contracting age-related macular degeneration, the chief cause of blindness in older folk. They cause dysfunction of the cells in the retina and loss of photoreceptor cells.
They investigated the effect of a high GI diet from refined starches as compared to a low glycemic diet from whole grains, but with the same number of total calories, on mice.
There were clear signs that those mice on a whole grain diet had far less loss of pigmentation and atrophy of the retinal cells, or the accumulation of toxic fatty cells caused by 'glycation'; the bonding of a sugar molecule onto a lipid or protein molecule in the cells of the eyes.
These advanced glycation end products are implicated in many degenerative diseases including macular degeneration, with consequent loss of sight.
They attributed this to the types of bacteria found in the gut. Those on a high glycemic diet had many pathogens of the Clostridiales order in the colon, but those on whole grains gained protection from the healthy Bacteroidales bugs; they released certain eye protective metabolites including serotonin.
Interestingly, changing the diet half way through the research to a third group of mice arrested and even to a degree reversed the macular degeneration.
The 2015 dietary guidelines for Americans recommending replacing some refined grains with whole grains until they make up no more than 50% of the diet.
Whilst that may be suitable as an achievable first step, we believe it does not go nearly far enough. We personally eat virtually no refined grains and give it much of the credit for the fact that in our seventies we take absolutely no chronic medication. We would take drugs for an infectious illness such as pneumonia obviously, but in fact have no need for any pills for well over a year.
A recent consultation with an optician confirmed good pigmentation of the retina, no signs of macular degeneration, or cataracts either, another proven benefit that whole grains are better.
40% of Americans eat no whole grains at all, and only 8% consume the recommended three helpings per day.
There are concerns in nutritional circles that the fad, if I may call it that, about gluten intolerance has meant that a great many people have moved away from whole grains to their overall detriment.
This is not to say that gluten intolerance does not exist, it certainly does, but to associate every grumble in the intestine with an allergy to wheat is sheer nonsense.
The first step when treating the unhappy tum is to increase the fibre in the diet, both insoluble as in whole grains, and insoluble as in fruits and vegetables.
In the refining of flour most of the best parts, the germ and bran, are removed.
You may be thinking, why do the millers removed the minerals and vitamins, and then have to 'enrich' the flour again? We started this page by saying that the fatty acids start to go rancid once the grain is milled, and oxygen starts to do its work. It is best to grind the wheat, and immediately bake the dough.
A reasonable compromise is to keep it in an airtight container in the fridge for up to a week, or the deep freezer for a month.
Beware of terms like "multigrain" on the packaging of bread products which just means there are several different grains, for example oats, wheat and rye, but they are usually highly refined.
Whole grains have far more flavour; once your tongue gets used to the fact that you have to chew more, you will never go back. Simply having an easier time on the loo will convince you; add some soluble fibre foods like spinach and apples several times a day and it becomes a two minute affair. Trust me, I'm a doctor, and I have had a life-long journey with constipation.
Why is whole grain better is an important question because of the assumption in many quarters that gluten is the cause of every problem of the intestine.
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