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Whole Grains

 Whole Grains─The Foundation of Healthy Eating

  • Whole grains have been the staple of human diet for more than 10,000 years. Current scientific evidence indicates that whole grains play an important role in lowering the risk of chronic diseases, such as coronary artery disease (CAD), diabetes, hypertension and cancer, and also contribute to body weight management and gastrointestinal health.1-9
  • A large shift from consumption of coarse grains to polished rice and refined wheat has occurred in many developing countries, especially India and China and contribute to the escalating epidemics of diabetes in these countries.10
  • What nearly all consumers and most health professionals fail to realize is that whole grains deliver as many if not more phytochemicals and antioxidants than do fruits and vegetables.
  • Whole grain intake consistently has been associated healthy lifestyle diet and nutrient intake in children and adolescents.11, 12 The essential macro- and micronutrients, along with the phytonutrients present in whole grains, synergistically contribute to their beneficial effects.1-8 Whole grain products are a good source of fiber, minerals, as well as several vitamins including vitamins B and E.
  • Whole grains and legumes rich in fiber and nutrients have been the staple food worldwide for millenniums, especially in vegetarians. Consumption of these foods not only decreases blood sugar and insulin resistance but also prevents the development of diabetes, particularly in people with metabolic syndrome.7, 13 Not consuming adequate amounts of whole grain is a modifiable dietary risk factor, for young and old alike.
  • The U.S. FDA defines whole grains as consisting of the intact, ground, cracked, or flaked fruit of the grains whose principal components, the starchy endosperm, germ, and bran, are present in the same relative proportions as they exist in the intact grain. Whole grains are characterized as being high in resistant carbohydrates as compared with refined grains, meaning they typically are high in fiber, nutrients, and bound antioxidants.
  • The essential macro- and micronutrients, along with the phytonutrients present in whole grains, synergistically contribute to their beneficial effects.1-8 Whole grain products are a good source of fiber, minerals, as well as several vitamins including vitamins B and E.
  • Whole grains are now recognized as an important source of fiber and other nutrients like trace minerals vitamins. Grain processing improves palatability and can have varying effects on nutrition (e.g., the process of milling and grinding flour increases glucose availability and decreases phytochemical content.12
  • Epidemiological studies strongly support the suggestion that high intakes of whole grain foods protect against the development of  diabetes  People who consume approximately 3 servings per day of whole grain foods are 20-34% less likely to develop diabetes than low consumers (<3 servings per week).14, 15
  • Whole grain intake will also improve glucose control in people with diabetes.2-7, 16 By improving insulin sensitivity, increased consumption of whole grain foods decreases the development of metabolic syndrome, a precursor to both diabetes and CVD.1-7, 17
  • Whole grains have dietary fiber that has a positive effect of blood fat levels, lowering the risk of coronary heart disease (CAD).18 Epidemiological studies indicate that individuals with higher levels (in the highest quintile) of whole-grain intake have a 29 % lower risk for ASCVD than individuals with lower levels (lowest quintile) of whole-grain intake.19  The bran component of whole grains could be a key factor in this relation.20
  • Whole grains are usually low in glycemic load and is recommended to diabetic patients for the prevention of cardiovascular complications.21  Whole-grain products, such as brown rice, have a lower glycemic index than white rice and are associated with a lower risk of diabetes.22
  • However, the glycemic index varies widely among the whole grains─ whole wheat 45, brown rice 41, and barley 25. As a consequence, compared with brown rice consumption of same amount of barley and whole wheat provide lower glycemic load.
  • Whole grains high in viscous fiber (oats, barley) decrease serum low-density lipoprotein (LDL) cholesterol and blood pressure and improve glucose and insulin responses. Grains high in insoluble fiber (wheat) moderately lower glucose and blood pressure.12
  • Obesity is inversely related to whole grain intake especially abdominal obesity.
  • Grains are the most important food source of the Indian population with carbohydrates accounting for 60-70% of the total energy consumption.
  • Variety of grains is available in India, and different grains form staple diets of people in different part of the country.
  • The recommended intake of whole grains is 3 servings a day. However, the average intake in the United States is less than 1 serving per day. The 2010 dietary guidelines recommend that at least half of all consumed grains should be whole grains. This can be achieved by replacing refined grains with whole grains.
  • A better understanding of the health benefits of whole grains is necessary to increase its intake to recommended targets.23
FAQ

 1.What is the difference between maida and atta?

A. Maida is a finely milled and refined flour of wheat, closely resembling cake flour, and used extensively in making many Indian bread (paratha, chapathi and naan) and bakery products such as pastries. It is made from the endosperm (the starchy white part) of the grain, while the fibrous bran is removed in the mill. Originally yellowish in color, maida is made white through bleaching with Benzoyl Peroxide and Chlorine dioxide which are  banned in the European Union, UK (1997) and China (2011).Maida contains Alloxan, (the source of which may be the use of bleaching agents) and alloxan is known to destroy beta cells in the pancreas, causing diabetes mellitus.24,25

Atta is obtained from grinding complete wheat grains. Since nothing is removed from true whole-meal atta, all the constituents of the wheat grain are preserved. High bran content of true whole-meal atta makes it a fiber-rich food. This may help to regulate blood sugar as well have other health benefits.

