Wheat Flour
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India [IN] 
The health benefits of wheat depend entirely on the form in which you eat it. These benefits will be few if you select wheat that has been processed into 60% extraction, bleached white flour. 60% extraction—the standard for most wheat products in the United States, including breads, noodles and pastas, baked goods like rolls or biscuits, and cookies—means that 40% of the original wheat grain was removed, and only 60% is left. Unfortunately, the 40% that gets removed includes the bran and the germ of the wheat grain—its most nutrient-rich parts. In the process of making 60% extraction flour, over half of the vitamin B1, B2, B3, E, folic acid, calcium, phosphorus, zinc, copper, iron, and fiber are lost.
Since 1941, laws in the United States have required "enrichment" of processed wheat flour with vitamins B1, B2, B3 and iron in response to the problems created by 60% extraction. Since not nearly as much of these B vitamins and iron are replaced as are removed from 60% extraction flour, "enriched" seems an odd word to describe this process.
If you select 100% whole wheat products, however, the bran and the germ of the wheat will remain in your meals, and the health benefits will be impressive! Our food ranking qualified whole wheat (in its original non-enriched form) as a very good source of dietary fiber and manganese, and as a good source of magnesium.
The many benefits of whole wheat products are being recognized more and more by consumers. Even though many health-conscious individuals have been cutting back on their intake of total carbs and refined wheat products (by about 10% between 1997-2007), the demand for whole wheat products has actually increased during that same time period. This trend fits in well with a Mediterranean diet approach to health, which looks to lower overall carbs but higher whole grains, including whole wheat.
A study published in the American Journal of Clinical Nutrition underscores the importance of choosing whole rather than refined wheat to maintain a healthy body weight. In this Harvard Medical School / Brigham and Women's Hospital study, which collected data on over 74,000 female nurses aged 38-63 years over a 12 year period, weight gain was inversely associated with the intake of high-fiber, whole-grain foods, such as whole wheat, but positively related to the intake of refined-grain foods, such as products made from refined wheat. Not only did women who consumed more whole grains consistently weigh less than those who ate less of these fiber-rich foods, but those consuming the most dietary fiber from whole grains were 49% less likely to gain weight compared to those eating foods made from refined grains.
First we were told, "Don't eat fat, and you'll stay trim." After following this advice only to see obesity expand to never before seen proportions, we're told by the food gurus, "Eating fat is fine. Shun carbohydrates to stay slim."
In our opinion, neither piece of dietary advice is complete, accurate or likely to help us stay slim or healthy. Just as different kinds of fats have different effects in our bodies (e.g., saturated and trans fats are linked to increased risk for cardiovascular disease while omega-3 fats decrease cardiovascular disease risk), some carbohydrates, such as whole grains, are healthful while others, such as refined grains and the foods made from them, are not.
The latest research is clearly supporting this vital distinction. Refined grains and the foods made from them (e.g., white breads, cookies, pastries, pasta and rice) are now being linked not only to weight gain but to increased risk of insulin resistance (the precursor of type 2 diabetes) and the metabolic syndrome (a strong predictor of both type 2 diabetes and cardiovascular disease), while eating more wholegrain foods is being shown to protect against all these ills. Common features of the metabolic syndrome include visceral obesity (the "apple shaped" body), low levels of protective HDL cholesterol, high triglycerides, and high blood pressure.
In one of the most recent studies, which appeared in Diabetes Care, researchers who analyzed data on over 2,800 participants in the Framingham Offspring Study, found that the prevalence of both insulin resistance and the metabolic syndrome was significantly lower among those eating the most cereal fiber from whole grains compared to those eating the least.
Prevalence of the metabolic syndrome was 38% lower among those with the highest intake of fiber from whole grains. Conversely, study subjects whose diets had the highest glycemic index and glycemic load, both of which are typically low in whole foods and high in processed refined foods, were 141% more likely to have the metabolic syndrome compared to those whose diets had the lowest glycemic index and glycemic load. In other words, compared to those whose diets were primarily composed of whole high fiber foods: whole grains, legumes, vegetables and fruits.
