Wednesday, February 25, 2009

The Children of the Wheat

Hello everyone out there in blog world. Let me start by apologizing for my prolonged absence. The recent lack of posting is partly a result of being busy with other aspects of life, not the least of which was searching for a new job. I feel very fortunate to have found an opportunity given the current economic situation; even more fortunate that I will be helping to build the next generation of genetic sequencing machines. So I get to have a job not only on the cutting edge of science, but also hopefully contributing to the health of our society. I expect to be pretty busy with the new gig, so I don't know that I'll be able to post much in the coming months either.

The other reason for the lack of posts is that I haven't really had much new to say. The one thing I'd like to get to is the rest of the energy regulation series, particularly some info about innate and learned food preferences, including why carbohydrates may be addictive (short answer: insulin tweaks an area of the brain called the insula, also lit up by drugs such as cocaine and opiates). I've started a few posts and abandoned them, mainly because they seemed to be covering the same ground. Let me throw out some these random thoughts here, rambling about in no particular order, sort of a brain dump before I disappear again.

First, I want to recommend a couple of DVDs. First is Tom Naughton's Fat Head, which is both funny and educational. Fat Head provides a gentle and highly accessible introduction to some of the topics covered in Gary Taubes' Good Calories, Bad Calories. Even my kids (8 and 4) "got it", though I suppose it didn't hurt that I've been pumping them full of the background info for a few years :-). Watch for the moment when Tom's doctor sees the measurable effects of eating an all fast-food low carb diet. The expression on his face is absolutely priceless (and to his credit, he didn't just blow it off like many in the mainstream of health would). Also watch the bonus interview footage, great stuff. I particularly liked a quote from Dr. Al Sears, something to the effect of "If you're not dead, you can still heal." Most doctors today seem resigned to mitigating the effects of metabolic syndrome through medication, rather than actually healing. I believe they're generally well-intentioned, just misinformed. But experience has shown that given the opportunity, the body has an amazing ability to heal itself, IF you can remove or at least mitigate the underlying factors reinforcing the underlying disease process. More on this later. Jimmy Moore has a great interview with Tom Naughton as well.

At one point in the bonus interviews, Dr. Sears discusses how rabbits were ultimately used as a model for heart disease. Apparently researchers started out by feeding dogs large quantities of lard, but the dogs would not develop athersclerosis. Of course that should have been obvious from the outset: saturated fat and cholesterol-containing animal fat are a cornerstone of the evolutionary diet of canines. Since the researchers didn't get their preconceptions validated using dogs, they switched to rabbits, whose natural diet is grass, and who thus never evolved any mechanisms for handling large dietary quantities of either fat or cholesterol. Not surprisingly, the poor bunnies' metabolism went berserk, and the researchers extrapolated this result to humans. Talk about confirmation bias.

Here's a personal related anecdote. Our dog Picasso is about 12 years old now. He was getting pretty porky and arthritic, and also began drinking a ridiculous amount of water, so I suspected he was developing doggy diabetes. I was going to take him to the vet, but first checked out the ingredients on his "healthy" doctor-recommended food. First ingredient: corn starch. I felt like a dope for not checking that earlier, and switched him to a diet of raw food, mainly patties made from ground up whole chickens, supplented with leftover bacon grease (we eat a lot of bacon here) and raw organ meats like heart, liver, kidneys, and tripe. The water-drinking issue disappeared almost immediately. Over time, Picasso has really trimmed up, looks like a young dog now, with a nice shiny coat. He's become a lot more friendly and playful now as well. People are always surprised to learn he's nearly 12. Hint hint: the evolutionary diet of humans is much closer to that of canines than bunny wabbits.

The other DVD is "My Big Fat Diet", which actually provides several examples of the healing powers of the human body. This documentary follows Dr. Jay Wortman as he treats metabolic syndrome in a group of Canadian Namgis First Nation people via a low carb diet. The results: not only did they lose fat, but also reduced or eliminated many of the other symptoms of metabolic syndrome along with associated medications. Even more striking was how the Namgis' sense of community and family returned as their bodies healed. Every time I watch My Big Fat Diet, I wonder how many of our various societal ills are fueled by poor health resulting from bad nutrition. The Western diet promotes a situation where the body perceives itself to be in constant crisis: insulin resistance essentially implies starvation at the cellular level, high blood sugar and dietary polyunsaturated fat contribute to glycative/oxidative stress, and hyperinsulinemia probably leads to chronically high levels of stress hormones like cortisol. Is it any wonder we find our society to be populated by individuals with greater focus on the immediate benefits to themselves rather than considering the much greater long-term benefits of contributing to societal well-being?

