Archive for August, 2011

I receive occasional emails and comments from people who can’t believe wheat isn’t health food. Some have quoted Bible passages about our daily bread, the staff of life, breaking bread with family, etc. Others have pointed out that Americans ate plenty of bread and other wheat products 100 years ago, but weren’t as likely to be fat and diabetic as people today.

I usually reply that the wheat products we consume today aren’t the same as those consumed by people in Biblical times, or even in more recent times. But I didn’t realize just how different today’s wheat is until I read Wheat Belly, a terrific new book by Dr. William Davis, the cardiologist you may already know from his Heart Scan Blog.

The title, of course, refers to the big gut that so many people today are carrying around in front of them these days.  While he’s no fan of sugar or other refined carbohydrates, Dr. Davis believes wheat is a primary (if not the primary) driver of the rise in obesity we’ve witnessed in the past quarter century, and he makes a strong case for that belief.   But getting fat is hardly the only price we pay for our love of bagels, breads, cereals and muffins. As Dr. Davis explains in the book’s introduction:

While much of the Wheat Belly story is about overweight, it is also about the complex and not fully understood range of diseases that have resulted from it – from celiac disease, the devastating intestinal disease that develops from exposure to wheat gluten, to an assortment of neurological disorders, curious rashes, and the paralyzing effects of schizophrenia. Documented peculiar effects of wheat on humans include appetite stimulation, exposure to brain-active exorphins (the counterpart of internally derived endorphins), exaggerated blood-sugar surges that trigger cycles of satiety alternating with increased appetite, the process of glycation that underlies diseases and aging, inflammatory and pH effects that erode cartilage and damage bone, and activation of disordered immune responses.

And later, in Part One:

There’s hardly a single organ system that is not in some way affected by wheat products. The health impact of Triticum aestivum, common bread wheat and its genetic brethren, ranges far and wide, with curious effects from mouth to anus, brain to pancreas, Appalachian housewife to Wall Street arbitrageur. If it sounds crazy, bear with me. I make these claims with a clear, wheat-free conscience.

In the rest of the book, Dr. Davis back up those claims. He delves into quite a bit of nutrition science and some biochemistry, but writes in a clear (and often humorous) style that makes for easy reading. As a doctor who’s treated thousands of patients, he has the added advantage of being able to cite case histories from his own practice – patients who came to him unknowingly damaged by wheat, but were cured by wheat-free diets.

One patient, a thirty-eight-year-old woman, was told by her doctor that she’d have to have part of her colon removed and replaced with an external bag. After Dr. Davis talked her into going wheat free, her colon healed itself. Another patient, a twenty-six-year-old man, was experiencing so much pain in his joints, he could barely walk. Three different rheumatologists failed to identify a cause. When he visited Dr. Davis for a heart condition, Dr. Davis suggested he try a wheat-free diet for the joint pain. Three months later, the young man strode into the office pain-free and reported he’d been jogging short distances and playing basketball. His heart condition had cleared up as well.

Before the chapters detailing the many ways wheat can damage our bodies and brains, Dr. Davis begins by recounting the history of wheat itself. It’s a fascinating story — in a Stephen King sort of way, that is. Here are a few quotes from that chapter, which is titled Not Your Grandma’s Muffins: The Creation of Modern Wheat.

Bread and other foods made from wheat have sustained humans for centuries, but the wheat of our ancestors is not the same as modern commercial wheat that reaches your breakfast, lunch and dinner table. From the original strains of wild grass harvested by early humans, wheat has exploded to more than 25,000 varieties, virtually all of them the result of human intervention.

The first wild, then cultivated, wheat was einkorn, the great-granddaddy of all subsequent wheat. Einkorn has the simplest genetic code of all wheat, containing only 14 chromosomes.

Shortly after the cultivation of the first einkorn plant, the emmer variety of wheat, the natural offspring of parents einkorn and an unrelated wild grass, Aegilops speltvoides or goatgrass, made its appearance in the Middle East. Goatgrass added its genetic code to that of einkorn, resulting in the more complex twenty-eight-chromosome emmer wheat.

