Healing Foods Pyramid™
Whole Grains are included in the Healing Foods Pyramid™ as part of a balanced, whole foods, plant-based diet. This Food Pyramid emphasizes foods that nourish the body, sustain energy over time, contain healing qualities and essential nutrients, and support a sustainable environment.
What are the recommended servings of grains & starchy vegetables per day?
- 4 -11 servings per day. For optimal health, we recommend mostly whole grains versus processed or refined grains.
What are whole grains?
Grains are the seeds of plants. Whole grains contain all parts of the grain, including the bran, endosperm and germ.
- Bran- Forming the outer layer of the seed, the bran is a rich source of niacin, thiamin, riboflavin, magnesium, phosphorus, iron and zinc. The bran also contains the majority of the seed's fiber.
- Germ- A concentrated source of niacin, thiamin, riboflavin, vitamin E, magnesium, phosphorus, iron and zinc. The germ also contains protein and fat.
- Endosperm- Also called the kernel, the endosperm makes up the bulk of the seed. It contains most of the grain's protein and carbohydrate and has small amounts of vitamins and minerals.
What are processed and refined grains?
- Unlike whole grains that contain at least part of their bran and germ layers, processed and refined grains have both the bran and germ removed during processing; therefore all of the nutrients in these layers are also removed.
- They are often “enriched” which means nutrients that were lost during food processing are added back. For example, B vitamins, lost when wheat is refined, are added back to white flour during processing. However, even after enrichment, refined grains often do not provide as many nutrients or as much fiber as their whole grain counterparts
- While whole grains are preferred, adding fiber-rich foods to refined or processed grains can lower the glycemic impact and help to stabilize blood sugar. Therefore, foods such as pasta and white rice can be part of a healthy diet when combined with high fiber foods such as vegetables or beans.
What are starchy vegetables?
- Starchy vegetables include corn, peas, potatoes (all kinds including sweet), winter squash, plantains, and yucca (cassava root)
- These vegetables are higher in starch than other vegetables and are metabolized in your body more like a grain
- They are often used as the central starchy part of a meal, for example: mashed potatoes or polenta (milled corn)
- When used whole, starchy vegetables provide ample fiber, nutrients, and phytochemicals
- Their primary function is to provide energy for the body, especially the brain and the nervous system. The body breaks down starches into glucose, which it then uses for energy.
Why choose whole grains and starchy vegetables?
- They are rich sources of fiber and naturally low in fat
- Whole grains and starchy vegetables are an important source of vitamins and minerals, such as B vitamins, vitamin E, folate, selenium, zinc and iron
- They contain a variety of phytochemicals and antioxidants
- Foods in this group usually have a low glycemic index, which helps to regulate blood sugar levels
- Consumption of whole grains is associated with reduced risk of type 2 diabetes, constipation, diverticulitis, obesity, heart disease, and some types of cancer
Select Sources of Refined Grains Versus Whole Grains:
Serving Size |
Refined Choice |
GI* |
Whole Grain |
GI* |
1 slice (1 oz) |
White / wheat bread |
High |
Whole wheat / whole grain bread |
Low |
1/3 cup |
Couscous |
Medium |
Whole wheat couscous |
Low |
1/3 cup |
Pasta |
Medium |
Whole wheat / multi |
Low |
1 medium |
Potato without skin |
High |
Potato with skin |
Medium |
3/4 cup |
Corn flakes, sugary breakfast cereal |
High |
Oatmeal, cereal based on oats, barley or bran |
Low |
*Glycemic Index information from: http://www.glycemicindex.com/
Specific Considerations
What are the glycemic index (GI) and glycemic load (GL)?
The glycemic index measures how different types of carbohydrate foods affect blood glucose (blood sugar) levels. The higher a food ranks on the glycemic index, the faster it increases glucose levels in the blood. The glycemic load is calculated by multiplying the glycemic index by the number of carbohydrates within a typical serving of the test food. Whole grains are generally low on the glycemic index indicating that they slowly increase blood sugar over time, which leads to better health outcomes including lower risk of diabetes, insulin resistance, obesity and cardiovascular disease.
Refined Grains and GI
When the fiber is removed from grains during the refining process the carbohydrate that remains is converted to glucose by the body much more quickly during digestion. The refining process increases the GI and therefore the GL of most grains, we recommend whole grains because they range from low to medium on the glycemic index. For example:
Grain |
Glycemic Index (GI) |
Glycemic Load (GL) |
Refined - White rice, instant, 1 c |
87 - High |
36 - High |
Whole - Brown rice, 1 c |
50 - Low |
16 - Medium |
Whole Grains and Fiber
- Whole grains are a good source of dietary fiber
- Dietary fiber is important in the prevention of chronic diseases such as heart disease, diabetes, diverticulitis, cancer, and obesity
- We recommend choosing whole grain foods with more than 3g of fiber per serving
- High fiber foods are usually low on the glycemic index
What are the health concerns associated with whole grains?
Gluten Intolerance
Celiac disease (CD) is also known as gluten intolerance. Gluten is the common name for the proteins in specific cereal grains that are not tolerated in persons with CD. These proteins are found in all forms of wheat (including durum, semolina, spelt, kamut, einkorn, and faro), rye, and barley. When individuals with CD ingest gluten, the villi, tiny hair-like projections in the small intestine that absorb nutrients from food, are damaged. This is due to an immune reaction to gluten. Damaged villi interfere with the body's ability to absorb basic nutrients - proteins, carbohydrates, fats, vitamins, minerals, and, in some cases, water and bile salts. There are several sources of whole grains that are gluten free including: corn, millet, sorghum, potatoes, quinoa and rice.
