Important Points:

• whole grains
• refined grains
• Western dietary pattern
• diabetes
• obesity

Refined Grains: The Good, the Bad, the Ugly

Flour is all around us and a temptation at every meal. Breakfast toast, bagels, cereal, and pancakes fill our tables. Lunch revolves around sandwiches, wraps, pasta and pizza. Refined grains have been vilified as one of the leadings causes of ill health. Is there any truth to this? Should we toss all refined grain products off our tables? We will have an in-depth look at the good, the bad, and the ugly of refined flour to give you a better understanding of the goodies on your plate.

What are Refined Grains?

Refined grain is the term used to refer to grains that are not whole, because they are missing one or more of their three key parts (bran, germ, or endosperm). White flour and white rice are refined grains, for instance, because both have had their bran and germ removed, leaving only the endosperm. Refining a grain removes about a quarter of the protein in a grain and half to two thirds or more of a score of nutrients, leaving the grain a mere shadow of its original self.

Further refining includes mixing, bleaching, and brominating; additionally, thiamin, riboflavin, niacin, and iron are often added back in to nutritionally enrich the product. Because the added nutrients represent a fraction of the nutrients removed, refined grains are considered nutritionally inferior to whole grains. However, for some grains the removal of fiber coupled with fine grinding results in a slightly higher availability of grain energy for use by the body.

Grain refining led to disastrous and widespread nutritional problems, like the deficiency diseases pelagra and beri-beri. In response, many governments recommended or required that refined grains be “enriched.”

The Good

The federal government’s 2010 Dietary Guidelines for Americans recommend that half your daily grain intake be from high-fiber whole-grain sources, foods like brown rice, oatmeal and whole-wheat bread. Nutritionists often exhort people to choose whole grains over refined ones whenever they can.

But according to one leading nutrition researcher, Julie Miller Jones, a professor emeritus at St. Catherine University, we shouldn’t be so eager to throw out refined grains altogether. Refined grains do have some benefits — namely, nutrients added to refined flours.

Since folic acid was added to bread, cereal and other grains in 1999, the rate of newborns with neural tube defects — a known consequence of folic acid deficiency — has decreased 46%. Additionally, important nutrients like copper and iron are more easily absorbed when eaten with refined grains. Whole grains are healthy because they’re so high in fiber, which Americans don’t get enough of, but that fiber also fast-tracks food through the digestive system, absorbing nutrients along the way.

The Bad

As our national appetite for flour has inched up, so has the incidence of diet-related ills, such as obesity, heart disease and diabetes. Coincidence? Many nutrition experts don’t think so. When they weigh the evidence linking food choices and disease, they see the white, dusty fingerprints of flour everywhere.

Flour started out as an ingenious fix to a vexing problem. Grass seeds were plentiful, but the tough outer shell (the husk) made the seeds difficult to chew and digest. Early humans outsmarted the seeds by grinding them between stones, crushing the outer layers to get at the goodness inside. The result — a coarse powder — was the first whole-grain flour.

The downside was spoilage. Crushing the germ released its oils, which quickly turned rancid when exposed to air. With the advent of industrial milling in the late 1800s, machines began filtering out the germ and pulverized the remaining endosperm into a fine, white powder that lasted on the shelf for months. And so all-purpose white flour was born — along with a host of health problems.

Beneath their rigid architecture, whole-kernel grains conceal an array of vitamins, minerals, phytonutrients and fiber. But when machines pulverize kernels into flour, even whole-grain flour, what’s left behind is a starchy powder capable of wreaking havoc on the body.

The Ugly

Overconsuming flour can lead to a number of problems in the body, including:

