Grain Foods and Health: A Primer for Clinicians

Preventing many chronic diseases in North America requires substantial changes in dietary habits. Achieving a better balance of grain-based foods through the inclusion of whole grains is one scientifically supported dietary recommendation. Epidemiological and other types of research continue to document health benefits for diverse populations who have adequate intakes of both folic acid-fortified grain foods and whole grains. Folic acid fortification of grains is associated with reduced incidence of neural tube and other birth defects and may be related to decreased risk of other chronic disease. Whole grain intake is associated with reduced risk of chronic disease. Specifically, there is a decreased risk of obesity, coronary heart disease, hypertension, stroke, metabolic syndrome, type 2 diabetes, and some cancers observed among the highest whole grain eaters compared with those eating little or no whole grains. Nationally promulgated dietary recommendations such as those in the US Dietary Guidelines or by health promotion organizations such as the American Heart Association have incorporated the science on whole grains, recommending that consumers increase their whole grain intake. The US Dietary Guidelines state that consumers select half of the recommended bread and cereal servings as whole grain. Thus, the recommendations recognize the importance of adequate folic acid intake from refined, fortified grains to reduce the risk of birth defects and other disorders and to reflect the existing science on whole grains. The association between whole grains and decreased chronic disease is not surprising because whole grains are a source of vitamins, minerals, fatty acids, anti oxidants, and other phytochemicals and dietary fiber. Each of these components can act singly or in tandem to contribute to specific health-maintaining and disease-preventing mechanisms. Health professionals should be aware of these benefits and advocate these dietary strategies to help prevent chronic disease and to improve overall health.