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”.

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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.