(c) Debbie Mulford-Joy 2012

Why are refined grains damaging to our health?

Since the advent of the agricultural revolution, more than 10,000 years ago, grains, especially those that have been refined, have become a staple in most societies diets. It is difficult to read the label of any processed food without stumbling across at least one grain in the list of ingredients. From cakes, to breads, from cereals to pizzas, most consumers eat a large proportion of grains in every meal. However, this over consumption may not be in the best interests of our health. In this essay, I will examine the potential damage that grains can cause to our health by examining the following issues: the problems caused by refining grains; the disadvantages of choosing refined grains over whole grains; and the inherent health implications caused by grain consumption.

Health effects of refined grains.

When used in relation to grains, the word refined means the processing of a grain, which results in a nutritionally inferior end product when compared to its natural formi. The refining process is usually milling, which separates the three constituents of the grain, resulting in the removal of most of the germ and the bran. The end product of this process is flour, which consists mainly of the remaining endosperm constituent. The germ is the nutrient packed inner heart of the grain, which is a valuable source of protein, vitamins and minerals, whilst the bran is the fibre rich protective coating of the grain, which is rich in iron. The endosperm, by contrast, is nutritionally empty, consisting mainly of starch. In contrast, whole grains are unrefined and thus are complete, containing the germ, bran and endosperm. When we consume refined grains, the loss of the bran and germ means that the end product is nutritionally deficient in important vitamins and minerals. Refined grains have lost the B vitamins, health promoting phytochemicals, minerals and iron from the bran, and the B vitamins, protein, essential fatty acids, vitamin e, phytochemicals and antioxidants, calcium and thiamin from the germ. The refining process results in a reduction in nutrient content of up to 90% of that of the whole grain. The refining process also removes the fibre from the grain resulting in slower transit time through the digestive tract. The health consequences of this can include constipation, abdominal pain, diverticulitis, high blood pressure and obesity. A further health problem associated with refined grains is that the process concentrates the sugars in the grain, converting the whole grain complex carbohydrate into a simple carbohydrate. Simple carbohydrates result in a fast release of glucose into the blood, stressing the pancreas, causing spikes in blood sugar levels, and fluctuating energy levels. This state of hyperglycaemia can ultimately result in diabetes, and if the excess glucose is not converted to energy quickly, it will be stored as fat.

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The exclusion of whole grains.

A major health consequence of the availability of refined grains is that by eating refined grains people are eschewing whole grains from their diets, thereby missing out on the numerous health benefits associated with whole grains. Research has shown that a healthy diet incorporating whole grains can help to reduce the risk of coronary disease, certain cancers and type 2 diabetes, as well as helping with weight management.ii Eating whole grains confers additional health benefits over refined grains due to the comprehensive collection of vitamins, minerals and other important nutrients they containiii. Whole grains, because they have not been subjected to the refining process, contain the bran, the endosperm, and the germ of the grain, and thus are beneficial sources of protein, fibre, B vitamins, essential fatty acids, calcium, iron, zinc, magnesium, vitamin E, and selenium. Whole grains also contain plant chemicals called phytochemicals, which have many health-promoting benefits, including helping to prevent oxidative stress, a process linked to obesity, heart disease and diabetesiv. Whole grains are also a good source of complex carbohydrates which release energy, in the form of glucose, slowly into the body. Research has shown that consumption of whole grains as part of a low-fat diet may reduce the risk of heart diseasev. Studies have demonstrated that people who have diets rich in whole grains tend to have lower levels of Low-density lipoprotein cholesterol, triglycerides, and blood pressure, and increased levels of High-density lipoprotein cholesterol (the good cholesterol)vi. A further health benefit of whole grains, which consumers of refined grains miss out on, is the potential reduction of the risk of certain cancers. Studies have shown that consumers of whole grains can have a 21 to 43 percent lower risk of gastrointestinal cancers compared to low consumption of whole grainsvii. It is not as yet clear by what mechanisms whole grains reduce the risk of cancerviii. It is proposed by some studies that the fibre content causes fermentation in the colon which helps to reduce transit time and improve gastrointestinal health. Other researchers suggest that the antioxidants in whole grains may help protect against oxidative damage, whilst others propose that it could be that whole grains may affect hormone levels and lower the risk of cancers in this way. Whole grains have also been linked to a reduction in the risk of type 2 diabetes and to a maintenance of blood glucose levelsix. It is thought that constituents of whole grains including magnesium, fibre, vitamin E and phenolic compounds, are responsible for contributing to the risk reduction of this type of diabetes as well as lowering blood glucose and blood insulin levelsx,xi. Studies have shown a reduction in risk of type 2 diabetes of up to 30 percent in those patients who follow a diet high in whole grainsxii . A final health benefit of whole grains when compared to refined grains relates to weight management. There are an increasing number of studies which show that a diet rich in whole grains can help with weight reduction and maintenance of a healthy weightxiii. In one study over a twelve year period, women who consumed more a diet rich in whole grains consistently weighed less than women whose diet featured a lower proportion of whole grains, and had a lower risk of major future weight gainxiv. The mechanisms by which whole grains may support weight management include enhanced satiety to lower energy intake, prolonged gastric

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emptying to delay the return of hunger, and increased insulin sensitivity to lower insulin demandxv.