Another fun fact from My Big Fat Diet is how the Namgis used fat rendered from the tiny Oolichan fish to supply fat soluble vitamins, particularly Vitamin D in the winter. The Namgis traditionally made the association between the yellow color of the Oolichan grease and sunshine, which I thought was pretty insightful. I started a post on Vitamin D, but there's so much info out there already I decided I had little extra to add. Vitamin D deficiency is quickly making it's way into the mainstream medical consciousness as well, which is outstanding. The hormonal version of Vitamin D activates over 1000 genes (something I hope to learn more about in my new job), so it probably should not be surprising that Vitamin D deficiency can lead to a broad spectrum of health problems, particularly those like multiple sclerosis which are known to be influenced by genetic risk factors.

And it's very interesting to think about diseases like influenza, traditionally thought of as being primarily infectious and requiring immunization. But the influenza virus has certainly been around as long as humans, and it's hard to fathom how humanity could have survived if we were all getting knocked flat by the flu once a year. A whole tribe of hunter-gatherers on their backs with flu seems like prime cave bear food. And the flu doesn't behave like an infectious disease, as does the common cold. For instance, Google has a cool new resource estimating flu activity in the US, based on search queries. I've been watching this thing all winter, and it definitely does not show any sort of epidemic pattern. You'd expect flu hotspots to spread geographically over time, but instead the map is pretty much random. This sort of non-infectious pattern for influenza is generally observed, where it just pops up simultaneously in geographically separated locations rather than spreading.

A good hypothesis is that humans generally have a given flu virus all year (and I wonder if anybody has bothered to test for influenza antibodies in the summer). We carry all kinds of viruses all the time, they're just suppressed by our immune systems. But if the immune system becomes weakened, say due to Vitamin D deficiency brought about by lack of sunlight exposure in the winter, the virus can take hold and make you sick. Further, it is known that the majority of symptoms from both flu and cold are basically due to your own immune reaction, not the virus itself. The innate immune system uses cells like neutrophils, whose job it is to seek and destroy potentially infectious agents like viruses and bacteria using both physical and chemical means. But once ramped up, these hunter-killer cells will also destroy your own tissue, and so need to be moderated. If not controlled, your immune system will kill you, which is precisely what happened to victims of the Spanish flu epidemic (Epidemiol Infect 2006;134:1129–1140). What is the primary mechanism for moderating this immune response? Vitamin D.

Another personal anecdote: winter used to be medically difficult for our family, as it is for most people. We'd have our two kids at the doctor at least once a month for ear/sinus infections, strep throat, etc. and the we adults would usually drag around some kind of virus for a few weeks. But that's just part of life, right? Wrong. Since we began supplementing with Vitamin D in the winter (about two years ago), zero doctor visits. I don't even think the kids have had a fever in this time, certainly not one high enough to cause any concern. We do get sick, but it's minor, never more than an annoyance, and short-lived. While the other kids at school are dropping left and right from strep throat and flu, our kids now sail through pretty much unscathed. I've seen it multiple times with friends and family as well. They have some drawn out respiratory disease, like a persistent cough. When we finally get them on the Vitamin D train, it's gone, never to return. I also used to get bad hayfever attacks - no more. Yes, it's anecdotal, but this is what you'd expect from the well-established interaction between Vitamin D and the immune system.

So it's good to see the mainstream picking up on this. They seem to be "getting it" on other fronts as well, albeit slowly. MSNBC recently had a long article on omega-3's, which also discussed the general problems inherent in vegetable oils processed from seeds and soybeans. It's frustrating, because they get some of it "right" (in the sense that their conclusions follow logically from all of the available evidence), yet still are hung up on issues like dietary cholesterol and almost completely miss certain living elephants, as it were. I posted a longish comment on the article, but my essential criticism is one I've voiced before: if you start with bad or incomplete prior information, even the most rigorously logical analysis will lead to goofy conclusions. This in turn implies choices for diet, supplements, medical treatments etc. Read the article, and watch how some key assumptions lead to all kinds of wild inferences and extrapolations.

Michael Pollan's book "In Defense of Food" is another example of this. Though Pollan's "The Omnivore's Dilemma" remains one of my favorites, I had avoided reading "In Defense of Food", mainly because it espoused the mantra "Eat food. Not too much. Mostly plants." I'm all for eating food vs. factory produced foodlike substances, but the last two statements smack of dogma. But our local library decided to feature this book, so I thought I'd better read it in the interest of causing trouble.

Pollan gets some of it right (again, in terms of drawing logical inferences from the available evidence), but frustratingly misses the big stuff, like the total lack of evidence that dietary fiber contributes to health, or that red meat consumption causes disease. For instance, he discusses Good Calories, Bad Calories, but cherry-picks the evidence that apparently supports his preconceptions and ignores the rest. He rails against reductionism, apparently following in the footsteps of T. Colin Campbell (just about the worst possible choice), missing the point that the point of studying isolated aspects of nutrition and metabolism is to inform the "big picture". While a complex system like the human body may be greater than the sum of it's parts, you certainly have no hope of understanding the whole without at least understanding the parts.

