Carbohydrate is an essential fuel for high-intensity athletic training. Yet many athletes are retreating from including carbohydrates in their diets, particularly the entire carbohydrate-rich grain group; this is sometimes based on real evidence and other times on random information. Is it possible that eliminating an entire food group in search of health and performance is not the best choice? 

A healthy diet rests on two principles: variety and moderation. Variety among food groups, as well as within food groups, allows for the most nutritional diversity. Elimination of any food group requires the replacement of not just macronutrients, but micronutrients, fibers, phytochemicals, food factors and all the other stuff in food that we have yet to discover. These factors all work in concert to create a greater health impact than that of each factor alone. The latest diet trends often run counter to variety by encouraging food group elimination, and against moderation through the zero tolerance recommendations. 

As a registered dietitian, I have found that one of the most common reasons clients give for missing workouts or not finishing an event is related to their gut health or discomfort. And more often than not, clients wonder if it’s the carbohydrates, bread or grains in their diets that are to blame and if they should eliminate these “offending” foods from their diet. 

Like many of my clients, some people mistakenly believe the idea that eating grains make them gain weight or could even make them ill. While there are certainly some populations that should abstain from consuming gluten-containing foods (those with celiac disease, for example, or non-celiac gluten sensitivity), this isn’t the case for most people, especially among those who are physically active (Antonio et al., 2019; Asrih et al., 2015; Gleeson and Bishop, 2000). Read on to learn more about why the types of grains one consumes is so important and how you can help your clients make healthier choices that will benefit both performance and their overall health. 

Industrial Bread: What’s Missing?

Industrially produced refined bread fills a need for calories. Although it is enriched and fortified with five nutrients—iron, riboflavin, niacin, folic acid and thiamine—which slightly improves the nutrition profile, this type of bread is no longer the substantial source of healthful nutrition and flavor that historically fed the Western world (Jones and Econopouly, 2018). 

The reason? Industrial roller milling of wheat kernels to create white flour removes nearly everything except the starchy carbohydrate and the gluten protein. According to standards set by the United States Departement of Agriculture (USDA), production of 100% whole-wheat flour can contain roller milled white flour that is blended with a minimum of 51% of the bran that was removed during the milling process. Standards also require a proportional return of the rest of the kernel, but in most cases these are either not added back or are denatured (removing their healthful characteristics) to allow for a longer shelf life. In fact, 60 to 90% of micronutrients are not replaced by enrichment and fortification, along with none of the fibers and phytochemicals (Torsten and Aaron, 2018; Econopouly and Jones, 2017). 

In addition to the types of grains used, the way grains are prepared also affects how they are processed by the body. For example, commercially produced, store-bought bread, whether white or whole wheat, typically rises in minutes and is baked in an hour with the support of dozens of chemicals and without wild yeast starters or fermentation time, both of which are important to the biological process of creating a nutritious loaf of bread. Artisan loaves, however, are typically baked with wild yeast starters and six to 12 hours of fermentation time for rising, which leads to the development of a more nutritious loaf of bread. When grains are consumed whole and simply prepared, they maintain their balance and benefits (Econopouly and Jones, 2017).

Grains: Who Needs Them?

Only 8% of adults and 3% of kids in the United States consume three servings per day of whole grains, and 40% of the population don’t consume any whole grains at all (Albertson et al., 2016). In addition to those who consume a predominately refined and processed diet, many people have eliminated grains from their diets due to a variety of reasons, including celiac disease, non-celiac gluten sensitivity, a desire to lose weight by following a low-carbohydrate diet, or the belief that grain and carbohydrate elimination is essential for increased health and fitness. 

Unlike highly processed foods, whole grains are a nutrient-dense choice to nourish your body daily. A whole-grain kernel is rich in carbohydrates, proteins, healthy fats, unique gut-health-promoting fibers and disease-preventing phytochemicals. A whole-wheat kernel contains at least 20 vitamins and 17 minerals, and for many of these nutrients, grains are the primary food source in our food supply. 