• Food Allergies/Intolerances. Gluten intolerance is a term that has become synonymous with the current generation. Wheat is one of the biggest dietary triggers of food allergies and intolerances. While the exact reason is unclear, many experts blame the higher gluten content of modern wheat varieties
• Blood-Sugar Spikes. The difference between a whole-kernel grain and a processed grain all boils down to the glycemic index, which is how quickly the body turns food into fuel, or glucose. Foods made with wheat flour are particularly damaging. A carbohydrate in wheat, called amylopectin A, is more easily converted to blood sugar than just about any other carbohydrate. Two slices of bread made with whole-wheat flour raise blood sugar higher than six teaspoons of table sugar and higher than many candy bars.
• Food Cravings.  One of the biggest changes in modern wheat is that it contains a modified form of gliadin, a protein found in wheat gluten. Gliadin releases a feel-good effect in the brain by morphing into a substance that crosses the blood-brain barrier and binds onto the brain’s opiate receptors and makes you want to eat more.
• Caloric Overload. A refined grain packs more calories than a whole-kernel grain because it is more concentrated, and foods that are high in grains also tend to be high in sugar and industrialized fats. These foods contribute largely to obesity and the diabetes epidemic.
• Metabolic Slowdown. Research shows that the body may shift nutrients into fat storage and away from muscle burning in the presence of high-glycemic-index foods. In 2004, Ludwig and his colleagues at Harvard conducted a study, published in the journal Lancet, in which they fed rats diets with identical nutrients, except for the type of starch. By the end of the study, rats in both groups weighed roughly the same, but those eating a high-glycemic diet had 71 percent more fat than the low-glycemic-index group.
• Inflammation. A diet high in grains stokes inflammation. When blood sugar spikes, glucose builds up in the blood significantly. When glucose drifts in the blood, it attaches itself to nearby proteins resulting in a chemical reaction called glycation, a pro-inflammatory process that plays a role in a host of inflammatory diseases.
• GI Disorders. Studies show that the lectins in grains inflame the lining of the gut and create fissures between cells. Also, when whole-kernel grains are refined, 80 percent of the fiber is lost, and gut health suffers. Additionally, fiber helps sweep the gut of debris and supports the body’s critically important elimination and detoxification processes, which also play a role in keeping high cholesterol and inflammation at bay.
• Acid-Alkaline Imbalance. The body has an elaborate system of checks and balances to keep its pH level at a steady 7.4. A diet high in acidic foods, such as grains, forces the body to pull calcium from the bones to keep things on an even keel. When researchers looked at how the diets of more than 500 women affected their bone density, they found that a diet high in refined grains, among other nutrient-poor foods, was linked to bone loss. A highly acidic diet also chips away at our cellular vitality and immunity in ways that can make us vulnerable to chronic disease. Grains are the only plant foods that generate acidic byproducts. Wheat, in particular, is among the most potent sources of sulfuric acid, a powerful substance that quickly overcomes the neutralizing effects of alkaline bases.

The Bottom Line….

Grains are not essential, and there is no nutrient in there that you can’t get from other foods.

Wheat is the key ingredient in the American diet. Unfortunately, after being milled, it is seldom utilized in its whole form with its components intact. The wheat we consume is in the form of bread, pies, cakes, cookies, biscuits, spaghetti, cream of wheat, cereals, and other forms that have been treated, heated, fractioned, and fragmented. Is consuming refined grains harmful? In this article, we expound on this.

1. What are refined grains?

Almost every nutrition expert agrees that refined carbs should be limited. However, they are still the main source of dietary carbs in many countries.

What Are Refined Carbs?

Refined carbs are also known as simple carbs or processed carbs.

There are two main types:

• Sugars: Refined and processed sugars, such as sucrose (table sugar), high fructose corn syrup, and agave syrup.
• Refined grains: These are grains that have had the fibrous and nutritious parts removed. The biggest source is white flour made from refined wheat.

Refined carbs have been stripped of almost all fiber, vitamins, and minerals. For this reason, they can be considered “empty” calories. They lead to rapid spikes in blood sugar and insulin levels.

They are also digested quickly and have a high glycemic index. This means they lead to rapid spikes in blood sugar and insulin levels after meals. Eating foods high on the glycemic index has been linked to overeating and increased risk of many diseases.

Sadly, sugars and refined grains are a very large part of the total carbohydrate intake in many countries. The main dietary sources of refined carbs are white flour, white bread, white rice, pastries, sodas, snacks, pasta, sweets, breakfast cereals, and added sugars. They are also added to all sorts of processed foods. Refined Grains Are Much Lower in Fiber and Micronutrients

How do grains get refined?

Whole grains consist of three main parts;

• Bran: The hard outer layer containing fiber, minerals, and antioxidants.
• Germ: The nutrient-rich core containing carbs, fat, protein, vitamins, minerals, antioxidants, and plant compounds.
• Endosperm: The middle layer contains mostly carbs and small amounts of protein.

The bran and germ are the most nutritious parts of whole grains. They contain high amounts of many nutrients, such as fiber, B vitamins, iron, magnesium, phosphorus, manganese, and selenium.

