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25.8 million children and adults in the U.S have diabetes. A quarter of them don’t even
know it yet. Experts estimate that by 2050, one out every of three adults will have the
disease. Among people over the age of 65, one out of four already has diabetes. Type
2 diabetes is the most common form of diabetes. The good news: type 2 diabetes is almost entirely
preventable. Dietary modification has long been thought to play an important role in
prevention of type 2 diabetes (1). Whole grain intake has been linked to decreased risk of
type 2 diabetes.
As you look down the aisles at the grocery store, you will notice many whole grain food
options such as whole grain pasta, whole grain cereal, whole grain bread, whole grain crackers,
etc. We are told that whole grains are better for us than refined grains. That leaves many
of us asking the question, what is it that makes whole grains better for us? The main
components of whole grains are the outer bran layer, inner germ layer, and the endosperm
(4). Whole grains are high in fiber, vitamins, minerals, and phytonutrients. Phytonutrients
are chemicals found in plants that are associated with reduced risk of chronic diseases (7).
Most of these substances are found in the bran and germ layers of the grain (6). During
the refining of whole grains, most of the bran and germ are removed. Therefore, the
refining process results in a substantial loss of fiber, vitamins, minerals, and phytonutrients
(4). Diabetes is a disease in which there are high
levels of sugar in the blood. During digestion, food is broken down and a sugar called glucose
is released. Glucose enters the bloodstream. Glucose is a source of energy for the body.
Insulin is a hormone produced by the body to control blood sugar levels. When blood
sugar levels are high, insulin removes glucose from the bloodstream and stores it in liver
cells. When blood sugar levels are low, the stored glucose can be released from the liver
and used for energy. Diabetes can be caused because the body doesn’t produce enough
insulin, or because the body no longer responds to insulin, also known as insulin resistance
(8). Compared with refined-grain products, whole-grain products are generally digested
and absorbed slowly because of their physical form and their high content of fiber, thus
stimulating the release of less insulin (3). There have been many studies done in order
to test the benefits of whole grains. In a study performed by Liese, et. al, 1625 subjects
were recruited for examination of insulin sensitivity. Insulin sensitivity is measured
by the responsiveness to glucose. The study was performed to assess the relationship between
dietary intake of whole grain-containing foods and insulin sensitivity. Insulin sensitivity
was assessed by using frequently sampled intravenous-glucose-tolerance-test. The glucose tolerance test determines how
quickly glucose is cleared from the blood. They found that whole-grain intake was significantly
(P=.0005) associated with increase in insulin sensitivity. Magnesium and fiber explained
most of the association of whole grains with insulin sensitivity (5).
A second study, performed by Fung, et. al, followed 42898 men for 12 years. Intakes of
whole and refined grains were measured every 4 years by use of food-frequency questionnaires.
The object of the study was to examine the association between whole and refined grain
intake and the risk of type 2 diabetes. They observed an inverse association between long-term
average whole grain intake and the incidence of type 2 diabetes. There was a 42% decrease
in risk of diabetes when comparing highest versus lowest whole grain intake (P