Settling the great grain debate. Can wheat and other grains fit into a healthy — and sane — diet?

Are grains saving your life — or trying to kill you? In this article, we’ll discuss both sides of the debate. We’ll also leave you with some actionable steps to start eating better immediately.

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Quick: How do you feel about grains?

Are they an essential food group that makes up the foundation of a nutritious diet?

Or are they evil little packages of carbs and toxins out to make you fat and inflamed, and slowly kill you?

This discussion is one of the great nutrition debates of our time.

In one camp are vegans, vegetarians, and macrobiotic dieters, who eat a ton of whole grains. They say grains will help them live longer and healthier, free of chronic disease. Indeed, recent news seized on a Harvard study connecting grains with lower risk of death.

In the opposing camp, you’ve got the Paleo, Whole30, and Atkins advocates, who strictly limit or even completely avoid grains. They say not eating grains will help them live longer and healthier, free of chronic disease. They dominate plenty of news, too.

Celiac disease has gone up over the last 60 years, which has given rise to a gluten-fearing food subculture (and the booming gluten-free marketplace to match). Tens of millions of North Americans now conduct grain-free experiments on themselves and read bestsellers like Wheat Belly.

As a result, many people now say they feel better when they limit or cut out one or more grains.

Who’s right?

And, most importantly, should you eat grains?

Let’s iron it out once and for all.

An old staple

Grains, the seeds of grasses, are an ancient food source that is still the main source of calories for people all over the world.

Along with the familiar wheat, rice, oats, corn, barley, buckwheat and rye, there are lots of lesser-known grains such as triticale, quinoa, teff, amaranth, sorghum, millet, spelt, and kamut.

The raging debate about grains can make it seem like they’re a relatively new addition to the human diet, but we’ve actually been consuming them in some shape or fashion for millions of years (yes, the real Paleos ate grains, too). Learning to cultivate wheat helped us give up the nomad life and create civilization as we know it today.

Grains provide a wide array of nutrients, including vitamins, minerals, fiber, and phytonutrients.

Of course, when it comes to grains’ nutrients, we’re talking about whole grains. As in the whole seed. Like this:

Whole vs. refined grains

One of the reasons that this debate became so muddled so quickly is that people conflate “grains” with “carbs.”

Carbohydrates are sugar-based molecules found in a range of foods, including bread, pasta, potatoes, beans, desserts, soft drinks, and — yes — whole grains.

Refined grains — ones that have had their bran and germ stripped away through milling — provide all the carbohydrates with hardly any of the nutrients found in whole grains. They’re often packaged with large amounts of fat and salt.

As a result, these processed grains are really tasty, easy to consume, but way less satiating — a deadly combo that leads many people to overeat, setting them on the path toward weight gain and chronic disease.

But what about whole grains?

Aren’t they bad for you, too?

The (supposed) ill effects of grains

Some say grains can really mess up your health by causing inflammation, intestinal damage, obesity, and more. What does science say?

Inflammation

A huge contingent in the grain-hating world claim these plants contribute to low-level inflammation, an ongoing immune response in which your body attacks its own tissue, causing cell damage.

They use a few studies to prove their point.

One study had people add 19 grams of wheat bran — the equivalent of about three cups of bran flakes — to their daily intake. Three months later, the subjects had slightly increased levels of oxidized LDL cholesterol, a possible marker of increased inflammation.

Cue the grains-cause-inflammation rumors.

The problem? By the end of the experiment, 44 of the 67 subjects had dropped out!

This makes the final data sketchy at best.

What’s more, several large epidemiological studies have actually linked whole grain intake to lower levels of inflammation.

Of course, these are just links. You need controlled trials to prove any causal relationship.

Overall, controlled trials are neutral or supporting of the epidemiological studies here, finding that whole grains either have no effect on inflammation or indeed result in a decrease.

Not one single controlled trial has shown that grains increase inflammation.

There’s an idea in the fitness industry that inflammation is the root of all health problems, and, therefore, that all health problems can be traced back to the diet and your gut. This is a false premise.