During the refining process, the bran and germ are removed, along with all the nutrients they contain. This leaves almost no fiber, vitamins, or minerals in the refined grains. The only thing left is rapidly digested starch with small amounts of protein. Whole grains are very high in dietary fiber.

That being said, some producers enrich their products with synthetic vitamins to make up for some of the loss in nutrients. Whether or not synthetic vitamins are as good as natural vitamins has long been debated. However, most people will agree that getting your nutrients from whole foods is always the best choice.

Diets high in refined carbs also tend to be low in fiber. Low-fiber diets have been linked with an increased risk of diseases like heart disease, obesity, type 2 diabetes, colon cancer, and various digestive problems.

2. The Effect of refined grains on your health

Abdominal Fat – Consuming mainly refined grains may increase your visceral adipose tissue, a type of fat found around your organs that may eventually lead to diabetes and heart disease; according to a study carried out, participants who consumed at least three servings of whole grains per day had approximately 10 percent less VAT than people who consumed only refined grains.

Overeating and Increase the Risk of Obesity- A large portion of the population is overweight or obese. Eating too many refined carbs may be one of the main culprits. Because they are low in fiber and digested quickly, eating refined carbs can cause major swings in blood sugar levels. This can contribute to overeating. This is because foods high on the glycemic index promote short-term fullness, lasting about one hour. On the other hand, foods that are low on the glycemic index promote a sustained feeling of fullness, which lasts about two to three hours.

Heart Health-Consuming refined grains instead of whole grains may result in atherosclerosis, or thickening of the arteries, which is a risk factor for heart disease. Another study found the bran component of whole grains, which is no longer present in refined grains, maybe the most protective against heart disease, as study participants who consumed the most added bran had the lowest risk for heart disease.

Diabetes-People who consume fewer whole grains and more refined grains have a higher risk for diabetes. Studies show that high consumption of refined carbs is linked with insulin resistance and high blood sugar levels. These are some of the main symptoms of type 2 diabetes. This may be in part due to the lower fiber, magnesium, and vitamin E content of refined-grain foods, as these nutrients are decreased when whole grains are refined.

Mortality-While fiber from whole grains may be protective against early mortality, the same is not true with fiber from refined grains. The fiber in refined grains comes from the endosperm of the grain, which doesn’t contain many nutrients, while the fiber in whole grains also includes fiber from the bran and germ of the grain, which have a higher nutrient content. The beneficial effects of whole grains may be due to more than the fiber contained in these grains.

3. Why are refined grain products harmful?

Refined grains and their food products are substandard foods for several reasons:

• They are excessively starchy and high in gluten.
• They are practically devoid of natural fiber.
• There can be up to approximately 25 different chemicals that are added to refined grains and bread products.
• Grains are fumigated.
• Bleaching chemicals are used.
• Artificial colorings and flavorings are used.
• They are nutritionally imbalanced.
• Because refined grain products are nutritionally imbalanced, they are responsible for contributing to several degenerative diseases. Calcium leaching from the bones and teeth occurs because of the altered phosphorous-calcium balance in these products. Sugar and refined grain products are primarily responsible for tooth decay in this country, as well as being the major cause of brittle bones in the elderly.

4. What are some Healthy Gluten-Free Whole Grain Alternatives?

• Amaranth
• Buckwheat
• Corn
• Millet
• Oats
• Quinoa
• Rice
• Wild Rice

5. To take, or not to take, refined grains?

In the US, the familiar white flour, which is the result of the modern refining process, is 72% extraction. This means that it has lost 28% of the bulk of the wheat, including half or more of many of the crucial nutrients. It would be prudent to cut down on refined flour products and instead opt for whole grains.

Eating a lot of refined carbs can have many negative health effects. However, not all carbs are bad. Some carbohydrate-rich, whole foods are extremely healthy. These are great sources of fiber, vitamins, minerals, and various beneficial plant compounds. Some healthy carb-rich foods include vegetables, fruit, legumes, root vegetables, and whole grains, such as oats and barley. Unless you are following a carb-restricted diet, there is absolutely NO reason to avoid these foods just because they contain carbs.

