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Whole Grains


WHOLE GRAINS 101

What Does "Whole Grain" Mean?

The definition of a whole grain is straightforward; identifying whether the foods you buy are whole-grain products is more of a challenge. Distinguishing whole grains from refined grains is well worth the effort because only the whole grain adds fiber to your diet and lowers your risk of developing cardiovascular disease and Type 2 diabetes.

Whole Grain Basics

All types of cereal grains consist of three layers. The outermost layer, called the bran, covers the entire grain. It adds a chewy texture because it's slightly tough so that it protects the grain. Underneath the bran, a middle layer called the endosperm forms the largest part of the grain. The third layer is like a small core of concentrated nutrients at the bottom of the kernel. This part -- the germ -- nurtures the growing grain.

FDA Definition

The U.S. Food and Drug Administration defines whole-grain foods as those that retain all three parts of the grain. Foods may contain ground, flaked, rolled and cracked grains, but they're still whole-grain products as long as they have all three parts of the kernel in the same proportion as the natural whole grain. The FDA allows food labels to carry a health claim stating that diets rich in whole-grain foods may reduce the risk of heart disease and some cancers, if the product contains 51 percent or more whole-grain ingredients and meets minimum fiber and low-fat requirements.

Whole-Grain Nutrients



Each layer in the grain contains different nutrients. The bran contains most of the grain's fiber, B vitamins and 50 to 80 percent of its minerals and phytochemicals. The germ has B vitamins and minerals, as well as vitamin E and healthy unsaturated fats. You'll get complex carbohydrates, protein and smaller amounts of vitamins from the endosperm. During processing, the bran and germ are removed to produce refined grains, so products such as white rice and white flour have fewer natural nutrients. Most refined grains are enriched to add back some B vitamins and iron, but they don't regain fiber, according to the American Heart Association.

Identifying Whole Grains



The only way to be sure that a product contains whole grains is to check the list of ingredients. The first item on the list is the most abundant ingredient. If it includes the word "whole," then the main ingredient is a whole grain. Look at the next few ingredients to see if any other types of grains are used and whether they're whole.

Brown rice and oats are exceptions because they're whole grains even if the word whole isn't used. Terms such as multi-grain, wheat flour, semolina and even “100 percent wheat don't necessarily indicate whole-grain ingredients.

They may mean that more than one type of refined grain was used, that it contains a mix of whole and refined grains, or that the flour is made from 100 percent processed wheat grains.

A whole grain, also called a wholegrain, is a grain of any cereal and pseudocereal that contains the endosperm, germ, and bran, in contrast to refined grains, which retain only the endosperm. Whole grains are a source of carbohydrates, multiple nutrients and dietary fiber.

Whole grains: Hearty options for a healthy diet

Find out why whole grains are better than refined grains and how to add more to your diet. All types of grains are good sources of complex carbohydrates and some key vitamins and minerals, but whole grains ? 

the healthiest kinds of grains ? in particular are an important part of a healthy diet.

Grains are naturally high in fiber, helping you feel full and satisfied ? which makes it easier to maintain a healthy body weight. Whole grains are also linked to a lower risk of heart disease, diabetes, certain cancers and other health problems.

The Dietary Guidelines for Americans recommends that at least half of all the grains you eat are whole grains. If you're like most people, you're not getting enough whole grains ? so see how to make whole grains a part of your healthy diet.

Types of grains

Cross section of whole grain showing bran, endosperm and germ.
Also called cereals, grains and whole grains are the seeds
of grasses cultivated for food. Grains and whole grains come in many shapes and sizes, from large kernels of popcorn to small quinoa seeds.

Whole grains. These grains are either present in their whole form or ground into a flour while retaining all parts of the seed (bran, germ and endosperm). Compared with other types of grains, whole grains are better sources of fiber and other important nutrients, such as B vitamins, iron, folate, selenium, potassium and magnesium. Whole grains are either single foods, such as brown rice and popcorn, or ingredients in products, such as buckwheat in pancakes or whole-wheat flour in bread.

Refined grains. Refined grains are milled to have had the germ and bran removed, which gives them a finer texture and extends their shelf life. The refining process also removes many nutrients, including fiber. Refined grains include white flour, white rice and white bread. Many breads, cereals, crackers, desserts and pastries are made with refined grains.

Enriched grains. Enriched means that some of the nutrients lost during processing are replaced. Some enriched grains have replaced the B vitamins lost during milling. Fortifying means adding in nutrients that don't occur naturally in the food. Most refined grains are enriched, and many enriched grains also are fortified with other vitamins and minerals, such as folic acid and iron. Whole grains may or may not be fortified.


Choosing whole grains

Make at least half the grains in your diet whole grains. You can find whole-grain versions of rice, bread, cereal, flour and pasta at most grocery stores. Many whole-grain foods, including a variety of breads, pastas and cereals, are ready to eat.

Examples of whole grains include:
Barley
Brown rice
Buckwheat
Bulgur (cracked wheat)
Millet
Oatmeal
Popcorn
Whole-wheat bread, pasta or crackers

It's not always easy to tell what kind of grains a product has, especially bread. For instance, a brown bread isn't necessarily whole wheat ? the brown hue may come from added coloring.

If you're not sure something has whole grains, check the product label or the Nutrition Facts panel. Look for the word "whole" on the package, and make sure whole grains appear among the first items in the ingredient list.


What about white whole-wheat bread?
It may seem like it doesn't add up, but actually white whole-wheat bread is made with whole grains, just as is regular whole-wheat bread.

White whole-wheat bread also is nutritionally similar to regular whole-wheat bread. So if you prefer the taste and texture of white bread, but want the nutritional benefits of whole wheat, choose white whole-wheat bread over refined white bread.

A word of caution

If all of the grains you eat are whole grains, you may need to take extra care to get sufficient folic acid, a B vitamin. While most refined-grain products are fortified, whole grains are not typically fortified with folic acid.

Look for whole grains that have been fortified with folic acid, such as some ready-to-eat cereals. Eat plenty of other folate-rich foods, including fruits, vegetables and legumes. Folic acid is especially important for women who could become pregnant or are pregnant.

How to enjoy more whole grains in your diet
Try these tips to add more whole grains to your meals and snacks:

Enjoy breakfasts that include whole-grain cereals, such as whole-wheat bran flakes (some bran flakes may just have the bran, not the whole grain), shredded wheat or oatmeal.

Substitute whole-wheat toast or whole-grain bagels for plain bagels. Substitute low-fat muffins made with whole-grain cereals, such as oatmeal or others, for pastries.
Make sandwiches using whole-grain breads or rolls. Swap out white-flour tortillas with whole-wheat versions.
Replace white rice with quinoa, brown rice, wild rice, barley or bulgur.
Feature wild rice or barley in soups, stews, casseroles and salads.

