You may be puzzled by the almost complete absence of grains on my list of 150 healthiest foods on the planet. In fact, it may seem like nutritional heresy. After all, aren’t whole grains supposed to be nutritious and healthy? We all know that refined grains aren’t any good for you, but aren’t whole grains among the world’s most perfect foods? Doesn’t research show that people eating them get tremendous health benefits?
Let’s see…

In the decade since the original publication of this book, there has been a virtual explosion of public awareness about gluten and about grains in general. As a result, questioning the value of grains is no longer confined to fringe nutritionists (as it was when the first edition of this book came out). Cardiologist William Davis’ blockbuster best seller, Wheat Belly was published in 2011, hit number one on the New York Times bestseller list in 2012, and continues to sell briskly. Wheat Belly was perhaps the first successful mass market book that took a stand against wheat (and grains), but it was hardly the last. Grain Brain by the integrative neurologist David Perlmutter—another book that presented powerful evidence against grains—also reached bestseller status, as did Eat Dirt by Josh Axe, D.N.M., D.C., C.N.S., and The Autoimmune Fix by Tom O’Bryan, D.C., C.C.N., D.A.C.B.N. And the rise of the Paleo movement—which shuns grains of any kind—has only served to reinforce a growing suspicion—when it comes to the value of grains, we have not been told the whole truth.

That said, it’s worth repeating some of the arguments in favor of grains. Keep in mind while reading the following section that grains may have been necessary or beneficial for the development of civilization, but that does not mean they are beneficial—or even necessary—for your personal health.

The human genetic constitution has not changed much in the past 40,000 years.

The vast majority of humankind rarely, if ever, consumed cereal grains.

The natural diet of humans is food that could be hunted, fished for, gathered, or plucked.

The natural diet served us well as long as populations were limited and wildlife was plentiful.

As the population of the world increased and the supply of wild game became more limited, it became necessary to provide an alternative or supplementary means of nourishment—and about 10,000 years ago, agriculture was born.

Agriculture has made it possible for humans to live in cities, and literally, for civilization to flourish.

Eight cereal grains (wheat, corn, rice, barley, sorghum, oats, rye, and millet) now provide 56 percent of the calories and 50 percent of the protein consumed on Earth. Without these crops, the planet could not support nearly 8 billion people.

So here’s the double-edged sword: Without cereal grains, we would not have cities, civilization, industry, or the planet as we know it. Take away rice, wheat, and corn, and half the people on Earth will not eat. As one researcher said, “Cereal grains literally stand between mankind and starvation.” The dwindling supplies of our natural diet of wild animals and wild plants, together with the huge expansion of the planet’s population, made agriculture a necessity for survival.

So, cereal grains are a recent addition to the diet of humanity. Agriculture didn’t really take hold until ten to twelve thousand years ago, which is less than a nanosecond in the twenty-four-hour time clock that represents the 2.4 million years the human genus has been on the planet. As Cordain points out, we have had little time since the inception of the agricultural revolution to adapt to a food type that now represents humanity’s major source of calories and protein.

One reason is that no grain can be eaten in a completely unrefined state. No one plucks wheat from the ground and starts chowing down. All edible grains have to be milled and ground because in their natural state they contain antinutrients, substances that interfere with the absorption and assimilation of nutrients in the grain, especially minerals. It’s not a matter of whether to refine them, it’s a matter of how much.

Ostensibly, whole grains have been less processed and less milled than the really refined junk and therefore contain more of the bran—the outer coating—of the grains, providing fiber for the diet. (Oats are different from barley, wheat, and other grains in that they retain the bran and germ layers where most of the nutrients are found.)

But read the label of most whole grain cold cereals—they are fiber lightweights. It’s rare to find a cereal with 5 g of fiber per serving—most have 1 or 2, making it a pretty bad nutritional bargain. Compare that to an avocado (11 to 17 g) or a serving of beans (11 to 17 g) or a guava (8 g).

Then there’s the gluten issue. Gluten is a primary component of grains such as barley, rye, oats, and especially wheat. A full-blown allergy to gluten is called celiac disease, and at one time it was thought to affect 1 in 200 people. Now it’s 1 in 133, 1 in 56 for people with related symptoms, with 60 percent of diagnosed children and 41 percent of diagnosed adults not showing any symptoms. But what has become increasingly clear is that full-blown celiac disease is just the extreme case of gluten sensitivity. There is now a condition called Non-Celiac Gluten Sensitivity (NCGS), and many experts—such as Tom O’Bryan—speak of gluten intolerance. The point is that people with celiac disease are not the only ones who have serious problems with gluten.

