Wheat Belly Book Review

“Wheat Belly” (2011) by William Davis, MD is the first of a triumvirate of books that I have read or am reading that take a critical look at the food we eat. The other two books are “Grain Brain” and “Salt, Sugar and Fat”. In these books associations are drawn between our modern diet and modern maladies. They capture the essence of the clash between the advance of technology and the evolutionary legacies of our biology.

Grains and the gluten within them are major players in two of these books. It is put forward in “Wheat Belly” that wheat is not only a problem for people with celiac disease but a scourge underlying many of the metabolic diseases that have reached pandemic proportions in Western countries and increasingly in the rest of the world. Diabetes, Heart disease, Metabolic syndrome, Crohn’s disease and Arthritis are some of the maladies that are attributed to the changes in quality and quantity of gluten in our diet. It does not matter whether you eat whole wheat or processed wheat the concerns raised in “Wheat Belly” are pertinent to both. The concerns about increased appetite and effects on metabolism and cognition are intrinsic to modern wheat itself and do not vary with method of cultivation.

Wheat Belly takes us through the evolutionary history of wheat from an ancient grain to our present day marvel of modern agriculture. Selection by man has become much more invasive over time and culminated in the hybridization efforts undertaken by the International Maize and Wheat Improvement Center in Mexico which was focused on increasing yields. Norman Borlaug has been lauded as a driving force leading these efforts being called the “Father of the Green Revolution” and awarded the Nobel Peace Prize. The dwarf wheat strains derived through his efforts are now predominant in agriculture and are estimated to comprise 99% of wheat cultivated worldwide. Praise for Dr. Borlaug is well deserved for achieving the goals of increasing yields substantially and converting grain shortages into surpluses. However over time the unintended consequences of his efforts have emerged.

A tangent on GMOs.

It is interesting to contrast the perspective of the 1960s and hybridization of plant strains with broad manipulation of genomes through hybridization with today’s debate regarding Genetically Modified Organisms (GMO’s) which often only possess a single modified gene. My view is that the whole discussion of GMO’s is muddled with many babies being thrown out with the bath water while valid concerns are overlooked.

One very legitimate GMO concern is the impact of the high concentrations of pesticides used for GM crops engineered for resistance (Yes, I mean you Glyphosate/Roundup/Monsanto). The argument for safety of glyphosate is that the shikimate pathway is not present in humans and animal cells which is a legitimate point. HOWEVER, as an organism we are walking ecosystem comprised of many bacterial and fungal commensal organisms which are sensitive to these compounds (BTW 90% of the cells in our bodies are not human cells). The emerging study of this human microbial ecology called the microbiome and the substantial impact of the microbiome on our health and behavior is a completely legitimate reason to be concerned about the unintended health consequences of  herbicides and pesticides in our food.

Unintended consequences of Modern Wheat

Blood sugar spikes due to efficiency of digestion of wheat carbohydrates. Wheat actually spikes blood glucose levels more than table sugar. Glucose spikes are the drivers of fat accumulation (thus “Wheat Belly”), insulin resistance and Diabetes.

Modification of gluten composition. Majority of protein composition of wheat are gluten family proteins. Modern wheat has a higher protein content which makes the texture optimal for baking. These properties are mainly due to quantitative and qualitative changes in gluten proteins. The most obvious clinical condition related to glutens is celiac disease. “Wheat Belly” puts forward the hypothesis that celiac disease is the tip of the iceberg in wheat related pathology.

Wheat effects on the mind. Wheat consumption as an addiction and even a hypothesis that wheat consumption worsen symptoms of schizophrenia and autism.

Increased intestinal permeability. Gliadin can disrupt the integrity of the intestine leading to immune sensitization to foods as well as autoimmune disease.

