Ancient grains found beneficial in T2D treatments

A new study finds that ancient grains such as oats, spelt, millet, or sorghum can improve health outcomes in people with type 2 diabetes (T2D). Ancient grains refer to a category of cereals that are believed to have been minimally altered by selective breeding over recent millennia. The health outcomes observed were in contrast to the more widespread cereals such as corn, rice and modern varieties of wheat, which are the product of thousands of years of selective breeding.

Oats, brown rice, millet, and all other ‘ancient grains’ are considered whole grains, which means that they have not been stripped of their bran and therefore provide more fiber than refined counterparts. Besides their starch content, whole grains also include fiber, vitamins, minerals, and healthy fats.

The meta-analytic study, which reviewed 13 out of 29 randomized controlled trials showed that in people with T2D, consumption of whole grains could improve cholesterol levels. Normally starch in the body is quickly digested into sugars and then absorbed into the bloodstream. This can cause a blood sugar spike. Over time, these blood sugar spikes can lower our body’s sensitivity to insulin, which is the problem in type 2 diabetes.

However the healthy fats and especially the fiber contained in whole grains work to slow the speed with which the sugar from the grain is absorbed into our bloodstream. This reduces glucose spikes and preserves the body’s insulin sensitivity, which helps reduce the risk of developing diabetes. The research team suggested that this could explain the lower rates of T2D observed among people consuming whole grains.

Many ancient grains are also good dietary sources of soluble fiber, which studies show have a positive impact on T2D and blood lipids such as cholesterol and triglycerides. Soluble fiber absorbs water in the intestinal tract and the gel that forms can slow gastric emptying, which could decrease the after-meal rise in blood glucose in T2D.

Soluble fiber also binds with bile salts in the intestinal tract, reducing absorption of these salts back into the body and reducing the amount of bile salts available to the liver to manufacture cholesterol. Additionally, soluble fiber also supports a healthy microbiome — the beneficial bacteria in the intestinal tract — which have a positive impact on the immune system and anti-inflammatory effects.

While the researchers found positive benefits of the grains for overall health, they were quick to admit that more studies would be needed to explain the relationship between consumption of ancient grains and reduced T2D. They also said that the different studies they researched had examined various types of grains over a period of time, so more studies would be needed to verify their findings.

Additionally, the team noted that most of the studies indicated a positive impact on measures of blood sugar management and lipid profiles. However, the small number of studies for each of the grains limited the ability to come to a definitive conclusion that ancient grains improve blood sugar management and blood lipid control in individuals with type 2 diabetes.

To help manage type 2 diabetes, it is important to stay on track with diet, especially by monitoring the intake of simple carbohydrates that can break down quickly leading to blood sugar spikes. Reducing overall sugar intakes not only from refined grain products but also from beverages, is a longstanding recommendation to reduce blood sugar swings in patients with T2D. Moreover, aside from diet, patients should also consider other lifestyle behaviors that are important for health, including obtaining sufficient sleep and exercise.

In managing type 2 diabetes, it is important to consider three treatment goals — to monitor: blood sugar, blood lipids, and blood pressure. Dietary modifications should take these three goals into account. There are several strategies to achieve these goals.

First we need to know which foods contain carbohydrates as that is the nutrient that will raise blood glucose the most after eating. With that knowledge, portion management can be very helpful..

Additionally, including heart-healthy fat (such as nuts, nut butters, avocado, olive oil) and/or lean protein (such as chicken, turkey, fish, lower fat cheese) at meals and snacks blunts the after-meal rise in blood glucose. Slowing down our eating pace also reduces the after-meal rise in blood glucose.

Also, the order in which we eat the foods on our plate can make a difference. If we eat vegetables (cooked vegetables and/or salad) first, then our protein (chicken, turkey, fish, lean meat) and finally our starch (potato, rice, pasta), this will help slow down the rise in blood glucose after eating. If the person with diabetes is not able to achieve their personal diet management goals, they should consult with a registered dietitian/nutritionist.

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