The researchers concluded, "Given that both a high cereal fiber content and lower glycemic index are attributes of wholegrain foods, recommendation to increase wholegrain intake may reduce the risk of developing the metabolic syndrome." Our perspective at the World's Healthiest Foods is that a way of eating that relies on the healthiest foods from all the food groups—the whole foods that contain the healthiest fats, carbohydrates and proteins—is the most effective, intelligent, and most enjoyable way to not only lower your risk of developing the metabolic syndrome, but to stay slim, vital and attractive throughout a long and healthy life.
Whole grains are a rich source of magnesium, a mineral that acts as a co-factor for more than 300 enzymes, including enzymes involved in the body's use of glucose and insulin secretion.
The FDA permits foods that contain at least 51% whole grains by weight (and are also low in fat, saturated fat, and cholesterol) to display a health claim stating consumption is linked to lower risk of heart disease and certain cancers. Now, research suggests regular consumption of whole grains also reduces risk of type 2 diabetes. (van Dam RM, Hu FB, Diabetes Care).
In this 8-year trial, involving 41,186 particpants of the Black Women's Health Study, research data confirmed inverse associations between magnesium, calcium and major food sources in relation to type 2 diabetes that had already been reported in predominantly white populations.
Risk of type 2 diabetes was 31% lower in black women who frequently ate whole grains compared to those eating the least of these magnesium-rich foods. When the women's dietary intake of magnesium intake was considered by itself, a beneficial, but lesser-19%-reduction in risk of type 2 diabetes was found, indicating that whole grains offer special benefits in promoting healthy blood sugar control. Daily consumption of low-fat dairy foods was also helpful, lowering risk of type 2 diabetes by 13%.
People whose diets supplied the highest average intake of choline (found in egg yolk and soybeans), and its metabolite betaine (found naturally in beets, spinach and whole wheat), have levels of inflammatory markers at least 20% lower than subjects with the lowest average intakes, report Greek researchers in the American Journal of Clinical Nutrition (Detopoulou P, Panagiotakos DB, et al.)
Compared to those whose diets contained <250 mg/day of choline, subjects whose diets supplied >310 mg of choline daily had, on average:
Compared to those consuming <260 mg/day of betaine, subjects whose diets provided >360 mg per day of betaine had, on average:
Each of these markers of chronic inflammation has been linked to a wide range of conditions including heart disease, osteoporosis, cognitive decline and Alzheimer's, and type-2 diabetes.
In an accompanying editorial in the American Journal of Clinical Nutrition entitled, "Is there a new component of the Mediterranean diet that reduces inflammation?," Steven Zeisel from the University of North Carolina at Chapel Hill noted that choline and betaine work together in the cellular process of methylation, which is not only responsible for the removal of homocysteine, but is involved in turning off the promoter regions of genes involved in inflammation.
"Exposure to oxidative stress is a potent trigger for inflammation. Betaine is formed from choline within the mitochondria , and this oxidation contributes to mitochondrial redox status ," Zeisel continued.
"If the association between choline and betaine and inflammation can be confirmed in studies of other populations, an interesting new dietary approach may be available for reducing chronic diseases associated with inflammation," he concluded.
Recommended daily intakes of choline were set in 1998 at 550 milligrams per day for men and 425 milligrams a day for women. No RDI has been set for betaine, which, since it is a metabolite of choline, is not considered an essential nutrient.
Practical Tip: Egg yolks are the richest source of choline, followed by soybeans. Spinach, beets and whole wheat products are primary sources of betaine. (Olthof MR, van Vliet T, et al. J Nutr)
Eating foods high in insoluble fiber, such as cereals and breads made from whole wheat, can help women avoid gallstones, shows a study published in the American Journal of Gastroenterology.
Studying the overall fiber intake and types of fiber consumed over a 16 year period by over 69,000 women in the Nurses Health Study, researchers found that those consuming the most fiber overall (both soluble and insoluble) had a 13% lower risk of developing gallstones compared to women consuming the fewest fiber-rich foods.