Yes, food sensitivities may cause inflammation and, eventually, after a long cascade of events, may lead to disease elsewhere in the body.

But the more likely scenario in most cases is that inflammation is a result of disease, and that it exacerbates other conditions or disease states that have already been set into motion.

There are lots of research papers on all of this. And lots of inflammatory markers we can now test.

No one — I repeat, no one — is really sure what it all means.

But inflammation probably does not cause most diseases, even those with an inflammatory component.

Intestinal damage

Another prevailing idea in the anti-grain movement is that grains damage your intestines because they contain anti-nutrients and other compounds that interfere with how well you absorb minerals.

At least three studies have investigated this theory. The findings: Consuming various amounts of whole wheat flour, wheat bran, and/or oat bran had no significant effects on absorption or blood levels of calcium, zinc, or iron.

Let’s look at a few anti-nutrient players.

• Lectins: These proteins bind to cell membranes, which can cause damage to intestinal tissue if you consume very large amounts or don’t cook the plant first (just a few sprouted red kidney beans would result in some terrible GI symptoms). But the body also uses lectins for basic functions like cell-to-cell adherence, inflammation control and programmed cell death. Lectins may even reduce tumor growth and decrease incidence of certain diseases.

• Phytic acid: The storage form of phosphorus, phytic acid can bind minerals in the digestive tract, preventing their absorption. In really large doses, it can cause nutrient deficiency and related problems (it’s been blamed for short stature throughout Egypt’s history). But you’d have to eat copious amounts of bread that hasn’t gone through leavening — a standard process that significantly reduces phytic acid levels — for this stuff to be a threat. In fact, in reasonable amounts, phytic acid has a number of possible health benefits.

• Protease inhibitors: When raw or lightly cooked, grains still contain large amounts of protease inhibitors, which block the action of protein-digesting enzymes, interfering with your protein absorption. But once appropriately cooked, grains contain very few protease inhibitors — and those that remain actually have anti-inflammatory and anti-cancer properties.

Thus, these anti-nutrients can be a problem if you eat way too much of them, or don’t cook the foods that contain them properly. But if you eat like most people do — consuming a variety of foods and carbohydrate sources — you’ll probably be just fine.

There is research showing that gluten — a protein found in certain grains (see below) — can cause your intestinal lining to be more permeable. But all of these studies were conducted ex vivo — meaning in an unnatural environment outside the body.

In vivo studies, done inside the body and thus more practically useful, have found that the consumption of grains actually improves GI symptoms in sufferers of Crohn’s, ulcerative colitis, and IBS.

You know, the people who would be most prone to the supposed intestinal damage inflicted by grains.

Yes, grains contain anti-nutrients — because all plants contains anti-nutrients. Broccoli, spinach, and other green leafy veggies. Red wine. Dark chocolate. Nuts. Seeds. Green tea.

Heck, fiber itself is an anti-nutrient.

Not eating plant foods because they have compounds designed to resist their digestion would be like not eating a lobster because it has a shell and claws. All living things try to avoid being eaten. It’s simply not a tenable argument.

Gluten intolerance

A protein found in wheat, rye, and barley, gluten’s visco-elastic properties are what make bread so darn delectable.

In people with celiac disease, exposure to gluten causes inflammation and stimulates the immune system to attack the small intestine, damaging its cells.

Over time this can inhibit digestion and make the gut more permeable, allowing in toxins, undigested food, and bacteria that would never normally make it through. Celiac can cause diarrhea, nutrient deficiencies, osteoporosis and even cancer. The only treatment for celiac is a gluten-free diet.

Overall, celiac is still poorly understood and a challenge to diagnose. There are currently several different blood screens and an intestinal biopsy, but none of these are 100 percent accurate.

That’s why the estimated celiac rate ranges so widely, generally from 0.3-1.2 percent of the population (some even speculate up to 3 percent). Most experts attribute celiac to about 1 percent of the American population.