Emmer wheat, Dr. Davis explains, was probably the wheat of biblical times. Later the emmer wheat mated naturally with another grass and produced Triticum aestivum, the forty-two-chromosome wheat that humans consumed for centuries – right up until the past 50 years or so. That’s when the story of wheat becomes a bit of a modern Frankenstein tale.

Like Dr. Frankenstein, the scientists who created today’s wheat had good intentions: the goal was to produce more wheat per acre in a shorter span of time, thus vastly increasing yields and preventing worldwide starvation as the planet’s population swelled. To that extent, they succeeded. Geneticist Dr. Norman Borlaug, who created the short, stocky, fast-growing “dwarf” wheat most of us consume today, is credited with saving perhaps a billion people from starvation.

The problem is that dwarf wheat varieties were developed through a combination of cross-breeding and gene splicing. The result is a mutant plant with a genetic code that never existed in nature before. In fact, today’s wheat literally can’t survive in a natural setting. Take away the modern pesticides and fertilizers and it’s (pardon the pun) toast.

Perhaps overjoyed at the prospect of the feeding the world, the developers of modern wheat varieties weren’t interested in conducting tests to see if these genetically-modified strains were actually fit for human consumption. Dr. Davis believes they’re not. At the very least, we’re now consuming wheat that’s genetically different from what our ancestors consumed:

Analyses of proteins expressed by a wheat hybrid compared to its two parent strains have demonstrated that while approximately 95 percent of the proteins expressed in the offspring are the same, five percent are unique, found in neither parent. Wheat gluten proteins, in particular, undergo considerable structural change with hybridization. In one hybridization experiment, fourteen new gluten proteins were identified in the offspring that were not present in either parent plant. Moreover, when compared to century-old stains of wheat, modern strains of Triticum aestivum express a higher quantity of genes for gluten proteins that are associated with celiac disease.

Hybridization efforts of the past fifty years have generated numerous additional changes in the gluten-coding genes in Triticum aestivum, most of them purposeful modifications of the “D” genome that confer baking and aesthetic characteristics on flour. It is therefore the the “D” genome of modern Triticum aestivum that, having been the focus of all manner of shenanigans by plant geneticists, has accumulated substantial changes in genetically determined characteristics of gluten proteins.

In other word’s, this ain’t your grandma’s wheat.  Little wonder that when researchers compared blood samples taken from thousand of soldiers 50 years ago to blood samples from today’s soldiers, they found that celiac antibodies are five times more common today among today’s soliders.

Dr. Davis recounts an experiment he conducted on himself to compare the different impacts of ancient wheat and modern wheat on his blood sugar. He managed to find some einkorn wheat and made bread from it. Two slices of that bread raised his blood sugar from 86 mg/dl to 110. Not bad. Then he made bread from modern whole wheat – you know, the stuff the USDA says is the key to great health. Two slices raised his blood sugar from 84 mg/dl to 167. That’s diabetes territory. As Dr. Davis writes in another chapter after explaining the specific types of carbohydrates found in wheat:

Wheat products elevate blood sugar levels more than virtually any other carbohydrate, from beans to candy bars.

As the graph I displayed in a previous post showed, the typical American consumes somewhere around 1,000 calories per day in the form of sugars and grains.  Our dominant grain by far is wheat — wheat that was never part of the human diet until 50 years ago.

The rest of the book details the damage modern wheat can do to our bodies and brains, with plenty of references to both academic studies and case histories from Dr. Davis’ medical practice. He covers the addictive properties of wheat, the effects wheat can produce in our brains (including actual brain damage), and of course the many ways wheat can wreak havoc on our digestive systems. Compared to those chapters, the chapters on skin conditions, accelerated aging, and heart disease seem almost tame. Sure, it’s not good to produce mostly small, dense LDL … but heart disease will kill you later. Untreated celiac disease will make you miserable for life – and most celiac sufferers are never diagnosed.