Pollan then gives 24 rules which we should follow when selecting and eating food. This is a great example of how starting from goofy assumptions just leads to over-complication. Who is going to walk around a store or look at a menu and mentally check off 24 different things? There's no way that the simple act of eating should require that level of mental effort; it certainly didn't for our hunter-gatherer ancestors. Some of his recommendations are good, like shop at your farmers market or eat wild foods, but a lot of it is just nonsense. For instance, he wants us to "Eat slowly". What other animal consciously regulates it's rate of food intake? Do lions devour their prey at a measured pace, and teach their young to do the same? Like most, Pollan is enthused about a plant-based diet, all hopped up on the idea that we require thousands of different phytonutrients for health. The evidence for this? "In all my interviews with nutrition experts, the benefits of a plant-based diet provided the only point of consensus." Really - after extolling the evils of "nutritionism" for half the book, now you're going to follow the consensus of nutrition experts? Aren't these the same boobs who developed ideas like the food pyramid? Take a walk around your local mall, and you can see how well that's played out in the context of human health. Remember also that scientific consensus rarely is the result of critical examination of the evidence. Rather it's a social phenomenon: the scientists keep repeating the same thing to each other, and eventually it becomes "truth". If you're lucky, somebody with half a brain gets the ball rolling by actually making a logical inference from evidence, but the usual situation is that of the diet-heart hypothesis, where an initial unproved hypothesis turns into scientific "fact" simply through social forces.

Pollan further wants us to focus on eating leaves. This recommendation certainly makes sense for a cow or a gorilla, both of which have vast digestive tracts built for the long process of breaking down cellulose and freeing the nutrition in leaves. Both animals also eat enormous quantities of leaves to meet caloric requirements, e.g. upwards of 60 lbs. daily for a gorilla. Of course humans can predigest leaves through cooking, and we can add fat to help assimilation of the micronutrients, acids to neutralize antinutrients like phytic acid, etc. But those are recent developments in the course of evolution. Humans almost certainly did not evolve getting any significant calories from raw leaves. Our digestive systems just can't handle it, and you need to eat many pounds of leaves daily to have any hope of of meeting caloric requirements. It seems far more likely that humans would have gravitated toward more calorically dense plant foods, like fruit, nuts, and starchy root vegetables. Of course the most nutritionally dense foods are of animal origin, including seafoods, organs, and eggs.

Pollan's first rule is the worst: "Don't eat anything your great grandmother wouldn't recognize as food." First of all, I don't have the faintest idea what my great-grandmother would or would not consider food, and since she's long since passed on, I can't ask her. But given that margerine popped up over 100 years ago, I would guess that would pass as food for her. Does that make it okay to eat margerine? And how about bread? Great grandma probably considered "bread" as food, but bread is the end result of extensively processing wheat, which in its raw state would be toxic. So is bread "food", and should I eat bread? Evidence seems to be mounting that the answer is "no". So this guideline is pointless.

The mental processing required to figure what to eat should be low. Humans evolved as omnivores, which means we can eat a very wide variety of foods. Any minimally processed food that doesn't taste bad or make you immediately ill is almost certainly going to be healthy (I'm trying to think of a counterexample, with no luck). If your food requires a lot of technology and industrial processing to render it edible, you might want to rethink whether it actually qualifies as "food". Dr. Sears makes this point during his bonus interview on the Fat Head DVD, noting that had our ancestors tried raw grains or soybeans, they would have found them distasteful and contracted a painful bellyache, not exactly a stimulus to eat more of those foods. Unlike fruit, which evolved to be desirable to eat in order to spread seeds, grains and legumes do not want their seeds to be eaten, as that of course prevents those seeds from ever growing into plants. So these plants developed a variety of chemical and physical defenses to discourage predation. Some animals, notably birds, responded with adaptations which allow them to flourish on grains (birds have a crop used to grind up the grains, and enzymes to block anti-nutrients like protease inhibitors). Mammals (and humans in particularly) generally lack these adaptations. Note, for example, the effort required to prevent grain-fed cattle from dropping dead inconveniently early.

The wonders of science allow us to turn wheat and soybeans into foodlike substances that at least won't immediately put you in the hospital, and of course these pseudo-foods are made more attractive by formulating them to appeal to innate flavor and texture triggers like fattiness, saltiness, and sweetness. But in our industrialized food environment, we can no longer rely on our senses to distinguish what is good to eat. By contrast, we see "primitive" peoples able to thrive on a wide variety of foods obtainable from their environment, from the flesh/fat laden diet of the Inuit to the largely carbohydrate-based diet of the Kitavans (supplemented with seafood for certain minerals and fat-soluble vitamins). The common thread is that they pretty much directly eat what they obtain from their environment, and intervening processing is usually minimal and aimed at either making nutrients more accessible (cooking) or for preservation (drying/smoking). They don't need 24 rules to figure out what to eat, and neither should we.

