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Less Processed Whole Grain Foods Linked with Better Blood Sugar Control in People with Diabetes

Replacing refined grains (like white bread or white rice) with whole grains (like whole grain bread or brown rice) is a simple swap that can yield measurable health benefits. But what if you are already eating whole grains and are ready to take the next step? In this study, researchers randomly assigned 63 adults in New Zealand with type 2 diabetes to a diet with either intact, minimally processed grain foods (whole oats, brown rice, whole wheat bread made with coarse whole grains) or more processed, finely milled whole grains (instant oats, brown rice pasta, whole grain bread made of finely milled flour). Those in the less processed group had a significantly lower post-meal blood sugar response and lower blood sugar variability throughout the day, indicating better blood sugar control.
Diabetes Care. 2020 May; dc200263. doi:10.2337/dc20-0263.(Åberg S et al.)

Whole Grain Breads with Larger Particle Size / Less Processing Linked with Healthier Blood Sugar Control

In a small study, researchers assigned 15 people to four different types of 100% whole grain bread and measured their blood sugar responses (using iAUC, post-meal glucose, and 3-hour glucose). One bread was made with 100% stone ground flour, one was made with 100% roller milled flour, one was made with 50% roller milled flour and 50% cracked whole wheat, and one was made with 40% roller milled flour, 30% intact whole wheat, and 30% cracked whole wheat — although all breads were 100% whole grain. Among the roller milled breads, they found that the larger the particle sizes in the bread (intact whole wheat > cracked whole wheat > roller milled wheat), the gentler the impact on blood sugar. Interestingly, the blood sugar response of the stoneground bread (as measured by iAUC) was better than the 50% cracked wheat / 50% roller milled bread, but not quite as good as the 40% roller milled / 30% intact whole wheat / cracked whole wheat bread.
Diabetes Care. 2019 Nov 19. pii: dc191466. doi: 10.2337/dc19-1466. (Reynolds AN et al.)

Whole Grains, Moderate Alcohol Intake Linked with Lower Diabetes Risk

Numerous studies have been published on diet and diabetes risk, but the quality of these studies varies widely, making it hard to compare the risks and benefits of different food choices. In this analysis, researchers reviewed 53 studies on diet and type 2 diabetes risk, and evaluated their strength and validity. There was high evidence that 30g per day of whole grains was linked with a 13% lower risk of developing type 2 diabetes and that 10g per day of fiber from grains was linked with a 25% lower risk of developing type 2 diabetes. There was also moderate evidence that 0.5-1 ounce of alcohol per day was linked with a 25% lower risk of type 2 diabetes than not drinking at all. On the other hand, eating 3.5 ounces of red meat daily, 2 ounces of processed meat daily, 2 slices of bacon daily, or one serving of sugar sweetened beverages were all strongly linked with a higher risk of type 2 diabetes.
BMJ. 2019 Jul 3;366:l2368. doi: 10.1136/bmj.l2368. (Neuenschwander M et al.)

Switching to Whole Grains May Help Improve Insulin/Blood Sugar Management

Insulin is a hormone that helps your body manage your blood sugar, by keeping it from getting too high or too low. In this study, 13 adults with “pre-diabetes” were given a diet with either whole grains or refined grains for 8 weeks, then given a glucose test to assess how well their blood sugar was being managed. They then had a washout period of their normal diet for 8-10 weeks, before switching to the other diet for 8 weeks and taking the glucose test again, thus serving as their own controls. The whole grain diet improved the function of beta cells (the cells that secrete insulin) compared with the refined grain diet, and this effect was found to be independent of gut hormones (such as grehlin, the “hunger hormone”).
Molecular Nutrition and Food Research. 2019 Apr;63(7):e1800967. doi: 10.1002/mnfr.201800967. (Malin SK et al.)

Whole Grains and Fiber Linked with Lower Risk of Many Diseases

Whole grains are one of the most popular food sources of fiber, and both whole grains and fiber are important for overall health. In this study, researchers analyzed data from more than 200 studies encompassing 4,635 participants to better understand fiber and whole grains’ relationship with disease prevention. Fiber was linked with a 15-30% lower risk of heart disease, stroke, type 2 diabetes, colorectal cancer, and death, with similar findings for whole grains. The researchers noted a dose-response relationship for both whole grains and fiber, indicating that those who eat the most may confer an even greater benefit.
The Lancet. 2019 Feb 02;393(10170):434-445. doi: 10.1016/S0140-6736(18)31809-9 (Reynolds A et al.)

Sprouted Triticale May Benefit Blood Sugar Management

Whole grains contain fiber, vitamins, minerals, and antioxidants, and sprouting grains may make these compounds more available. In this study, researchers fed volunteers a meal of sprouted whole wheat, sprouted whole grain triticale, or sugar and compared how these foods affected the volunteers blood sugar and insulin levels. People who ate the sprouted triticale had lower levels of blood sugar and insulin than those who ate sugar; the volunteers who ate sprouted wheat had lower blood sugar than those who had just sugar, but there was no difference in insulin response. Both grains were associated with improved blood sugar control, however this effect was strongest in the sprouted triticale group. This study indicates that whole grain triticale may be especially beneficial to blood sugar management.
Journal of Nutrition and Metabolism. 2019 Jan 10;2019:6594896. doi: 10.1155/2019/6594896. (Meija et al.)

