Whole grains, such as whole grain bread and cereals, are linked to significant health benefits including reduced risks of chronic diseases and premature death. This was a fact before carnivore or paleo influencers like Baker, Chaffee or Saladino voiced concerns over inflammation and anti-nutrients.
Multiple comprehensive meta-analyses (studies on collections of studies) in have found a clear dose-response relationship between whole grain consumption and improved health outcomes, highlighting the importance of incorporating them into our diets.
As ever, please talk to your doctor, or medical practitioner most familiar with your medical history before implementing any changes in diet, exercise or lifestyle; especially if you are under treatment. Relevant studies are shared at bottom of page.
What is Being Said about Grains?
We will take an example from the website of the 'Carnivore MD' Paul Saladino. Here is what is written about oats:
So, is this true? Are oats toxic, what are the health outcomes?
Why Whole Grains Matter
Whole grains retain their bran and germ, which are rich in nutrients, antioxidants, and dietary fibre. These components are stripped away in refined grains, reducing their health benefits.
A meta-analysis by Aune et al demonstrated that eating 3 servings of whole grains daily (approximately 90g, or, 2 slices of whole grain bread and a small bowl of cereal) is associated with the following reductions in risk:
21% lower risk of coronary heart disease (CHD)
22% lower risk of cardiovascular disease (CVD)
15% lower risk of total cancer
17% lower risk of premature death
The studies also included pasta and rice. Recent research confirms that refined grains, such as white bread or rice, showed no significant health benefits and are even linked to higher risks of all-cause mortality.
Whole grains benefit health through several mechanisms:
Fibre and Polyphenols. Whole grains contain insoluble and soluble fibres that nourish beneficial gut bacteria, improving gut health. Polyphenols act as antioxidants and prebiotics, further diversifying the microbiome and reducing gut inflammation.
Heart Health. By improving arterial flexibility and lipid profiles, whole grains help reduce atherosclerosis risk. They also support better insulin sensitivity, lowering long-term cardiovascular disease risk.
Inflammation Reduction. The antioxidants, magnesium and fibre in whole grains decrease systemic inflammation. Reduced C-reactive protein levels indicate lower risks for conditions like diabetes, heart disease, and cancer.
Weight Management. Whole grains delay gastric emptying, prolonging fullness and reducing overeating. Additionally, their complex carbohydrates stabilise blood sugar levels, curbing hunger spikes.
Food Intolerances and Phytate
While grains offer numerous health benefits, some individuals are sensitive or even allergic to gluten and other compounds found in them. Paying attention to individual responses to foods, dietary patterns, and overall nutrition is essential. If you suspect sensitivity to grains or FODMAPs*, further testing can help provide clarity.
Proponents of the carnivore diet, such as Saladino, Baker and Chaffee, highlight concerns about certain compounds in grains that may raise inflammation. These micro-stressors, however, are not unique to grains; they are found in many foods that promote health over time through a process called hormesis. Even exercise operates on this principle, causing temporary stress and inflammation that ultimately leads to improved health.
One specific concern raised is phytic acid (phytate), an “anti-nutrient” that can bind to minerals like iron, calcium, and zinc, potentially reducing their absorption. While this effect can impact mineral bioavailability, it is generally negligible for those consuming a varied diet. In fact, research (Armah et al.) suggests that habitual consumption of high-phytate foods may adapt the body to reduce these inhibitory effects over time.
What Saladino, Baker, and Chaffee often omit is the range of benefits associated with a phytate-rich diet, including antioxidant, anti-inflammatory, and potential anti-cancer properties. Phytates may also help lower the risk of chronic conditions such as cardiovascular disease and type 2 diabetes. Evidence from multiple meta-analyses consistently demonstrates positive health outcomes associated with grain-rich diets.
It’s also worth considering that some grains are treated with pesticides to accelerate drying before harvest, raising concerns about chemical residues. Choosing organic grains, when feasible, can help minimise exposure to these substances.
*FODMAPs: Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols—short-chain carbohydrates and sugar alcohols that may cause digestive discomfort in individuals with irritable bowel syndrome or sensitivities.
Whole Grains on the Table
In the Aune study, 1 serving of whole grains is defined as 30 grams, which corresponds to about:
For cereals like oats or muesli 30g dry weight is typically equal to 2 or 2.5 tablespoons. (for reference, we use a standard IKEA tablespoon)
½ cup (this is 80g when cooked) for grains like brown rice or quinoa.