Returning to the point about whether or not bread is "food": the role of grains in the modern diet deserves examination. Let me start by putting some context around this. It is, I think, increasingly clear that our "diseases of civilization" are strongly rooted in metabolic disturbances caused by food. Volek and Feinman have made a very strong argument that "metabolic syndrome" can be defined by the response of an individual to dietary carbohydrate, and that the cure is removal of such from the diet. This hypothesis is supported by many scientific studies, both "Fat Head" and "My Big Fat Diet", as well as the personal anecdotes of many thousands (including myself, having lost 100 lbs. and restored many aspects of health on a low carb diet). But the cause of a disease is not necessarily the inverse of the cure, i.e. just eating too many carbohydrates doesn't necessarily cause metabolic syndrome. The traditional diet of the Kitavans and Tarahumara is carbohydrate-based, but neither group develops metabolic syndrome. So I'd venture that it's the type of carbohydrates that drive the development of metabolic syndrome. Once you've broken your metabolism, then any significant quantity of dietary carbs will cause you problems, but what got you to that broken state? For example, your gasoline-powered car can go a long time burning gasoline with no significant issues. Put diesel in the tank, though, and you've really screwed things up, and no longer can use gasoline as fuel until you've fixed the damage done by the diesel.

Now I'll be the first to admit that this question is sort of academic. After all, if you just ate low carb across the board, you'd avoid any subclasses of carbohydrate food that could contribute to chronic metabolic problems. But the reality is that our food environment is flooded with refined-carbohydrate-rich (pseudo)foods. They are deeply ingrained in our culture, pushed on us from every direction. And there's also the issue of what to eat if your metabolism is not broken. I think about this particularly in terms of what to feed my children. Is it better to let the kids eat a slice of pizza or french fries? Chocolate-covered pretzels or a lollipop? And you can't monitor their food intake 24/7. You know they'll be offered crap from every direction when you're not around, so how can you teach them to make reasonable choices, e.g. taking bad instead of worse?

I don't think the scientific evidence is really there to provide a definitive answer. But we can make some reasonable guesses based on what is known about various aspects of metabolism and physiology and how these may hypothetically respond to various inputs. I'm increasingly of the opinion that in the spectrum of carbohydrates wheat is particularly bad. Stephan at the Whole Health Source blog has many articles discussing potential antinutrients in grains, definitely worth reading. One interesting aspect of grains are lectins, which are proteins that basically have the ability to bind to cellular receptors. Lectins in food are often not broken down to amino acids in the gut, and thus can cause mischief in the digestive system and, if they cross over into circulation (which they do), in the rest of the body as well.

Wheat germ agglutinin (WGA) has been studied in the test tube. If you Google "wga insulin receptor" you'll find a lot of papers, probably because WGA can bind to insulin receptors, which makes it easier to study various aspects of the receptor chemistry. From a physiological standpoint, WGA at least has the potential to be troublesome. For instance, not only does WGA bind to insulin receptors, it sticks there. When an insulin molecule binds to an insulin receptor, the whole complex is absorbed by the cell. One insulin molecule thus generates a specific and discrete response in a cell. When WGA binds to an insulin receptor, the complex is not absorbed, it just sits there activating at least part of the insulin signaling chain until it is knocked off (certain sugars accomplish this, like N-acetyl glucosamine). That's potentially nasty. In test tube experiments, at least, WGA is just as effective at insulin at stimulating glucose tranport and blocking lipolysis in fat cells. Stephan also notes that WGA has the potential to block leptin receptors. Leptin resistance is one of the hallmarks of metabolic syndrome.

It is, of course, treacherous to infer effects of grain lectins on a whole organism based on these test-tube experiments. I don't know of any studies which have really studied such effects in detail. But certain anecdotal evidence is at least consistent with the idea that wheat may play a special role in causing metabolic problems. Take the recent much-ballyhooed study of obesity in China. If you look at the data, you'll note that while there is a trend for the more obese subjects to eat more carbohydrates than the less obese, the differences are fairly small, on the order of 10% or less. By contrast, the most obese quartile for men at 5x more wheat flour than the least obese quartile. Hmmm.

The movie My Big Fat Diet provided another interesting bit of evidence. There's a big annual festival held by the Namgis each year. The chief (whose name escapes me) who had Type II diabetes and heart disease had been on a low carb diet for some time, which had allowed him to control his blood sugar entirely without any medication. At the festival he had one piece of "traditional" bannock, a deep-fried bread made from white wheat flour. His blood sugar then soared, and then did not return to normal for a week. Now I very much doubt that such elevated blood sugar was simply the result of the carbohydrate in the bread. Even given his impaired carbohydrate metabolism, this should have been cleared in the course of a day or so. But what if WGA from the flour was instead binding to insulin receptors and sticking there, causing his liver to crank out more sugar? Complete speculation, but interesting to think about.