Replacing White Rice with Whole Grain Bread May Lower Diabetes Risk

White rice has displaced many traditional whole grains across Asia, so researchers wonder how white rice might relate to diabetes risk. In a study of 45,411 Chinese adults followed for 11 years, researchers found that replacing white rice with white bread and whole grain bread can reduce type 2 diabetes risk by 10% and 18% respectively, and that replacing white rice with noodles, red meat, or poultry might actually increase diabetes risk. Rice intake itself was not associated with higher type 2 diabetes. The authors conclude that “recommendations to reduce high white rice consumption in Asian populations for the prevention of [type 2 diabetes] may only be effective if substitute foods are considered carefully.”
European Journal of Nutrition. 2018 Dec 10. doi: 10.1007/s00394-018-1879-7. [Epub ahead of print] (Seah JYH et al.)

Plant-Based Korean Diet with Brown Rice Can Improve Blood Pressure and Blood Sugar in Hospitalized Patients

Many people are surprised at how effective lifestyle changes can be when it comes to managing chronic disease. In this study, 160 hospital patients in South Korea with high blood pressure changed their diet to eat a plant-based (vegan) diet based on brown rice at each meal, with lots of kimchi and pickled vegetables, fermented soy foods, and lots of other vegetables (both raw and cooked). They averaged about 1,700 calories per day and did not eat any refined grains or any noodles or breads, relying on brown rice as the staple. Their sodium intake was quite high, at 7,382mg per day. However, after about 2 weeks, 86% of the patients were able to stop taking their blood pressure and diabetes medications, and their reduced blood pressure levels remained stable even after stopping the medications. Similarly, HBA1C reduced from 7.6 to 7.2, indicating better blood sugar management. More research is needed to see if similar approaches might be effective in other populations.
Journal of Ethnic Foods. 2018 Nov 1. DOI: https://doi.org/10.1016/j.jef.2018.09.002 (Jung SJ et al.)

Whole Grains Linked with Better Blood Sugar Management

Metabolic syndrome is a cluster of conditions (high blood pressure, high blood sugar, high cholesterol, and excess fat around the waist) that can increase your risk of heart disease, stroke, and diabetes if they occur together. In this study, researchers randomly assigned more than 100 adults with metabolic syndrome from Finland and Italy to a diet with whole grains or a control diet without whole grains for 12 weeks. The whole grain group had better blood sugar control after meals. Researchers hypothesize that this may be because eating whole grains may help stimulate the production of certain chemical compounds (betaine compounds, such as pipecolic acid betaine) which are linked with improved insulin resistance and insulin secretion.
American Journal of Clinical Nutrition. Am J Clin Nutr. 2018 Sep 25. doi: 10.1093/ajcn/nqy169. [Epub ahead of print]. (Kärkkäinen O et al.)

Whole Grains Associated with Lower Risk of Diabetes

Whole grains are healthy carbohydrate foods that may be especially protective against type 2 diabetes. In this study, researchers analyzed the eating habits and health status of 55,465 middle-aged adults in Denmark. Those eating more whole grains were 11% and 7% less likely to develop type 2 diabetes (for men and women, respectively) over the 15-year study period. Rye bread, whole-grain bread, oatmeal, and muesli were all significantly associated with a lower risk of type 2 diabetes for both men and women, indicating a benefit for whole grains in general, rather than just one specific type of whole grain food.
The Journal of Nutrition. 2018 Sep 1;148(9):1434-1444. doi: 10.1093/jn/nxy112. (Kyrø C et al.)

Quality Carbohydrates, Like Whole Grains, Linked with Numerous Health Benefits

Not all carbohydrates are created equal. After all, everything from quinoa and blueberries to candy bars and soda have carbohydrates. In this review, researchers examined the links between different types of carbohydrates and health. They concluded that whole grains are linked with numerous health benefits, including lower cholesterol, body fat, and healthier blood sugar management, as well as lower risks of type 2 diabetes, heart disease, many cancers, and death from all causes. Given that much of the research on whole grains is done using more processed whole grain products (like breakfast cereals and breads), the authors note that more research is needed to determine if intact whole grains without as much added sugar may have even greater health benefits.
BMJ. 2018 June 13. (Ludwig DS et al.) [Epub ahead of print.]

Delayed Gluten Introduction May Be Linked with Type 1 Diabetes Risk

In a study of 8,676 babies with a genetic risk for type 1 diabetes, researchers took blood samples every 3 months for at least 9 months after birth and analyzed their diet. Every 1-month delay in gluten introduction was linked with a significantly higher risk of the immune system attacking the pancreatic cells that are important for blood sugar regulation (as measured by islet autoimmunity) as well as higher levels of insulin autoantibodies, which are predictors of type 1 diabetes. In fact, introducing gluten after 9 months was linked with a 57% higher risk of islet autoimmunity than introducing gluten between 4-9 months of age. The researchers suggest that the timing of gluten be studied further, so that healthcare providers can more confidently suggest a recommended window.
Diabetes Care. 2018 Mar;41(3):522-530. (Uusitalo U et al.)

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