A High Diet of Whole Grains May Help Prevent Disease

1. Fulani Thrasher Beloit College, Beloit, WI III. RESULTS/DATA: Study Number 1 (4): Intake of Refined Grains and Whole Grains in Relation to Type 2 Diabetes and Heart Disease In this review it has been found through surveying, experiments, and epidemiological data that there is a relation between whole grains and type 2 diabetes & coronary heart disease. The basis of this conclusion are from the understanding of the roles played by insulin resistance in the pathogenesis of these two diseases. In the Iowa Women’s Health Study, 1141 incidental cases of diabetes were recorded over a six-year follow up period in a prospective group of 35,988 healthy women, after making adjustment for age, BMI, education, cigarette smoking, alcohol intake, and physical activity. Women who consumed relatively large amounts (based on the recommended level of 3 servings a day by the USDA) of refined grain and relatively small amounts of whole grains had a 57% higher risk of type 2 diabetes than did those who had a reverse diet with more whole grains included. Data indicates that replacing refined grains and potatoes with whole grain and small amounts of processed grains, as well as increasing fruits and vegetables, can lower dietary glycemic load and insulin demand that may ultimately reduce risk of type 2 diabetes and coronary heart disease. ABSTRACT: Dietary modification plays an important role in prevention of most diseases. I hypothesize that a diet including at least 3 servings of whole grains per day - whole rather than refined grains - can prevent chronic disease as well as provide other health benefits. Through the analysis of peer reviewed nutritional journals I have compared the consumption of refined with whole grains. It has been shown that adding the recommended level of three severing a day or more of whole grains in one’s diet can protect against heart disease. Whole grains are associated with a lower risk of type 2 diabetes, cardiovascular disease, stroke, and obesity. The nutritional difference between whole grains and refined grains is that whole grains include germ, endosperm, and bran. Refined grains only contain the endosperm. Bran and germ have most of the nutritional value, especially bran which contains fiber, essential fatty acids, and other vitamins. Given the current overall low intake of whole grains by Americans, efforts should be made to decrease the cost and increase the availability and consumption of whole grain products. I. INTRODUCTION: Two of every five deaths in the United States are attributed to coronary heart disease (CHD) and Type 2 diabetes mellitus (4). Together these two diseases accounted for more than $220 billion in direct medical costs in 1997. Type 2 diabetes is an epidemic of our time, affecting approximately 15 million individuals in the US alone, almost 8% of the US population. These two diseases are correlated with obesity, insulin sensitivity, and a diet with a high glycemic index. The glycemic index (GI) is the measurement of the effects of carbohydrates on blood sugar levels. Food that has a low glycemic index contains carbohydrates that break down more slowly, releasing glucose gradually into the bloodstream. Insulin is a hormone the body produces to regulate glucose and energy metabolism. When insulin becomes less effective then blood glucose levels rise above the normal range. This is called insulin sensitivity or resistance. Whole grains have a low GI, as low as vegetables and fruits. Whole grains, because of their low GI, are good for your health. The USDA has established the daily value intake for whole grains which is 3 servings a day. Other scientific organizations have supported an increase in whole grain intake including: The Surgeon General’s Report on Nutrition and Health, Diet and Health: Implications for Reducing Chronic Disease Risk (2), and the American Cancer Society. Americans only consume about half of the daily recommended amount of 3 servings a day, given by the USDA for whole grains. Whole grains are full of nutrients and vitamins because they are not stripped of them in the milling process. I hypothesize that a diet including at least 3 servings of whole grains per day - whole rather than refined grains - can prevent chronic disease as well as provide other health benefits. II. METHODS: My research and data comes from using peer reviewed nutrition journal articles. A High Diet of Whole Grains May Help Prevent Disease Figure 1: Composition of a typical whole grain. Refined grain contains only the endosperm, which is primarily starch (see Table 2) Table 1. Compositional differences between whole and refined wheat Study Number 2 (3): Whole-grain intake and the risk of type 2 diabetes: a prospective study in men In this nutrition article men from the Health Professionals Follow-up Study without history of diabetes or cardiovascular disease in 1986 were followed for 12 years. Intake of whole grains and refined grains were measured every 4 years by food-frequency questionnaires and then analyzed. The data showed an inverse association between long-term average whole grain intake and type 2 diabetes in men during this follow up over 12 years. The decrease in risk of type 2 diabetes was 42% in men who were consuming 3.2 servings or more of whole grains per day. Those who were consuming than 3.2 servings or more a day tended to be leaner, more physically active, to consume less fat, and to be less likely to smoke or have a history of hypertension. This was reduced when adjustments to BMI were made, which may be one mechanism through which whole grain intake reduces type two diabetes. There was no concrete association with refined grain intake and the risk of type 2 diabetes. Review of Study Number 3 (1): Cereal grains and legumes in the prevention of coronary heart disease and stroke: a review of the literature This review was composed of investigation of five studies examining the relationship between whole grain consumption, coronary heart disease and cardiovascular disease, and found protection for either or both diseases. Results show that there is a relationship between intake of whole grain foods and Coronary Heart Disease, with at least 20% and perhaps a 40% reduction for those who eat wholegrain food habitually vs. those who eat them rarely. Fiber, magnesium, vitamin B6 and vitamin E may also be important. The recommendation was that carbohydrate-rich foods should be whole grain and if they are not, then the lowest glycemic index product available should be consumed. V. REFERENCES 1. Dr P Clifton Cereal grains and legumes in the prevention of coronary heart disease and stroke: a review of the literature European Journal of Clinical Nutrition, May 2006; 60: 1145–1159 http://www.nature.com.proxy.uchicago.edu/ejcn/journal/v60/n10/full/1602435a.html  2. L.E. Cleavland, A.J. Moshfegh, AM. Albertson, J.D. Goldman Dietary Intake of Whole Grains Journal of the American College of Nutrition, February 2000; 19 (3): 331S-338S http://www.jacn.org/cgi/reprint/19/suppl_3/331S  3.. T. T. Fung, F. B. Hu, M. A. Pereira, S. Liu, M. J. Stampfer, G. A. Colditz and W. C Willett Whole-grain intake and the risk of type 2 diabetes: a prospective study in men American Journal Clinical Nutrition, September 2002; 76 (3): 535-540, http://www.ajcn.org.proxy.uchicago.edu/cgi/content/full/76/3/535 4.Simin Liu Intake of Refined Carbohydrates and Whole Grain Foods in Relation to Risk of Type 2 Diabetes Mellitus and Coronary Heart Disease Journal of American College of Nutrition, October 2002; 21 (4): 298-306 5.Victoria Shanta Retelny, Annie Neuendorf, and Julie L. Roth Nutrition Protocols for the Prevention of Cardiovascular Disease Nutrition Clinical Practice, October 2008; 23 (5): 468-476 http://ncp.sagepub.com.proxy.uchicago.edu/content/23/5/468.long V. CONCLUSION/DISCUSSION: From research reviewed and my analysis I would recommend eating 6 grain products a day and at least three being whole grains . It is known that whole grains are beneficial to your health and may prevent disease, but there is some debate in the medical field whether or not refined grains encourage disease and are harmful to one’s health. It is not definite that whole grains will protect against the development of any disease, but there is data supporting this claim.