Add whole grains, such as cooked brown rice or whole-grain bread crumbs, to ground meat or poultry for extra bulk. Use rolled oats or crushed whole-wheat bran cereal in recipes instead of dry bread crumbs. Eating a variety of whole grains not only ensures that you get more health-promoting nutrients but also helps make your meals and snacks more interesting.

Health experts advise everyone - men and women, young and old - that grains are a healthy necessity in every diet, and that it's important to eat at least half our grains as whole grains. But what IS a whole grain? And why does it matter?


WHOLE GRAINS

Whole grains include grains like wheat, corn, rice, oats, barley, quinoa, sorghum, spelt, rye - when these foods are eaten in their whole form (more on that later). Whole grains even include popcorn!

You may already be eating whole grains. When you munch popcorn in the theater, or give Toasty-O's to your toddler, or enjoy a bowl of hot oatmeal, you're probably focusing more on the delicious taste than on the fact that these foods are whole grains.

ANTIOXIDANTS, VITAMINS AND MINERALS

Consumers are increasingly aware that fruits and vegetables contain disease-fighting phytochemicals and antioxidants, but they do not realize whole grains are often an even better source of these key nutrients.

Moreover, whole grains have some valuable antioxidants not found in fruits and vegetables, as well as B vitamins, vitamin E, magnesium, iron and fiber.

HEALTH BENEFITS OF WHOLE GRAIN

The medical evidence is clear that whole grains reduce risks of heart disease, stroke, cancer, diabetes and obesity. Few foods can offer such diverse benefits.

People who eat whole grains regularly have a lower risk of obesity, as measured by their body mass index and waist-to-hip ratios. They also have lower cholesterol levels.

Because of the phytochemicals and antioxidants, people who eat three daily servings of whole grains have been shown to reduce their risk of heart disease by 25-36%, stroke by 37%, Type II diabetes by 21-27%, digestive system cancers by 21-43%, and hormone-related cancers by 10-40%.


WHOLE GRAINS AND IMMUNE HEALTH

Staying healthy relies upon an array of variables - genetics, age, pre-existing conditions, physical environment, the list goes on. A factor we can largely control, and an impactful one at that, is our diet. Although there is no magic pill, or food that is the answer to good health, there is common ground among experts on what a healthy diet looks like. Not only does our diet play a role in promoting and maintaining healthy systems, but it also impacts our ability to actively fight off illness and pathogens that exist in the world around us.

The human immune system is extremely complex and diverse. It is made up of an array of cells and tissues, communicating and interacting with each other to keep tabs on all potential threats to our body. The food you eat plays a leading role in immune health, and whole grains do their part by maintaining the health of our digestion system and regulating inflammation, helping to give our immune system the best chance of doing its job well.



New scientific focus has found that the health of our digestive system directly impacts not just functions related to digestion, but our health as a whole, including immune strength and reduced inflammation in our body. In fact, it is our gut microbiome, full of helpful bacteria and other microorganisms, that teaches our fliedgling immune system not all bacteria is bad bacteria at birth.

To maintain a healthy gut, eating a balanced diet full of prebiotic foods is the best path - with whole grain fiber being particularly beneficial.   Our body produces a range of enzymes to break down the food we ingest. These enzymes, however, cannot digest dietary fiber - we rely on specific microbiota in our digestive tract for that. These helpful bacteria ferment dietary fiber, breaking it down into a variety of short-chain fatty acids. These fatty acids directly contribute t healthy bodily functions, including the maintenance of our gut mucus barrier.

It is our mucus barriers, such the barrier in our digestive tract, that keep pathogens out of our system. Because our gut is a main entry point for pathogens, immune system hubs are strategically located all along the gut. It is important, then, for immune health to keep the protective gut mucus barrier layer substantial and strong.

Without the help of short-chain fatty acids produced from fermented fiber, the integrity of the mucus barrier in our intestines diminishes. With its permeability compromised, unwanted organisms can start traveling more freely, leading to inflammatory conditions.



This tiny army of millions in the gut helps keep our immune system in balance, making sure our immune cells continue to differentiate between healthy cells and unhealthy ones. When the body detects unhealthy cells, like an infection or pathogen, the immune system jumps to action, sending fighter immune cells to the area of interest.

This rush of blood and helpful cells can cause swelling, redness, and other symptoms which we know as inflammation. Inflammation is one of the most common ways your immune system reacts to a threat. Inflammation is not bad, it's a response for healing. However, if inflammation does not subside it can have detrimental effects to overall health.

When inflammation does not go down, or becomes chronic, this healthy balance is thrown off and our overactive immune response may start to damage healthy cells and tissue. New research shows that chronic inflammation may play a role in a variety of common diseases.

Inflammation management is a benefit of many popular diets, such as the DASH diet or the Mediterranean diet. Whole grains are featured in both. This is because whole grains can help with managing inflammation levels in the body. Diets high in fiber have been shown to cut C-reactive protein (CRP) levels, a known marker for inflammation, up to 40%.

To add an extra immunity boost, oats and whole grain barley contain a fiber called beta glucan which helps to boost immune health and reduce inflammation. Oats also contain compounds called polyphenols which have strong antioxidant, anti-itching and anti-inflammatory properties, potentially reducing the effects of chronic inflammation.

While there is not one solution to great immune health, it is clear that whole grains contribute to a balanced immune system. New to whole grains? Not to worry, we have loads of recipes and resources to help.


NOTES ON OATS

Oats are one of the most beloved whole grains ? in fact, when we surveyed American consumers in 2018, oats were the second most popular whole grain after whole wheat, and oatmeal was the nearly the most popular whole grain food, coming in second only to whole grain bread. Despite this - or perhaps because of it - we get lots of questions from consumers who want to understand the differences between steel-cut, old-fashioned, and instant oats. Consider this your FAQ guide to all things oaty:

Eating More Whole Grains Linked with Lower Risk of Death

Eating at least three servings of whole grains every day could lower your risk of death, according to new research in the American Heart Association's journal Circulation. Although dietary guidelines around the world have included whole grains as an essential component of healthy eating patterns, people aren't eating enough, according to the analysis. In the United States, average consumption remains below one serving a day, despite the long-time recommendation of three servings a day.

In the first meta-analysis review of studies reporting associations between whole grain consumption and death, researchers noted that for about every serving (16 grams) of whole grains there was a:

7 percent decreased risk in total deaths;
9 percent decline in cardiovascular disease-related deaths; and
5 percent decline in cancer-related deaths.
The more whole grains consumed, the lower the death rate. According to researchers, when three servings (48 grams) were consumed daily the rates declined:

20 percent for total deaths;
25 percent for cardiovascular deaths; and
14 percent for cancer-related deaths.
Previous studies have suggested an association with consumption of whole grains and reduced risk of developing a multitude of chronic diseases that are among the top causes of deaths, although data linking whole grain intake and mortality were less consistent, said Qi Sun, M.D., Sc.D., senior author of the study and assistant professor at the Harvard T.H. Chan School of Public Health in Boston, Massachusetts. These findings lend further support to the U.S. government's current Dietary Guidelines for Americans, which suggest higher consumption of whole grains to facilitate disease prevention.