Many people have undiagnosed or delayed food sensitivities, and wheat and gluten are prime triggers. (Wheat is one of the seven top allergens in the diet.) I can tell you that among nutritionists, naturopathic physicians, and doctors practicing integrative and functional medicine, one of the first dietary orders of business with patients who have multiple complaints is to take them off wheat, dairy, and sugar. Although I can’t prove it scientifically beyond a shadow of a doubt, in the experience of thousands of people the removal of wheat (and dairy and sugar) produces remarkable relief from a very wide variety of symptoms, not the least of which is unwanted weight and bloat.

Think it’s all that different with people? Think again. While the urban legend is that whole grains raise blood sugar much more slowly than their refined cousins, an examination of the glycemic index and glycemic load tables shows this is not always the case. Brown rice and white rice have virtually the same glycemic impact. So do whole wheat and white bread. Grains, by and large, are starch juggernauts and almost all of them raise blood sugar (and insulin) quickly.

Personally, I’ve seen very few grain-foods that could hold a candle—nutritionally speaking—to most of the vegetables or legumes in this book. Grains can be prepared deliciously, and many people are very attached to them. But the notion that grains should be an essential part of any diet is far from the truth.

Sure, there are plenty of studies of healthy diets that show that people eating fruits, vegetables, fish, omega-3 fats, and whole grains do much better healthwise than those eating the Standard American Diet. But it’s a real stretch to attribute those health benefits to the grains. In my opinion, if people were eating plenty of fish, vegetables, fruits, omega-3 fats, and M&Ms they’d still be much healthier than most of America.

Let’s put it this way: If you ate a great balance of foods from the 150 that make up the list of the healthiest foods on the planet, and you never touched a grain for the rest of your life, you wouldn’t be missing a thing, nutritionally speaking. The same cannot be said of the fruits, vegetables, eggs, oils, spices, meat, fish, and poultry.

And in any case, there’s always oatmeal. That’s a minimally processed grain that’s truly worth eating.

Oatmeal

Oatmeal has a place on virtually everyone’s “best foods” list. It’s like the Muhammad Ali of foods—universally loved, no matter where you stand in your dietary philosophy. Even those who are stringent about keeping carbs low soften a bit when it comes to oatmeal. The guru of diabetic diets, Richard Bernstein, M.D., who, one might say jokingly, “never met a carb he didn’t dislike,” allows oatmeal once a day for his diabetic patients. And of course, it’s been a staple of the high-carb folks for decades. I can still remember seeing the bodybuilders at Gold’s Gym with their Tupperware full of the stuff, usually mixed with scrambled eggs.

What is it about oatmeal that makes it go to the head of the list for everyone’s favorite health foods? Let’s start with fiber. Oats are simply a great source of fiber and contain a nice mix of both essential kinds (55 percent soluble and 45 percent insoluble). But the soluble fiber in oats, known as beta-glucan, makes oatmeal special.

Beta-glucans enhance the body’s immune system by turbocharging its response to bacterial infection. They do this by activating certain white blood cells called macrophages, which act like hungry little Pac-Men, gobbling up foreign invaders like fungi and bacteria. Research is currently going on to determine whether beta-glucans might boost the ability of the body to kill cancer cells, in addition to their ability to lower bad cholesterol and triglycerides, some of this research is quite promising.

Oatmeal also has a very low glycemic load, meaning it has a very, very modest effect on blood sugar. Type 2 diabetics also seem to benefit from the beta-glucan, as it appears to be helpful in stabilizing blood sugar, which is probably why diabetes expert Richard Bernstein, M.D., allows it on his programs.

Oats contain avenanthramide, a polyphenol antioxidant unique to oats and believed to have anti-inflammatory and heart-healthy properties. Many people believe that it’s the avenanthramides in oats that are responsible for the healing properties of a traditional oatmeal bath.

There are two groups of people who should be very cautious in their consumption of oats. First, those who are gluten sensitive. Celiac disease is the most dramatic example of gluten intolerance, but many people are gluten sensitive without having full-blown celiac disease. Oats themselves do not contain gluten; however, they are frequently processed in facilities that also process wheat products, and gluten contamination can occur through farming, storage, and transportation. That’s why people with gluten-issues are frequently warned to be careful with oats.