The inherent damaging nature of grains.

Finally, I will examine the health implications of a diet which relies on grains, whether whole or refined. Potentially harmful mycotoxins can be present in supplies of grains, having formed either pre-harvest in the fields, or post-harvest in damp storage conditions. Mycotoxins are produced by toxic fungi which infect crops, usually in warm and humid conditions. Evidence has been emerging in recent years that mycotoxins found in grains can significantly and adversely affect our health. Mycotoxins have been linked to liver cancer, kidney damage, gastrointestical problems, damage to the reproductive system and suppression of the immune systemxvi. It would seem sensible to limit consumption of grains where possible, or at least to try to ensure that grains purchased have not been stored in damp conditions, which may encourage mould growth. A further problem relates to grains and acidity. According to Dr Robert Young,xvii our bodies strive to attain a balance between acidity and alkalinity. If our body, and thus blood, is too acidic, due to consumption of a highly acidic diet or lifestyle influences, this acidity can cause numerous diseases and health complaints, including cancer, obesity, osteoporosis, candida and skin disorders. Grains, according to Young, are acidic, with refined grains being of greater acidity than whole grains. Thus it would seem sensible to limit refined grains in order to reduce the risk of acidosis, and also to soak or sprout grains before consuming, as this can also make them more alkaline-forming for the bodyxviii. Finally, grains can cause health problems in many individuals as they are responsible for triggering allergic reactions or intolerances. Gluten is a protein found in wheat, rye and barley (and a contaminant in many oat crops, due to the proximity of wheat crop fields to those used for oats). As well as the natural gluten content of these grains, grains are being genetically modified so that their gluten content is higher than normal, so that individuals are being exposed on a daily basis to higher and higher levels of gluten. This gluten component of these staple grains, can cause serious health problems for individuals suffering from gluten intolerance or auto-immune coeliac disease. A report published in 2001 noted that the incidence of coeliac disease in the UK population was 1 in 112xix. Gluten intolerance causes the body to produce antibodies: anti-gliadin IgA andibody (AGA), anti-tissue transglutaminase antibody (tTGA) and antiendomysial antibiody (EMA). Unlike with an allergy, these antibodies do not trigger histamines; instead they cause chronic inflammation, which can result in the flattening of the intestinal villi, leading to mal-absorption of dietary nutrientsxx. Coeliac condition can have concomitant health implications as sufferers are more likely to suffer from osteoporosis and bowel cancer. Gluten intolerance differs from an allergic reaction. In an allergic reaction, following exposure to a food to which you are allergic, the body produces an antibody called immunoglobulin E (IgE). One side of this antibody recognises the allergic food and binds to it in an attempt to destroy it. The other side of the IgE antibody attaches to a mast cell, which is an immune cell found in all the tissue in the body which contains histamine. It is this histamine release from the mast cells which cause the allergic symptoms such as skin rashes, diarrhoea,

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difficulty breathing or gastric symptoms. An allergic reaction tends to be immediate and short lived, whereas an intolerance may result in symptoms sometime after the food is consumed and the damage to the body tends to be long term and cumulative. A common food allergen is wheat. In conclusion, it can be seen that there are many negative health implications associated with refined grains, compared to numerous benefits associated with whole grains. It would seem that, assuming no intolerance or allergy, incorporating small amounts of whole grains into a varied diet should be encouraged.
References

i Campbell, Hauser & Hill, Nutritional Characteristics of Organic, Freshly Stone-Ground, Sourdough & Conventional Breads, McGill University, 1991 ii U.S. Department of Health and Human Services and U.S. Department of Agriculture. Dietary Guidelines for Americans, 2005. 6th edition, Washington DC: U.S. Government Printing Office, January 2005.

iii

Jacobs DRJ, Pereira MA, Meyer KA, Kushi LH: Fiber from whole grains, but not refined grains, is inversely associated with all-cause mortality in older women: The Iowa Womens Health Study. J Am Coll Nutr. 2000; 19:326S-330S. Slavin J. Why whole grains are protective: biological mechanisms. Proc Nutr Soc. 2003;62:129-134. http://www.naturalnews.com/027616_degenerative_disease_phytochemicals.html

