Friday Favorites: Is Millet Healthy?

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

In this video, I review the health benefits of millets, including its potential impact on diabetes. Check it out.

Millets are highly nutritious, but vastly ignored as a main source of food, primarily due to lack of awareness. You’ve heard of “ancient grains”? Millets ain’t messin’ around, arguably the first grains cultivated by humankind––not just dating back 5,000 years, but maybe 10,000 years.

Why the plural, millets? Talk about lack of awareness! I had no idea that millet wasn’t the name of a specific grain. Millet is just a generic term that doesn’t just apply to a bunch of different species, but to a bunch of totally different plants. There are so-called major and minor millets. There’s pearl millet, which is what I think most people think of as millet, but then there are proso, foxtail, and finger millets, which are all completely different grains. They look similar, but they’re not the same.

Fiber is one of the main things we’re looking for in a whole grain, and kodo millet is like off the charts. But compared to other grains, finger and foxtail millet also beat out the bunch, though note that what most people think of as millet is really on the low side. But looking at the polyphenol content, even plain millet beats out the other grains, including sorghum, which I previously hyped for its polyphenol content. But again, kodo millet seems to win the day. Total antioxidant-wise, though, kodo and finger millet are comparably high.

Nutrition-wise, finger millet is said to have eight times more calcium than other grains, but it looks to me more like ten times more, just off the charts, and three times as much calcium as milk. Some of the millets are exceptionally high in iron as well. Regular millet is high, but barnyard millet has like five times more iron than steak.

Okay, so it’s nutritious, but what about specific potential health benefits? In the medical literature, you’ll read things like this: Millets may prevent cardiovascular disease by reducing triglycerides in hyperlipidemic rats. Who cares (other than perhaps pet owners) whether a food reduces cardiovascular disease in rodents?

There was that epidemiological study in China that found lower esophageal cancer mortality rates in areas that ate more millet and sorghum, compared to corn and wheat––but that may have been more due to avoiding a contaminating carcinogenic fungus than from benefit in the millet itself. Studies show millets may be effective against cancer cell proliferation, in a petri dish, with kodo and proso millet rapidly inhibiting cancer cell growth compared to pearl or foxtail millet, knocking down the growth of cancer cells, but leaving normal cells alone. And also, millets reducing the growth of colon cancer cells as well as human breast cancer and human liver cancer cells, potentially also helping to prevent metastases by inhibiting cancer cell migration. My patients are neither pets nor petri dishes, though, and to date, there have been no clinical cancer trials with millet.

Are there any unique health-promoting attributes? Finger millet is supposedly known for its health benefits, such as blood sugar-lowering, cholesterol-lowering, and anti-ulcer characteristics. But the anti-ulcer study they cite just noted that some of the areas with a low incidence of ulcers also happened to be eating millet. But that’s far from establishing cause-and-effect. And the cholesterol-lowering study they cite? It explored what happens when you take tail tendons from rats and soak them in sugar and millet. What?! But the blood-sugar lowering benefits are legit. Apart from the fact that millets don’t contain gluten, which is good for the 1 or 2 percent of people with celiac disease or non-celiac gluten sensitivity, millets can also be exploited in the management of type 2 diabetes due to their blood sugar lowering properties, as reported by several studies on millets and millet-based foods in actual people, which we’ll cover next.

How does millet come to the help of diabetics? A substantial portion of the starch in millet is resistant starch––meaning resistant to digestion in our small intestine, so, providing a bounty for the good bugs in our colon. Here’s how the various millets do––all way more than more common grains like rice or wheat, but proso and kodo millet lead the pack.

What’s going on? The protein matrix in millet not only acts as a physical barrier, but actually also partially sequesters your starch-munching enzyme, and the millet polyphenols also can act as starch blockers in and of themselves.

Millet also has markedly slower stomach-emptying times than other starchy foods. If you eat white rice, boiled potatoes, or pasta, your stomach takes about an hour to digest it before starting to slowly dump it into your intestines, and two or three hours to empty about halfway. Whereas, you eat sorghum or millet, and stomach emptying doesn’t even start until two or three hours, and may take five hours to empty even halfway. Note this was for both a thick millet porridge and for just millet couscous. Since the non-viscous millet couscous meal was also equally slow in emptying, this suggests that there may just be something about millet itself that helps slow stomach emptying, which should blunt the blood sugar spike. But you don’t know, until you put it to the test.

