Dietary guidance universally supports the importance of grains in the diet. The United States Department of Agriculture pyramid suggests that Americans consume from six to 11 servings of grains per day, with three of these servings being whole grain products. Whole grain contains the bran, germ and endosperm, while refined grain includes only endosperm. Both refined and whole grains can be fortified with nutrients to improve the nutrient profile of the product. Most grains consumed in developed countries are subjected to some type of processing to optimize flavor and provide shelf‐stable products. Grains provide important sources of dietary fibre, plant protein, phytochemicals and needed vitamins and minerals. Additionally, in the United States grains have been chosen as the best vehicle to fortify our diets with vitamins and minerals that are typically in short supply. These nutrients include iron, thiamin, niacin, riboflavin and, more recently, folic acid and calcium. Grains contain antioxidants, including vitamins, trace minerals and non‐nutrients such as phenolic acids, lignans and phytic acid, which are thought to protect against cardiovascular disease and cancer. Additionally, grains are our most dependable source of phytoestrogens, plant compounds known to protect against cancers such as breast and prostate. Grains are rich sources of oligosaccharides and resistant starch, carbohydrates that function like dietary fibre and enhance the intestinal environment and help improve immune function. Epidemiological studies find that whole grains are more protective than refined grains in the prevention of chronic disease, although instruments to define intake of refined, whole and fortified grains are limited. Nutritional guidance should support whole grain products over refined, with fortification of nutrients improving the nutrient profile of both refined and whole grain products.