Whole grains, such as whole wheat, oats and brown rice, contain dietary fiber, which may help improve blood cholesterol levels, and lower the risk of heart disease, stroke, obesity and Type 2 diabetes. Dietary fiber can also make you feel full longer, so you may eat fewer calories.

Sun noted that low-carbohydrate diets that ignore the health benefits of whole grains foods should be adopted with caution, as they may be linked to higher cardiovascular risk and mortality.

Based on the solid evidence from this meta-analysis and numerous previous studies that collectively document beneficial effects of whole grains, I think healthcare providers should unanimously recommend whole grain consumption to the general population as well as to patients with certain diseases to help achieve better health and perhaps reduce death, Sun said.

The American Heart Association recommends a heart-healthy dietary pattern emphasizing fruits, vegetables, whole grains and other nutritious foods and specifically that at least half of grain consumption should be whole grains. Whole grains provide many nutrients, such as fiber, B vitamins, and minerals, which are removed during the refining process. Source: American Heart Association News


Which oats are whole grain?

We have good news for those of you oat-lovers seeking whole grain options. Oats are almost never refined, which means that no matter which box or canister you choose at the grocery store you're pretty much guaranteed to be getting a whole grain product. Remember that a whole grain has all three of its original, edible parts - the bran layer, full of fiber and B vitamins; the germ, rich in healthy oils and other nutrients; and the starchy endosperm.

When we say that a grain is refined, we mean some part of the original kernel has been removed. Often, in the case of refined flours, the germ and bran are stripped away leaving only the starchy endosperm. When it comes to oats, however, all three parts of the kernel remain regardless of the processed form you're buying them in, which is why plain oats qualify as 100% whole grain. Ok then, what's the difference between steel-cut oats and the instant variety- Is it a question of whether or not they're processed?

The degree to which the oat kernel has been processed turns out to be the main distinguishing feature between the various types of oats. Here's a breakdown of the most common forms of oats available to consumers:



Oat groats are fully intact oat kernels after they've been hulled and cleaned. These can be cooked much like you'd cook brown rice or wheat berries. They can take up to an hour to cook. Steel-cut oats (sometimes referred to as Irish or Scottish oats) are oat groats that have been chopped or sliced into smaller pieces. They have a chewy texture and nutty flavor and are most commonly used in porridge. They take about 30 minutes to cook. Old-fashioned or rolled oats are oat groats that have been steamed and flattened. They can be cooked into oatmeal, baked into breads and muffins, or roasted into granola. They take about 5-10 minutes to cook.

Instant oats are generally made from rolled oats that have been pre-cooked, dried, and then finely chopped. This is the type of oat you find in little packets, which often just require a little boiling water to cook.

When we talk about processed foods, we're talking about how much they have been changed from their original state in nature. Sometimes processed foods get a bad rap, but many people don't realize that lots of common, healthy foods are processed. Yogurt, for example, was invented long ago as a way to keep milk edible for more than a few hours before refrigeration existed.


Plain yogurt, made with just milk and natural bacteria (the good kind), is what we consider a minimally processed food. Of course, today you can find yogurts in your grocery store that are much more heavily processed, using pectin to thicken them rather than natural fermentation, and with lots of added sugars, artificial colors and flavorings, etc.

While almost all grains have to be separated from their hull, cleaned, and cooked before eating - all forms of processing in the strictest sense of the word - we generally consider whole grains like brown rice, steel-cut oats, and quinoa to be unprocessed. A lightly processed whole grain would be something like whole grain pasta, or rolled oats, while a heavily processed whole grain would be something like instant oats with lots of added sugar, or a whole grain cookie.

Do the different types of oat processing have an impact on nutrition or digestion?

As we mentioned before, virtually all oats are whole, so no matter which type you choose, you can be confident you're getting all the nutritional benefits of a whole grain. The nutrient content of your oats won't fluctuate from one bowl (of old-fashioned oatmeal) to the next (of instant oatmeal). That doesn't mean that our bodies will digest every bowl the same way, though.



Our bodies all need carbohydrates, but different carbohydrate choices can affect our bodies differently. As carbs are digested, they get broken down into blood sugar, which acts like fuel for our bodies. Carbs that break down slowly are said to have a low Glycemic Index.

These are carbs that deliver energy to you bit by bit, as you need it. Carbs that break down quickly have a high Glycemic Index - they give you a big spike in blood sugar that overloads your body, followed by a crash that can leave you feel hungry and tired. In the world of grains, generally the more processed a grain is (whether it’s whole or not) the more likely it is to cause a blood sugar spike.

In 2015, researchers from Quaker Oats tested the Glycemic Index of 72 oat products to understand how different types of oats affect blood sugar. They found that steel-cut oatmeal, large rolled oats, muesli, and granola produced a significantly lower glycemic response than quick-cooking and instant oatmeal. The scientists concluded that smaller particle size and increased starch gelatinization appear to increase the glycemic response.

We hope you're feeling inspired to cook up a comforting pot of your favorite oats! Check out our recipes for some great, flavorful ideas. (Caroline)


DEFINITION OF A WHOLE GRAIN

Whole grains or foods made from them contain all the essential parts and naturally-occurring nutrients of the entire grain seed in their original proportions. If the grain has been processed (e.g., cracked, crushed, rolled, extruded, and/or cooked), the food product should deliver the same rich balance of nutrients that are found in the original grain seed.

This definition means that 100% of the original kernel - all of the bran, germ, and endosperm - must be present to qualify as a whole grain.

GLUTEN FREE WHOLE GRAINS

Most people find whole grains are a delicious way to improve their health, and they enjoy the pleasures of choosing among all the different whole grains. However, the millions of people who can't properly digest gluten must choose their grains carefully. Luckily for them, most grains are gluten free.


CELIAC DISEASE, GLUTEN INTOLERANCE, AND WHEAT ALLERGIES

Gluten is a protein in wheat (all kinds, including spelt, Kamut khorasan, einkorn and farro/emmer), barley, rye and triticale (a rye/wheat hybrid) that is hard for some people to digest. This group includes the estimated 1-2% of the population with celiac disease - an autoimmune form of gluten intolerance - who must eat a gluten-free diet for life.

Other people may not have celiac disease, but may be allergic to wheat (about 0.2-0.4% of people) or may have what's termed non-celiac gluten sensitivity (a group some experts estimate at from 1% to 6% of the population) - though new research shows NCGS may not actually be the issue it was once thought to be.