References

1. Healthline (2017): Refined Carbs Are Bad For You. Retrieved from https://www.healthline.com/nutrition/why-refined-carbs-are-bad#section1

2. SF Gate (2018): The Health Side Effects of Refined Grains. Retrieved from https://healthyeating.sfgate.com/health-side-effects-refined-grains-3064.html

3. NCBI (2019): Perspective: Refined Grains and Health: Genuine Risk, or Guilt by Association? Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520038/

4. Food Matters (2011): Why Refined Grains Are Harmful + 8 Gluten-Free Whole Grain Alternatives. Retrieved from https://www.foodmatters.com/article/why-refined-grains-are-harmful

5. Sott (2019): Why Refined Grains Are Harmful. Retrieved from https://www.sott.net/article/226260-Why-Refined-Grains-Are-Harmful

Contrary to previous research findings, refined grain consumption is not associated with any of the adverse health effects it has been linked to, such as obesity, heart disease, and diabetes. This is according to a new study from the Healthy Lifestyles Research Center at Arizona State University (ASU) published in Advances in Nutrition. The researchers note that what counts is the number of consumed calories, not so much their source. Should you totally do away with refined grains? In this article, we will discuss finding a balance.

1. Whole grains vs. regular grains: What’s the difference?

Whole grains provide a variety of healthy nutrients and are naturally low in fat.

Both refined grains and whole grains are important in your diet. Whole grains are important for health since they provide fiber and essential vitamins. Enriched/refined grains provide fiber too, and 39 percent of the dietary fiber Americans eat comes from refined grains. As a population, US consumers still fall far short of reaching their daily goals for fiber as it were.

Eliminating enriched grain products will result in nutrient shortfalls. Refined grain foods that have been enriched and/or fortified help to alleviate shortfalls, including B vitamins, folic acid, thiamin, niacin, riboflavin, and iron. An example is that enriched grains are the largest contributor to folic acid in the American diet. Folic acid is key in preventing neural tube birth defects.

What are the different types of grains?

Also called cereals, grains and whole grains are the seeds of grasses cultivated for food. They come in many shapes and sizes, from large kernels of popcorn to small quinoa seeds.

1. Whole grains. These unrefined grains haven’t had their bran and germ removed by milling; therefore, all of the nutrients remain intact. Whole grains are better sources of fiber and other important nutrients, such as selenium, potassium, and magnesium. Whole grains are either single foods, such as brown rice and popcorn, or ingredients in products, such as buckwheat in pancakes or whole wheat in bread.
2. Refined grains. In contrast to whole grains, refined grains are milled, a process that strips out both the bran and germ to give them a finer texture and longer shelf life. The refining process also removes many nutrients, including fiber. Refined grains include white flour, white rice, white bread, and degermed cornflower. Many pieces of bread, cereals, crackers, desserts, and pastries are made with refined grains, too. These processed foods will not keep your blood sugar levels steady, which is why you will be hungry again soon after consumption.
3. Enriched grains. Enriched means that some or many of the nutrients that are lost during processing are added back in later.

Most refined grains are enriched. Many enriched grains are also fortified — meaning nutrients that don’t occur naturally in the food are added — with other vitamins and minerals, such as folic acid and iron. Enriched grains lack fiber and are not an optimal choice because while they have traces of nutrition, many important vitamins and nutrients are lost during processing.

Opt for whole grains

Chances are you eat lots of grains already. But are they the healthiest kind? If you’re like most people, you’re not getting enough whole grains in your diet. Aim to choose whole grains for at least half of all the grains you eat. Examples of whole grains include:

1. Barley
2. Brown rice
3. Buckwheat
4. Bulgur (cracked wheat)
5. Millet
6. Oatmeal
7. Popcorn
8. Whole-wheat bread, pasta, or crackers
9. Wild rice

It’s not always easy to tell which grains are in a particular product, especially bread. For instance, brown bread isn’t necessarily whole wheat — the color may come from added coloring. If you’re unsure something has whole grains, check the product label or the Nutrition Facts panel. Look for the word “whole” on the package, and ensure whole grains appear among the first items in the ingredient list.

How to enjoy more whole grains in your diet

Try these tips to add more whole grains to your meals and snacks:

1. Enjoy breakfasts that include whole-grain cereals, such as bran flakes, shredded wheat or oatmeal.
2. Substitute whole-wheat toast or whole-grain bagels for plain. Substitute low-fat bran muffins for pastries.
3. Make sandwiches using whole-grain bread or rolls. Swap out white flour tortillas with whole-wheat versions.
4. Replace white rice with kasha, brown rice, wild rice, or bulgur.
5. Feature wild rice or barley in soups, stews, casseroles, and salads.
6. Add whole grains, such as cooked brown rice or whole-grain bread crumbs, to ground meat or poultry for extra body.
7. Use rolled oats or crushed bran cereal in recipes instead of dry bread crumbs.