Finally, I can relate my own experience. After going low carb, I would generally find that even moderate "cheating" would lead to some obvious long-term effects, the most notable was that I'd break out in painful acne. But one night we were at our favorite local restaurant. They have a wonderful scallop dish with a fantastic sauce, and the whole thing is on top of thinly sliced red potatoes. I decided to go ahead and eat the potatoes, mainly just to get at the sauce without being socially unacceptable by drinking it straight from the bowl. Interestingly, though this represented a lot of carbohydrates for me, it had no noticeable effect. I've reproduced this with potatoes a number of times, which seem to not freak out my metabolism when eaten in moderation. On the flip-side, even a small amount of bread will reliably trigger a breakout that lasts a week or more. A more dramatic example occurs with beer. If I drink even two or three premium beers now, I will get quite ill, and then suffer a week or so of acne. It's not the alcohol, because an equivalent amount of red wine or vodka has little effect beyond the usual buzz.

One final crumb for thought: why have we as a society developed such a love for wheat? There's plenty of other places you can load up on starch, such as potatoes, corn, and rice. But we seem to have a special soft spot for wheat-based foods, and cultures seem to be quite willing to displace other forms of carbohydrate with wheat (e.g. the Chinese as discussed above). Remember near the beginning of the post I noted that insulin stimulates the area of the brain known as the insula. One function of the insula is to mediate food-related rewards, e.g. eat some nice sweet fruit, get a bit of an insulin spike, and the insula reinforces that behavior. That makes sense from an evolutionary standpoint: fruit is nutrient dense, but doesn't last for long, so it's a good idea to load up on it while it's around. Certain addictive drugs like cocaine and opiates light up the same area, just with much greater intensity. Suppose WGA were able to get in to the insula and bind to insulin receptors there? That would probably reinforce our desire for wheat, even more so if WGA shows the "stickiness" observed in the test tube. Totally unproven hypothesis, but it seems like one worth testing.

Well, I think I've pretty much emptied my head at this point. Let me just close with a quote from Sir William Drummond:
He who will not reason is a bigot; he who cannot is a fool; and he who dares not is a slave.
I feel like this sums up the situation we currently face as a society. Too often, we rely on "experts" to think for us. In other words, we tend to be "slaves" (I personally believe that most people are not "fools": they have the capacity to think, they just don't bother). Yet these "experts" are far too often "bigots", driven by personal goals and desires rather than reason. Scientists generally don't engage in what constitutes actual science, in the sense of testing a hypothesis and objectively evaluating belief in that hypothesis, because there's no money in that. Instead they concentrate on confirming the beliefs of those who hold the purse-strings, and that makes them "bigots" in the sense described by Drummond.

So don't be a slave. All it takes to break free from the bonds the bigots would impose is to start using your own brain, and this intellectual freedom (and only this) will allow you to make choices which maximize your own health, wealth, and well-being.


Chris said...

great post

Stephan Guyenet said...

Hey Dave,

Nice post and thanks for the links. Your experience adds to my suspicion that carbohydrate per se is not the problem. As you said, the science isn't there yet to be able to make any definitive statements, but it's the only hypothesis I've got that can encompass all the data. It's amazing how many people find they don't tolerate wheat well when they avoid it for a while.

Dave said...


Drs. Cynthia and David said...

Enjoyed your thoughts. We're having similar experiences after supplementing with vitamin D too.

I've resisted the urge to read Pollan. Some of what he says is helpful I think, in recognizing the role of agribusiness in pushing unhealthy diets on us. And I'm quite fond of eating vegies with my meat- maybe the "mostly plants" is meant in terms of volume not calories!?

We're looking forward to seeing the movies you recommended.

Good luck with the new job. Is it with DNA2.0?


Dave said...

Thanks Stephan.

I ran out of steam and never did get in to the ideas that inspired to title of the post. The short version is the "devolution" I see in children, probably a consequence of a variety of factors, including deficiencies in fat soluble vitamins and way WAY too much wheat (and probably soy) in the diet. Very clear patterns emerge, e.g. there's a subclass of children with small narrow skulls and crowded teeth, almost always accompanied by overdevelopment of long bones giving the a gangly appearance. Feet are poorly developed, overly long, narrow, and flat. The body type is pretty closely correlated with behavior as well, mainly a lack of self-control. On fieldtrips, I've observed kids after eating their lunch consisting of chips, other chips, fruit juice, a bagel, and a cupcake. They go completely nuts, in some cases literally rolling around on the floor and screaming. Their parents, unfortunately, seem to be inured to all of this, taking it as "kids will be kids". Similarly, these children are often "sickly", displaying a host of allergies (most notably severe nut allergies), seem to constantly have some sort of respiratory problem, etc.