This is an excellent book, and also an important book. A story a co-worker told me last week illustrates why: his wife suffered from debilitating headaches for years. She went from doctor to doctor, but none could offer an explanation or solution, other than pain medications that basically knocked her out. Then a few months ago, she mentioned the headaches to some acquaintances over dinner. One of them – not a doctor – told her the headaches could be caused by a reaction to wheat gluten and suggested she try a gluten-free diet. She did … and headaches went away.

As my co-worker told me, “I’m glad someone finally gave her the answer, but why did she have to hear this from some Joe Schmoe after years of suffering? Why didn’t any of the doctors we consulted think of that?”

The doctors didn’t think of that because they weren’t trained to think of that. Ask the vast majority of doctors for dietary advice, and they’ll tell you to limit your fats and eat your “healthy whole grains.” They can’t teach what they don’t know.

I hope you all read this book. But more than that, I hope you buy a copy and stick it in your doctor’s hands. The next time a patient shows up suffering from splitting headaches (or irritable bowel, or stomach cramps, or acne, or psoriasis, or depression, or emotional problems, or high triglycerides, or high blood sugar, or arthritis, or asthma), perhaps the doctor will take a careful dietary history and suggest trying a wheat-free diet before reaching for the prescription pad.

Next week I’ll be posting a Q & A with Dr. Davis.  I have a list of questions I want to ask, but if you have questions of your own, post them in a comment.  I’ll pick some to add to my list.

 

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The handsome young man you see in the picture above is Grant Naughton, the Older Brother’s middle son. If his name sounds vaguely familiar, it’s because he’s listed in the credits for Fat Head as a camera operator. When he visited us in California a few years ago, Grant volunteered to do some shooting for me, since he knew I was less than happy with the footage I was getting from a film-school intern whose courses apparently didn’t include basic lessons such as “Don’t let the top of the frame cut off your subject at the nose.” (I had to toss most of his footage.)

Grant shot several scenes for me, including me hanging around in front of restaurants, the interview with my mom, and me asking the clerk at the drive-up window if anyone would force me to eat french fries.

Grant’s always been a sweet and funny guy. My girls adore him. He’s now also officially the toughest S.O.B. I know, since he just attended Ranger school and was among the 39% who survived the cut. The Older Brother and several other family members drove down to Georgia to attend his graduation and stopped by the mini-farm on the way back to get the “before” view.

The videos below provide a pretty good idea of what Grant just endured – in temperatures that exceeded 100 degrees most days. In addition to the usual training tortures, he ended up with a full-body case of poison ivy and was stung in the face by a hornet. But he refused to quit and is now the proud owner of a Ranger tab.

Way to go, Sergeant … Hoo-Ah!

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A couple of interesting tidbits about salt and health came my way via Facebook this morning.  Check out the Q & A from this online article:

Q: Isn’t there universal agreement that these low sodium targets are best for everyone?

A: Although most researchers agree that excessively high sodium intake is not good for health, there is disagreement about the ideal level of daily sodium intake. Dr. David McCarron and other researchers from the University of California at Davis and Washington University in St. Louis have questioned the feasibility of aiming for such low sodium intake targets. McCarron and colleagues point out that contrary to popular belief, sodium intake has not increased or decreased during recent decades and that humans naturally consume significantly more than the new recommendations for potentially valid physiological reasons.

It is well-known that sodium is one of the few nutrients for which humans have a “specific appetite,” meaning that if we are low in the nutrient we crave, we seek out foods that provide it. McCarron stresses that when sodium levels in the body drop too low, there are a series of hormonal responses that may have undesirable long-term consequences.

Q: What are some possible negative consequences of excessive reduction of sodium intake?

A: Two studies out of Australia, hot off the press in the journal Diabetes Care, report that for both type 1 and type 2 diabetics, low sodium intake was associated with increased risk of mortality from cardiovascular disease and all other causes. This was not completely surprising because it is known that low sodium intake results in increased insulin resistance. This means that more insulin is needed to stimulate insulin-sensitive cells to remove glucose from the blood. Although these studies do not prove cause and effect, they do stress the need for caution in making sodium recommendations and the need to conduct appropriately controlled human studies.

