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Whole grains are often recommended as a ‘safe’ diabetic food and yet are they?
Well I could give you my opinion but it would be just that, my opinion – which at the end of the day doesn’t stand up to much.
So in my usual style I decided to search the web and the medical journals to see what evidence really exists for recommending whole grains to type 2 diabetics – I’m always learning too.
In today’s post on whole grains and diabetes I’m going to present a few different views and the research that currently exists.
As usual it gets my back up when I start reading things. The amount of bad and wrong information, the lies and deception – well at least that’s how I think of it.
I encourage you to read the whole post because I’d like to hear your perspective on things once you read it.
Whole Grains vs. Refined Grains
Whole Grains
One of the easiest way to distinguish a whole grain is by it’s brown coloring, as compared to refined grains, which are white.
As the Minnesota Department of Health explains, the whole grain kernals are made up of 3 parts:
- Bran – Outer layer of the grain that contains fiber, antioxidants, B vitamins, phytochemicals, and 50-80% of minerals in grains like iron, copper, zinc, magnesium
- Endosperm – middle largest layer containing mostly carbohydrates, protein, and small amounts of some B vitamins and minerals
- Germ – inner component containing healthy fats, B vitamins, phytochemicals, and antioxidants like vitamin E
Refined Grains
Refined grains are all the white stuff – white pasta, white rice, white bread and so forth.
When you eat refined grains you are only getting the endosperm – the middle layer containing the highest carb count and the lowest nutrients.
Basically all of the nutrition has been stripped from the grain, which isn’t ideal because this means they have low vitamin and mineral content.
We need vitamins and minerals for many important functions in the body.
So if you are going to choose any type of grain, choose only whole grains.
But there is more to the story…
Reduced Risk vs. Treatment of Type 2 Diabetes
Study after study after study shows that whole grain intake is associated with reduced risk, prevention, decreased incidence of type 2 diabetes.
Without a doubt, you go searching through the medical journals and you’ll find plenty of research that suggests this.
BUT reduced risk is different to treatment.
Reduced risk generally means someone doesn’t yet have diabetes, treatment refers to how someone who already has diabetes can benefit.
I find many people use these terms interchangeably but they are completely different scenarios so you can’t just lump them into the same bucket.
Whole Grains Evidence
What does the Food and Drug Administration (FDA) think of the evidence behind whole grains and diabetes?
Here’s an excerpt I found on Today’s Dietitian:
When evaluating evidence for health claims, the FDA considers well-controlled clinical trials to be the gold standard for approval. For the whole grains and type 2 diabetes petition, the agency reviewed six such trials but found no significant association between whole grain consumption and fasting blood glucose or insulin resistance in five other studies. Most of the research on whole grains and type 2 diabetes has been observational in nature (ie, studies of populations, what they eat, and the incidence of disease). Of the 41 observational studies the FDA evaluated, the agency concluded that it couldn’t draw any conclusions for 38 because of inconsistencies in the way whole grains were defined and identified. Establishing an association between health and the consumption of any type of food is possible only if the food is clearly described and can be easily identified.
Overall, the FDA determined that only three observational studies and one intervention study supported an association between whole grains and a reduced risk of type 2 diabetes, while the others either found no association or provided inadequate definitions of the whole grain foods consumed in the study population.
However, after the FDA’s assessment, a systematic review and meta-analysis of whole grains and type 2 diabetes was published online in October 2013 in the European Journal of Epidemiology, which concluded that “our results support public health recommendations to replace refined grains with whole grains and suggest that at least two servings of whole grains per day should be consumed to reduce type 2 diabetes risk.”
Conclusion: The FDA finds poor evidence.
And again the evidence is all about reduced risk, not treatment.
Be on The Lookout For Rubbish Information
It annoys me no end to see rubbish articles like this, which are everywhere – written by a dietitian, someone that should have their facts straight.
The beginning of the articles says: YES, type 1 and type 2 diabetics should eat whole grains.
But it then goes on to give research based on reducing risk and how carbs are the thing that has the biggest impact on blood sugar – so… IT DOESN’T MAKE SENSE!
That’s just bad information in my opinion.
Are people actually thinking about this when they write things?