The second group needing to be careful are those suffering from uric acid–related problems (i.e., gout and kidney stones). Oats contain purines, which are substances that break down to uric acid in the body.

One more thing: It seems to be a well-kept secret that oats do not need to be cooked. Spoiler alert: You do not have to cook them. Ever see the Swedish cereal muesli in the supermarkets? It’s basically raw oats, dried fruit, and nuts!

Raw oats are amazing—I have them all the time, lightly moistened in either raw milk or juice, or even hot water. I let them sit a few minutes, then throw on the berries and nuts. And don’t let the package instructions put you off—while that 20-minute cooking time does give you a rich, hearty flavor, it’s completely unnecessary to get the health benefits or even the rich taste. I make them on the stove in less than 5 minutes. They taste just fine.

Quinoa

Quinoa is another of those foods that keeps getting miscategorized—everyone thinks it’s a grain, everyone uses it like a grain, but it’s actually a seed. Anyway, who really cares? You know how the old saying goes… if it looks like a grain and it acts like a grain… same principle.

Quinoa is a highly nutritious food, and it is considered a high-protein “grain.” The protein quality and quantity in quinoa seed is often superior to those of more common cereal grains, and the nutritional quality of this crop has been compared to that of dried whole milk by the Food and Agriculture Organization (FAO) of the United Nations. Quinoa is higher in lysine than wheat (lysine is an amino acid that’s scarce in the vegetable kingdom), and the amino acid content of quinoa seed in general is considered well balanced for human and animal nutrition, and like that of casein.

In the decade since the original publication of this book, quinoa has gone mainstream. It’s become a staple of the whole foods set, it’s popping up on the menus of more and more restaurants, while an increasing number of people are becoming aware of it. And it’s about time. It makes a great base for a salad, it’s terrific as a hot side dish, and it’s ideal for breakfast. It’s high protein, low glycemic, and generally delicious. What’s not to like?

Quinoa has a lower sodium content and is higher in calcium, phosphorus, magnesium, potassium, copper, manganese, and zinc than wheat, barley, or corn. It’s particularly high in iron—1/2 cup (93 g) contains almost 8 mg, way more than any other cereal grain. And last but hardly least, it contains a hefty 5 g of fiber.

Teff

Teff is a grain, but it’s a grain with an old soul. It was one of the earliest plants to be domesticated, probably between 4,000 and 1,000 B.C.E. in the Ethiopian highlands, and it continues to be a staple of traditional Ethiopian cooking. Along with spelt, amaranth, barley, kamut, and millet (and a few others), teff is considered an ancient grain.

It also has the distinction of being the smallest grain in the world. A single kernel of wheat is as big as one hundred grains of teff! In fact, the word “teff” comes from the Ehio-Semitic root tff which basically means “lost”—because of the size of the grain! Get it?

Teff is a nutritional heavyweight, certainly as far as grains go. One cup of cooked teff (252 g) has 10 grams of protein and 7 grams of dietary fiber, not to mention a whole bunch of nutrients like potassium, phosphorus, calcium, and magnesium. And it’s one of the best food sources for manganese.

One reason we’re hearing a lot about teff these days is that it’s naturally gluten-free. The National Research Council of the United States suggested that teff seeds are more nutritious than wheat (National Research Council, 1996), and that they contain higher amounts of the essential amino acids. The overall amino acid profile of teff is regarded as well balanced.

Teff is known to have a subtle yet nutty flavor. It can be used as a cereal—it makes a great porridge—or it can be used to thicken soups and stews. It’s also used as a flour, and it makes a great wheat alternative.

Grain Runner-Up

Rice (brown)

Depending on which of the different varieties we’re talking about—and how it’s prepared—rice can be a great food or it can be a useless waste of time. There are thousands of strains of rice today, including those grown in the wild and those that are cultivated as a crop; more than 550 million tons of the stuff are produced annually around the world, 92 percent of it in Asia. So, two folks may both be talking about eating rice, but, from a nutritional point of view, they may in fact be eating entirely different foods.