Those eating the most foods rich in insoluble fiber gained even more protection against gallstones: a 17% lower risk compared to women eating the least. And the protection was dose-related; a 5-gram increase in insoluble fiber intake dropped risk dropped 10%.
How do foods rich in insoluble fiber help prevent gallstones? Researchers think insoluble fiber not only speeds intestinal transit time (how quickly food moves through the intestines), but reduces the secretion of bile acids (excessive amounts contribute to gallstone formation), increases insulin sensitivity and lowers triglycerides (blood fats). Abundant in all whole grains, insoluble fiber is also found in nuts and the edible skin of fruits and vegetables including tomatoes, cucumbers, many squash, apples, berries, and pears. In addition, beans provide insoluble as well as soluble fiber.
Wheat bran is a popular bulk laxative. A third of a cup per day is all that is needed. Research studies support this popular practice. A fiber-rich diet, primarily composed of whole wheat breads, cereals high in bran and supplemental "millers bran" was shown to alleviate the symptoms of diverticular disease (pain, nausea, flatulence, distension, constipation, etc.) in 89 percent of patients enrolled in a study which examined the effects of fiber on bowel regularity. Diverticular disease, a condition often marked by inflammation and lower abdominal pains in which chronic constipation and excessive straining results in a sac or pouch in the wall of the colon, is typically treated with dietary roughage such as cereal fiber (i.e., wheat bran), fruit and vegetable fiber, and plenty of fluids.
The benefits of wheat's bran portion don't stop here; it has also been shown to function as an anti-cancer agent. Wheat bran is thought to accelerate the metabolism of estrogen that is a known promoter of breast cancer. In one study, pre-menopausal women, ages twenty to fifty, who ate three to four high fiber muffins per day made with wheat bran, decreased their blood estrogen levels by 17 percent after two months. The women eating corn bran or oat bran did not show the same benefits.
Interestingly, whole grains such as wheat also contain lignans, which are phytonutrients that act as weak hormone-like substances. Lignans occupy the hormone receptors in the body, thus actively protecting the breast against high circulating levels of hormones such as estrogen. By accelerating the metabolism of estrogen and occupying estrogen receptors in the body, the components of wheat appear to have a dual function in protecting women against one of the leading causes of cancer death.
The fact that only wheat bran, and not corn or oat bran, is beneficial in preventing cancer-promoting changes in the colon, provides additional clues that wheat bran contains something special that makes it a true cancer fighter. Only the bran from wheat has been shown to reduce the concentration of bile acids and bacterial enzymes in the stool that are believed to promote colon cancer.
The protective dose for colon cancer may be more than 28 grams a day, since men who ate this amount had only one-third the rate of colon polyps (precancerous tumors) compared to those who ate only 17 grams/day. The amount of wheat bran needed for protection from other cancers is still unknown, but based on the health benefits of this food, it may be wise, if you are not sensitive to wheat or gluten, to include several servings of whole wheat grain foods such as bread, pasta, and bran cereals every day in your diet.
When researchers looked at how much fiber 35,972 participants in the UK Women's Cohort Study ate, they found a diet rich in fiber from whole grains, such as whole wheat, and fruit offered significant protection against breast cancer for pre-menopausal women. (Cade JE, Burley VJ, et al., International Journal of Epidemiology).
Pre-menopausal women eating the most fiber (>30 grams daily) more than halved their risk of developing breast cancer, enjoying a 52% lower risk of breast cancer compared to women whose diets supplied the least fiber (<20 grams/day).
Fiber supplied by whole grains offered the most protection. Pre-menopausal women eating the most whole grain fiber (at least 13 g/day) had a 41% reduced risk of breast cancer, compared to those with the lowest whole grain fiber intake (4 g or less per day).
Fiber from fruit was also protective. Pre-menopausal women whose diets supplied the most fiber from fruit (at least 6 g/day) had a 29% reduced risk of breast cancer, compared to those with the lowest fruit fiber intake (2 g or less per day).
Practical Tip: As the following table shows, it's surprisingly easy to enjoy a healthy way of eating that delivers at least 13 grams of whole grain fiber and 6 grams of fiber from fruit each day.
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