There’s simply no logic in it.
I just feel like people are insulting your intelligence. Seriously, if you had the right information would you work to change your diet?
I bet you would because you want to feel better.
Just because people do commonly consume grains doesn’t mean they have to. And it also doesn’t mean we should keep recommending it just because that’s what people commonly eat!
Diabetics want, and more importantly need to know what to eat to improve their health, period!
Sure, it’s tough to get to the bottom of it. But, can these dietitians and health organizations just stop regurgitating the status quo and present a properly constructed evidence based argument?
Anyway, now that I’ve said my bit, let’s get back on point.
Evidence Behind Whole Grains for Diabetes TREATMENT
There is VERY limited evidence that whole grains are actually good for diabetic treatment.
One study took 11 obese subjects (note these are not diabetic and 11 is a very small study). The people had hyperinsulinemia – meaning they had insulin resistance and were prediabetic. They did find that insulin was 10% lower in the whole grain diet compared to the refined grain diet (well it doesn’t take science to reach that conclusion).
Another common argument is that grains are low glycemic index (GI) and low GI helps diabetes.
Again, while that may be true to a certain extent, the reality is that the thing that influences your blood sugar and A1C the most is the amount of carbohydrate you eat.
Let’s repeat…
The thing that influences your blood sugar and A1C the most is the amount of carbohydrate you eat.
Anyway, I decided the best place to dig for more research was the highly regarded Cochrane Library.
The Cochrane Library is a medical journal that contains all the randomized control trials and highly regarded systematic reviews. Randomized trials are considered the highest form of evidence we have.
What I was looking for was research that shows whole grains actually have a benefit in treatment – not just in reducing risk.
Here’s the very limited evidence I found.
Research on Benefits for TREATMENT of Type 2 Diabetes
Study: 23 type 2 diabetic patients – the study looking at glycemic control and risk factors for cardiovascular disease in T2D.
Conclusion: “High-fiber cereal foods did not improve conventional markers of glycemic control or risk factors for CHD in type 2 diabetes over 3 months.” (1)
Study: 14 obese prediabetic people – comparing whole grain to refined grain.
Conclusion: “In conclusion, a WG diet reduces blood glucose by enhancing peripheral glucose uptake and pancreatic function in prediabetes independent of fat loss.” (2)
There were a couple of other studies showing slight benefits for obese people with metabolic problems – but these are not type 2 diabetics.
Overall conclusion: There is virtually no evidence that shows any benefit for consuming whole grains for treatment of type 2 diabetes!
If you know something I don’t please step forward with the info – I’d love to hear it, as I’m sure readers of this blog would too.
Whole Grains Are A Better Choice
For once the American Diabetes Association and I agree:
“There is no end in sight to the debate as to whether grains help you lose weight, or if they promote weight gain….
One thing is for sure. If you are going to eat grain foods, pick the ones that are the most nutritious. Choose whole grains. Whole grains are rich in vitamins, minerals, phytochemicals and fiber.”
THEY ARE HIGH CARBS.
Whole Grains and Diabetes
Please pin this infographic. 🙂
NOTE: If you want a copy of this list and lots of other carbohydrate foods, you can get it by joining our 30 Day Turnaround Program.
So…Should Whole Grains Get the Cut?
Some people can eat small portions (1/4-1/2 cup max) of whole grains without seeing too much of an impact on their blood sugar levels.
MOST people can’t get away with it and need to go grain free, cutting out pasta, rice, noodles, and so forth – at least high carb ones anyway.
At the end of the day it is your choice and your body, so test, test, test, and then work toward making better choices.
I know this comes as a shock to many people – I mean what are you going to eat if you can’t eat pasta and rice??
That’s why Diabetes Meal Plans is here. We’ve got a 30 Day Turnaround Program that takes you through all the foods step by step.
And we’ve also got ready-made meal plans to help make it easier.
Anyway, I hope this has given you some food for thought. 😉
Please share, pin, or tweet this post. Thanks 🙂
References
- Jenkins et al. 2002. Effect of wheat bran on glycemic control and risk factors for cardiovascular disease in type 2 diabetes.
- Mailin et al. 2014. Whole grain diet improves glucose tolerance, insulin sensitivity, and beta-cell function in overweight prediabetic adults.