The Bottom Line

“Wheat Belly” is a well written book that unlocks the Red Pill for modern wheat and the impact of its consumption. The focus is on the appetite stimulating and addictive properties of wheat and their impact on weight and health. It is a great starting point especially for people who exercise regularly but still struggle with maintaining an optimal body composition. In my opinion wheat is a significant aspect of the problem along with excess carbohydrates in general. The massive low-fat dietary experiment has clearly failed. It is definitely time to reexamine the premises that have so obviously led us in the wrong direction.

It is of interest to everyone to critically examine the connection of increasingly pressing health issues driven by our food. The choices we make impact us as individuals but also reverberate beyond due to the impact on the limited resources of the health care system. To state that the trends in obesity are alarming is an absurd understatement. I applaud Dr. Davis and this attempt to mitigate this crisis. I strongly recommend that you view the documentary “Cereal Killers” (http://www.cerealkillersmovie.com/) as a companion to “Wheat Belly”.

Advertisements

Quantified Self, 23andMe, Risk Perception and Alzheimer’s disease.

It has been my greatest fear about growing old and I believe that it is shared by many. Loss of coherence, memory and identity. It is a form of death in my view made no less cruel (and perhaps moreso) by the continuation of the body. I saw it happen to my grandfather. Not at close range but it happened in the background and I did not really want to observe it any closer. To face this fear is why I originally created DNA Digital. My focus has shifted but this aim is never far from my mind.

My 23andMe results have come back and indicate that I have a lower than average risk for Alzheimer’s disease based on my profile in the Apoε gene. The Apoε locus remains the most potent influence on the risk of Alzheimer’s disease but even the worst case genotype at Apoε does not guarantee Alzheimer’s disease development although it very substantially increases the risk.

Our current understanding of genetics does not enable us to have any pretensions of clear cut determinism. Single genes with dramatic manifestations in our biology are very much the exception rather than the rule (Please watch the movie GATTACA to reinforce this point). I had already undertaken behaviours to mitigate my risk of Alzheimer’s disease and will continue them. However, I did breathe a sigh of relief when I discovered my Apoε genotype.

In reviewing the data my perspective shifted to some risks that I was not previously aware existed. One of which was the presence of genes associated with iron accumulation. I had been a sporadic blood donor because I was aware in general that men tend to accumulate iron and excess iron can be toxic. I had also avoided iron containing vitamin supplements for this reason. Now I realize that it is even more compelling for me to give blood in light of the additional risks that I have due to my genotype. Fortunately for myself and my children there were not any other genetic disease alleles present among those that were tested.

My deviation from rationality.

One realization that I had from the data was that the risk that I was paying the most attention to was not the risk with the highest probability. I have an elevated risk of Type 2 Diabetes and the absolute magnitude of that risk (34.2%) was about seven times higher than my risk (4.9%) of Alzheimer’s Disease. It is a common cognitive bias to focus on risks disproportionately with their actual probability and this is something I am determined to avoid going forward.

Some good news on the metabolic syndrome front is that several of my genes predispose me to be a high responder to exercise which can effectively mitigate my risk for weight gain, Diabetes and metabolic disease. Historically I have had low blood pressure and cholesterol when measured.

Quantified Self

A driving force behind this narcissistic focus on my health parameters is my approach to the Quantified Self. Briefly the Quantified Self movement tracks personal data because today’s technology enables large amounts of real time personal data to be captured including activity levels and health parameters. As an experimental scientist and drug developer my approach is geared to understanding the underlying parameters of the system that I am studying (Myself) so that I can identify the priority items to follow in order to optimize my health going forward.

Medical practice lags substantially behind the current scientific literature and is not designed to be tailored to the individual. In my view the best path to personalized medicine is for the patient to become an active steward of their own health and gather baseline data when they are healthy which will be very informative if they become ill because their will be a history to compare with the disease state or better yet the monitoring can enable early interventions before conditions become clinical. You have heard it many times “An ounce of prevention is worth a pound of cure.”

Action steps

In my view an important measure of utility of information is how it is used to inform actions. I renewed my commitment to giving blood by donating last week and scheduling another donation as soon as possible to reduce my iron load. I have been increasing my activity level with dedicated exercise time. I have moved to more actively monitor blood pressure and iron levels going forward. I am researching glucose monitoring technologies and will start to monitor that parameter as well. I have pushed my diet even more away from simple sugars and carbohydrates and increased the percentage of fat calories which is a different story which I will address at a later date.