Thus, a small bowl of whole grain cereal or cooked grains would equal one serving.
For breakfast I eat a large bowl of mixed grain muesli most days, approx 100g; supplying about 10g fibre. That's over 3 servings, so already (hopefully! statistically!) receiving the benefits described by Aune et al.
For maximum health benefits, offering further reductions in risk for CVD, CHD and all-cause mortality, consuming 7 to 7 and a half servings per day (210 to 225 g of dry whole grains) is recommended. This amounts to approximately 7 small bowls of whole grain cereal or cooked grains daily. So getting to this level is achievable with lunch or dinner
Final Thoughts
Including three to seven small servings of whole grains in your daily diet can significantly lower the risk of chronic diseases and premature death. Replacing refined grains with whole grains is a simple step that offers profound health benefits, supporting longevity and overall wellbeing. While sensitivities exist for some, the overwhelming evidence supports the health-promoting nature of grains - packed with fibre, polyphenols and low in saturated - for the majority of the population.
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Stay Healthy,
Alastair
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Related Studies
Meta-analyses and systematic reviews in blue:
Mathews R, Chu Y. An encompassing review of meta-analyses and systematic reviews of the effect of oats on all-cause mortality, cardiovascular risk, diabetes risk, body weight/adiposity and gut health. Crit Rev Food Sci Nutr. 2024 Aug 13:1-22. doi: 10.1080/10408398.2024.2382352. Epub ahead of print. PMID: 39137936.
Ying T, Zheng J, Kan J, Li W, Xue K, Du J, Liu Y, He G. Effects of whole grains on glycemic control: a systematic review and dose-response meta-analysis of prospective cohort studies and randomized controlled trials. Nutr J. 2024 Apr 25;23(1):47. doi: 10.1186/s12937-024-00952-2. PMID: 38664726; PMCID: PMC11044462.
Liu J, Cai D. Causal relationship of cereal intake and type with cardiovascular disease: a Mendelian randomization study. Front Nutr. 2024 Jan 23;10:1320120. doi: 10.3389/fnut.2023.1320120. PMID: 38323222; PMCID: PMC10844472.
Hu H, Zhao Y, Feng Y, Yang X, Li Y, Wu Y, Yuan L, Zhang J, Li T, Huang H, Li X, Zhang M, Sun L, Hu D. Consumption of whole grains and refined grains and associated risk of cardiovascular disease events and all-cause mortality: a systematic review and dose-response meta-analysis of prospective cohort studies. Am J Clin Nutr. 2023 Jan;117(1):149-159. doi: 10.1016/j.ajcnut.2022.10.010. Epub 2022 Dec 15. PMID: 36789934.
Llanaj E, Dejanovic GM, Valido E, Bano A, Gamba M, Kastrati L, Minder B, Stojic S, Voortman T, Marques-Vidal P, Stoyanov J, Metzger B, Glisic M, Kern H, Muka T. Effect of oat supplementation interventions on cardiovascular disease risk markers: a systematic review and meta-analysis of randomized controlled trials. Eur J Nutr. 2022 Jun;61(4):1749-1778. doi: 10.1007/s00394-021-02763-1. Epub 2022 Jan 3. PMID: 34977959; PMCID: PMC9106631.
Yu J, Xia J, Yang C, Pan D, Xu D, Sun G, Xia H. Effects of Oat Beta-Glucan Intake on Lipid Profiles in Hypercholesterolemic Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2022 May 13;14(10):2043. doi: 10.3390/nu14102043. PMID: 35631184; PMCID: PMC9147392.
Xu X, Zhang J, Zhang Y, Qi H, Wang P. Associations between dietary fiber intake and mortality from all causes, cardiovascular disease and cancer: a prospective study. J Transl Med. 2022 Aug 2;20(1):344. doi: 10.1186/s12967-022-03558-6. PMID: 35918724; PMCID: PMC9344643.
Wehrli F, Taneri PE, Bano A, Bally L, Blekkenhorst LC, Bussler W, Metzger B, Minder B, Glisic M, Muka T, Kern H. Oat Intake and Risk of Type 2 Diabetes, Cardiovascular Disease and All-Cause Mortality: A Systematic Review and Meta-Analysis. Nutrients. 2021 Jul 26;13(8):2560. doi: 10.3390/nu13082560. PMID: 34444718; PMCID: PMC8398256.