An estimated 10-20 percent of the population may suffer some other form of gluten intolerance. Originally coined “non-celiac gluten sensitivity” (NCGS), this condition seems to result in many of the same symptoms seen with celiac (bloating, pain, diarrhea) without the intestinal damage or biological markers of an autoimmune disease.

But all of this is up in the air. Experiencing doubts, the researcher whose work seemed to prove the existence of NCGS performed a more rigorous follow-up study. He and his colleagues concluded that NCGS actually does not exist.

Unless you have a confirmed intolerance, there is little evidence to support eliminating gluten from your diet.

In fact, avoiding gluten unnecessarily could have the exact opposite effect you’re looking for. Many packaged gluten-free products are jammed with extra sugar and fat to make up for the palatability that’s lost when gluten is removed.

FODMAP intolerance

What’s going on in people who seem to have gluten sensitivity if it’s not celiac or NCGS?

Researchers now believe their symptoms of pain, bloating, and gas may be due to “FODMAPs”: fermentable, oligo-, di-, mono-saccharides and polyols.

FODMAPs are carbohydrates that are found in some grains but also in dairy, vegetables, fruits, and many other foods. Some people don’t break them down or absorb them properly in the small or large intestine.

FODMAPs then draw water into the gut and get fermented by the bacteria in our colon, producing hydrogen instead of methane (plus a bunch of undesirable GI symptoms).

Does 10-20 percent of the population have a FODMAP problem? Frankly, the research is far from conclusive here.

The best we can say is that if you suffer from NCGS-type symptoms, removing wheat from your diet might be prudent.

Otherwise, there’s no need to mess with it. For those who tolerate FODMAPs, the fructans in wheat actually seem to be a beneficial prebiotic.

Obesity

There’s been a lot of research on grains and body weight. Unfortunately, most of this research is, you guessed it, epidemiological.

Regardless, these epidemiological studies are unanimous in showing that higher whole grain consumption is associated with lower body weight.

Controlled trials have been less consistent in their results. In these tests, whole grains don’t consistently lead to superior fat loss — though the studies didn’t show the grains caused people to gain weight, either.

To go beyond the inconclusive controlled-trial data, we can look at how real people do on grain-heavy diets.

These aren’t perfect data, because there are many variables. But it can suggest possible trends and give us an idea of how grain consumption affects body weight in the real word, during real life.

If grains were inherently fattening, vegetarians and vegans, as well as many eaters in less-industrialized countries (where grains like rice or sorghum are usually a staple) would likely be more overweight or obese.

No literature exists showing that plant-based eaters, or those folks in regions for whom grains are a staple, have a higher incidence of overweight or obesity. In fact, the research shows just the opposite.

While these correlations certainly don’t prove anything, it’s likely that if grains really did cause obesity, we would see some trends and correlations to reflect it.

But here’s the crux of the issue: Buckwheat, oats, and quinoa aren’t making anyone fat.

In their original form, these and other whole grains are relatively bland foods, not overly calorie-dense, not unusually delicious, high in fiber and relatively satisfying. (Remember the old commercials with the grandfatherly Wilford Brimley telling us that oats would “stick to our ribs”?)

But refined grains are a different story.

Whole kernel corn becomes corn syrup. Whole wheat grains become refined white flours for cookies and muffins, pizza dough or toaster pastries. Whole grain rice becomes Rice Krispies and rice noodles that we can then slather with Pad Thai sauce (potentially containing the aforementioned corn syrup).

With processed foods, “carbs” are just a way to deliver hyper-palatable, “can’t-eat-just-one” enjoyment as well as calorie-dense fatty meats, cheeses, sauces, and condiments. But are the “carbs” themselves really the main problem here?

OK, so, are whole grains good for you?

Here’s what we know about the benefits of whole grains. They are:

• high in fiber, a nutrient that can help you maintain a healthy GI tract.
• slow to digest, which helps keep blood sugar under control.
• packed with vitamins and minerals.
• satisfying, which helps keep your appetite in check.

And there may be more specific benefits.