Put this in an evolutionary context, and I think it's clear we never would have made it as a species if this condition were the norm for children. Indeed, visitors to remote hunter-gatherers often express amazement at how well-behaved and independent the children are, despite how, compared to Western norms, the adults "spoil" them. Yet the connection is rarely made that these "primitive" people, supposedly living in squalor and filth, without the benefit of modern medicine/psychology/parenting books have children whose physical and mental health is generally superior to that of their civilized counterparts.

Another thing that consistently amazes me: I've gotten several friends on the low carb train. Yet despite the obvious improvements in their health, none of them translate that into their children's diets, feeding them piles of the same crap that led to illness in adult life. It's that "slave" mentality again.

Dave said...

Thanks Cynthia. Pollan is pretty good when he sticks to the sociological/ecological aspects of food. He strikes me as pretty sharp in the way he puts together various threads in that context, which makes it all the more disappointing that he didn't seem to put the same effort into grasping the scientific portion.

Personally I think plants are fine food. I like them too, particularly greens, provided they accompany 1-2 lbs. of steak :-) However, I don't think there's any rationale supporting the idea that we HAVE to eat mostly plants and eschew meat. There are enough counter-examples to pretty much squash that hypothesis into the dirt. But if you like your veggies, by all means have at it. Just don't forget the butter :-)

My new position is with Illumina. Can't say what I'll be working on, other than it will probably shake things up in the genomics world.

Anonymous said...

I'm glad you found a job, Dave.

Wheat is getting dissed a lot over the last few years, at least in the blogosphere. I'm skeptical about it being so harmful, but will try to keep my mind open to the evidence.

Many health and disease issues seem to be coming down to genetics. With one gene combo, wheat may be harmful. With others, no harm. And environment influences gene expression.

Maybe 20 years from now we can undergo individual genetic analysis, then devise an optimal diet and exercise program. Then we simply decide if we want to follow it.


Dave said...

Thanks Steve.

I agree that case against wheat is far from clear. But I think it is a strong hypothesis - lots of individual bits of evidence pointing in the same direction, and like Stephan says, it seems to explain the broadest spectrum of observations about nutrition and metabolic health. It would be very interesting to see a counter-example, a group which eats a lot of wheat but with a low rate of metabolic syndrome. Conversely, we need more controlled studies of the effects of lectins etc. on metabolism. Most of the evidence there is indirect or associative. And for modern diets, there seems to be an ubiquitous confound: societies moving to a wheat-based diet also seem to eat more sugar and seed oils.

I think I've mentioned this commenting on other blogs, but the Aztecs, with their corn-based diet, did not document many of the conditions associated with metabolic syndrome, like diabetes or heart attacks. They did leave detailed documentation for a variety of medical woes, including obesity, tooth decay, and angina. Another culture with a high-carb diet, but different disease profile than either Westernized societies or other high-carb primitive societies like the Kitavans. The lectins in corn bind to different sugars than those in wheat, so we might expect different physiological effects.

On the flipside, I really wonder why it is that grains are considered particularly healthy. They certainly don't make anyone's "superfood" list for micronutrients, and do not provide complete protein. Grain foods aren't really even palatable, unless you jazz them up with sugar, salt, or fat. Maybe that's personal preference on my part, but I don't think anyone is gobbling handfuls of low-fat, low salt whole-grain crackers.

Anonymous said...

My experiences with wheat and potatoes are similar to yours. I tested postive for gluten intolerance at Since going completely gluten-free, I've decreased my use of migraine medications by half.

Dr. B G said...

Glad your back! I've started to notice dental arches and jaw lines now too. Hard not to now having Weston Price information translated to modern times *wink*!

I've noticed that all the starlets/celebrities have very narrow dental arches and a certain jawline that bespeaks of high carb, high grain diets. Hilary Duff (who i enjoy some of her music, yes) particulary has a predominantly narrow jawline. Her diet has recently changed to low carb + resistance training so hopefully her mental outlook will stay stronger than her dentition.

People with diabetes who go low carb, grain-free instantly notice reduction in arithritis pains in 2wks and wt loss in 2-4 wks. It is really quite amazing. Is diabetes an auto-immune disease? or just WAG on the insulin receptors? Wheat and gluten do promote the genetic machinery for our 'stress' adaptations. Have you seen the FUNGENUT study?

I think your new j-o-b sounds cool -- we'll know more about our VDRs (taq, fok, bsm and others are getting well-characterized for their disease implications).

Pls share ur revelations in the future :)


Dave said...

