Monday, April 16, 2012

Wheat Belly? Wheat BERRY!



Diet books come and go - the shelves are filled with titles that generally go unnoticed. Every once in a while there comes a book that, as a dietitian who works with the public, you just know you have to read. Wheat Belly, by William Davis MD, is one of them. Actually, it is probably THE book to read in 2012 if you are interested in this sort of thing. 


The premise of the book (spoiler alert!) is that wheat (and gluten - for which he uses the term "wheat" incorrectly and interchangeably) is the reason we are sick, fat and inflamed. To his credit, Dr Davis (and/or his editor at Rodale) knows how to spin a yarn. He has a very convincing and direct style - the only acceptable conclusion to the information he presents is that wheat makes us ill. In fact, Dr Davis' writing would be very much at home on the gossip sites - such is his sensational story-telling style. His arguments might be very convincing, until you look a little closer. 


Franken-wheat?
Core to his argument is that modern wheat has been cross-bred to the point that it barely resembles the wheat we ate even 50 years ago. I won't argue that our 42 chromosome modern wheat is anything like the 14 chromosome einkorn wheat and that, according to a baker friend of mine, it is "much stronger" than wheat commonly used in Europe. It is also true that Celiac Disease is increasing in numbers; it is estimated that 1 in 133 of us have Celiac Disease and we might not even know it. And non-Celiac gluten sensitivity is also on the rise. Dr Alessio Fasano, one of the heavyweights of Celiac research, estimates that 6% of us have gluten sensitivity. So for those of us who fall into those categories, wheat and gluten do make us sick. But those numbers do not equal 100%. Dr Davis is a cardiologist, not a Celiac specialist.


1+1=3?
My biggest concern with the book are the Swiss cheese-like holes in his logic and the way he cherry picks his evidence to support his arguments. Dr Davis makes the case that the molecular structure of wheat causes it to raise your blood sugar more than any other food. Then he tells you that you must also avoid most gluten free alternatives because they also raise your blood sugar. If it truly was the wheat/gluten (which one is it?) raising your blood sugar, then shouldn't gluten free options not have the same effect? In reality, it is all of our processed wheat products that wreak havoc with our blood sugar - any processed grain food, be it rice, oat or quinoa will do the same. Dr Davis knows that - his diet plan is pretty low on grains of any sort. Here are just a couple more of his transgressions:


1. Dr Davis claims that gluten acts like an opium-like drug in our system, making it addictive. To back up his argument, he cites a study from 1979 which used a concentrated gluten sample that had 10,000 times more opiate-like activity than the original 100g sample of gluten it was derived from. If you drank a glass of wine that had 10,000 times the alcohol...you wouldn't be so alive. The poison is in the dose.


2. Dr Davis also claims that newly diagnosed Celiacs lose weight when they eliminate gluten. The study he incorrectly cites to back his claim actually found that 82% of already overweight patients gained even more weight on a gluten free diet. People with Celiac Disease generally have malabsorption issues; as their gut heals and they are better able to absorb nutrients, weight gain isn't uncommon. In addition, many gluten free foods have lower fibre than their gluten-containing counterparts - making them easy to overeat and contributing to weight gain.


Yes, but....
I agree with Dr Davis on this: wheat has a large part to play in our current diabesity epidemic. But it isn't the wheat itself - our biggest sin is what we have done to the incredibly nutritious wheat berry. And the fact that we eat it 4-6 times a day in place of healthier foods like fruits, vegetables and beans. I have never met anyone who had blood sugar issues or uncontrolled appetite or weight gain from eating a wheat berry salad. I will bet $20 that many of you have never actually seen a wheat berry! Take a peek here. Cup for cup, they are higher in fibre than quinoa and have almost as much protein. And we call quinoa a superfood. Using more sound logic, by that rationale, wheat berries should be superfood too.


I have met a few people who have lost significant amounts of weight on Dr Davis' plan. And the internet is packed with glowing testimonials. That his plan works is not part of the debate. If you, like most North Americans, gave up all the processed wheat products you currently eat there wouldn't be much left but a bit of meat and a few veg. You would be, in fact, on a low carb plan much like Atkins or South Beach. Those plans help you lose weight because they replace high calorie, unsatisfying food with very satisfying options that result in a lower calorie intake. 


Dr Davis knows this. He also would know, after years of counselling, that people will have less trouble following a diet plan if the rules are clear and concrete. If wheat and gluten are poison, it is easier to rationalize avoidance of a whole food group. It takes willpower out of the equation somewhat because the overarching diet philosophy is so black and white. If you simply hear that you should "try and avoid processed grain foods" which is the kind of sane nutrition advice a dietitian would give - it requires you to make constant judgements about the definition of processed, how much is too much, etc. Much easier to rationalize falling off the wagon. 


Do the ends justify the means?
What bothers me most about this book is that it further confuses an already confused public, nutritionally speaking. Yes, you can lose weight by avoiding processed grain foods like cereals, granola bars and cookies. No, wheat is NOT the same as gluten. Wheat contains gluten but so do other grains such as rye, barley, spelt and commercial oats. Eating a wheat berry will not cause the health effects outlined in Wheat Belly (unless you are gluten sensitive or intolerant, in which any crumb of gluten will trigger a reaction). If you think gluten-containing foods are causing illness, you should go and get the tTg blood test to screen for Celiac Disease so you can get the medical care you need and nutrition support to help you fully adopt a gluten free diet for life. Because a lot of foods that have nothing to do with bread - BBQ sauce, ice creams and trail mixes - contain gluten.


Yes, wheat contributes to weight gain but only because we abuse it, not because it is some franken-plant. Sure, having a diet rich in processed (usually wheat) foods can contribute to acne but only because unstable blood sugars lead to acne-promoting inflammation and usually leave a person without much in the way of nutrition to support healthy skin. Switch all your processed wheat to wheat berries and let's see what happens.


The bottom line
If you take one thing away from Wheat Belly (and this review!), I hope it is this - we are not meant to eat wheat 6 times a day and we should not eat such poor quality, processed wheat foods all the time. Just please don't allow his mis-information to cloud your mind. You are savvy, intuitive eaters - real food brings health, processed food diminishes it. Now go enjoy an apple. You know, to keep Dr Davis away. 


A HUGE thank you to Melissa Baker, Marianne Bloudoff, Kim Lucas - three very savvy future dietitians - who took the time to dig deep into the science behind Wheat Belly. Marianne has her own blog, French Fries to Flaxseeds. Follow her on Twitter here. Melissa, who has been one of my amazing volunteers this year, also has a Twitter page here
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