My fasting level hangs out around 120. My physician says anything below 130 is good. I’m not really buying that. Fortunately, my levels do come down during the day between eating low carb and being active. So my question is how can I get that overnight fasting level down? Thanks.
That’s a great question Diana, and in a few days we will have some details and tips on that exact thing. Under 130 is considered the general goal, under 110 is better and under 100 is considered normal non-diabetic levels. The good thing is your levels are coming down and time in range is very important! Thanks for checking in and stay tuned for that info on morning levels.
Hi Checking in day 4
I don’t eat them because they raise the. B/S to much.
Yes, exactly Wendy!
When I was a kid in the 50s, our parents were told to give up pasta, rice, bread, potatoes in order to lose weight. Over the years, advice morphed into low fat instead. In 1985, I jumped on the low-fat bandwagon, thinking others knew more than I did. I packed on the pounds, fasting blood sugar creeping up over the years. Sad part is I knew in my gut carbs were bad for me as I’d dropped quite a bit of weight after college on a low carb diet, prior to the LF fad. So all of your articles, advice and recipes are very helpful. Toughest part has been transitioning to LC and realizing I really am okay (not hungry or feeling deprived) without them. The biggest surprise has been realizing that I have to be very careful about fruit as well.
It is really interesting to see (and hear firsthand) how nutrition information has changed over the years. I am happy you are finding something that works for you!
Great stuff on grsins. Now, what about fruits. The 3 fruits per day recommendation is a lot of carbs. Nd fructose sugar. Could you do same review on fruiys thst you did on grains.
You are right, Dave, that fruit is very high in fructose. We actually have previously written a guide on the best fruit for diabetics that I think will answer many of your questions. Make sure to watch your portion size of fruit, and probably sticking to one serving per day is a better goal. Let us know if you have any further questions!
HOW MUCH O
F CARBS IS GOOD DAILY
Thank you..
Find more on that here and here Sonia.
Egyptian folks are great people but their Wheat is not. After being a diabetic for almost 40 years, take my word WHEAT, the whole grain is the enemy of the diabetics. Do not go for it.
Thank you for all of the information you are providing. I am so happy to have found your site. Finally a nutritionist and dietitian who truly understand and provide helpful advice! I forwarded your site to the nurse in charge of diabetic research at the hospital I go to for treatment. Thank you!
Thanks for your kind words Kim and so glad you find our site helpful!
Hi Jedha and thanks for all the really informative articles. I have learned more from your articles than I ever learned from my doctors over 20 years that I have had Diabetes. you are right about whole grains and studies that only discuss reduced risk. Nobody until you came along pointed out reduced risk does not correlate with people who have diabetes already. Keep up the great work and thank you for helping us diabetics navigate through the muddy waters of diabetes information.
Thanks for your comments Pat, much appreciated. So glad the info is helping you, that’s why we do what we do. 🙂
Hi Jedha, I find this post on grains very informative and helpf as always. I think am a grain addict, i changed fro white rice to brown rice because the thought of me not eating rice?Is unthinkable , i also love oatmeal i usually make overnight oat but i know it w be better to reduce my grain to only once a week. I think i will have to make a lot of Hard changes to my Food and have weekly meal plans with your help so i can be where i want to be . Thank you again
We’re all grain addicts Josephine, and carb/ sugar addicts. Unfortunately it has become the nature of our society. As for rice, you may still be able to eat it, brown rice, just watch your portions and in time keep an eye on your levels. If they are not improving, then you can work on cutting more carbs. Find some info on oatmeal here.
The good thing is, there are PLENTY of foods you can eat so there is no need to feel deprived. As you find alternatives, you’ll find they are just as enjoyable. 🙂
Hello Jedha. I’m finding your posts most informative. I’m a newly diagnosed prediabetic, petite female in my early 60s. My weight has never been an issue, but have cut out potatoes, pasta and rice, everything made with white flour, sugars, etc. to keep my blood sugars under control. So far so good. your article on whole grains is interesting. this is all new to me and Re-learning how to cook/bake at my age is challenging. it’s trial and error, but I’m getting there. My goal is to delay having to take medications for as long as I can. Always look forward to reading your articles.