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v Liu S, Stampfer MJ, Hu FB, Giovannucci E, Rimm E, Manson JE, Hennekens CH, Willett WC. Wholegrain consumption and risk of coronary heart disease: results from the Nurses Health Study. Am J Clin Nutr. 1999;70(3):412-9. Jensen MK, Koh-Banarjee P, Hu FB, Franz MJ, Sampson L, Gronbaek M, Rimm EB. Intake of whole grains, bran, and germ risk of coronary heart disease among men. Am J Clin Nutr. 2004 Dec;80(6):1492-9 Jacobs DRJ, Meyer KA, Kushi LH, Folsom AR. Whole-grain intake may reduce the risk of ischemic heart disease death in postmenopausal women: the Iowa Womens Health Study. Am J Clin Nutr. 1998;68:248-257. Jacobs DRJ, Meyer KA, Kushi LH, Folsom AR. Is whole grain intake associated with reduced total and cause-specific death rates in older women? The Iowa Womens Health Study. Am J Pub Health. 1999;89:322. Pietinen P, Rimm EB, Korhonen P. Intake of dietary fiber and risk of coronary heart disease in a cohort of Finnish men: The alphatocopherol, beta-carotene cancer prevention study. Circulation. 1996;94:2720-2727. Steffen LM, Jacobs DRJ, Stevens J. Associations of whole-grain, refined-grain, and fruit and vegetable consumption with risks of all-cause mortality and incident coronary artery disease and ischemic stroke: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Clin Nutr. 2003;78:383-390.

Mellen PB, Walsh TF, Herrington DM. Whole grain intake and cardiovascular disease: A metaanalysis. Nutr Metab Cardiovasc Dis. 2007. vii Jacobs DRJ, Meyer KA, Kushi LH, Folsom AR. Whole-grain intake may reduce the risk of ischemic heart disease death in postmenopausal women: the Iowa Womens Health Study. Am J Clin Nutr. 1998;68:248-257. viii Slavin J, Marquart L, Jacobs D. Consumption of whole-grain foods and decreased risk of cancer: proposed mechanisms. Cereal Foods World. 2000;45:54-8. ix Franz MJ, Bantle JP, Beebe CA et al. Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications. Diabetes Care. 2002;25:148198.

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Montonen J, Knekt P, Jarvinen R, Arommaa A, Reunanen A. Whole-grain and fiber intake and the incidence of type 2 diabetes. J Am Coll Nutr. 2003;77:622-629. Hu FB, Manson JE, Stampfer MJ. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. New Engl J Med. 2001;345:790-797. Salmeron J, Manson JE, Stampfer MJ, Colditz GA, Wing AL, Willett WC. Dietary fiber, glycemic load, and risk of noninsulin-dependent diabetes mellitus in women. J Am Med Assoc. 1997;277:472-477.
xi Slavin J. Whole grains and human health. Nutrition Res Rev. 2004;17:99-110. Murtaugh MA, Jacobs DRJ, Jacob B, Steffen LM, Marquart L. Epidemiological support for the protection of whole grains against diabetes. Proc Nutr Soc. 2003;62:143-149. xii Murtaugh MA, Jacobs DRJ, Jacob B, Steffen LM, Marquart L. Epidemiological support for the protection of whole grains against diabetes. Proc Nutr Soc. 2003;62:143-149.

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xiii

Koh-Banerjee P, Rimm EB. Whole-grain consumption and weight gain: a review of the epidemiological evidence, potential mechanisms and opportunities for future research. Proc Nutr Soc. 2003;62:25-29. Koh-Banerjee P, Franz M, Sampson L, Liu S, Jacobs DRJ, Spiegelman D, Willett W, Rimm E. Changes in whole-grain, bran, and cereal fiber consumption in relation to 8-y weight gain among men. Am J Clin Nutr. 2004;80:1237-45.

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 middleaged women. Am J Clin Nutr. 2003;78:920-927.
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xiv

Koh-Banerjee P, Rimm EB. Whole-grain consumption and weight gain: a review of the epidemiological evidence, potential mechanisms and opportunities for future research. Proc Nutr Soc. 2003;62:25-29. Slavin J. Whole grains and human health. Nutrition Res Rev. 2004;17:99-110. xvi http://www.food.gov.uk/safereating/chemsafe/mycotoxins/ xvii Dr Robert Young, The pH Miracle xviii http://thehealthadvantage.com/grainsandmycotoxins.html xix A Fassano, Current approaches to diagnosis and treatment of celiac disease: An evolving spectrum, Gastroenterology, 120(2001) :636-651 xx Dr Shari Lieberman, Is Gluten Making Me Ill? (2007) Rodale

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