Multiple studies have shown that consuming at least three servings of whole-grain foods per day has a positive impact on body weight, low-grade inflammation, cognitive function, cardiovascular and cancer illness and death, and all causes of illness and death (Fortune et al., 2019; GBD, 2019; Slyper, 2018). Conversely, a recent study examining the impact of ultra-processed diets on calorie intake and weight gain concluded that “limiting consumption of ultra-processed foods may be an effective strategy for obesity prevention and treatment” (Hall et al., 2019).

Additionally, research suggests that whole grains are high in some unique fibers that feed the gut microbiota and keep those friendly cultures healthy (Paoli et al., 2019; Cooper et al., 2015). Danish researchers, for example, found that subjects who experienced gut disturbances due to consuming ultra-processed bread reported that stone-ground whole grain loaves made them feel better. The researchers concluded that “Compared with a refined grain diet, whole grain...reduced body weight and systemic low-grade inflammation (Roager et al., 2019).

Finally, active and athletic women and girls who consume a very-low-carbohydrate diet may be at risk of upsetting a hormone pathway that control metabolism and multiple body systems. Called the peripheral metabolic pathway, it interacts through chemical messengers with nutrient and energy metabolism, muscle, bone, gastrointestinal tract, reproductive organs, and more (Fontana and Torre, 2016). Grains, in particular, are rich in nutrients that promote and support this pathway (Cooper, 2015).

Training Considerations 

While whole grains are ideal for nutrition throughout the day, they are not ideal to fuel the body right before training. Fibers, proteins and fats all slow stomach emptying and digestion time, which can leave individuals feeling too full to train. Immediately before and during exercise, evidence-based carbohydrate sports products designed specifically to fuel athletic activity may work better for some people. Collaborate with your clients to support self-directed goals focused on experimenting with different foods or products to see which ones feel and work best, and time these experiments well before competition day (Burke et al., 2019).

Urge Your Clients to Make Whole-grain Choices

Beyond Wheat

The following grains are available in most supermarkets or online; cooking instructions can generally be found on the box.
Amaranth* (a seed)
Barley
Buckwheat*
Corn*
Millet*
Oats*
Quinoa* (a seed)
Rice*
Rye
Sorghum*
Teff*
* gluten-free

Wheat (many different varieties noted here)

Spelt
Einkhorn
Emmer
Farro

There are many gluten-free whole-grain choices for those who need to eliminate gluten (see sidebar). While artisan breads and heritage grains may be more expensive, the nutritional return on investment is much higher.

Three whole-grain servings a day is a moderate inclusion to promote a healthy, high-quality life. It’s also important to realize that whole grains can be consumed in a variety of forms, including bread. More than ever, a wide variety of heritage whole grains are available in supermarkets, so support your clients and provide them with the information they need to feel empowered to try some of these grains using the recipes included below, which will make it easy and fun to add them to their diets. 

Recipes to Try and Share

These recipes, taken from The New Power Eating (Human Kinetics, 2018), are easy to make and feature whole grains and simple ingredients.

Seashore Buckwheat

2/3 cup (70 g) whole-grain mini pasta shells
1 tbsp (15 ml) canola oil
1 cup (70 g) sliced mushrooms
1 small onion, diced
2 cups (480 ml) chicken stock
1 whole egg, slightly beaten
1 cup (164 g) pre-roasted buckwheat kernels or groats
Pinch of white pepper and salt to taste

  1. Cook the pasta shells until al dente according to package directions; drain and set aside.
  2. Heat the oil in a nonstick pan over medium heat. Add the mushrooms and onion and sauté until the onion is translucent, about 7 minutes. Set aside.
  3. Heat the stock to boiling. In a small mixing bowl, combine the egg with the buckwheat until the kernels are coated. Turn the buckwheat into a medium-sized skillet. Stir the egg and buckwheat mixture over medium-high heat for 3 to 4 minutes until it is hot and slightly toasted, and the egg-coated kernels are well separated. Reduce the heat to low and carefully stir in the boiling stock, sautéed mushrooms and onions, and pepper and salt. Cover tightly and simmer 10 to 12 minutes, or until the buckwheat kernels are tender and all the liquid has been absorbed.
  4. Turn into an oven-safe casserole dish and mix in the pasta shells. Place uncovered under an oven broiler for 3 to 5 minutes, just to brown the top. Watch closely and remove promptly.