There's no reason for the rest of us to go gluten-free, no matter what fear-mongering books like Wheat Belly and Grain Brain may say. Peer-reviewed scientific journals like those below have rebutted the misconceptions in pop-science books like these, with a point-by-point approach:

Which Grains are Gluten-Free? (Answer: Most of them!)

It's important to note that gluten-intolerant people CAN eat whole grains. In fact, as you'll see from the list below, a large number of gluten-free grain choices are available. Most grains are gluten-free! The grains on the right are gluten-free whole grains, when they are consumed with all of their bran, germ, and endosperm.



Grains with Gluten
Wheat, including varieties like spelt, kamut, farro and durum; and products like bulgur, semolina
Barley,
Rye,
Triticale,
Oats** see below

Gluten FREE Grains
Amaranth
Buckwheat
Corn
Job's Tears (or Hato Mugi)
Millet
Montina (Indian rice grass)
Oats** see below
Quinoa
Rice
Sorghum
Teff
Wild Rice

**Oats are inherently gluten-free, but are frequently contaminated with wheat during growing or processing. Several companies (Bob's Red Mill, Cream Hill Estates, GF Harvest (formerly Gluten Free Oats), Montana Gluten Free, and Avena Foods are currently among those that other pure, uncontaminated oats. Ask your physician if these oats are acceptable for you. Click here for a discussion on oats in the gluten-free diet or visit Health Canada's website for their very clear May 2015 Marketing Authorization clearly explaining which oats can be safe in a GF diet.


Gluten free grains pair with Other Healthy Substitutes

Many creative recipes have been developed for gluten-intolerant people, using the gluten-free grains above along with foods like nuts, arrowroot, beans, chestnuts, mesquite, potato, soy, and tapioca, all of which are gluten-free. Some of these ingredients make deliciously healthy breakfast cereals and side dishes, while others are ground into flours for flavorful baked goods such as pizza, desserts, and breads.

Reading Labels to Scout Out Gluten

Gluten hides in many unsuspecting places such as candy, sauces, and malt flavoring. Other ingredients appear suspicious, but may be safe. To learn more, visit Gluten Free Living. If in doubt about a particular food, ask the manufacturer about the ingredients and the standards they use to assure your safety.

Reading labels is very important. In the U.S., the Food Allergen Labeling and Consumer Protection Act mandates that labels on foods manufactured after January, 2006, will list the word wheat to indicate the presence of wheat. But the label doesn't have to list other gluten-containing grains such as barley, rye, spelt, kamut, or triticale.

In mid-2013, the U.S. Food & Drug Administration (FDA) released long-awaited standards for what food companies can label as gluten-free. These standards define gluten-free as containing fewer than 20 parts per million (ppm) of gluten - a level consistent with standards in other countries.


WHAT IS AN ANCIENT GRAIN?

There is no official definition of ancient grains. All whole grains in the larger sense are ancient - they all can trace their roots back to the beginnings of time. However, here at the Whole Grains Council, we generally define ancient grains loosely as grains that are largely unchanged over the last several hundred years.

This means that modern wheat (constantly bred and changed) is not an ancient grain, while einkorn, emmer/farro, Kamut®, and spelt would be considered ancient grains in the wheat family. Heirloom varieties of other common grains - such as black barley, red and black rice, blue corn - might also be considered ancient grains. Other grains largely ignored until recently by Western palates (such as sorghum, teff, millet, quinoa, amaranth) would also be widely considered to be ancient grains. Sometimes less common grains, like buckwheat, or wild rice, are also included.


ARE ANCIENT GRAINS HEALTHIER THAN MODERN GRAINS?

Ancient grains are certainly more nutritious than refined grain products (like white flour or refined crackers). But healthy whole grains need not be exotic. Common foods like brown rice, whole grain pasta, oatmeal, popcorn, and whole wheat bread, and often at lower price points.

Many ancient grains thrive with lower levels of pesticides, fertilizers, and irrigation, making them an attractive choice to consumers who choose to shop with their carbon footprint in mind. However, the best way to ensure that you're getting the full spectrum of nutrients available in nature is to eat a variety of different grain foods. After all, each whole grain has something different to other (from the calcium in teff, to the soluble fiber in barley), making it impossible to play favorites.

SPROUTED WHOLE GRAINS

Until about a hundred years ago, humans harvested their grains, tied them into sheaves, and left them in the field until the grain was needed. Exposed to weather, inevitably at least some of the grain would begin to sprout. Then just a byproduct of harvest, sprouted grain is now a health-food trend that has continuously gained traction since it appeared back on the health-food scene during the counterculture movement in the second half of the 20th century.

Although still considered a niche trend by many, manufacturers are starting to take note of consumer reactions to sprouted grains' healthful properties and more and more sprouted products - from bread to breakfast cereals - have started to make their way onto store shelves.


SPROUTED GRAINS

It can be easy to forget that the cereal grains we eat are actually dormant seeds, holding the potential for whole new plants within their walls. Just like the seeds you might plant for your garden, these grains are simply waiting for the right temperature and moisture to activate the growth process - waiting for the right conditions to sprout.

All three parts of the grain - the bran, the germ, and the endosperm - are essential to the growth of a new plant. The germ is the plant embryo, which will feed on the sugars stored as starch in the endosperm. The bran layers provide some additional nutrients to the germ and help protect the grain until it’s ready to start its growth cycle.

To date there is no regulated definition of what constitutes a sprouted grain. As part of the effort to standardize definitions of whole grains and whole grain foods, the Cereals and Grains Association has defined a malted, or sprouted grain, as follows:

DEFINITIONS OF SPROUTED GRAINS

There is at this time no regulated definition of sprouted grain. Consumers who want to understand what they are eating, and companies who are considering manufacturing or marketing sprouted grains may find it useful to start by reviewing how the Cereals & Grains Association, formerly known as AACCI and one of the world's leading authorities on grains, defines sprouted grains; their definition has subsequently been endorsed by USDA.


CEREALS & GRAINS ASSOCIATION (FORMERLY AACCI)

In early 2008, Cereals & Grains Board of Directors decreed that, Malted or sprouted grains containing all of the original bran, germ, and endosperm shall be considered whole grains as long as sprout growth does not exceed kernel length and nutrient values have not diminished. These grains should be labeled as malted or sprouted whole grain.

Then, we asked different companies making sprouted grain products to explain their definition of sprouted grains, or explain their process, and we received the following statements:

EDME

The sprouting process is known to enhance nutritional availability and produce or increase other plant bioactive compounds, notably those with anti-oxidant properties. At Edme, we have used a patented process to stabilise the sprouted grains so that they can be used as inclusions in bread and other baked product recipes. The concept of sprouted whole grains in bakery applications is established in many parts of Europe and we are seeing particular demand from the craft bakery sector in these markets.


