Why I Eat Whole Grains

David L. Katz

I recently spoke at a conference sponsored by the food and nutrition nonprofit Oldways and the Whole Grains Council. My specific mission was to address what we know and don't know about the paleo diet, which I hope I did satisfactorily.

But of course, the conference was something of a pep rally for whole grains, and that was fine with me. I eat them routinely, and think the case for doing so is very strong -- for most people, most of the time.

Here are four common reasons people ostensibly reject whole grains -- and why, though each may be valid in individual cases, none stand up to scrutiny as a generalizable argument:

1. Whole grains were not part of our Stone Age diet.

This one, presumably, was the basis for my topic at the recent conference. The contention is true, or at least mostly true. Grains became a part of the human diet at the dawn of agriculture and civilization, about 15,000 years ago. There is some debate about occasional grain consumption prior to that, which is certainly possible, considering that grains are really just the large seeds of certain grasses.

The important point here, though, is: Who cares? Almost nothing we eat in the modern world was a part of our Stone Age diet, and almost everything our Stone Age ancestors ate is now extinct. Plenty of other departures from our native lifestyle such as our use of technology, our failure to walk miles every day, our lack of sleep and our chronic stress contribute to modern day poor health. Our Paleolithic ancestors ate little or no grains, but we are also told they consumed close to 100 grams of fiber daily. Leaving aside the desirability of that in modern context, we should note that evicting grains from modern diets generally takes an already lamentably low average fiber intake (about 12 grams a day) and makes it downright pitiful, with a whole array of adverse health effects.

Truly staunch adherents to a paleo diet can justify excluding grains on that basis, in the context of also excluding all dairy and all processed foods, and eating only game and wild plants. For everyone else, 15,000 years constitutes a longer relationship than we have with almost anything else in our modern lives.

2. Grains contain gluten.

Some do, some don't, but for most of us, it's irrelevant. Gluten is a complex protein that has also been in our diets for some 15,000 years. The roughly 1 percent of us who have celiac disease and make antibodies to gluten must avoid it. The roughly 10 percent of us who have lesser sensitivities to gluten will feel better for avoiding it as well.

These are big numbers, and the exact reasons for them are still uncertain. Perhaps genetic modification of crops has something to do with it. However, whatever the concentration in a given strain of grain, gluten is still gluten. Peanut allergies are also more common than they used to be, and the concentration of peanut in peanuts hasn't changed. I suspect changes to the microbiome, and thus the integrity of our gastrointestinal tracts, has much to do with this.

Whatever the explanation, the fact remains that nearly 90 percent of us have no problems with gluten. In this large group, I've argued that rejecting gluten is simply a matter of fashion or fad. It can have unintended consequences. For one thing, evicting grains takes valuable nutrients and fiber out of diets. For another, the food industry is happily manufacturing "gluten free" junk foods to exploit this fashion trend, as they have done with every nutrient fixation over the years. For these, and related reasons, I reject the rejection of gluten as a generalizable crusade.

3. Wheat makes us fat and grains make us stupid.

So say recent best-sellers. But in both cases, literature was cited very selectively. I have gone deep into these weeds before, and won't do so here. Suffice it to say that whole grains are associated with exactly the opposite effects: weight control and better mental and physical health. Whole grains, for instance, figure rather prominently in the diets of almost all "Blue Zones," or populations around the world that live the longest and best, experiencing the least obesity, the least dementia, the least chronic disease and the most vitality. This profound epidemiologic association was conveniently overlooked to turn whole grains into a scapegoat, and propagate book sales.

4. Modern grains have been genetically modified.

By one means or another, virtually everything we eat in the modern world has been genetically modified -- that's what domestication of crops and animals does. As for the kind of genetic modification involving test tubes, it is a modern variant on a rather ancient theme. Yes, it can result in unintended harms, but it can also do good. I favor disclosures about when it is being done, but reject the idea that it is intrinsically bad. The domestic dog is a genetically modified wolf -- and I love several of those GMOs very much! Genetic modification, per se, is neither good nor bad; it is just a method. Every product needs to be judged on its liabilities and merits.

These, of course, are simply arguments against whole grains. What about arguments for them? I'm glad you asked.

1. Whole grains are an excellent fiber source.

As noted, most of us get far too little fiber -- both soluble and insoluble. The health benefits of fiber are considerable. Grains are generally an excellent source of it. Since even diets with grains tend to fall far short of fiber targets, diets that exclude them are very unlikely to come close. This dietary deficiency can contribute to risk for a range of conditions including constipation, diverticulosis and diabetes.

2. Whole grains provide a variety of valuable micronutrients.

Grains are a diverse food group with a diverse nutrient profile. In general, though, they provide a rich array of B vitamins and a variety of minerals. Many contain antioxidant compounds, and some provide novel antioxidants found almost nowhere else in our food supply.

Grains are also an important protein source. Some are better than others, but in general, the amino acid profiles in grains are complementary to those of other plant foods, such as beans and legumes. Rice and beans, for instance, make up a traditional dish in a number of cultures, and perhaps not coincidentally, provide a complete array of essential amino acids, serving as an alternative to meat. Whole grain pasta with beans (pasta fagiola) does the same.

3. Grains can improve glycemic effects of other foods.

There is research to show that both low-carbohydrate and high-carbohydrate diets can result in a comparably low glycemic load. The same research suggests that a low-glycemic, high-carbohydrate (meaning high in plant food) diet has preferable effects on an array of chronic disease risk measures. Other research shows that a high intake of fiber from cereal grains at one meal can actually blunt glycemic responses to another meal later that same day.

4. The planet's longest living, healthiest populations eat lots of grains.

As noted, grains are a time-honored fixture in all of the "Blue Zone" diets. They figure prominently in variations on the theme of Mediterranean diets, Asian diets and vegetarian diets.

5. Whole grains are a versatile dietary component.

From an eater's perspective, the diversity of grains available to us means a whole array of options for adding their nutritional benefits to our diets, from oatmeal at breakfast, to tabbouleh for lunch, to pasta fagiola for dinner. For a cook, they similarly expand options for enhancing dishes and meals with appetizing, if generally mild, flavors -- all while adding favorable nutrients.

I don't grow grains in my backyard. I have no grains to sell. And for that matter, I have no ax to grind. I do, however, eat whole grains routinely.

If you choose not to eat whole grains, that's your business; you are the boss. But from my perspective, generalized arguments against eating whole grains are more chaff than wheat. Arguments in favor of whole grains as part of that winning dietary formula -- "eat food; not too much; mostly plants," as Michael Pollan put it -- are strong. Whole grains figure consistently in whole dietary patterns associated with good health. And that, pretty much, is the whole story.

David L. Katz, MD, MPH, FACPM, FACP, is the founding director of Yale University's Prevention Research Center; president of the American College of Lifestyle Medicine; editor-in-chief of the journal Childhood Obesity; chief science officer for NuVal LLC; and director of the Integrative Medicine Center at Griffin Hospital. A clinician, researcher, author, inventor, journalist and media personality, Dr. Katz is the recipient of numerous awards and recognitions, including an honorary doctoral degree and widely supported nominations for the position of U.S. Surgeon General. He has authored nearly 200 scientific papers and chapters, 15 books, and hundreds of on-line columns and blogs -- with a resulting following of well over a quarter million people. A two-time diplomat of the American Board of Internal Medicine, and a board-certified specialist in preventive medicine/public health, he is recognized globally for expertise in nutrition, weight management and the prevention of chronic disease. He has been acclaimed by colleagues as the "poet laureate" of health promotion.