Valido E, Stoyanov J, Bertolo A, Hertig-Godeschalk A, Zeh RM, Flueck JL, Minder B, Stojic S, Metzger B, Bussler W, Muka T, Kern H, Glisic M. Systematic Review of the Effects of Oat Intake on Gastrointestinal Health. J Nutr. 2021 Oct 1;151(10):3075-3090. doi: 10.1093/jn/nxab245. PMID: 34486656.
Marshall S, Petocz P, Duve E, Abbott K, Cassettari T, Blumfield M, Fayet-Moore F. The Effect of Replacing Refined Grains with Whole Grains on Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with GRADE Clinical Recommendation. J Acad Nutr Diet. 2020 Nov;120(11):1859-1883.e31. doi: 10.1016/j.jand.2020.06.021. Epub 2020 Sep 12. PMID: 32933853.
Gaesser GA. Whole Grains, Refined Grains, and Cancer Risk: A Systematic Review of Meta-Analyses of Observational Studies. Nutrients. 2020 Dec 7;12(12):3756. doi: 10.3390/nu12123756. PMID: 33297391; PMCID: PMC7762239.
Villegas-Aguilar MDC, Fernández-Ochoa Á, Cádiz-Gurrea ML, Pimentel-Moral S, Lozano-Sánchez J, Arráez-Román D, Segura-Carretero A. Pleiotropic Biological Effects of Dietary Phenolic Compounds and their Metabolites on Energy Metabolism, Inflammation and Aging. Molecules. 2020 Jan 29;25(3):596. doi: 10.3390/molecules25030596. PMID: 32013273; PMCID: PMC7037231.
Reynolds A, Mann J, Cummings J, Winter N, Mete E, Te Morenga L. Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. Lancet. 2019 Feb 2;393(10170):434-445. doi: 10.1016/S0140-6736(18)31809-9. Epub 2019 Jan 10. Erratum in: Lancet. 2019 Feb 2;393(10170):406. doi: 10.1016/S0140-6736(19)30119-9. PMID: 30638909.
Zhang B, Zhao Q, Guo W, Bao W, Wang X. Association of whole grain intake with all-cause, cardiovascular, and cancer mortality: a systematic review and dose-response meta-analysis from prospective cohort studies. Eur J Clin Nutr. 2018 Jan;72(1):57-65. doi: 10.1038/ejcn.2017.149. Epub 2017 Nov 1. PMID: 29091078.
Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, Tonstad S, Vatten LJ, Riboli E, Norat T. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ. 2016 Jun 14;353:i2716. doi: 10.1136/bmj.i2716. PMID: 27301975; PMCID: PMC4908315.
Benisi-Kohansal S, Saneei P, Salehi-Marzijarani M, Larijani B, Esmaillzadeh A. Whole-Grain Intake and Mortality from All Causes, Cardiovascular Disease, and Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Adv Nutr. 2016 Nov 15;7(6):1052-1065. doi: 10.3945/an.115.011635. PMID: 28140323; PMCID: PMC5105035.
Hormesis
Sharma V, Mehdi MM. Oxidative stress, inflammation and hormesis: The role of dietary and lifestyle modifications on aging. Neurochem Int. 2023 Mar;164:105490. doi: 10.1016/j.neuint.2023.105490. Epub 2023 Jan 24. PMID: 36702401.
Phytate
Pires SMG, Reis RS, Cardoso SM, Pezzani R, Paredes-Osses E, Seilkhan A, Ydyrys A, Martorell M, Sönmez Gürer E, Setzer WN, Abdull Razis AF, Modu B, Calina D, Sharifi-Rad J. Phytates as a natural source for health promotion: A critical evaluation of clinical trials. Front Chem. 2023 Apr 14;11:1174109. doi: 10.3389/fchem.2023.1174109. PMID: 37123871; PMCID: PMC10140425.
Brouns F. Phytic Acid and Whole Grains for Health Controversy. Nutrients. 2021 Dec 22;14(1):25. doi: 10.3390/nu14010025. PMID: 35010899; PMCID: PMC8746346.
Armah SM, Boy E, Chen D, Candal P, Reddy MB. Regular Consumption of a High-Phytate Diet Reduces the Inhibitory Effect of Phytate on Nonheme-Iron Absorption in Women with Suboptimal Iron Stores. J Nutr. 2015 Aug;145(8):1735-9. doi: 10.3945/jn.114.209957. Epub 2015 Jun 3. PMID: 26041677.
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