Sorghum is an important cereal grain food, grown globally, that is rich in nutrients, dietary fiber, and bioactive components yet is considered of low value to humans and often used as an animal feed. This review provides an overview of key sorghum grain components, including starches, dietary fiber, protein, lipids, and phytochemicals, with functional properties that have potential to impact on health. Though acknowledging the impact of the whole food will reflect the synergy between the components, studies of these components implicate effects on energy balance, glycemic control, lipids, gut microbiota, and cell-mediated immune responses, including antioxidant and anti-inflammatory effects. For these to be confirmed as contributory effects from sorghum consumption, evidence from quality randomized controlled trials is required. If proven effective, there may be a role for sorghum grain–based diets to assist in the prevention of chronic diseases such as diabetes, obesity, and heart disease. Future research addressing effects of sorghum consumption may help drive a paradigm shift from sorghum as a low value food to a potentially health-promoting, highly valued human grain food.

Whole‐grain sorghum foods may elicit health‐promoting effects when consumed regularly in the diet. This review discusses key functional sorghum grain constituents, including dietary fiber, slowly digestible and resistant starches, lipids, and phytochemicals and their effects on metabolic processes that are associated with the development of chronic diseases, such as heart disease and diabetes. Currently, the range of sorghum food products available to consumers is limited globally, hindering the potential consumer benefits. A collaborative effort to innovate new product developments is therefore needed, with a focus on processing methods that help to retain the grain's favorable nutritive, health‐enhancing, and sensory attributes. Evidence for sorghum's purported health effects, together with evidence of impacts of processing on different sorghum foods, are presented in this review to fully elucidate the potential of sorghum grain to confer health benefits to humans.

Sorghum requires fewer inputs for sustainable cultivation in harsh climates and has the potential to be utilized in modern food product innovations. Moreover, consumption of sorghum may elicit favorable health effects similar to other commonly consumed cereals, like wheat. Animal and human research exploring health effects of sorghum consumption indicates potential beneficial effects on blood glucose and lipid regulation, oxidative stress modulation, appetite regulation and weight management. However, a recent appraisal of the strength of evidence has not been conducted. Therefore, this study aims to evaluate the effects of sorghum consumption on metabolic indicators of chronic disease, including blood lipid and blood glucose levels, markers of oxidative stress, and factors associated with weight management. Using CINAHL, Cochrane Library, PubMed and MEDLINE databases, a systematic review of intervention studies published up to May 2020 was conducted and 16 interventional studies met the criteria for inclusion. Evidence for favorable effects of sorghum consumption on indicators of chronic disease, including blood glucose responses, markers of oxidative stress, satiety measures and weight management was demonstrated. Evidence from this systematic review may assist to promote sorghum's potential health benefits globally, including in food markets where it is underutilized, stimulating more sorghum-based food innovations in the future.

Key Points: Increasing plant diversity (≥30 plant foods/wk) reduced symptom burden and shifted the gut microbiome toward beneficial metabolite production. Increasing plant diversity was more effective for individuals with more advanced kidney disease and higher levels of uremic toxins at baseline. Increasing plant diversity, in addition to usual diet care, resulted in a substantial reduction in potential renal acid load of 47%. Background: Research suggests that eating a plant-dominant dietary pattern is beneficial to people with CKD. The aim was to investigate how increasing the diversity of plant food intake would affect metabolomic, microbiome, and clinical parameters in people with CKD. Methods: This study was a cross-over, randomized controlled trial involving 25 Australian adults diagnosed with stage 3–4 CKD. Participants were randomly allocated to follow two diets for 6 weeks each, separated by a minimum 4-week washout period: a high-diversity plant-based diet (HDPD, ≥30 unique plant foods weekly) and a low-diversity plant-based diet (LDPD, ≤15 unique plant foods weekly), alongside a usual kidney diet prescription. Data collection was completed at four time points (beginning and end of each intervention period). Primary outcome included a change in uremic toxins (indoxyl sulfate and p-cresyl sulfate) concentrations. Secondary and exploratory outcomes included diet quality and nutritional status, fecal microbiome composition and diversity, plasma metabolome, symptom burden, quality-of-life scores, BP, biochemical, and anthropometric measures. Results: Plasma and urinary uremic toxin levels did not consistently decrease across the cohort; however, significant reductions were observed in responders to the HDPD, particularly those with poorer kidney function and higher baseline uremic toxin levels. Neither diet caused electrolyte imbalances. The HDPD significantly improved diet quality, reduced potential renal acid load by an average of 47% from baseline, with an estimated marginal mean reduction of 9.96 (95% confidence interval, −16.28 to −3.64), and compared with the LDPD, decreased total symptom burden, including constipation (95% confidence interval, −4.11 to −0.54 and −0.91 to −0.22, respectively). It also shifted the gut microbiome toward increased production of beneficial metabolites such as butyrate/isobutyrate. By contrast, the LDPD reduced microbial diversity and decreased the abundance of 27 species and 33 functional genes. Conclusions: This study demonstrated the safety and clinically relevant therapeutic benefits of aiming to incorporate 30 or more unique plant foods weekly in the diet of individuals with moderate CKD. It was observed that individuals with more advanced kidney disease and higher levels of uremic toxins may derive the greatest benefit from adopting a HDPD. Clinical Trial registry name and registration number: ACTRN12619000442101.