While white rice accounts for most of the rice eaten worldwide, brown rice is by far the more nutritious of the two, mainly because brown rice is the entire grain of rice, while white rice has had the bran layer removed. Stripping the grain of its bran layer strips it of many its fiber content along with many of its vitamins and minerals. Brown rice only has the outer hull removed, and it retains such nutrients as niacin, vitamin B₆, magnesium, manganese, phosphorus, selenium, and even some vitamin E.

A cup (195 g) of cooked brown rice contains about 4 g of fiber (four times the amount in white rice). Even better, most of it is insoluble fiber that helps protect against various types of cancers, including colon, breast, and prostate.

Rice in general is pretty much a no-no on low-carb diets because of its high glycemic impact. In general, rice raises blood sugar quickly, causing all sorts of problems for those concerned with diabetes or weight. The fiber in brown rice does help lower the glycemic index of some varieties, but still does not make rice a low-glycemic food.

So what’s the best advice? If you eat rice, stick with whole grain. Forget about white, and avoid instant rice. Consider using rice the way the Europeans and Asians do, as a small side dish, about the size of an ice cream scoop.

Rice can be a decent food, but not if it’s been processed to death like most of the rice we see in industrial nations. In my opinion, the best use of conventional, processed, instant white rice is as a packing material.

THE EXPERTS’ TOP TEN LISTS

Mark Houston, M.D., M.S., F.A.C.P.

Mark Houston is my go-to guy for anything at all to do with hypertension or metabolic syndrome. He’s a clinical professor of medicine at Vanderbilt University Medical School and director at Hypertension Institute in Nashville. His book, What Your Doctor May Not Tell You about Hypertension: The Revolutionary Nutrition and Lifestyle Program to Help Fight High Blood Pressure, should be required reading—I recommend it to everyone. I love his practice philosophy, “A wise healer uses that which works,” and I love him!

1. Spinach: This vegetable contains thirteen flavonoids with anticancer properties and is especially effective against prostate, skin, colon, and bone cancer. It’s a natural anti-inflammatory, is good brain food, reduces neurological damage after strokes, improves vision, and is a good source of iron. Plus it contains four natural ACE inhibitors to reduce blood pressure, and vitamin K for osteoporosis prevention.

2. Kale: This contains organosulfur compounds for cancer prevention. It improves detoxification, reduces cataracts due to the lutein and zeaxanthin that it contains, plus it’s a great antioxidant with fiber, calcium, and cardiovascular protection.

3. Broccoli: This contains numerous agents such as sulforaphane and the indoles (indole-3-carbinole and DIM) that are protective against prostate, gastric, skin, and breast cancer. The flavonoids reduce cardiovascular disease and blood pressure. Broccoli contains compounds that are anti-inflammatory and antioxidant and support the immune system and the eyes.

4, 5. Blueberries and blackberries: Blueberries have the highest antioxidant capacity, making them highly protective for the cardiovascular system. They contain pterostilbene, which lowers cholesterol, and anthocyanins, which improve vision and brain function and guard against macular degeneration. The ellagic acid in them has anticancer activity. Blackberries are similar.

6. Strawberries: This fruit contains phenols such as anthocyanins and ellagitannins, which are potent antioxidants and anti-inflammatory agents; they’re natural COX-2 inhibitors. Strawberries help improve brain function, reduce macular degeneration, and improve rheumatoid arthritis. The ellagitannin helps prevent colon cancer.

7. Raspberries: They contain ellagic acid, quercetin, kaempferol, and other flavonoids that are great antioxidants with anticancer properties; plus, they support eye and cardiovascular health.

8. Cold-water fish (e.g., tuna, salmon, mackerel, cod, and herring): Their omega-3 fats offer cardiovascular protection and reduce heart attacks, sudden death, and cardiac arrhythmias. The omega-3s are anti-inflammatory and improve brain function, memory, skin health, and kidney function. Plus they lower blood pressure and reduce triglycerides, cancer risk, and stroke risk.

9. Whey protein: This boosts the body’s stores of glutathione, one of the most important antioxidants. Whey protein contains natural ACE inhibitors, which lower blood pressure and improve cardiovascular health. It also improves immune function.

10. Wild game (venison, caribou): Wild game is high-quality protein with a complete complement of amino acids, low saturated fat, no trans fat, and a higher content of polyunsaturated and especially omega-3 fats. It also contains natural ACE inhibitors, which reduce blood pressure, and compounds that improve skin, bone, and vascular health.