Pesticide Use
Pesticides are chemicals that are used to control pests that destroy crops. They are used in the production of most crops sold in the United States. These chemicals may increase your risk for cancer or other chronic diseases and should be limited in your diet.
Consider Organic
We recommend organic grains because they contain less pesticide residue. We believe they also provide better flavor and may be a better nutritional choice than conventionally grown grains.
Ideas for Increasing Consumption of Whole Grains
- Choose whole grains with at least 3 grams of fiber per serving.
- Choose cereals made primarily of oats, barley, and bran for breakfast or a snack.
- Use “grainy” breads made from whole grains.
- Eat brown rice instead of white rice.
- Experiment with cooking various whole grains like quinoa, barley and millet. These can be used in soups, stews, salads, casseroles or as a side dish.
- When buying bread products, read the label. Look for items labeled “100% Whole Grain” to ensure you are truly buying a whole grain product.
- Wheat flour and whole wheat flour are not the same! Look for whole grain, stone ground, whole ground, whole wheat flour, whole oat flour or whole barley flour.
- When eating a refined grain, add foods with plenty of fiber (fruits, vegetables, and legumes) to lower the glycemic impact.
- Many foods are now available in whole wheat / whole grain versions: pasta, couscous, frozen waffles, pancake mixes, crackers, bagels and pretzels.
- Make your own granola instead of buying pre-packaged high sugar varieties.
Resources
Celiac Disease
Celiac Disease Foundation
www.celiac.org
Accessed September 4, 2009
Enriched, Fortified: What’s the Difference?
American Dietetic Association
www.eatright.org
Accessed September 4, 2009
Fiber
American Heart Association
www.americanheart.org
Accessed September 4, 2009
Fiber – Start Roughing It!
Nutrition Source, Harvard School of Public Health
www.hsph.harvard.edu
Accessed September 4, 2009
Get on the Grain Train
USDA Center for Nutrition Policy and Promotion
www.usda.gov
Accessed September 4, 2009
Glycemic Index Database
The Official Site of the Glycemic Index
www.glycemicindex.com
Accessed September 4, 2009
Glycemic Index, Glycemic Load & Cancer Risk
Dixon, S.
Nutrition Cancer Information, LLC
www.caring 4cancer.com
Accessed September 4, 2009
The Ins & Outs of Insulin Resistance
International Food Information Counsel
www.ific.org
Accessed September 4, 2009
The Glycemic Index: What is it?
American Dietetics Association
www.eatright.org
Accessed September 4, 2009
Sugar and Cancer: Is there a connection
Dixon, S.
Cancer Nutrition Information, LLC
www.caring4cancer.com
Accessed September 4, 2009
Organic Labeling & Marketing Information Fact Sheet
USDA Agricultural Marketing Service
www.ams.usda.gov
Accessed September 4, 2009
Whole Grains Made Easy
American Dietetic Association
www.eatright.org
Accessed September 4, 2009
Whole Grains: Hearty options for a healthy diet
Mayo Clinic
www.mayoclinic.com
Accessed September 4, 2009
Original Research and Review Articles
Adom KK and Liu RH. Antioxidant activity of grains. Journal of Agricultural and Food Chemistry. 2002;50:6182-6187.
Anderson JW, et al. Carbohydrate and fiber recommendations for individuals with diabetes: a quantitative assessment and meta-analysis of the evidence. Journal of the American College of Nutrition. 2004;23(1):5-17.
Barclay AW, et al. Glycemic index, glycemic load, and chronic disease risk- a meta-analysis of observational studies. American Journal of Clinical Nutrition. 2008; 87: 627-237.
Chavarro JE, et al. A prospective study of dietary carbohydrate quantity and quality in relation to risk of ovulatory infertility. European Journal of Clinical Nutrition. 2009; 63:78-86.
Delzenne NM and Cani PD. A place for dietary fibre in the management of the metabolic syndrome. Current Opinion in Clinical Nutrition and Metabolic Care. 2005;8:636-640.
Hsieh C. Treatment of constipation in older adults. American Family Physician. 2005;72(11):2277-2284.
Jenkins DJA, et al. Glycemic index: an overview of implications in health and disease. American Journal of Clinical Nutrition. 2002;76(suppl):266s-273s.
Liese AD, et al. Whole-grain intake and insulin sensitivity: the insulin resistance atherosclerosis study. American Journal of Clinical Nutrition. 2003;78:965-971.
Liu RH. Potential synergy of phytochemicals in cancer prevention: mechanism of action. Journal of Nutrition. 2004;134:3479s-3485s.
Liu S et al. Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle-aged women. American Journal of Clinical Nutrition. 2003;78:920-927.
Marlett JA, et al. Position of the American Dietetic Association: Health implications of dietary fiber. Journal of the American Dietetic Association. 2002;102(7):993-1000.
Pagano A. Whole grains and the gluten free diet. Practical Gastroenterology. 2006; 2: 66-78.
Scharlau D, et al. Mechanisms of primary cancer prevention by butyrate and other products formed during gut flore -mediated fermentation of dietary fibre. Mutation Research/Reviews in Mutation Research. 2009; doi: 10.1016/j.mrrev.2009.04.001
The Healing Foods Pyramid™ was created by the Nutrition Education Team at the University of Michigan Integrative Medicine, Department of Family Medicine in 2005 and updated in 2009.
© copyright 2013 Regents of the University of Michigan - University of Michigan Integrative Medicine
Monica Myklebust, M.D. and Jenna Wunder, M.P.H., R.D. For questions and licensing information please call 734-998-7874 or email umim-hfp@umich.edu.
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