    Makes 4 servings.


Easy Energy Couscous

4 tbsp (27 g) slivered almonds
4 tbsp (40 g) golden raisins
12 dried apricots, quartered
8 dried figs, quartered
1/2 tsp (1.2 g) cinnamon
1/2 cup (120 ml) fresh orange juice
1 1/2 cups (360 ml) water
1/4 tsp (1 ml) salt
1 tbsp (12 g) butter
1 cup (173 g) whole-wheat couscous

  1. Place the almonds, raisins, apricots, and figs in a bowl with the cinnamon.
    Cover with the orange juice and refrigerate for a minimum of 30 minutes and up to overnight.
  2. In a saucepan, bring the water, salt, and butter to a boil. Stir in the couscous. Cover and simmer over low heat for 5 minutes. Remove from heat and let stand 5 minutes. Fluff the couscous lightly with a fork.
  3. Transfer the fruit and nut mixture to a saucepan and warm thoroughly over medium-low heat. Turn into a mixing bowl and add the cooked couscous. Mix well. Couscous can be served warm or cold.

    Makes 6 servings.

References

Albertson, A.M. et al. (2016). Whole grain consumption trends and associations with body weight measures in the United States: Results from the cross sectional NHANES 2001-2012. Nutrition Journal, 15, 8.

Asrih, M. et al. (2015). Ketogenic diet impairs FGF21 signaling and promotes differential inflammatory responses in the liver and white adipose tissue. PLoS One, 10, 5, e0126364

Burke, L.M. et al. (2019). International Association of Athletics Federations Consensus Statement 2019: Nutrition for Athletics. International Journal of Sport Nutrition and Exercise Metabolism, 29, 2, 73−84.

Cooper, R. (2015). Rediscovering ancient wheat varieties as functional foods. Journal of Traditional and Complementary Medicine, 5, 3, 13−143.

Cooper, D.N. et al. (2015). Does whole grain consumption alter gut microbiota and satiety? Healthcare, 3, 2, 364−392.

Econopouly, B.F. and Jones, S.S. (2017). The rewards of (gluten) intolerance. Gastronomica: The Journal of Crucial Food Studies. 17, 2, 76–78.

Fontana, R. and Torre, S.D. (2016). The deep correlation between energy metabolism and reproduction: A view on the effects of nutrition for women fertility. Nutrients, 8, 2, 87.

Fortune, N.C. et al. (2019). Dietary intake and cognitive function: Evidence from the Bogalusa Heart Study. American Journal of Clinical Nutrition, 109, 6, 1656−1663.

GBD 2017 Diet Collaborators (2019). Health effects of dietary risks in 195 countries, 1990-2017: A systematic analysis for the Global burden of Disease Study 2017. The Lancet, 393, 10184. 

Gleeson, M. and Bishop, N.C. (2000). Special feature for the Olympics: Effects of exercise on the immune system: Modification of immune responses to exercise by carbohydrate, glutamine and anti-oxidant supplements. Immunology and Cell Biology, 78, 5, 554−561.

Hall, K.D. et al. (2019). Ultra-processed diets cause excess calorie intake and weight gain: An inpatient randomized controlled trial of ad libitum food intake. Cell Metabolism, 30, 1−11.

Jones, S.S. and Econopouly, B.F. (2018). Breeding away from all purpose. Agroecology and Sustainable Food Systems, 42, 6, 712−721.

Paoli, A. et al. (2019). Ketogenic diet and microbiota: Friends or enemies? Genes, 10, 7, 534. 

Roager, H.M. et al. (2019). Whole grain-rich diet reduces body weight and systemic low-grade inflammation without inducing major changes of the gut microbiome: A randomized cross-over trial. Gut, 68, 83−93.

Slyper, A.H. (2018). A paradigm shift for the prevention and treatment of individual and global obesity. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 11, 855−861

Torsten, M and Aaron, L. (2018). Microbial transglutaminase is immunogenic and potentially pathogenic in pediatric celiac disease. Frontiers in Pediatrics, 6, 389.