The Carbohydrate Conundrum
To eat, or not to eat; that is the question...
Posted Jun 28, 2016
A recent study, a meta-analysis of over 750,000 people drawn from over 14 different studies, examined the role of whole grain consumption in maintaining health. Specifically, the researchers looked at the rates of total mortality, cardiovascular mortality (CVD), and cancer mortality with respect to consumption of whole grain servings. They compared those who consumed the most to those who consumed the least. But such research sometimes causes more confusion and controversy than it answers; especially as other recent data seems to indicate high carbohydrate consumption as a dietary regimen to be avoided. It is something reflected in the current media buzz that the popularity of approaches like The Paleo Diet highlight.
Here in the confusing collection of carbohydrate conditions; definition makes a difference in being able to wade through the data and the distraction. Firstly, what exactly is a “whole grain?” According to the Whole Grains Council:
“Whole grains or foods made from them contain all the essential parts and naturally occurring nutrients of the entire grain seed in their original proportions. If the grain has been processed (cracked, crushed, rolled, extruded, and/or cooked), the food product should deliver the same rich balance of nutrients that are found in the original grain seed.
"This definition means that 100 percent of the original kernel—all of the bran, germ, and endosperm—must be present to qualify as a whole grain.”
Whole grain is not the same thing as multi-grain or the ever misleadingly popular 12-grain. These terms have no legal meaning and just suggest the presence of more than one grain type; all of which may be refined flours. The same is true for the term “wheat flour,” this is just a clever way to market refined white flour. Both “bleached” and “unbleached wheat flour” are, you guessed it, refined white flour. If the package reads just “wheat bread,” it is likely made from a majority, if not entirely, from refined wheat flour.
Likewise, “made with whole grains,” and “multi grain,” may be manufactured predominately with refined white flour. Products that carry the phrase “high in fiber,” may have had fiber additives; like carboxymethylcellulose (CMC), maltodextrin or other compounds added during the manufacturing process. The phrase that means something (in the US at least, as it varies by country) is “whole wheat” or “whole grain whole wheat;” this implies that you are receiving whole grain wheat products.
Refining is a process that normally removes the bran and the germ, leaving only the endosperm. Removing the endosperm removes fatty acids, and thus significantly increases shelf life. However, without the bran and germ, about 25 percent of a grain’s protein is also lost, and the remaining product is greatly reduced in at least seventeen key nutrients.
Processors can add back some vitamins and minerals to supplement refined grains, so refined products labeled “enriched,” can still contribute valuable nutrients. However, they often remain inferior to whole grains in terms of protein, fiber and many important vitamins and minerals.
All grain products contain carbohydrates. Refined wheat flour products, since they contain mostly endosperm, are predominately carbohydrate in composition. Carbohydrates can be defined chemically as neutral compounds of carbon, hydrogen and oxygen. Carbohydrates come in simple forms such as sugars and in complex forms such as starches and fiber.
All simple carbohydrates are sugars. These carbohydrates are made of just one or two sugar molecules. They are a quick source of energy, and they are very quickly digested. This can lead to a rapid rise in blood sugar levels after ingestion and why such foods high in sugars generally have a high glycemic index (GI).
Complex carbohydrates are larger compounds and consist of both starches and fiber. Fiber comes in the form of insoluble and soluble. Fruits and vegetables are the leading dietary sources of important soluble fiber. Along with whole grains, beans, pulses, legumes, nuts and seeds such foods supply the soluble and insoluble fiber required for our gastrointestinal health as well as the health of our gut micro-biome.
Whole grains may be eaten whole, cracked, split or ground. They can be milled into flour or used to make breads, cereals and other processed foods. If a food label states that the package contains whole grain, the "whole grain" part of the food inside the package is required to have the same proportions of bran, germ, and endosperm as the harvested kernel does before it is processed. Make sure you use this as a guide and look for this when sourcing your foods.
The recent research paper conducted a whole grains meta-analysis and showed impressive benefit to including such comestibles as part of a healthful dietary tactic. Many indigenous diets and approaches like the Mediterranean Diet emphasize these wholesome, authentic foods over highly processed ones. The group eating the most whole grains, compared to the group consuming the least, reduced their overall mortality rate by 16 percent. They were 12 percent less likely to die from cancer and 18 percent less likely to die from cardiovascular disease. Interestingly, another recent study looking at barley, a Mediterranean staple, showed that it significantly reduced two different forms of LDL, or “bad” cholesterol.
Each 16g/day serving of whole grains, an amount which is considered a daily serving, reduced total mortality by 7 percent, cancer mortality by 5 percent and cardiovascular mortality by 9 percent. The highest consumers ate three or more servings per day. In other studies, whole grains have also been shown to significantly reduce the incidence of stroke and type II diabetes (T2DM). Current Dietary Guidelines for Americans recommends at least three servings per day of whole grain intake.
Including such whole grains in the diet does not always require the consumption of gluten, either. Gluten is only found in wheat (all varieties), barley, rye and triticale (a rye/wheat hybrid). That gluten free meat and cheese lunch time combo should be gluten free without paying an extra dime for it. It’s a bit like charging you extra for water with ice. Other options that are gluten free include some seeds, but since they are prepared and consumed like grains they are usually included with them. Using sprouted flours or methods like sourdough fermentation can also decrease the gluten content, although not completely eradicate it. Remember, governmental standards only require that:
“In general, foods may be labeled “gluten-free” if they meet the definition and otherwise comply with the final rule’s requirements. More specifically, the final rule defines "gluten-free" as meaning that the food either is inherently gluten free; or does not contain an ingredient that is: 1) a gluten-containing grain (spelt wheat); 2) derived from a gluten-containing grain that has not been processed to remove gluten (e.g., wheat flour); or 3) derived from a gluten-containing grain that has been processed to remove gluten (wheat starch), if the use of that ingredient results in the presence of 20 parts per million (ppm) or more gluten in the food. Also, any unavoidable presence of gluten in the food must be less than 20 ppm.” So gluten-free, a voluntary labeling, is less than 20 ppm per serving; not zero.
A partial gluten free list includes amaranth, buckwheat, corn, millet, quinoa, rice, wild rice, sorghum, teff, and oats (although many prepackaged and pre-prepared oat products contain a gluten warning because there is cross contamination in the plants where they are manufactured).
Our diet, like our lives, needs balance. And in the addition or subtraction to make it so; remember to keep it forever delicious. At the end, it is the taste of the experience that lingers and seals the memory.
FDA. (2016, May 2). Questions and Answers: Gluten-Free Food Labeling Final Rule. Retrieved from FDA.gov: fda.gov/Food/GuidanceRegulation/
Leamy, E. (2012, February 7). Companies Not Telling the Whole Truth About Whole Grains. Retrieved from ABC News.com
Lebwohl, B., Ludvigsson, J. F., & Green, P. H. (2015). Celiac disease and non-celiac gluten sensitivity. BMJ, 351: h4347. doi: 10.1136/bmj.h4347.
NIH. (2016, June 6). Carbohydrates. Retrieved from Medline Plus
Whole Grains Council. (2013). Definition of Whole Grains. Retrieved from Whole Grains
Zong, G., Gao, A., Hu, F., & Sun, Q. ( 2016). Whole Grain Intake and Mortality From All Causes, Cardiovascular Disease, and Cancer: A Meta-Analysis of Prospective Cohort Studies. Circulation, 133:2370-2380.