To eat, or not to eat, refined grains?

It is recommended that you increase your consumption of whole grains without drastically reducing your refined grain intake. You can enjoy up to six or seven servings per day of refined grains without increasing your risk for coronary heart disease, Type 2 diabetes, hypertension, or premature death.

A lot of products will contain both whole grains and refined grains. In these cases, the placement of the whole grain or whole grain flour on the ingredients list indicates the relative amount in the product. If you’re looking for a mostly whole-grain product, the whole-grain or whole-grain flour should be either first on the ingredients list or high up, according to the Dietary Guidelines (and certainly before any refined-grain flour). Foods made from at least 50 percent whole-grain ingredients by weight may have a whole grains claim on the label, per the Dietary Guidelines. It’s a good idea to also peek at the nutrition facts to see how much fiber and protein are in the product if you want to make sure you’re getting some nutrients, even though a product contains both whole and refined grains.

So do you actually need to worry about refined carbs?

Ultimately, most of us could probably stand to eat fewer refined grains and more whole grains. At a minimum, the Dietary Guidelines recommend getting at least half of your grains from whole grains. The average refined grain intake, though, is “well above” recommended limits among men and women in most age groups. In contrast, the average whole-grain intake is “far below” the recommended amount, according to the Dietary Guidelines.

So if you notice that your own diet leans pretty heavy towards refined carbs and you want to incorporate more whole grains into your diet, you can swap out refined grains for whole-grain versions where you can—such as brown rice instead of white rice and 100 percent whole-wheat bread instead of wheat bread or white bread.

Certainly, eating a few refined grains every day, along with a healthy diet and at least half of your grain intake as whole grains, is fine. Everyone needs treats and sweets in their life to enjoy and enhance eating pleasure, for celebration, and for many other reasons. Just make sure whole grains get invited to the party, too.

References

1. Choose My Plate: What foods are in the Grains Group? Retrieved from https://www.choosemyplate.gov/eathealthy/grains

2. Self (2019): What Exactly Are Refined Carbs? Retrieved from https://www.self.com/story/what-are-refined-carbs

3. The Mayo Clinic (2019): Whole grains vs. regular grains: What’s the difference? Retrieved from http://diet.mayoclinic.org/diet/eat/whole-grains-vs-regular-grains?xid=nl_MayoClinicDiet_20160421

We have heard a lot about the harmful effects of refined grains on our health. Interestingly, recent research seems to point in a different direction, exonerating them from the label they have held for so long. Are refined grains not so bad after all? What are the facts? In this article, we will take a closer look at why refined grains seem to have been unfairly vilified.

1. Refined grain consumption and your health

Have you been avoiding refined grains such as white bread and pasta? Do you feel bad when you do eat them? Apparently, there’s no evidence to show that refined grains are “bad” for you. Conversely, there is evidence that shows that whole grains are good for you. Somehow along the way, the message has been mixed up – putting a slice of white bread or a dish of white pasta in the same category as pie and piece of cake.

The dietary recommendation has been to make half of your grains whole grains. This does not mean “avoid all refined grains”. They too can fit into your diet.

Contrary to previous research findings, refined grain consumption is not associated with any of the adverse health effects it has been linked to, such as obesity, heart disease, and diabetes. This is according to a new study from the Healthy Lifestyles Research Center at Arizona State University (ASU) published in Advances in Nutrition. The researchers note that what counts is the number of consumed calories, not so much their source.

Analyses of existing research – including 32 publications with data from 24 distinct cohorts – showed that refined grains are not linked to increased disease risk or premature death. The study highlights that the current dietary recommendation to reduce refined grain consumption conflicts with the substantial body of published scientific evidence.

Professor Glenn Gaesser, Ph.D., Director of the Healthy Lifestyles Research Center at ASU“Simply put, refined grains are not the bad guy,” says study author, Professor Glenn Gaesser, Ph.D., Director of the Healthy Lifestyles Research Center at ASU. “Contrary to popular belief and current dietary guidance, refined grain intake is not associated with type 2 diabetes, cardiovascular disease, coronary heart disease, stroke, hypertension, cancer or death.”