Hi Dr. B G. Fashion models are increasingly extreme examples of the one of the "wheaty" body types: exaggerated long bones/feet, narrow faces and "delicate" jawlines, with a very narrow nose. This has now become the standard of beauty, so much so that people get plastic surgery to mimic it, which is a bit of a freak show, if you ask me.

My little daughter even came home one day asking some of the other kids said she had a "fat face". I told her it isn't fat, just wide, and that's the way healthy people's faces are supposed to look. She promptly asked for another bowl of sausage and egg yolks, which I take as a good sign :-)

Stephan Guyenet said...

Ha! That's great.

Dave, I wanted to ask you, do you have evidence for the statements you made about "wheaty" body types outside of Price's work? I would tend to agree with what you said, but if you have more evidence I'd be interested to hear about it.

Dave said...

Hi Stephan. No evidence beyond my own observations, e.g. standard of beauty was once Marilyn Monroe, Rita Hayworth, etc. Compare with what we see now. Similarly you can look at photos of people, and (at least I think) the differences are pretty obvious, at least until you get back to the Depression era, where you find a lot of wheatiness (hmmm, any coincidence there?) I've tried to do a bit of the Internet version of Weston Price's travels, looking at pictures of "primitive" peoples, especially their children, and have not yet seen an example of what I would call "wheatiness".

There's probably a decent hypothesis in there, connecting insulin and other hormones (e.g. estrogen) to the various skeletal growth processes. If lectins like WGA are mucking up the receptors for these hormones, the effect might be amplified.

Dave said...

BTW, in case anybody thinks I'm being judgmental about "wheaty" people, my body is about as wheaty as they come (see wheat-head in photo) :-)

Olga said...

Just curious about your comment that your family eats lots of bacon. Do you eat nitrite free bacon, or just the regular grocery store variety? I live in Ottawa Canada and I can't find the nitrite free stuff. Thanks for the great post.

Dave said...

Hi Olga. I don't worry about nitrites. I don't find the evidence of increased cancer risk from nitrites very compelling. My understanding is that the hypothesis was generated in studies on rats, where they gave the rats enormous quantities of nitrites to try and accelerate the disease process, which is predicated on some very sketchy assumptions about the associated dose-response.

Further, as with any potential carcinogen, the risk of actually developing cancer is likely modulated by other factors such as refined carbohydrate consumption (via insulin) and Vitamin D status.

Dr. B G said...


I've thought that too...! Cindy Crawford and other 'midwesterny' types come to my mind...even Gisele Bundchen w/her wide jaw seem more symmetrical v. pointy.

As your thoughts are transforming...don't worry -- so will the bode composition. You should consider ck'ing out Crossfit -- I got to but they are everywhere now (Wcr, Dublin, Livermore, Pls).


Dave said...

Hi Dr. B G. I'd love to do Crossfit, but don't really have the time now that I've had to take a real job (need to leave something for the family). I do manage to squeeze in a Slow Burn workout once a week or so.

But I don't think any amount of exercise is going to expand my skull :-)

Dr. B G said...


Hey I heard Slow Burn is great!! So is a J.O.B.!!

That's why I take fish oil...3-6 grams EPA DHA... It raises my IQ *hee* Requirement for my bloggin...


Olga said...

Thanks for the information about nitrites. I have long suspected that it's another exaggerated concern, but have never looked into it myself. Dr. Atkins also pushed the notion, so I made the assumption that perhaps there was something to it and so I erred on the side of caution. I think I'm finally at the point where, if I hear or read it in the popular press, I do the exact opposite. Thanks for sharing your wonderful research.

elhnad said...

What do think about Lyle Mcdonald's opinion on Gary Taubes as seen here:

In his April 17 comment, he accuses Gary of cherry picking his data as well.
Lyle is a very prominent coach in bodybuilding and fat loss. In my view, super low body fat percentages may be pleasing to the eye but doens't translate into superior health.

Dave said...


I've read some of McDonald's writings. I think he is very thorough, but takes a somewhat adverserial attitude which often indicates a lack of objectivity. Taubes necessarily picked a subset of metabolic research to keep his book to a reasonable length and readability for his target audience. And what I get from Taubes' book is not that he is asserting that insulin is the ONLY thing controlling metabolism, just that it's a big hitter.

There is no absolute truth in science. All hypotheses are likely to be "wrong" in the sense that we can never be 100% sure of their truth as we never know if we have 100% of the relevant information. That an existing hypothesis can be extended is does not mean it's wrong: it depends on whether that hypothesis is phrased as an exhaustive hypothesis of cause and effect. There's a big difference between the hypothesis "Insulin is the only hormone that controls metabolism" (what many people take away from Taubes' book) and "Insulin plays a major role in metabolic regulation" (what I got). The former is trivially refuted by finding any other hormone that affects metabolism. The latter requires that you demonstrate that insulin does not play a major role, and that something else does. And I don't think you'll find much evidence opposing the second hypothesis, and tons against the first.