ESSENTIAL EATING SPROUTED FOODS

Here at Essential Eating, our sprouted grain is high-quality grain which has been sprouted under precise, controlled conditions of time and temperature. When a sample, ground into flour, has a Falling Number* equal to or lower than half its original Falling Number, we know that the enzyme action of sprouting is at its peak, and we immediately dry the grain to lock in this optimum sprouting level. The dried, sprouted grain can then be ground into sprouted flour.

*The Falling Number Test, an internationally standardized method, measures the alpha-amylase enzyme activity in flour to determine how much sprout a grain has achieved and to assure the grain has not been drowned. While a lower falling number indicates high enzyme (sprouting) activity, it is very important to compare the falling number prior to sprouting with the falling number after sprouting, to accurately measure how much sprout action has occurred. A grain that started with a falling number of 350 and is now 150 has sprouted more completely than a grain that started at 250 and is now 150.

FOOD FOR LIFE

In our Ezekiel breads, we have six different grains, legumes and seeds. Each of the grains (wheat, barley, spelt, millet) and legumes (lentils, soybeans) are germinated for different lengths of time for maximum nutrition depending on the product we are producing (Sprouted Grain Breads, Sprouted Grain English Mufins, Sprouted Grain Tortillas, Sprouted Grain Cereal or Sprouted Grain Pasta).

We believe in sprouting the grains we use in our breads because sprouting is the best way to release all of the vital nutrients stored in whole grains*. To unlock this dormant food energy and maximize nutrition and flavor, we add a carefully calculated amount of filtered water to healthy, whole, organically-grown grains which are already high in nutrients.



As sprouting begins, beneficial enzymes are activated which cause the grains to become a living food. For example, enzymes such as amylase are released which go to work converting the starch into maltose, lowering the glycemic index of the grain. Enzymes also break down phytic acid (a natural absorption-inhibitor found in grains and other foods), making the nutrients more accessible.

All of this helps explain why our exclusive sprouting process not only significantly increases vitamins such as vitamin A, vitamin C and B-vitamins, but also causes a natural change allowing the protein and carbohydrates to be assimilated by the body more efficiently. Finally, our proprietary baking process preserves these valuable nutrients and retains the important natural fiber and bran.

Shiloh Farms began baking sprouted grain breads nearly 40 years ago because consumers demanded a healthier alternative to the mass-produced baked goods of that era. Soaking and sprouting grains before baking was a well-known step in the creation of hearty artisan breads, but little was known of the chemistry behind the scenes. Now, science is leaving little doubt that sprouted grains provide consumers with health benefits over unsprouted grains. Studies point to phytic acid reduction that results in greater bioavailabilty of nutrients like iron, zinc and magnesium. Germination increases folate content. Starches are converted into more easily digestible energy. At Shiloh Farms, we use several different approaches to sprouting grains, tailoring the germination time to suit the needs of different products and different grains. This variety allows us to provide consumers with many choices to take advantage of the healthy benefits of sprouted grain foods, from raw grains to Essential Eating flours to pretzels and noodles and hearty whole grain sprouted bread.

At Silver Hills Bakery , we believe that sprouting is the only way to release all the vital nutrients stored in whole grains. The sprouting process activates beneficial enzymes which cause the grains to sprout and become living, nutrient-rich, food. Documented stores of vitamins and minerals dramatically increase over the amount available in normal refined flour. With sprouting there is an entire polysaccharide change in the kernel. Starches in the grains are converted into maltose - which is ordinarily done by the body during digestion - thereby predigesting nutrients for you. The enzymatic action enables the body to assimilate the vitamins and minerals more efficiently. Plus, the sprouting process naturally increases the protein content and decreases the calories and carbohydrates found in the original grain. Our entire sprouting and mixing process takes 50 hours, after which the dough is baked, resulting in a flavor-packed, nutritious product.

VALLEY SELECT / SUN VALLEY RICE Sprouted brown Rice is an emerging health food. The germination process liberates the nutrients to achieve maximum nutritional value and flavor. Sprouted brown rice is unique because it has gone through the process of partial-germination. The sprouting (germination) process adds a variety of nutrients through the activation of dormant enzymes, while undergoing measured high-humidity treatment. At Valley Select, the rice kernel is sprouted until the flavor and nutritional benefits are maximized. Subsequently, the germination process is interrupted and the kernel moisture is reduced to pre-germination levels, preserving the nutritional benefits and retaining the function of a conventional rice.


NUTRITION

As with any living thing, a grain goes through some drastic changes when it starts to grow. No longer dormant, all parts of the grain need to get ready to support the growth of the germ into a new plant. The biochemical changes that take place impact macro- and micronutrients, making most of them more bioavailable - both for the budding plant and for us.

sprouted grains Each grain has a different mix of nutrients, and sprouting effects the nutrient levels of each grain type differently. In addition, the nutrient changes that take place in a sprouting grain are impacted by an array of factors such as genotype and germination conditions, like temperature, light, and time. This sensitivity of sprouting grains to external inputs has inspired an exciting area of research dedicated to understanding how different inputs elicit desired nutrient change in sprouted grains.



Despite these variations, the sprouting process makes the grain's nutrients more bioavailable to those consuming the grain. When sprouting begins, enzymes within the grain are activated and start to metabolize the starchy endosperm. This transforms long-term storage starch into simple sugars that are more easily digested by the growing plant. Protein compounds within the grain go through the same type of transformation - newly activated enzymes increase the bioavailability of storage proteins by transforming them into peptides and amino acids.

These changes - the transformation of starch to simple sugar and the degradation of storage proteins - make the grain easier for humans to digest. This includes gluten, which is a protein found in some grains such as wheat, barley and rye. Because the geminating seeds enzymes basically pre-digest the gluten, those with non-celiac gluten sensitivities tend to be less reactive to gluten in sprouted grains.

Like gluten, phytates are a component of grains that some people try to avoid. Phytates are bioactive compounds that are found naturally in nearly all plant foods. Phytates are sometimes referred to as anti-nutrients because they can bind some minerals and make them less available to your body. Although the quantity of nutrients that your body can absorb from a food varies widely depending on what other foods you're pairing it with, how it's cooked, and what your overall diet is like, sprouting is known to decrease the phytate content in grains. These decreased phytate levels increase the bioavailability of phosphorous and other important minerals for absorption into the body.

SPROUTING GRAINS

Sprouting grains is a delicate process. Just the right amount of time, temperature, and moisture is necessary jumpstart germination, and expertise is needed to know the right moment to stop the sprouting before key nutrients begin to degrade. Too much moisture, and the grain drowns. If the moisture is not removed once the grain does begin to sprout, it can begin to ferment or even to rot. Manufacturers sprout their grains under carefully-controlled conditions, with just the right amount of moisture and warmth until the enzymatic processes are at their peak. The sprouted grains are then made into products using two different approaches:



The Dry Approach
Grains are sprouted then dried. This dried sprouted grain can be used in cooking as is, or it can be milled into sprouted grain flour which is in turn used to make a wide variety of products.