Congrats on all the changes you’ve made Charlotte. It is a challenge but there are still plenty of options. We wish you the best in health!
What a pleasure to have someone tell us what they really think! My experience with “the industry” tells me you are spot on.
This lesson on grain was very interesting. As I chased through the various links I learned more about testing and immediate results based on consumption. I also learned to be even more careful about what I read and believe. Many people push whole grains when no grains may be better.
Observation about carbs: eating carbs requires eating more carbs. By that I mean once I add too many carbs into my meal plan, then I’m trapped and am pretty powerless not to keep piling on more carbs. It’s sort of like an old potato chip commercial that says you can’t eat just one. Do you have any thoughts or comments that might address this.
Glad you enjoyed it Jim. People can and do live fine without grains, especially diabetics. As for the carb thing, it is interesting and much of it has to do with both ingrained habits of eating and liking carb-rich foods, and specific hormones that get triggered when we eat carbs. If you can’t moderate certain foods, know what they are, then it’s best to stay away from them.
Good afternoon Jedha here in the UK the information we are given is zero,I was diagnosed in October this year,given a sheet of paper which more or less said that I could eat anything in moderation and come back in 3 months.
thanks to you for being there and for all your advice which I am following ie I have cut out all sugar even in my tea,no sweets,no pastry,no potatoes,no processed food of any kind,no salt,I am finding it difficult to stop eating my wholemeal bread but i am down to two slices of toast every other day with 2 poached eggs for breakfast the next day I have porridge with either raspberries or blueberries.
Thank you for being here.
William
Hey William, great to have you here. What you explain seems to be a common scenario, unfortunately. Great to hear that you’ve made lots of changes and hopefully you’re already seeing the results reflected in your numbers. Look forward to hearing how you go!
I have been a type 2 diabetic for 15 year’s. Your facts reguarding grains are spot on. 2 year’s ago i found out cutting out grains of any kind made a huge difference. I have lost 208 pounds over the last 2 years and enjoy a healthy life style with an A1C of 5.1. Now lets talk about intestinel inflamation and diabetes. Great job.
WOW Margaret, that is a great result. Good for you and thanks for sharing. 🙂
We have got some info on inflammation and will be covering gut bacteria/ health soon.
Hi Jedha
I am really enjoying this course and it is definitely helpful. I was diagnosed type 2 in Feb this year and put myself straight on low carb course. Now lost 3 stone and back in pré diabetic state. Hoping next test will show normal. As a vegetarian I have found it difficult to choose food without meat or fish but this course is helping. Any tips you have for veggies would be most welcome. Thank you. Kate
Awesome, well done Kate!
Here is some info on vegetarian food you might find helpful. We will definitely aim to put together a veggie meal plan at some stage.
My husband has just been told he is pre diabetic so we are doing research. He is on board with going no grains. But, I was wondering about Quinoa. I haven’t seen any mention of it on your site so far. Thanks
Hi Kysti, Unfortunately you’ll have to rule out quinoa too. It’s a high carb whole grain as well.
My doctor told me that I am prediabetic. I purchased your course to learn the correct way to eat so it will not develop into T2. Now my A1C levels are up and down (82 to 142). Could you help me implement a meal plan that will keep my A1C study?
Also, I need to lose 20 pounds need a 1200 calories prediabetic meal plan.
Please help!!!
Sj
Hi Sandra, first don’t panic.
I noticed you are a VIP member so you have everything you need at your disposal. The same dietary guidelines apply to prediabetes as to type 2. There’s a 4 wk prep ahead meal plan, food lists and resources, and the 30 day program you could follow. These will help you achieve your goals, your A1C levels will come down and remain steady.