I haven't read McDonald's work on low bodyfat. My own belief is that your body probably knows how much fat it needs, unless you screw up the energy regulation systems. The body evolved to be robustly maintain a healthy state in the face of a variety of environmental conditions, most notably food intake. My guess is that if you stick to the kinds of foods we evolved to eat and have some reasonably level of physical activity, your body will figure out the rest without you having to measure your bodyfat percentage.

Dana Seilhan said...

This is brilliant. But here's another thought. We know from paleopathology that there are definite differences between farming cultures and forager (hunter-gatherer) cultures, and you can tell which type of culture a specimen is from just by looking at the bone structure.

This is universally true. They've found differences in every region of the world they've looked at, including North and South America.

But here's the kicker. Wheat is not indigenous to the New World. So how is an increase in grain producing chronic disease and underdevelopment in cultures that have not encountered wheat, if wheat is the only real problem?

I think they're going to find that wheat is A major problem in the diet and is ONE means of producing chronic disease. But there will be other factors as well. I think in the end all the seed carbohydrates will be implicated, if only for different reasons.

Even in Weston Price's data, guess which traditional group had the most dental caries? The Swiss. Guess which group ate the most bread? The Swiss. They still had a remarkably low number of dental caries per person compared to city Swiss who'd abandoned their traditional diets. Sourdough leavening and high dairyfat intake probably saved them. But they still didn't have as good of dental health as, say, the isolated, traditional Inuit.

It's all a continuum. IF you must eat grain, some grains are safer than others and some preparation methods are better than others. But you'll probably be healthier eschewing grain entirely. Even the traditional Kitavans get their carbohydrates from tuber starches, not corn or rice.

Dana Seilhan said...

Oh, couple more thoughts:

I have noted far more mental well-being in myself when I follow a high-fat regimen (low-carb or not, although low-carb seems to do better for me) than otherwise, and most of it has to be animal fat. Of the plant fats, I thrive on coconut and olive oils best (more the former than the latter).

My mother will be 56 this December and has been diagnosed a type 2 diabetic since age forty. She's suffering from mental illness now and on all kinds of meds. Ten years ago I happened to get a look at her blood sugar journal. Her numbers were all in the 200-400 range. I don't know how the woman is still able to walk, see, and stay off dialysis. Given my own experiences with blood sugar swings and mental instability, it's not hard to figure out what else is wrong with her.

Every time I see a low-carber suggest that new low-carbers donate their excess carbs to a food pantry I get very, very angry. Mom's in poverty, has been for years. (I've been too, or I wouldn't be writing this because I'd have taken her in to help her long ago.) She gets food donations from the local pantry. Most of it is rice and beans and noodles. Did I mention she's a type 2 diabetic? Just because you're poor doesn't mean you're healthy. In fact, you're less likely to be, at least in the United States. I recently learned that animal foods are the most difficult foods for food pantries to keep in stock.

I'm starting to think the fix for our society does not lie in ideology or tax schemes but in securing the right to access animal foods for everyone, regardless of social class. Whatever else kind of foods you want to eat, everyone needs animal fats at the very least. We're dying out here and malnutrition is the cause.

montmorency said...

Bacon: personally I do worry a little about nitrites (in bacon and processed meats generally), but one could relatively easily make one's own bacon from belly pork. (Barry Groves gives a recipe in one of his books), but what I personally prefer to do is just eat the belly pork.

Female physical ideals in days gone by: I'll resist the temptation to post a picture link, but can I just put in a mention for Barbara Stanwyck in her "Double Indemnity" days, and Veronica Lake in her "Blue Dahlia" period (with Alan Ladd).

Moving swiftly on:

McDonald: I've looked at his stuff, and as has been mentioned, the adversarial nature of his comments is rather off-putting. Same with Colpo. But the target audience of people like that is not the average, say 75% of the population who are not ultra-marathoners and are at least somewhat prone to overweight.

They are aiming at jocks who are trying to squeeze the last percentage point of "performance" out of their bodies, and are prepared to pour carbs down their throats to achieve it. They criticise low-carb because it affects their "performance" in high-intensity sports.

I have to ask myself: what precisely is the point of these high intensity sports? What are they trying to prove? I admire the bravery of, say, the riders in the Tour de France and enjoy watching it on TV (mainly for the beautiful scenery), but in terms of health, what those riders are doing to themselves seems like sheer lunacy to me. At least they are being paid for it; why one would go to similar extremes and not be paid, I can't imagine.

As for cherry picking, I think when push comes to shove, there is a tendency to accuse one's opponent of things one either has done or would like to do. Taubes has said on numerous occasions that if he'd included in GC, BC all the material he'd found, it would be about three times as long as it ended up.