The Wet Approach.
Alternately, wet sprouted grains are mashed into a thick puree which is used to make breads, tortillas, muffins and other products. These products are often described as flourless and are frequently sold frozen.

TIME TO EAT!



Because they have already begun to break down, intact sprouted grains cook in a shorter amount of time than intact unsprouted whole grains. Sprouted whole grain flours can be used in 1:1 substitution with their conventional counterpart.

They act a little differently in baking than conventional grains, but many of these differences improve the performance of the flour. For instance, the enzymatic activity produced during the sprouting process allows sprouted wheat to form stronger gluten bonds in developing bread dough, which means less kneading is necessary. The more active dough also ferments very rapidly, which eliminates the need for overnight proofing and prefermentation, saving significant time.

Additionally, breads made with sprouted grains tend to have a longer shelf life, and sprouted dough can take on more water than conventional dough, which makes for a more airy, open crumb (which bakers and bread-eaters love). Try your hand at cooking and baking with sprouted grains with the best recipes.

WHOLE WHITE WHEAT FAQ

Whole white wheat is now available, with all of the nutritional advantages of traditional whole wheat, but with lighter color and milder taste. Learn about it here!



Q. WHAT IS WHOLE WHITE WHEAT? White Wheat (photo courtesy of Farmer Direct) A. White wheat (pictured here) is a different type of wheat that has no major genes for bran color (unlike traditional red wheat which has one to three bran color genes). An easy way to think of it is as a sort of albino wheat. The bran of white wheat is not only lighter in color but it's also milder in flavor, making whole white wheat more appealing to many people accustomed to the taste of refined flour.

The term white flour has often been used to mean refined flour, so whole white wheat flour sounds like a contradiction in terms. But it is simply WHOLE flour - including the bran, germ and endosperm - made from WHITE wheat.

Q. WHY IS WHITE WHEAT MILDER IN FLAVOR A. White wheat does not contain the strongly-flavored phenolic compounds that are in red wheat. This gives white wheat a milder flavor, and also means that products made with white wheat require less added sweetener to attain the same level of perceived sweetness.

Q. IS THERE ANY DIFFERENCE NUTRITIONALLY BETWEEN WHOLE WHITE WHEAT AND REGULAR WHOLE WHEAT A. Experts consider these two kinds of whole wheat to be the same, nutritionally. Most of the nutrition differences among wheat varieties are driven by environmental conditions, such as weather and soil composition. For example, when crops are in a drought, the protein in wheat will be higher and may function differently.



Q. WHEN DID WHOLE WHITE WHEAT FIRST BECOME AVAILABLE IN THE US A. White wheat has been the principal type of wheat grown in Australia for many decades, but different varieties needed to be developed to match conditions in the US. Varieties of white wheat currently grown in the US were developed during the 1970s and 1980s by cross-breeding strains of red wheat. While most red wheat has three genes for red bran color, some have only one or two such genes; when these strains are cross-bred, a certain proportion of the offspring have no color genes.

Much of the early research and cross-breeding for US varieties of whole white wheat was done at Kansas State, and early crops were commercialized by the American White Wheat Producers Association. Today AWWPA is known as Farmer Direct. Based in Atchison, KS, Farmer Direct is a cooperative of over 300 producer members who have been working for almost two decades to grow and popularize white wheat. King Arthur, Farmer Direct Foods, and Hodgson Mill have been selling whole white wheat in retail markets since the early 1990s, and Sunnyland Mills has sold white-wheat bulgur in the U.S. since 1935.

Q. WHAT PROPORTION OF THE WHEAT GROWN IN THE U.S. IS CURRENTLY WHITE WHEAT? A. According to the USDA, white wheat accounts for at most 10-15% of America's total wheat crop.1 But this proportion has been changing rapidly. Production bushels of hard white wheat are estimated to have more than quadrupled between 2002 and 2004, rising from 13,021,903 bushels to 56,554,260.2 In Australia, the vast majority of the wheat produced is white wheat.

Q. WHAT PROMPTED THE U.S. SWITCH TOWARD WHITE WHEAT? A. Ironically, the trend toward white wheat was not originally prompted by its advantages for making whole wheat products for the U.S. market. The original incentive was to reverse a decline in U.S. wheat exports. From 1980 to 1990, hard red wheat exports fell by 34%. Where U.S. hard red wheat constituted 60% of the market in Central and South America in the mid-1970s, market share had dropped to just 12% two decades later.3 It is largely a serendipity that this earlier drive to develop varieties of white wheat suited to the U.S. has resulted in greater availability of the white wheat option just as whole grain consumption and interest have risen.



Q. DOES WHITE WHEAT GROW IN DIFFERENT CLIMATE/GEOGRAPHY THAN RED, OR COULD A RED-WHEAT FARMER EASILY SWITCH TO WHITE A. In the U.S., white wheat farmers were once concentrated in the Northwest. In 1998, for instance, Montana led the nation in white wheat production - but this type of wheat made up only about 1% of American wheat.4 Now, with new varieties adapted to different conditions, white wheat can grow in virtually the same climate/geography as red wheat. Once a farmer has decided to plant hard winter wheat, he or she can then choose whether to plant red or white wheat.

According to the University of Nebraska, The performance data on hard white winter wheat varieties shows that they are highly adapted and their grain yields and test weights are similar to those of hard red winter wheat. All production practices (seeding date, seeding rate, fertilization, and harvesting) are alike for hard white wheat and hard red winter wheat.

The same equipment is used for both crops. However, extra attention is needed to avoid mixing the grain. A three to four year cropping interval may be need to completely control volunteer wheat when white wheat is to be planted after red wheat. Drills, harvesting equipment (combines, trucks, augers, grain-carts), and storage facilities must be cleaned carefully to assure mixture of the two classes does not occur. On-farm grain storage may be an indispensable aspect of white wheat production at its inception due to the fact elevators may not have sufficient demand to dedicate storage space for white wheat. Keeping grain of hard red winter wheat and hard white wheat separate is essential because of the substantially discounted prices paid for mixed grain.



Q. WITH SO MUCH ATTENTION TO WHOLE WHITE WHEAT, IS OUR SUPPLY SUFFICIENT? DOES DEMAND THREATEN TO OUTSTRIP SUPPLY, AS IT MAY WITH ORGANIC FOOD A. Because white wheat is also preferred in other countries - especially in Asia, where it is thought to make better noodles ? the U.S. has been working hard to increase production of white wheat. In fact, a preference for white wheat products in Asia has contributed to a decline in the export of U.S. red wheat to this rapidly growing region of the world.5 Since farmers can switch fairly readily to white wheat, the forces of supply and demand should ensure that there is enough white wheat to make popular whole grain products.