And indeed, millet caused about a 20 percent lower surge in blood sugar than the same amount of carbs in the form of rice. Remember how excited I was to show you how it only took the body like half the insulin to handle sorghum, compared to a grain like corn? Well, millet did even better.

Give a group of prediabetics only about three-quarters of a cup of millet a day, and within six weeks, their insulin resistance dropped so much their prediabetic fasting blood sugars turned into non-prediabetic blood sugars. This so-called “self-controlled” clinical trial, the same subjects before and after, is just a sneaky way of saying an uncontrolled trial. There was no control group that didn’t add the millet or added something else. And we know just being in a study under scrutiny can cause people to eat better in other ways. So, we don’t know what role, if any, the millet itself played. What we need is a randomized, controlled crossover trial where the same people eat both a millet-containing and non-millet containing diet and see which works better.

And, here we go! A randomized, crossover study having hundreds of patients both do an American Diabetes Association-type diet, with and without about one and one-third cup of millet every day, and…the millet-based diet lowered hemoglobin A1C levels––meaning an improvement in long-term blood sugar control, along with some side benefits, like lowering cholesterol.

The target for good blood sugar control recommended by the American Diabetes Association is an A1C less than 7. They started out at 8.37, but after a few months on millet, dropped it to an average of 6.77. Is it just because they lost weight or something? No, suggesting that it was an effect specific to the millet. But they didn’t just give millet. They mixed the millet with split black lentils and spices, and we know from dozens of randomized, controlled experimental trials in people with and without diabetes that the consumption of pulses (meaning beans, split peas, chickpeas, or lentils) can improve long-term measures of blood sugar control, like A1C levels. So, while the researchers conclude that millets have the potential for a protective role in the management of diabetes, a more accurate conclusion might be a mix of millet and lentils can be protective––though, hey, maybe the spices helped too. They didn’t say which ones they used, and I couldn’t get a hold of the authors, but a similar study done by one of the same researchers included about a tablespoon a day of a mixture of fenugreek, coriander, cumin, and black pepper, with a fifth spice, perhaps cinnamon or turmeric.

Please consider volunteering to help out on the site.