You should not test your A1C all the time. It is an average measure of glucose in the blood from the past 3 months. It’s not something you test daily like you would with blood glucose levels. It will take TIME to come down and remain steady. Also, you do not need a 1200 calorie diet, this is way too low and often people struggle to lose weight with so little calories because the body goes into “starvation” mode and stores fat instead of shedding it. You just need to eat the right things and focus on quality foods. You can find all that help in the members site. 🙂
Thank you for saying it as it is. I have just been diagnosed with type 2 and really struggling. Your information is fantastic. Just want to get the energy so I can get back to exercise and a normal life. I just have to keep on reading and learning…
Thanks Sandy, glad you’re finding it helpful. Your energy will come back. Just focus on what you’re eating and bring your sugars down – the high glucose brings on fatigue. Definitely keep reading and learning and shout out if you need help with anything. You’re not alone. 🙂
What about sprouted whole grains most I see are about 9 to 11 carbs is it safe to eat them with type 2 diabetes
Hi Don, technically yes, sprouted grains are better (in a sense) but whether they are safe is questionable because it depends. For example, 1 slice of bread ‘7 Sprouted Grains Loaf’ is still 13 g carbs – it will depend what else is in the ingredients, especially with breads anyway. You may be able to find one better.
1/2 cup sprouted wheat is still 22 g carbs. I also don’t really know anyone that eats sprouted wheat or rice as a base for meals so it’s kind of null and void. Certainly sprouted legumes like lentils and beans are good, it greatly lowers their carb count when sprouted as opposed to cooked.
At the end of the day it comes down to how things influence you as an individual. Only your meter can tell you that. 🙂
Thank you for your help after what you say and what o have found it is probably better just not to eat it .thank you so much for all your help it means a lot to me and I’m sure all diabetes patients
You’re welcome Don, great to have you round. 🙂
And you’re right – there are plenty of other options to choose from.
Everything is so informative…..thank you…
what about whole grain rice cakes ???? I eat them a lot.
marie
Glad you’re enjoying the info Marie 🙂
Rice cakes are pretty much the same, high carb and very little fiber or nutrients…
LOL, another error, the OB has 20 gms of carbs for a net of 16. that’s for a third cup so multiply that by 3 and it’s greate r than Buckwheat.
Yes, it an be surprising right? Whole grains have lots of carbs and although they do contain some vitamins and minerals, they are no way near as beneficial for our health or as nutrient dense as vegetables.
That should be “on 5”. Just looked at the labels on the Buckwheat, 1 cup prepared has36 gm of carbs and only 1 gm of fiber. Quaker Oat Bran has 0 carbs and 4gms of fiber, looks like OB is the better choice they both show 0 sugar
My daily breakfast usually consists of a bowl of unsweetened cereal. Shredded Wheat or Muffets cold, or hot Buckwheat, Quaker Oats or Oat Bran. I sweeten them with a dash of Stevia and have been using skim milk forever. Saturday is toast day, for me two slices of thin marble bread with light Becel and light peanut butter, also have Fifty 50 sugar free jam. The Becel I’m using has 87% less fat than butter.
Sunday is egg day, two poached eggs on the a toasted slice of the marble bread accompanied by small pieces of ham or peameal bacon
A cup of perked coffee is a daily starter with skim milk and Stevia.
I’m a heart/stroke patient so it’s important to watch my fat intake.
That’s my comment on the dairy post. This am I’m at 5.6. and that’s with 500mg of Metformin daily. Now we’re at the gym 5 days a week. I do a half hour on the treadmill and 12 rep’s of 5 of their exercise machines each day, I’m getting by OK.
Hey Brewster, everyone does have a different carbohydrate tolerance but majority of people can’t eat a lot of whole grains without blood sugar going crazy. As you can see, they do contain a lot of carbs and since this is what influences blood sugar the most, it is in most people’s interest to cut them down or cut them out.
It looks like you are keeping your blood sugar under control, for now. But watching the whole grains could be something to keep in mind should you need to refine your own results. Also, if you were to work toward eliminating all medication, you may need to reduce carbs, lots of research shows this works best. Here’s a great case study too https://diabetesmealplans.com/7145/t2-low-carb-diabetic-diet-case-study/
By the way, when you read food labels, the ‘sugar’ component is really irrelevant. Carbs are sugar, sugar are carbs, they are the same.
I am receiving really good information from your posts. I have always been a carb junkie and I am trying to change that and this is helping with all the correct information I am getting. Thanks
It’s too easy to be a carb junkie right Cathy – carbs are everywhere!
But, there are lots of delicious options we can choose instead. Glad you’re finding the info helpful. 🙂