White wheat, in fact, usually has a higher extraction rate than red wheat - meaning that a bushel of white wheat kernels will make slightly more whole wheat flour than the same amount of red wheat. This also helps ensure that the white wheat supply will be adequate.

This could change as white wheat becomes popular in the export market. However, different varieties of white wheat are grown for the U.S. market (where high-protein varieties are needed for bread) than for the Asian market (where lower protein varieties make better noodles.)

Q. WHAT POPULAR BRAND-NAME FOODS ARE NOW BEING MADE WITH WHOLE WHITE WHEAT? HOW CAN THE CONSUMER TELL? A. In the U.S., many breads are made with whole white wheat including: Wonder (IBC), Pepperidge Farm, Sara Lee, Mrs. Bairds (Bimbo), Stroehmann and Freihofer's (Weston), Nature's Own and Cobblestone Mill (Flowers), Wholesome Harvest (Maple Leaf Bakery) and Aunt Millie's (Perfection).

Other products include Dr. Kracker crackers, Near East (Quaker) Pilaf and Tabouli mixes, Arrowhead Mills Organic Bulgur Wheat, and Fantastic Foods Tabouli Mix.

King Arthur Flour has a popular series of baking mixes including Whole-Grain Chewy Chocolate Chip Cookie mix, Whole-Grain Soft Molasses Cookie mix, Fudge Brownie with Whole Grains mix, Whole-Grain Chocolate Fudge Waffle mix, and Holiday Herb Roll mix. They also have pancake, mufin, scone, biscuit, biscotti, cinnamon bun, and pizza crust mixes made with whole white wheat flour, and they sell fresh-baked croissants and cookies made with whole white wheat.

Both King Arthur Flour and Eagle Mills are widely distributed sources of whole white wheat flour in bags, sold in retail stores to home bakers. Farmer Direct Foods and Hodgson Mill both offer genuine stoneground whole white wheat flour.

Because savvy consumers may seek out whole white wheat, manufacturers may choose to specify it in the ingredient list of their product. Lacking that, if the product lists whole wheat flour as the first ingredient yet is light in color, it has very likely been made with whole white wheat.

Q. FROM A MANUFACTURER'S POINT OF VIEW, ARE THERE ADVANTAGES TO WORKING WITH WHOLE WHITE WHEAT OVER RED? A. Yes. Aside from the previously-mentioned advantages of milder taste and lighter texture, there is some evidence that breakfast cereals made with whole white wheat hold their crispness longer in milk. And because of the lack of phenolic compounds in hard white wheat, fresh refrigerated oriental noodles will not develop black specks as they can when made with red wheat. 7

Q. IS THERE ANY HARD DATA ON CONSUMER PREFERENCES FOR WHOLE WHITE WHEAT? A. Several research projects have studied this issue, and research is ongoing. One such study at Wichita State University compared hamburger buns made from whole white wheat, red whole wheat, and refined red wheat. Overall acceptance favored the whole white wheat over either alternative. In fact, 55% of respondents said they would definitely or probably purchase the whole white wheat buns, versus 46% for the red whole wheat and 40% for the refined wheat buns.


Whole Grains and Disease

As researchers have begun to look more closely at carbohydrates and health, they are learning that the quality of the carbohydrates you eat is at least as important as the quantity. Most studies, including some from several different Harvard teams, show a connection between whole grains and better health.

A report from the Iowa Women's Health Study linked whole grain consumption with fewer deaths from inflammatory and infectious causes, excluding cardiac and cancer causes. Examples are rheumatoid arthritis, gout, asthma, ulcerative colitis, Crohn’s disease, and neurodegenerative diseases. Compared with women who rarely or never ate whole-grain foods, those who had at least two or more servings a day were 30% less likely to have died from an inflammation-related condition over a 17-year period. [4] A meta-analysis combining results from studies conducted in the U.S., the United Kingdom, and Scandinavian countries (which included health information from over 786,000 individuals), found that people who ate 70 grams/day of whole grains compared with those who ate little or no whole grains had a 22% lower risk of total mortality, a 23% lower risk of cardiovascular disease mortality, and a 20% lower risk of cancer mortality.

Cardiovascular Disease

Eating whole instead of refined grains substantially lowers total cholesterol, low-density lipoprotein (LDL, or bad) cholesterol, triglycerides, and insulin levels.

In the Harvard-based Nurses Health Study, women who ate 2 to 3 servings of whole-grain products each day were 30% less likely to have a heart attack or die from heart disease over a 10-year period than women who ate less than 1 serving per week. A meta-analysis of seven major studies showed that cardiovascular disease (heart attack, stroke, or the need for a procedure to bypass or open a clogged artery) was 21% less likely in people who ate 2.5 or more servings of whole-grain foods a day compared with those who ate less than 2 servings a week. 



Replacing refined grains with whole grains and eating at least 2 servings of whole grains daily may help to reduce type 2 diabetes risk. The fiber, nutrients, and phytochemicals in whole grains may improve insulin sensitivity and glucose metabolism and slow the absorption of food, preventing blood sugar spikes. [8] In contrast, refined grains tend to have a high glycemic index and glycemic load with less fiber and nutrients.

In a study of more than 160,000 women whose health and dietary habits were followed for up to 18 years, those who averaged 2 to 3 servings of whole grains a day were 30% less likely to have developed type 2 diabetes than those who rarely ate whole grains. [9] When the researchers combined these results with those of several other large studies, they found that eating an extra 2 servings of whole grains a day decreased the risk of type 2 diabetes by 21%.

A follow-up to that study including men and women from the Nurses Health Studies I and II and the Health Professionals Follow-Up Study found that swapping white rice for whole grains could help lower diabetes risk. Those who ate the most white rice five or more servings a week had a 17% higher risk of diabetes than those who ate white rice less than one time a month. Those who ate the most brown rice two or more servings a week had an 11% lower risk of diabetes than those who rarely ate brown rice. Researchers estimate that swapping whole grains in place of even some white rice could lower diabetes risk by 36%.

A large study of more than 72,000 postmenopausal women without diabetes at the start of the study found that the higher the intake of whole grains, the greater the risk reduction of type 2 diabetes. A 43% reduced risk was found in women eating the highest amount of whole grains (2 or more servings daily) as compared with those who ate no whole grains.

Cancer

The data on cancer are mixed, with some studies showing a protective effect of whole grains and others showing none.
A large five-year study among nearly 500,000 men and women suggests that eating whole grains, but not dietary fiber, offers modest protection against colorectal cancer.  A review of four large population studies also showed a protective effect of whole grains from colorectal cancer, with a cumulative risk reduction of 21%.

Digestive Health

By keeping the stool soft and bulky, the fiber in whole grains helps prevent constipation, a common, costly, and aggravating problem. It also helps prevent diverticular disease (diverticulosis) by decreasing pressure in the intestines.