Atta is more healthful flour and is recommended for making flat bread such as roti, chapatti, naan and puri, instead of maida. (Atta also refers to the oven used in cooking the bread). Most atta is milled from the semi-hard wheat varieties that comprise 90% of the Indian wheat crop. Chapati mixes maybe made from a combination of maida and atta.

Sources

1. Jonnalagadda SS, Harnack L, Hai Liu R, et al. Putting the whole grain puzzle together: health benefits associated with whole grains–summary of american society for nutrition 2010 satellite symposium. J Nutr. May 2011;141(5):1011S-1022S.

2. Steffen LM, Jacobs DR, Jr., Murtaugh MA, et al. Whole grain intake is associated with lower body mass and greater insulin sensitivity among adolescents. Am J Epidemiol. Aug 1 2003;158(3):243-250.

3. Steffen LM, Jacobs DR, Jr., Stevens J, Shahar E, Carithers T, Folsom AR. 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. Sep 2003;78(3):383-390.

4. Liu S, Stampfer MJ, Hu FB, et al. Whole-grain consumption and risk of coronary heart disease: results from the Nurses’ Health Study. Am J Clin Nutr. Sep 1999;70(3):412-419.

5. Liese AD, Roach AK, Sparks KC, Marquart L, D’Agostino RB, Jr., Mayer-Davis EJ. Whole-grain intake and insulin sensitivity: the Insulin Resistance Atherosclerosis Study. Am J Clin Nutr. Nov 2003;78(5):965-971.

6. Liese AD, Schulz M, Fang F, et al. Dietary glycemic index and glycemic load, carbohydrate and fiber intake, and measures of insulin sensitivity, secretion, and adiposity in the Insulin Resistance Atherosclerosis Study. Diabetes Care. Dec 2005;28(12):2832-2838.

7. Sahyoun NR, Jacques PF, Zhang XL, Juan W, McKeown NM. Whole-grain intake is inversely associated with the metabolic syndrome and mortality in older adults. Am J Clin Nutr. Jan 2006;83(1):124-131.

8. Flint AJ, Hu FB, Glynn RJ, et al. Whole grains and incident hypertension in men. Am J Clin Nutr. Sep 2009;90(3):493-498.

9. Misra A, Rastogi K, Joshi SR. Whole grains and health: perspective for Asian Indians. J Assoc Physicians India. Feb 2009;57:155-162.

10. Hu FB. Globalization of Diabetes: The role of diet, lifestyle, and genes. Diabetes Care. Jun 2011;34(6):1249-1257.

11. O’Neil CE, Nicklas TA, Zanovec M, Cho SS, Kleinman R. Consumption of whole grains is associated with improved diet quality and nutrient intake in children and adolescents: the National Health and Nutrition Examination Survey 1999-2004. Public Health Nutr. Feb 2011;14(2):347-355.

12. Harris KA, Kris-Etherton PM. Effects of whole grains on coronary heart disease risk. Curr Atheroscler Rep. Nov 2010;12(6):368-376.

13. Lindstrom J, Peltonen M, Eriksson JG, et al. High-fibre, low-fat diet predicts long-term weight loss and decreased type 2 diabetes risk: the Finnish Diabetes Prevention Study. Diabetologia. May 2006;49(5):912-920.

14. Venn BJ, Mann JI. Cereal grains, legumes and diabetes. Eur J Clin Nutr. Nov 2004;58(11):1443-1461.

15. Flight I, Clifton P. Cereal grains and legumes in the prevention of coronary heart disease and stroke: a review of the literature. Eur J Clin Nutr. Oct 2006;60(10):1145-1159.

16. Murtaugh MA, Jacobs DR, Jr., Jacob B, Steffen LM, Marquart L. Epidemiological support for the protection of whole grains against diabetes. Proc Nutr Soc. Feb 2003;62(1):143-149.

17. Gaskins AJ, Mumford SL, Rovner AJ, et al. Whole grains are associated with serum concentrations of high sensitivity C-reactive protein among premenopausal women. J Nutr. Sep 2010;140(9):1669-1676.

18. Joint WHO/FAO Expert Consultation. WHO Technical Report Series 916: Diet, Nutrition and the Prevention of Chronic Diseases Geneva: World Health Organization 2003.

19. Anderson JW. Whole grains protect against atherosclerotic cardiovascular disease. Proc Nutr Soc. Feb 2003;62(1):135-142.

20. 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. Dec 2004;80(6):1492-1499.

21. Qi L, Hu FB. Dietary glycemic load, whole grains, and systemic inflammation in diabetes: the epidemiological evidence. Curr Opin Lipidol. Feb 2007;18(1):3-8.

22. Barclay AW, Petocz P, McMillan-Price J, et al. Glycemic index, glycemic load, and chronic disease risk–a meta-analysis of observational studies. Am J Clin Nutr. Mar 2008;87(3):627-637.

23. Jones JM, Reicks M, Adams J, Fulcher G, Marquart L. Becoming Proactive With the Whole-Grains Message. Nutr Today. Jan 2004;39(1):10-17.

24. Lenzen S. The mechanisms of alloxan- and streptozotocin-induced diabetes. Diabetologia. Feb 2008;51(2):216-226.

25. Mrozikiewicz A, Kielczewska-Mrozikiewicz D, Lowicki Z, Chmara E, Korzeniowska K, Mrozikiewicz PM. Blood levels of alloxan in children with insulin-dependent diabetes mellitus. Acta Diabetol. Dec 1994;31(4):236-237.

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