• Majid A, Priyadarshini C G P. Millet derived bioactive peptides: A review on their functional properties and health benefits. Crit Rev Food Sci Nutr. 2020;60(19):3342-51.
• Taylor JRN. Chapter 4 - Millets: Their Unique Nutritional and Health-Promoting Attributes. In: Gluten-Free Ancient Grains: Cereals, Pseudocereals, and Legumes: Sustainable, Nutritious, and Health-Promoting Foods for the 21st Century. Woodhead Publishing. 2017;55-103.
• Annor GA. Why do millets have slower starch and protein digestibility than other cereals? Trends Food Sci Technol. 2017;66:73-83.
• Lu H, Zhang J, Liu KB, et al. Earliest domestication of common millet (Panicum miliaceum) in East Asia extended to 10,000 years ago. Proc Natl Acad Sci U S A. 2009;106(18):7367-7372.
• Dias-Martins AM, Pessanha KLF, Pacheco S, Rodrigues JAS, Carvalho CWP. Potential use of pearl millet (Pennisetum glaucum (L.) R. Br.) in Brazil: Food security, processing, health benefits and nutritional products. Food Res Int. 2018;109:175-86.
• Devi PB, Vijayabharathi R, Sathyabama S, Malleshi NG, Priyadarisini VB. Health benefits of finger millet (Eleusine coracana L.) polyphenols and dietary fiber: a review. J Food Sci Technol. 2014;51(6):1021-40.
• Chandrasekara A, Naczk M, Shahidi F. Effect of processing on the antioxidant activity of millet grains. Food Chem. 2012;133(1):1-9.
• Pradhan A, Nag SK, Patil SK. Dietary management of finger millet (Eleusine coracana L. Gaerth) controls diabetes. Curr Sci. 2010;98(6):763-5.
• Saleh AS, Zhang Q, Chen J, Shen Q. Millet grains: nutritional quality, processing, and potential health benefits. Compr Rev Food Sci F. 2013;12(3):281-95.
• Chen F, Cole P, Mi Z, Xing LY. Corn and wheat-flour consumption and mortality from esophageal cancer in Shanxi, China. Int J Cancer. 1993;53(6):902-6.
• Chandrasekara A, Shahidi F. Antiproliferative potential and DNA scission inhibitory activity of phenolics from whole millet grains. J Funct Foods. 2011;3(3):159-70.
• Shan S, Shi J, Li Z, et al. Targeted anti-colon cancer activities of a millet bran-derived peroxidase were mediated by elevated ROS generation. Food Funct. 2015;6(7):2331-8.
• Zhang L, Liu R, Niu W. Phytochemical and antiproliferative activity of proso millet. PLoS One. 2014;9(8):e104058.
• Shan S, Li Z, Guo S, Li Z, Shi T, Shi J. A millet bran-derived peroxidase inhibits cell migration by antagonizing STAT3-mediated epithelial-mesenchymal transition in human colon cancer. J Funct Foods. 2014;10:444-55.
• Chethan S, Malleshi NG. Finger millet polyphenols: characterization and their nutraceutical potential. Am J Food Technol. 2007;2(7):582-92.
• Tovey FI. Diet and duodenal ulcer. J Gastroenterol Hepatol. 1994 Mar-Apr;9(2):177-85.
• Hegde P, Chandrakasan G, Chandra T. Inhibition of collagen glycation and crosslinking in vitro by methanolic extracts of Finger millet (Eleusine coracana) and Kodo millet (Paspalum scrobiculatum). J Nutr Biochem. 2002;13(9):517.
• Kam J, Puranik S, Yadav R, et al. Dietary Interventions for Type 2 Diabetes: How Millet Comes to Help. Front Plant Sci. 2016;7:1454.
• Annor GA, Marcone M, Bertoft E, Seetharaman K. In vitro starch digestibility and expected glycemic index of kodo millet (Paspalum scrobiculatum) as affected by starch–protein–lipid interactions. Cereal Chem. 2013;90(3):211-7.
• Annor GA, Tyl C, Marcone M, Ragaee S, Marti A. Why do millets have slower starch and protein digestibility than other cereals? Trends Food Sci Technol. 2017;66:73-83.
• Jin Z, Bai F, Chen Y, Bai B. Interactions between protein, lipid and starch in foxtail millet flour affect the in vitro digestion of starch. CYTA J Food. 2019;17(1):640-7.
• Cisse F, Erickson DP, Hayes AMR, Opekun AR, Nichols BL, Hamaker BR. Traditional Malian Solid Foods Made from Sorghum and Millet Have Markedly Slower Gastric Emptying than Rice, Potato, or Pasta. Nutrients. 2018;10(2):124.
• Narayanan J, Sanjeevi V, Rohini U, Trueman P, Viswanathan V. Postprandial glycaemic response of foxtail millet dosa in comparison to a rice dosa in patients with type 2 diabetes. Indian J Med Res. 2016;144(5):712-7.
• Abdelgadir M, Abbas M, Järvi A, Elbagir M, Eltom M, Berne C. Glycaemic and insulin responses of six traditional Sudanese carbohydrate-rich meals in subjects with Type 2 diabetes mellitus. Diabet Med. 2005;22(2):213-7.
• Jali MV, Kamatar MY, Jali SM, Hiremath MB, Naik RK. Efficacy of value added foxtail millet therapeutic food in the management of diabetes and dyslipidamea in type 2 diabetic patients. Recent Res Sci Technol. 2012 4(7):3-4.
• Ren X, Yin R, Hou D, et al. The Glucose-Lowering Effect of Foxtail Millet in Subjects with Impaired Glucose Tolerance: A Self-Controlled Clinical Trial. Nutrients. 2018;10(10):1509.
• Sievenpiper JL, Kendall CW, Esfahani A, et al. Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomised controlled experimental trials in people with and without diabetes. Diabetologia. 2009;52(8):1479-95.
• Itagi S, Naik R, Bharati P, Sharma P. Readymade foxtail millet mix for diabetics. Int J Sci Nat. 2012;3(1):47-50.

Video production by Glass Entertainment

Motion graphics by Avocado Video