I read your letter and am here to help. With all the recent hype about Wheat Belly and gluten-free diets, it is hard not to think there must be real science supporting the trend.
Wheat’s biggest foe for the last two years has, without a doubt, been Dr. William Davis, cardiologist and author of the book Wheat Belly: Lose the Wheat, Lose the Weight and Find Your Path Back to Health.
What’s so wrong with wheat, anyway? We all recognize that the Mediterranean countries have successfully been eating wheat as part of a healthy, balanced diet for centuries. I thought it was worthwhile to put Wheat Belly to the test and take a closer look at the claims in the book.
Wheat Belly – The Good
Wheat Belly does contain some interesting and accurate scientific information.
- We’re a carb nation – Most Americans (probably myself included) eat far too many carbohydrates, including wheat, and don’t come close to eating enough fruits and vegetables. When I ask my obese patients to take me through their daily diets, most eat 1-2 servings of fruits or vegetables a day, which is far less than the recommended 5-13 servings. If you’re eating a 2000 calorie diet, you need 9 servings (about 4 ½ cups) of fruits and veggies a day. And no, ketchup does not count as a vegetable.
- We eat too much – As the book points out, too many calories and carbs contribute to obesity, diabetes and high cholesterol – all of which contribute to the #1 cause of death in women (and men, for that matter) – heart disease (see here). So it follows that cutting back on calorie-dense carbs will certainly lead to weight loss and improvements in cholesterol and blood glucose numbers. Though this could also be done just by decreasing portions of all foods, not just carbs or wheat.
- Celiac Disease is attributable to wheat – This is the one disease mentioned in the book that actually IS attributable to wheat but is rare (U.S. prevalence is 0.71%) (see here). Most people do not have this condition, characterized by diarrhea and malabsorption, which can be diagnosed on a simple blood test. Irritable bowel syndrome (IBS) and other GI woes are unlikely related to wheat, though there may be a non-celiac IBS-like condition that responds to a gluten-free diet (see here). But before you decide to eliminate wheat, check with your doctor.
Wheat Belly – The Bad and The Ugly
Dr. Davis makes numerous outrageous health claims about wheat in his book, and here is just a sampling:
The first two claims above are completely unfounded, and Dr. Davis takes huge leaps of logic to reach these conclusions. Simply put, the science does not support those two particular arguments.
The other claims in the list above are all related to carrying excess body weight and cannot be attributed to wheat alone. And here lies the major flaw of the book – it’s being overweight, not wheat, that is actually wreaking havoc on our bodies.
Let’s take inflammation as an example. Dr. Davis points out visceral (belly) fat functions as an organ in the body – an inflamed organ that releases inflammatory cytokines into the bloodstream. These cytokines are cell signaling molecules that invoke a number of responses. For starters, they worsen arthritis and add to pancreatic injury that is already occurring in diabetics and pre-diabetics.
There are many more examples of this sort of logic in Wheat Belly. But the bottom line is, wheat ≠ inflammation ≠ obesity ≠ the root of all evil.
My most recent patient success story actually didn’t have anything to do with wheat. I have a patient who was drinking 130 ounces of Dr. Pepper a day. That’s 1625 calories per day of liquid love handles! Not surprisingly, when he cut that out and stopped eating fast food, he lost 13 pounds in two months. And even with this relatively small absolute weight loss, his cholesterol improved and his pre-diabetes vanished.
The Whole Story about Whole Grains
Unfortunately, Dr. Davis leaves out an important part of wheat’s story – the proven health benefits of whole grain wheat and other whole grains.
Consuming whole grains has been associated with:
- Lower cholesterol
- Decreased risk for diabetes
- Lower risk of heart disease and all-cause mortality
Why are whole grains (including wheat) superior to refined grains? It most likely has to do with glycemic index, the rate at which blood sugar rises after eating certain foods. Whole grains still contain the bran and germ (fiber) that are removed in the grain refining process. While refined grains – white flour, white rice – have a high glycemic index (rapidly spike blood sugar levels), whole grains are generally lower glycemic index. A good rule of thumb – the more fiber in a food, the lower the glycemic index. Spikes in blood sugar associated with ingestion of high glycemic index foods lead to metabolic syndrome – high cholesterol, insulin resistance, and obesity. And the reverse is also true – eating lower glycemic index foods like whole grains, fruits, and vegetables lowers this risk of these conditions (see here).
Wheat Belly – Final Exam
In my book, there’s nothing wrong with incorporating whole wheat as part of a healthy diet. In Dr. Davis’s book, on the other hand, there are plenty of anecdotes of miraculous “cures” for his patients who eliminate wheat from their diets.
I don’t doubt the Wheat Belly stories, just the reasons behind them.
So why might people feel better after eliminating wheat?
- They lose weight – Restricting anything you are prone to overeat (Cheez-Itz, Oreos, pasta) will help you lose weight.
- They get a higher proportion of their calories from protein – What’s left after you eliminate the bread from your lunchtime sub? A salad with lean protein. This increase in the proportion of calories from protein leads to greater satiety. Simply put, protein fills you up more than carbs.
- They increase fiber intake – Because of their fiber and water content, fruits and vegetables also make you feel full, similar to protein. For example, which do you think would fill you up more – four Oreo cookies -OR- five cups of romaine lettuce topped with a carrot, a tomato, and a cucumber with an apple on the side? (They both have approximately 220 calories.) Fiber also helps relieve constipation and IBS symptoms.
I would be remiss without mentioning another fashionable argument against wheat. Yes, “Wheat contains antinutrients” seems to be quite the common catch phrase these days.
- It’s true. Wheat contains phytic acid, aka phytate, the storage form of a plant’s phosphorus. As do all plants. When something that contains pyhtate is eaten, phytic acid binds to certain minerals in the gastrointestinal tract, and too many bound minerals can lead to mineral deficiencies (severe mineral deficiencies could eventually result in osteoporosis or rickets).
- By dry weight, nuts (particularly brazil nuts, almonds, and walnuts) generally contain more phytic acid than similar amounts of grains and legumes (see here). Phytic acid is also present in coconut meat.
- Research is constantly evolving regarding the healing compounds of plants. Despite all the bad PR surrounding phytic acid, it may have some potential health benefits. Phytochemicals have been known to exhibit potent antioxidant activity (see here). Preliminary research also shows that it can stop growth of certain breast cancers (see here).
The anti-nutrient argument is an argument against excessive ingestion of wheat, legumes, or nuts, not an argument against these foods in absolute terms. You will likely maintain a balance between high-phytate foods versus the nutrients affected by phytate if you are eating a wide variety of foods in your diet.
In fact, the risk that any adult in the U.S. would suffer severe manifestations of nutritional deficiencies is exceedingly rare. In my eight years of interacting with patients, I have only seen one case of severe nutritional deficiency – we diagnosed a patient with scurvy (vitamin C deficiency) and later found out his diet consisted of only the meat portion of Salisbury steak TV dinners.
Above all, keep in mind that “wheat-free” is one in a long line of America’s fad diet obsessions. And diets are only effective so long as you can maintain them your entire life.
A more sustainable approach is balance – a variety of fruits, vegetables, whole grains, and lean proteins.
Michael Pollan says it best: “Eat food. Not too much. Mostly plants.” … including whole grains.
Mary is a regular guest contributor to Good Not Perfect. Mary grew up in Kansas City – raised by two science lovers – and met Laura and Emily during her stint as a Hoosier in college. She currently lives in Denver with her husband and two daughters and works as a physician in internal medicine. She aspires to be one of those women still running 10Ks in their 70s, and her bucket list includes visiting all 59 U.S. National Parks.