Another study found that when adults (ages 40 to 65 whose blood pressure exceeded 120 over 80) added vegetable juice containing 480 to 960 mg of sodium to their daily diet, their blood pressure dropped during this 12-week study. This juice also added a similar amount of potassium to their diets.

McCarron points out that worldwide sodium intake varies between about 3,100 and 3,800 mg per day. When sodium intake drops too far below 3,000 mg per day, hormonal changes apparently trigger the drive to seek out food sources of sodium.

Low sodium intake increases insulin resistance?  Have to admit, that was a new one on me.  But here’s a link to a study that came to exactly that conclusion.

Yeah, uh, but, you see, there’s this one tribe in the Amazon where people have a low sodium intake and they’re really, really healthy …

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A reader sent me a paper about a study in which researchers got people to eat less by adding pureed vegetables to foods.  (Maybe they didn’t like the puree.) That wasn’t the interesting part.  This was — a breakdown of where the average American adult’s calories come from, according to the USDA’s data.

I can almost hear the members of the Dietary Guidelines Committee tsk-tsking about the 638.6 calories of added fats and oils and the 468.8 calories of added sugars — and of course I’d agree about the sugar, which they now recommend only “in moderation.”  (How about none?  Is that too extreme?)

But look at the calories from grains — 617 calories.  In America, grains mostly means wheat.  So the average adult is getting around 1,000 calories per day from sugar and wheat.

I recently finished reading an advance copy of Dr. William Davis’ soon-to-be-released (and terrific) book Wheat Belly. I already knew wheat is bad news, but until I read his book, I didn’t realize how dramatically the wheat we consume today differs from the wheat people consumed just 100 years ago.

I’ll write a full review of the book next week.  Until then, I’ll just say that 1,000 calories per day of sugar and wheat is a prescription for lousy health and runaway health-care costs — in other words, pretty much what we’re facing today.

 

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I’m honored to be the featured guest on the most recent episode of Dr. Robert Su’s excellent podcast show Carbohydrates Can Kill.  You can visit his site to listen to the episode.

And while you’re there, listen to several more.  Like my buddy Jimmy Moore, Dr. Su interviews top-notch medical and nutrition experts, providing the rest of us with a free, on-going education.  During our list trip to Illinois, we listened to several of his podcasts in the van.  Even our girls were interested.

I was pleased when Dr. Su invited me on his show because he’s one of my medical heroes.  In his book Carbohydrates Can Kill, he recounts how his health began failing him in middle age. As a doctor, he was of course familiar with the standard-issue dietary advice to cut back on fat and eat more whole grains, but became frustrated when following that advice only led to worse health problems. So he set out on a personal research mission and determined it was the excess carbohydrates in his diet causing his problems, not the fat. In the book, he recounts his own journey back to health and explains the science of how and carbohydrate restriction can clear up a number of health issues.  It sure worked for him.

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When I returned from the Ancestral Health Symposium, I mentioned that one of the other speakers pooh-poohed a point I made in my speech about how sodium intake has little effect on blood pressure, then argued his point using bad science – which I found amusing, since my speech was about how to tell good science from bad science.

Here’s his speech. If you skip ahead to about the 9:00 mark, you’ll hear how Dr. O’Keefe “proves” that sodium does indeed cause hypertension.

Well, there you have it. The Yanomami Indians in South America have a low sodium intake compared to ours, and by gosh, you can’t find a single case of hypertension among ‘em. We’ve clearly established a link between A and B, so A must cause B. Case closed. See you next post.

No, wait … hang on a second … I hear some critical-thinking questions banging around in my head. Such as:

Q. Did the researchers control their variables?

You can’t see his slides in the video, but while Dr. O’Keefe was explaining how little sodium the Yanomami Indians consume, he was showing the audience pictures similar to these:

Hmmm … I wonder if sodium intake is the only difference between the lifestyle of the average American and lifestyle of the average Yanomami Indian? Based on these pictures, I’m guessing probably not. In fact, based on these pictures, I’m proposing a new hypothesis about hypertension:

Hypertension is caused by wearing pants.

