USA— A recent study published in the Mayo Clinic Proceedings finds that counter to popular belief, refined grains are not associated with the development of type 2 diabetes.

Refined grains are milled to have had the germ and bran removed, which gives them a finer texture and extends their shelf life. However, the refining process also removes many nutrients, including dietary fiber, iron and certain vitamins.

The 2020-2025 Dietary Guidelines for Americans (DGAs) recommends limiting refined grain intake to no more than half of total grain intake. This directive is attributed, per the guidelines, to scientific evidence that eating refined carbohydrates with a high glycemic index — like white bread and rice — raise the risk of type 2 diabetes. But eating whole grains like bran cereal and oatmeal can lower that risk.

The study counters this argument against refined grains, drawing on data from all published observational cohort studies that looked at the associations between refined grain intake and risk of type 2 diabetes, comprising nearly 400,000 men and women.

The analysis found refined staple grain foods, such as breads, cereal and pasta, were not associated with risk of type 2 diabetes. The study also explored the impact of indulgent refined grain foods, such as cakes, cookies and muffins, on type 2 diabetes risk, and found no association.

Instead, total grain intake—defined as the sum of refined- and whole-grain intake— was associated with lower risk of type 2 diabetes, the analysis showed.

“The results of these cohort studies are contrary to the conclusions of the 2015 and 2020 [Dietary Guidelines Advisory Committees (DGACs)],” the authors wrote. “This is most likely because the DGACs relied primarily on studies of dietary patterns and their association with [type 2 diabetes] risk rather than on studies in which refined grain foods were considered as a distinct food category.

The authors concluded that, the higher type 2 diabetes risk associated with the unhealthy (Western) dietary pattern is likely attributable to consumption of red and processed meat and sugar-sweetened beverages rather than to refined grain foods per se.

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