Gaesser theorizes that refined grains have developed a guilt-by-association reputation. He explains that while refined grains are frequently characterized as unhealthy, this can be attributed to their inclusion in a dietary pattern that contains a range of foods that are the real culprits in the link between an unhealthy dietary pattern and an increased risk of a number of chronic diseases.

What were the results of the study?

• No association was observed between refined grain intake and cardiovascular disease or coronary heart disease.
• No association was found between refined grain intake and stroke risk. In fact, one study demonstrated a 10 percent lower reduction of stroke risk.
• No association was found between refined grain intake and risk of Type 2 diabetes.
• Cancer studies are limited. Nonetheless, one meta-analysis shows an inverse association between refined grain intake and total cancer deaths. A second meta-analysis shows that refined grain intake was not associated with the risk of rectal or colorectal cancer.
• Five out of six studies show no relationship between refined grain intake and death rate. The other study shows a statistically significant inverse association between refined grain intake and all-cause death rate.
• Three systematic reviews show no consistent relationship between refined grain intake and body mass index (BMI).

2. Is there a link between refined grains and obesity?

The demonization of refined grains has deterred people from consuming them, opting for whole grains instead. Whole grains are higher in calories but touted as more nutritionally-rich.

In reality, the association between refined grain consumption and obesity is murky, with no clear relationship. Weight gain is essentially a result of consuming more calories than you burn. It’s the number of calories that matters most, not so much the type of calories. In studies that do indicate that refined grains are associated with increased risk of weight gain, the association is “inconsequentially small.” Randomized dietary interventions of whole grains and refined grains compared head-to-head reveal no differences between the two.

Both refined grains and whole grains are important in people’s diets. Whole grains are important for health since they provide fiber and essential vitamins. Enriched/refined grains provide fiber too, and 39 percent of the dietary fiber Americans eat comes from refined grains. “As a population, US consumers still fall far short of reaching their daily goals for fiber.

It is important to note that eliminating enriched grain products will result in nutrient shortfalls. Refined grain foods that have been enriched and/or fortified help to alleviate shortfalls including B-vitamins, folic acid, thiamin, niacin, riboflavin, and iron.

A good example is that enriched grains are the largest contributor of folic acid in the American diet. This is key to preventing neural tube birth defects.

3. So, what should you eat?

To reduce disease risk and balanced nutrition, the DGA dietary recommends you eat:

• A variety of vegetables from all of the subgroups—dark green, red and orange, legumes (beans and peas), starchy, and other
• Fruits, especially whole fruits
• Grains, at least half of which are whole grains
• Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages
• A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds, and soy products
• Oils

4. What is the future for refined grains?

Future research efforts must distinguish between staple grain foods, such as cereals, bread and pasta and indulgent grain foods, such as cakes, cookies, and donuts, according to Gaesser. Most of the studies included in the current paper did not make such distinctions, so it’s impossible to know whether the results would be different if refined grains were categorized separately as a staple or indulgent grain foods.

It is possible that the risk of chronic diseases would be different for the consumption of staple grain foods as compared to the consumption of indulgent grain foods. Randomized-comparison trials are needed to better differentiate the health effects of whole grain and refined grain foods. Most published studies have been too short and do not include enough outcome measures to draw definitive conclusions.

As currently stands, the results of randomized-comparison trials show no consistent benefits of whole-grain foods over refined grain foods. These findings are at odds with the results of large-scale observational studies, which show a clear superiority of whole grains over refined grains. This is a paradox that needs to be resolved,” Gaesser concludes.

References

1. Nutritioninsight (2019): Let us eat cake? Refined grains “falsely” linked to obesity and chronic disease risk. Retrieved from https://www.nutritioninsight.com/news/let-us-eat-cake-refined-grains-falsely-linked-to-obesity-and-chronic-disease-risk.html

2. Rust Nutrition (2019): Refined Grains Redefined. Retrieved from https://rustnutrition.com/blog/2019/07/03/refined-grains-redefined/

3. NCBI (2019): Perspective: Refined Grains and Health: Genuine Risk, or Guilt by Association? Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520038/

4. Baking Business.com (2019): Study disputes negative health claims surrounding refined grains. Retrieved from https://www.bakingbusiness.com/articles/48376-study-disputes-negative-health-claims-surrounding-refined-grains