A study of 170,776 women followed for more than 26 years looked at the effect of different dietary fibers, including that from whole grains, on Crohn's disease and ulcerative colitis. Though a reduced risk of Crohn's disease was found in those eating high intakes of fruit fiber, there was no reduced risk of either disease found from eating whole grains.

Some grains contain the naturally-occurring protein, gluten. While gluten can cause side effects in certain individuals, such as those with celiac disease, most people can and have eaten gluten most of their lives without any adverse reaction. However, negative media attention on wheat and gluten has caused some people to doubt its place in a healthful diet, though there is little published research to support such claims. 
For further information on gluten and health, see: Gluten: A Benefit or Harm to the Body?


Gluten: A Benefit or Harm to the Body?

The quick answer is that it can be either, but it all depends on the individual.

What is Gluten?

Gluten is a protein naturally found in some grains including wheat, barley, and rye. It acts like a binder, holding food together and adding a stretchy quality think of a pizza maker tossing and stretching out a ball of dough. Without gluten, the dough would rip easily.

Other grains that contain gluten are wheat berries, spelt, durum, emmer, semolina, farina, farro, graham, khorasan wheat, einkorn, and triticale (a blend of wheat and rye). Oats though naturally gluten free—often contain gluten from cross-contamination when they are grown near, or processed in the same facilities as the grains listed above. Gluten is also sold as wheat gluten, or seitan, a popular vegan high-protein food. Less obvious sources of gluten include soy sauce and modified food starch, however gluten-free options of these products are available and labeled as such to comply with the U.S. Food and Drug Administration's gluten-free labeling rule.

Gluten and Health Benefits

Gluten is most often associated with wheat and wheat-containing foods that are abundant in our food supply. Negative media attention on wheat and gluten has caused some people to doubt its place in a healthful diet. There is little published research to support these claims; in fact published research suggests the opposite.

In a 2017 study of over 100,000 participants without celiac disease, researchers found no association between long-term dietary gluten consumption and heart disease risk.  In fact, the findings also suggested that non-celiac individuals who avoid gluten may increase their risk of heart disease, due to the potential for reduced consumption of whole grains.

Many studies have linked whole grain consumption with improved health outcomes. For example, groups with the highest intakes of whole grains including wheat (2-3 servings daily) compared with groups eating the lowest amounts (less than 2 servings daily) were found to have significantly lower rates of heart disease and stroke, development of type 2 diabetes, and deaths from all causes.

Gluten may also act as a prebiotic, feeding the good bacteria in our bodies. Arabinoxylan oligosaccharide is a prebiotic carbohydrate derived from wheat bran that has been shown to stimulate the activity of bifidobacteria in the colon. These bacteria are normally found in a healthy human gut. Changes in their amount or activity have been associated with gastrointestinal diseases including inflammatory bowel disease, colorectal cancer, and irritable bowel syndrome. 


When Gluten Is a Problem

What's not great about gluten is that it can cause serious side effects in certain individuals. Some people react differently to gluten, where the body senses it as a toxin, causing one's immune cells to overreact and attack it. If an unknowingly sensitive person continues to eat gluten, this creates a kind of battle ground resulting in inflammation.

The side effects can range from mild (fatigue, bloating, alternating constipation and diarrhea) to severe (unintentional weight loss, malnutrition, intestinal damage) as seen in the autoimmune disorder celiac disease. Estimates suggest that 1 in 133 Americans has celiac disease, or about 1% of the population, but about 83% of them are undiagnosed or misdiagnosed with other conditions.  Research shows that people with celiac disease also have a slightly higher risk of osteoporosis and anemia (due to malabsorption of calcium and iron, respectively); infertility; nerve disorders; and in rare cases cancer.

The good news is that removing gluten from the diet may reverse the damage. A gluten-free diet is the primary medical treatment for celiac disease. However, understanding and following a strict gluten-free diet can be challenging, possibly requiring the guidance of a registered dietitian to learn which foods contain gluten and to ensure that adequate nutrients are obtained from gluten-free alternatives. Other conditions that may require the reduction or elimination of gluten in the diet include:

Non-celiac gluten sensitivity, also referred to as gluten sensitive enteropathy (GSE) or gluten intolerance.
An intolerance to gluten with similar symptoms as seen with celiac disease, but without the accompanying elevated levels of antibodies and intestinal damage. There is not a diagnostic test for GSE but is determined by persistent symptoms and a negative diagnostic celiac test.



Wheat allergy
An allergy to one or more of the proteins (albumin, gluten, gliadin, globulin) found in wheat, diagnosed with positive immunoglobulin E blood tests and a food challenge. Compare this with celiac disease, which is a single intolerance to gluten. Symptoms range from mild to severe and may include swelling or itching of the mouth or throat, hives, itchy eyes, shortness of breath, nausea, diarrhea, cramps, and anaphylaxis. People who test negative for this condition may still have gluten sensitivity. This condition is most often seen in children, which most outgrow by adulthood.

Dermatitis herpetiformis (DH)
A skin rash that results from eating gluten. It is an autoimmune response that exhibits itself as a persistent red itchy skin rash that may produce blisters and bumps. Although people with celiac disease may have DH, the reverse is not always true.

It is important to note that gluten is a problem only for those who react negatively to it, or test positive for celiac disease. Most people can and have eaten gluten most of their lives, without any adverse side effects.

What Is a Gluten-Free Diet?

This is essentially a diet that removes all foods containing or contaminated with gluten. However, since gluten-containing whole grains contain fiber and nutrients including B vitamins, magnesium, and iron, it's important to make up for these missing nutrients. Along with consuming naturally gluten-free foods in their whole form like fruits, vegetables, legumes, nuts, seeds, fish, eggs, and poultry, the following whole grains are also inherently gluten-free:

Quinoa
Brown, black, or red rice
Buckwheat
Amaranth
Millet
Corn
Sorghum
Teff
Gluten-free oats

It's also key not to rely on processed gluten-free foods that may be high in calories, sugar, saturated fat, and sodium and low in nutrients, such as gluten-free cookies, chips, and other snack foods. Often, these foods are made with processed unfortified rice, tapioca, corn, or potato flours.



The gluten-free food industry has grown 136% from 2013 to 2015 with almost $12 billion in sales in 2015. Interestingly, studies show that people who do not have celiac disease are the biggest purchasers of gluten-free products.  Consumer surveys show that the top three reasons people select gluten-free foods are for “no reason, because they are a healthier option, and for digestive health.

For those who are not gluten-intolerant, there is no data to show a specific benefit in following a gluten-free diet, particularly if processed gluten-free products become the mainstay of the diet. In fact, research following patients with celiac disease who change to a gluten-free diet shows an increased risk of obesity and metabolic syndrome. This could be partly due to improved intestinal absorption, but speculation has also focused on the low nutritional quality of processed gluten-free foods that may contain refined sugars and saturated fats and have a higher glycemic index.