Overall the 23andMe experience has been quite worthwhile and I recommend it to anyone who would like to take a more active role in the curation of their own health.

23andme and Me

I have finally bitten the bullet and sent in my sample to 23andme. I have also sponsored the uBiome Indiegogo project this year. It looks like 2013 is the year I get to know myself to a degree that was impossible a few years ago. The Quantified Self movement is gaining momentum which is a very positive trend.

With my background you might expect that I would have jumped aboard much sooner. Particularly since I was seriously examining personal genomics as a business opportunity in 2005 and I had identified an Oragene kit like the one that is currently used by 23andme as the best way to obtain customer samples. My business partner was using Google Adwords to promote the business. The pieces did not come together at that time but I still retain the business name DNA Digital and I remain a firm believer in the power of this information in the hands of health conscious individuals.

I have hesitated to do 23andme because if I was going to go down this road I wanted to be ready to do it right. It will take a significant time commitment to look at the data and do my own due diligence as to significance. It also does not hurt that at $99 it is ridiculous the value you are getting for the cost.

I wonder how many people receive their reports from 23andme and drown in the data. Often a plethora of information can cause analysis paralysis. My interest and approach will be focused mainly on genes related to health and longevity. Of primary interest will be alleles related to Alzheimer’s disease and metabolic disease risk. My grandfather had Alzheimer’s and it is a very cruel fate. I will chronicle my analysis in this blog. My sample was delivered yesterday (April 3rd) so I am looking forward to data overload in the next few weeks.

A Minor Roadblock

Since I live in Ontario close to the border with New York it would have been convenient for me to send my samples some point when I was crossing the border to save some postage and expedite their arrival. However, it seems that New York prohibits taking samples or mailing them to 23andme from within New York state. They have taken the position that the consumer should not be allowed to access this information without the oversight of an M.D. I strongly disagree with this position and it begs the question of whom this law is meant to serve.

The Bigger Picture

I realize that 23andme is becoming a big data play and they are looking to monetize the information that they are accumulating. If they continue to support and extend the efforts of Curetogether.com and continue to expand their offerings then they are welcome to try to make some coin from my data.

The power of combining such data is tremendous especially if it is open. One of the most powerful databases of the last twenty years has been GENBANK where sequencing information has been compiled annotated and stored in an open database. For those unfamiliar with GENBANK it is a repository where researchers submit DNA sequences from any organism or virus where they can be cross referenced with other sequences. It has an accompanying set of tools that allow you not only to look for identical matches but also find nonidentical matches with statistics to indicate how likely the match is to be random rather than a direct relationship. This is much more powerful than only being able to find exact matches because you can find related genes and even attribute functions to genes that have not been previously characterized.

I am unable to count the times that I have used the GENBANK, Pubmed and related tools at NCBI to create value. These tools have had an incalculable impact on advancing biology and are basically taken for granted by researchers. The NCBI site is free and open so I encourage you to play with it, you might discover something interesting.

The benefits

It is impossible a priori to predict the myriad ways that collecting this data together could benefit us all. I urge you to participate in these citizen science efforts because PhDs do not have a monopoly on thinking and MDs do not have a monopoly on health.

Let us explore together what it means to be human and how we can become proactive stewards of our health rather than reactive when we are ill. It is very true that an ounce of prevention is worth a pound of cure because many chronic diseases once entrenched are very difficult to overcome. However, there are often simple lifestyle steps that could have been taken beforehand to reduce risks.

 In Conclusion

I decided to embark upon a career in biology with the aim to extend lifespan because I wanted to experience as many of the wonders of the future as I am able. Having worked in research and drug development for half my life now I am humbled by the difficulty of the task facing us. However, unlike many I view our main obstacles not as difficulties requiring more scientific research and discovery. The major roadblocks are in the area of translating discoveries that are already here into practice to overcome entrenched practices and institutions that thwart progress in this field.