If makes sense if you think about it. Your body is a bit like a big water balloon, and everyone knows if you squeeze a balloon, you increase the pressure inside. Now add in the fact that many Americans insist on wearing the same size clothes even as they get older and fatter, and you have a good explanation for why blood pressure tends to increase after middle age. I hereby propose we start prescribing nakedness as a cure for hypertension. (This will have the added benefit of speeding up security checks at airports.)

Pictures of the Yanomami have also inspired me to propose a second hypothesis:

You can prevent hypertension by poking holes in your skin and inserting bones.

I think this one is self-explanatory. If you think about that water-balloon example again, you’d have to agree that even if you increase the internal pressure by squeezing the balloon, you could offset the entire effect by poking a hole in the balloon’s skin.

The fact that these people consume less salt than we do and also have lower blood pressure than we do proves absolutely nothing. The lower blood pressure could be due to any number of factors.

Dr. Richard Johnson has presented some compelling evidence that hypertension is largely the result of consuming too much fructose, as I recounted in a previous post. Now, I must admit I’ve never visited the Yanomami tribes in person, but I’m willing to bet Dr. O’Keefe a thousand dollars that in addition to consuming far less sodium than we do, hunter-gatherers living in the Amazon jungle also consume far less fructose … unless they somehow manage to venture into the jungle and gather Krispy Kreme donuts, Frosted Mini-Wheats, Little Debbie Snack Cakes, Chunky Monkey ice cream, Heinz ketchup, fruit rollups, half-gallon jugs of Mott’s apple juice, and 44-ounce Coca-Cola Big Gulps.

Q. If we’re told A is linked to B, do we see that correlation consistently, or are there glaring exceptions in other populations?

A recent article published in Scientific American titled It’s Time to End the War on Salt reported on a meta-analysis of salt-restriction studies by the Cochrane Collaboration. Here’s what they found:

Intersalt, a large study published in 1988, compared sodium intake with blood pressure in subjects from 52 international research centers and found no relationship between sodium intake and the prevalence of hypertension. In fact, the population that ate the most salt, about 14 grams a day, had a lower median blood pressure than the population that ate the least, about 7.2 grams a day.

Well, but, uh, you see … there’s this one tribe in South America that consumes very little salt, and they have low blood pressure, so that must prove salt causes hypertension. We’ll just forget about all those contradictions we find in other populations ….

Q. Is this an observational study or a clinical study?

Dr. O’Keefe’s observation is just that – an observation. So what do the clinical trials tell us about salt intake and blood pressure?

Hypertension is defined as blood pressure that’s more than 20 points above normal. If salt causes hypertension, then drastically restricting salt intake – all by itself – should produce a drop in blood pressure of 20 points or so. But that simply isn’t the case. In the section of my speech that Dr. O’Keefe didn’t like, I recounted the results of a large clinical study in which researchers had the study subjects reduce their salt intake by 75%. That led to a whopping three-point drop in blood pressure on average.

Other clinical studies have produced similar (or even less-impressive) results. Here’s more from the Scientific American article:

Over the long-term, low-salt diets, compared to normal diets, decreased systolic blood pressure (the top number in the blood pressure ratio) in healthy people by 1.1 millimeters of mercury (mmHg) and diastolic blood pressure (the bottom number) by 0.6 mmHg. That is like going from 120/80 to 119/79. The review concluded that “intensive interventions, unsuited to primary care or population prevention programs, provide only minimal reductions in blood pressure during long-term trials.” A 2003 Cochrane review of 57 shorter-term trials similarly concluded that “there is little evidence for long-term benefit from reducing salt intake.”

Since my blood pressure has always been normal or a little on the low side, I believe I’ll keep putting salt on my food, Dr. O’Keefe. But if it makes you feel any better, I’ll spend more time not wearing any pants.

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