Refined grains like white bread are linked to heart disease risk, according to new research.
White rice was not linked to those risks, according to data from 137,130 people in 21 countries.
Whole grains and rice could be a healthier alternative to processed carbs, the study found.
It's no surprise that processed foods full of added sugar, fat, and salt are bad for our health. But new evidence suggests processed carbohydrates like white bread, breakfast cereal, pasta, and pastries could play a role in chronic disease, regardless of what else is in your diet.
Eating too many refined grains is linked to a higher risk of heart disease and early death, according to a study published February 3 in The BMJ.
In a study of 137,130 adults across 21 different countries, researchers from St. John's Research Institute in India and more than a dozen other international universities collected data on demographics, lifestyle, and eating habits. They compared these factors to health outcomes across nearly a decade of follow-up.
Participants who ate seven to 10 slices of white bread a day (or similar amount of refined carbs), were 33% more likely to have a heart attack or stroke, and 27% more likely to die during the study than those who ate less than one serving a day.
But not all carbs were linked to health risks. Participants who ate a lot of whole grains and white rice didn't have a higher risk of disease.
These results indicate that improving the quality of carbohydrates could be an important factor in helping people maintain a healthy diet, according to the researchers.
Refined grains have fewer nutrients and greater effect on blood sugar levels
These findings support a previous study from the researchers that found high carbohydrate consumption overall was linked to greater risk of heart disease, according to Mahshid Dehghan, co-author of the study and an investigator at the Population Health Research Institute at McMaster University in Canada.
This latest research goes even further, specifying that foods like white bread, pastries, crackers, and pasta have the strongest association with health risks, compared to whole grain alternatives.
"We were not surprised to see higher refined grain consumption has an adverse impact on health," Dehghan told Insider.
That's because the refining process strips away parts of the grain that are rich in nutrients, including fiber, fatty acids, and beneficial plant-based compounds called phytochemicals.
The resulting refined grain product can raise blood sugar more quickly than its whole grain counterpart. That in turn can cause higher concentrations of insulin, and eventually lead to health issues like metabolic dysfunction and more abdominal fat, both risk factors for heart disease.
White rice may be different from other refined grains
The researchers in this study found that white rice was not associated with the same health risks as other refined grains.
That's contrary to previous studies which have suggested that white rice can spike blood sugar levels and potentially increase the risk of diseases like diabetes.
That research often fails to include different populations where rice is a staple food, however, and doesn't account for cultural differences in the type of white rice used and how it's prepared, according to Dehghan.
In this study, researchers used country-specific (and even region-specific) questionnaires to more accurately assess how white rice was included in participants' diet, and how it might affect health outcomes as a result.
Refined grains are cheaper than healthy alternatives
Dehghan is currently working on an investigation of ultraprocessed foods and health outcomes, which could further add to our knowledge of what foods to avoid.
For now, the biggest challenge with this research is figuring out how to apply it. Nutritional guidelines are often based on data from high-income countries, according to Dehghan. If we want to help people improve the quality of carbs they eat, it's important to account for socio-economic factors that play a major role in those food choices, she said.
"Refined grains are cheaper, and when people cannot afford to buy whole grains, they have to survive, they have to eat something. This is the part where government and public health agencies need to be involved," she said.
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