23andme and curetogether.com are lighting the way to a better-informed population in matters of health and well-being. I applaud their efforts and urge you to participate as well.

Cancer as a primeval survival program.

In my encounters with cancer biology as a researcher I have always had a nagging feeling that our focus has been somewhat off target. Cancer cells are evolution in action, which is why it is such a difficult disease to treat. There is a great degree of variation within and between tumors. Cancer cells are replication machines that rapidly adapt to their environment. Cancer is on my mind even more than usual because over the past few years friends and relatives have been battling this disease.

A recent paper (See reference below) probes the deep evolutionary origins of the survival program employed by cancer cells. It is a compelling idea and this paper surveys the prior work and extends it. This view characterizes cancer as not only a new species but as a separate kingdom than the ancestor/host organism since it has moved from being part of a multicellular organism to being a parasite that operates at a single cell level.

This characterization rings true in the description of cancer cells as a single celled organism adapted to Pre-Cambrian conditions and pursuing a replication strategy of “any-cost cellular survivalism.”  This perspective is consistent with the capacity of cancer cells to survive and even thrive in conditions of hypoxia (low oxygen). This has many implications for the treatment of cancer because the primary therapeutic strategies like radiation and chemotherapy resemble the harsh environmental threats faced by our ancient ancestors when this survival program arose.  So it is no wonder that many cancers remain viable after treatment and the surviving lineages often become even more robust after such challenges.

In the original context this survival program could provide an escape hatch or lifeboat for a single cell from the constraints of being part of a multicellular organism. Basically the cell adopts an “every cell for itself” mentality when the going gets tough as a strategy to insure cellular survival. As multicellular organisms further evolved the control mechanisms to inhibit the defection of cells became stronger but not insurmountable.  In the ancient aquatic environment it was possible for the survivalist cell to make a go of it on its own. However the current endgame of cancer is the death of the host it is overrun by unchecked proliferation of the cancer cells. With some notable exceptions being the rare cases of cancers becoming a transmissible disease as is the case for a facial cancer in Tasmanian devils or being selected as a standard laboratory strain like HeLa cells (http://en.wikipedia.org/wiki/Henrietta_Lacks).

In order to implement this strategy as a heuristic replicator the cancer cell jettisons regulatory programs required for good citizenship in a multicellular organism. Rapid mutation rates and genomic instability allow the cancer cell lineage to quickly explore configurations for optimal survival and replication as a parasite.

The Implications

This view of the cancer cell as an artefact of evolutionary history is both encouraging and discouraging. This perspective is consistent with the limited success that we have achieved in decades long “War on Cancer”. Our current paradigm to challenge cancer cells with harsh regimens also wreaks havoc with the rest of our body. However it is heartening that there are aspects of this survival program that may expose vulnerabilities of cancer which could be exploited to derail the survival program. For example, low oxygen levels appear to drive more aggressive tumor behaviors including metastasis. A focus on increasing oxygen levels in the core of tumors is a promising avenue for further research.

Reference

Bioessays 34:72-82 (Mark Vincent, 2011).

An introduction.

Good day to you!

The purpose of this blog is to explore the phenomenon of aging and associated diseases from the perspective of a scientist with a drug development background. My goal is to balance optimism and rationality to evaluate courses of action to minimize and perhaps even reverse age related declines in function.

Forestalling the process of aging was the inspiration for my focus on molecular biology in my training and career even though that has not been a direct focus of much of my work.

There are many disconnects between what we know about aging and how we choose to live. Therefore healthy aging is an interdisciplinary lifestyle ranging from philosophy to physiology and from minds to molecules.

In my next post I will take a look at cancer and review some recent insights into the deep evolutionary origins of the lifestyle of the cancer cell.

In the meantime you can check out The Life Extension Foundation (www.lef .org) and The Methuselah Mouse Prize (www.mprize.org).