Overall, research shows that whole grains, with varying degrees of success, seem to decrease the risk of colorectal cancer, cardiovascular disease, and diabetes. They also seem to improve blood sugar control and insulin sensitivity, and protect against high blood pressure.

OK, fine. But are grains crucial to health?

Do you need to eat grains?

No. You don’t need to eat any one particular food — be it grains, apples, kale, or fish.

But you need carbs. The amount of carbs you need depends on your activity level.

If you exercise fairly frequently, then you’ll likely do best with a moderate carb intake. Not getting enough could mess with your metabolism, stress hormones, and muscle-building hormones.

If you’re sedentary, have blood sugar issues, and/or need to lose a bunch of weight, then you’ll likely do best with a lower carb intake.

You could replace whole grains with a variety of other high-quality carbs, like potatoes, sweet potatoes, fruit, legumes, squash, yuca, and yams. You’d be able to get all the carbs you need, in addition to plenty of fiber and a wide array of beneficial phytonutrients.

But trying to eliminate grains entirely is going to be difficult in even the best of circumstances.

In a life that involves family holidays, birthday parties, work functions — any instance where others are preparing the food — completely cutting out grains if you’re not suffering from celiac or a sensitivity becomes way, way more trouble than it’s worth.

Getting perspective on where grains fit

Often when we talk about food, we talk about the awesome things food X does. Or the terrible things food Y does.

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.

The position that all grains are unhealthy and should be categorically avoided is too extreme.

So is the notion that grains are inherent “superfoods” that everyone should consume in massive quantities.

Neither end of the spectrum is right.

Most people can be fit and healthy with a mixed carb intake that includes some whole grains (a few refined carbs can be OK, too).

Weigh the benefits against the risks.

Might wheat carry some low-level of risk for some people? Possibly.

Is it likely that the benefits of whole-grain wheat still outweigh this risk? Yes. The same is true for most whole grains — and whole foods — in general.

In the end the best thing to do is:

• objectively evaluate the research
• review the differing opinions of qualified experts with an open yet skeptical mind
• test to find what works best for YOU
• know that what’s best for you may change over time

What to do next

It’s all a lot to process. Where should you go from here?

Let this list be your guide:

1. Focus on whole, minimally processed, nutrient-rich foods. This means you’ll be eating plenty of lean protein and plants — including grains. It’ll also help you limit refined grains (those don’t hit the “whole” mark). Remember that what’s on top of the potato skin affects your health more than that sad, maligned tuber does itself.

2. Make sure your grains are thoroughly cooked. Cooking food drastically reduces its lectin, phytic acid, and protease inhibitor content. For example, fully cooking kidney beans knocks their lectin content from 20,000-70,000 units down to 200-400. Don’t eat a lot of unleavened bread.

3. Try sprouted and fermented breads. To take it further, grains that have been sprouted (e.g. Ezekiel bread) or fermented (e.g. sourdough) have even lower levels of phytates, lectins, and protease inhibitors. This increases mineral bioavailability and also tends to boost the protein quality of the bread.

4. If you suspect a problem with gluten, get tested. Go see your doctor, and get help implementing a gluten-free diet if you test positive for celiac disease.

5. Zero in on wheat. While whole-grain wheat is likely still mildly beneficial for most (sprouted wheat might be even better), this appears to be the grain with the most problems and fewest advantages. If you’re having GI issues, it’s reasonable to see if avoiding wheat helps. Here again, talk to your doctor.

6. Try other grain options. Variety is good. We’ve given you a list of whole grains in the beginning of this article. Try some others you don’t normally eat. Have fun expanding your horizons.

7. Consider an elimination diet. Food sensitivities do exist, though we don’t know with what frequency. They’re linked to GI problems and a host of other conditions throughout the body. The gold standard for uncovering a food sensitivity (grain-related or otherwise): elimination diets, in which you systematically remove and then reintroduce foods in your diet, making note of any changes in symptoms.

8. Stay sane. Diet extremism leads to stress, unhappiness, and, unfortunately, weight gain and health problems. Tune out the “great grain debate” and use that energy to cook delicious food — and eat it with beloved friends — instead.

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