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February 20, 2013

Should You Worry About Wheat?

Wheat has long been a dietary pariah for the millions of people who have jumped on the low-carb-diet bandwagon or who think they’re allergic (or at least sensitive) to the grain. Now even more people are hesitating about eating wheat after reading the claims made by William Davis, M.D., a cardiologist and author of the bestseller Wheat Belly, which is subtitled “Lose the Wheat, Lose the Weight, and Find Your Path Back to Health.”

Not only does wheat make us fat, Dr. Davis says, it is addictive and causes everything from heart disease, diabetes and obesity to arthritis, osteoporosis, cognitive problems and cataracts. In fact, he claims, it has caused “more harm than any foreign terrorist can inflict on us.”

Wouldn’t it be great if there was a single villain behind the chronic health problems plaguing us, and if all it took to reverse them was to stop eating wheat? It's true that those with celiac disease, an increasingly common genetic disorder in which gluten (a protein in wheat) causes an autoimmune response and symptoms such as diarrhea, bloating, cramps, weight loss, fatigue and more, do have good reason to avoid wheat. (For more information, you can contact the Celiac Disease Foundation or the Celiac Sprue Association.) And about 6 percent of Americans are thought, rightly or wrongly, to be gluten-sensitive—a condition that's the subject of much debate—but don't have celiac disease.
But for the rest of us, there doesn't appear to be one sole dietary scoundrel.

Claim: Most grains are bad, but modern wheat is the worst because it has been altered over the years via selective breeding and is now a virtual “Frankengrain.” It is loaded with amylopectin A (a starch unique to wheat), which is “worse than table sugar,” Dr. Davis says, boosting blood sugar dramatically and stimulating appetite. Modern wheat also contains other components with adverse effects, and its gluten, a protein, is more likely to trigger reactions than that in older wheat.

Fact: For well over a century, food scientists have developed hybrid varieties of wheat to be sturdier and have higher yields, better quality and greater resistance to disease and insects. That’s true of most food crops. There’s no clinical evidence that differences between today’s wheat and older varieties have adverse effects on our health. It’s all supposition on Dr. Davis’s part, and feeds into pervasive fears of modern agricultural methods. We think this particular fear is unfounded.

Claim: Wheat is the main culprit behind the obesity epidemic.

Fact: Wheat is a staple in most parts of the world, and there’s little or no correlation between regional intakes (as a proportion of daily calories) and rates of obesity. Per capita wheat consumption in the U.S. has actually dropped since 2000, but there’s no sign that that is slowing the expansion of our waistlines.
In fact, a century ago Americans ate much more wheat than we do today, and very few were obese (granted, diets and lifestyles differed in many ways then). In any case, the obesity epidemic certainly can’t be attributed to any single factor.
What about Dr. Davis’s claims that when he told his patients to avoid wheat they lost weight and become healthier? As with nearly all diet books, this is only anecdotal evidence, but it’s not surprising. Had he told his patients to cut out all meat or all sugary snacks, for instance, they might have done as well or better. Nearly all diets work for a while, especially in supervised settings, usually by getting people to avoid whole categories of foods and thus tricking them into cutting calories. Keep in mind, too, that Dr. Davis basically recommends a low-carb diet, and well-designed studies have found that such diets work no better than other diets in the long term.

Claim: Wheat has played an outsized role in surging rates of diabetes, heart disease and other chronic disorders.

Fact: There’s no evidence that wheat bears special blame for these. Blood sugar does rise after eating bread, pasta and other wheat products. But that’s true of any foods containing carbohydrates—even those in gluten-free products—especially if the grains are refined.
The effect of carbohydrate-rich foods on blood sugar, which is ranked by the “glycemic index” (GI), depends on many factors, including how much fiber is in the food, how the food is processed and prepared and what else is in the meal. Wheat ranks moderately high on the GI. But research looking at the effect of a high-GI diet on weight control and the risk of diabetes and heart disease has had inconsistent results.
Refined wheat, like other starchy or sugary foods, can also have adverse effects on blood cholesterol and triglycerides—for instance, increasing levels of the small, dense LDL cholesterol particles that are most damaging. To avoid this, you needn’t avoid all wheat or go on a very-low-carb diet. Just choose healthier wheat products that are minimally refined or unrefined, and don’t go overboard.

Claim: Whole wheat isn’t much better than refined wheat, so overweight people and those with chronic diseases should avoid it as well.

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Fact: Many studies have linked higher intakes of whole grains, including whole wheat, with a reduced risk of diabetes, heart disease and stroke, as well as improvements in blood cholesterol, blood pressure and blood sugar control. Other studies have found that whole wheat can help people control their weight and/or lose body fat, especially when they eat it in place of refined-wheat products. Thus, the Dietary Guidelines for Americans, American Heart Association, American Diabetes Association and most nutrition experts recommend foods made from 100 percent whole grains.

Bottom line: Unless you have celiac disease or another type of gluten intolerance or sensitivity, there’s no reason to avoid wheat. No doubt many Americans eat too much refined wheat, usually in the form of cakes, cookies, pizza and other foods loaded with added sugar and/or fat (which can double or triple the calorie count), as well as lots of sodium.
Cutting down on such wheat products can help people lose weight and improve their overall diet, provided they substitute lower-calorie foods. But 100 percent whole-wheat and other whole-grain products can fit well into a healthy diet, as can many refined-wheat dishes that include nutritious ingredients, such as pasta with vegetables. As with so many dietary matters, moderation is the key.

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