Replacing Refined Grains with Whole Grains for Heart Health

Published on: Mar 15 2021

Whole grains are a staple of many global dietary recommendations, but most grains people consume are refined grains due to taste, texture, and ease of use in many applications.

A new study published in The British Medical Journal found that consuming a high number of refined grains, such as croissants and white bread, is associated with a higher risk of major cardiovascular disease, stroke and death.

The Prospective Urban Rural Epidemiology (PURE) study has been examining diets from diverse populations in low-, middle- and high-income countries around the world. Over 16 years of analysis of 137,130 participants in 21 countries, including Canada, the researchers found the intake of refined grains and added sugars have greatly increased over the years.

Grains were categorized into three groups: refined grains, whole grains and white rice. Refined grains included goods made with refined (e.g. white) flour, including white bread, pasta/noodles, breakfast cereals, crackers, and bakery products/desserts containing refined grains. Whole grains included whole grain flours (e.g. buckwheat) and intact or cracked whole grains (eg. steel cut oats).

The study found that having more than seven servings of refined grains, or over 350 grams, per day was associated with a 27 per cent greater risk for early death, 33 percent greater risk for heart disease and 47 per cent greater risk for stroke.

“This study re-affirms previous work indicating a healthy diet includes limiting overly processed and refined foods,” says Lear.

No significant adverse health effects were found with consuming whole grains or white rice.

Examples of refined grains

Refined grains were defined in the study as wheat grain products or flours that have been modified to remove the bran and germ from the grain. Refined grains are commonly found in the following foods:

-White bread


-Breakfast cereals


-Bakery products/desserts



Why is refined grain intake linked to poorer health?

Processing grains to remove the bran and germ layers removes the fiber, vitamins, minerals, and other components potentially linked to health from the grain. This means that the numerous health benefits associated with whole grain intake, like heart health, digestive health, immunity, and weight management, are not found in foods made with refined grains.

The study suggests eating whole grain foods like brown rice and barley, and having fewer cereal grains and refined wheat products, can improve health. Reducing one’s overall consumption of refined grains and having better quality carbohydrates is essential for optimal health outcomes.

Currently, whole grain intake is much lower than recommendations globally – many people in developed countries consume less than 1 serving of whole grains per day.

What can we do to increase whole grain intake?

Replacing refined grains with whole grains in the foods people eat day-to-day is an important way the food and beverage industry can improve public health.

Major opportunities to replace refined grain with whole grains include:

-Burger buns, sandwich bread, and tortillas


-Pizza crust

-Savoury snacks

However, taste and texture are major barriers to whole grain consumption, so the solution is not necessarily to just replace a food like white bread with wheat bread.

Creative ways to get whole grain servings into foods people are already eating may be more successful. For example, oat-based dairy alternatives are becoming more common. Using raw materials that do not remove the bran or germ from the oat can help deliver whole grain servings to people choosing oat-based dairy alternatives. Other examples could be using a whole grain quinoa or amaranth as a base for snack foods, or incorporating a whole grain into a pizza crust.

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