The current gluten-free diet craze is unhealthy for those who do not need it—those without celiac disease. In search of weight loss and/or feeling better, millions of Americans risk becoming sicker and fatter by increasing their intake of gluten-free products. Estimates are as high as 15 to 25 percent of consumers in the US want gluten-free food, with the global market of gluten-free products approaching $2.6 billion in 2010.

Gluten-free Can Be a Disguise for Low-carb Eating

The national best-selling book, Wheat Belly, by William Davis, MD, has fueled the current rage for gluten-free foods. The book’s subtitle is “Lose the wheat, lose the weight, and find your path back to health.”Misquoting the research and ignoring the bulk of the scientific evidence, Dr. Davis has convinced people, as well known as Fox News TV co-host Bill O’Rielly, that avoiding wheat is the solution to America’s obesity and health crises. Dr. Davis says “modern wheat is a perfect chronic poison; it causes diabetes, it causes inflammation, it causes heart disease, it causes high blood pressure….” He goes on to claim in aCBS News interview that the elimination of wheat will cure these conditions and cause people to stop their medications.

Although I applaud Dr. Davis for bringing problems with wheat to greater public awareness, I consider this fad a serious diversion away from what I believe to be the real solution to obesity and common diseases: a starch-based diet. Traditionally my kind of high-carbohydrate eating has been the diet of people throughout recordable human history, and a large share of these civilizations, ancient and modern, have relied on generous amounts of wheat, barley, and/or rye for survival.

While exaggerating the benefits of a wheat-free diet, Dr. Davis makes clear his alliance with the low-carb movement, typified by the popular Paleo and Atkins diets. He recommends people eat unlimited amounts of eggs, full fat cheese, other dairy products, meat, fish, chicken, and vegetable (olive) oils; and reducing or eliminating favorite (even non-gluten) “comfort foods,” like corn, rice, oats, quinoa, millet, buckwheat, potatoes, and beans. My opposite conclusion is that Dr. Davis’s prescription for filling the dinner table with rich foods, those once reserved for the tables of opulent kings and queens, is actually the cause of the current epidemics of obesity and common illnesses in the developed world, not the solution.

The AACC International (formerly the American Association of Cereal Chemists), a global nonprofit organization of 2,500 grain scientists and professionals studying the chemistry of cereal grains and their products, also disagrees with Dr. Davis and has responded with a scientific analysis of a few of his claims.

Gluten-free Diets Cause Weight Gain

Patients with celiac disease are usually suffering with malnourishment because of the problems created by damage to their intestines from gluten. Following removal of the wheat, barley, and rye, the GI track usually heals, and only then are calories and other nutrients efficiently assimilated. Weight gain is the desired and expected result for underweight people with celiac disease. Some people with documented celiac disease, however, are overweight, and even obese, before starting a gluten-free diet. You might expect that the dietary restrictions imposed by a strict gluten-free protocol alone would cause weight loss for them. Unfortunately, weight gain is a common occurrence in overweight and obese adults and children with celiac disease who go on gluten-free diets. A 2012 study of 1018 patients with biopsy confirmed celiac disease found significant weight gain; with 16 percent of patients moving from a normal or low BMI (body mass index) class into an overweight BMI class, and 22 percent of the patients who were overweight at the time of diagnosis gaining weight after starting their strict gluten-free diet.

Let me be more to the point for the growing masses looking for the answer: “There are no published reports showing that a gluten-free diet produces weight loss in persons without celiac disease or gluten sensitivity.” To reiterate this point, a 2011 article in the Journal of the American Dietetic Associationstates, “At this time there is no scientific evidence supporting the alleged benefit that a gluten-free diet will promote weight loss.”

The primary reason for unwanted weight gain found in people buying gluten-free products is that these imitations often contain more calories, fat, and sugar, and fewer important nutrients (dietary fiber, complex carbohydrates, vitamins, and minerals) than the original gluten-containing foods. Even the causal observer can see the folly in eating gluten-free cakes, cookies, and pies, and expecting weight loss and better health. A trip through your local health food store or supermarket reveals rows of desserts where the wheat has been replaced with another grain (flour); and fats, vegetable oils, simple sugars, dairy products, and eggs are abundant on the ingredient lists.

When an expert dietitian, knowledgeable about proper food choices for a healthy gluten-free diet, devoid of cakes, cookies, and pies, is involved in patient care, then weight loss is accomplished. In one studyoverweight and obese patients were advised to choose a high quality gluten-free diet with naturally gluten-free foods (fruits and vegetables) and alternate non-gluten containing grains (quinoa and buckwheat). These properly counseled patients consistently lost excess weight. There is unfortunately a paucity of dietitians and medical doctors available for the proper management of celiac disease.

This Fad Ultimately Harms Many Celiac Patients

If you are one of the few people with celiac disease, then avoiding gluten is crucial to your health. You cannot cheat! With the popularity of “going gluten-free,” for unsubstantiated reasons, the importance of this dietary restriction for the truly needy has been diminished. Waiters at restaurants become used to customers asking for “gluten-free dishes” and then failing to object when a few whole wheat bread crumbs appear as a decoration on top of their potato soup. Since wheat, barley, and rye did not cause any apparent distress in the previous 99 customers, the waiters and chefs think, “It can’t be all that important.” But it is for that one percent.

Dr. McDougall’s Recommendations:

If you suspect that you have celiac disease, get tested by your physician. Avoidance of gluten foods is a lifelong restriction. If you are unsure about your diagnosis, but still suspect gluten, then go on a starch-based diet, with no wheat, barley or rye. For example, you can base your diet on rice, corn, sweet potatoes, white potatoes, and beans, with fruits and green and yellow vegetables. The connection between gluten and celiac disease is so close that the diagnosis can often be made when the patient experiences dramatic improvement of symptoms upon following a gluten-free diet. Confirmation of your diagnosis can be made by carefully adding back any suspected foods.

If you, like two-thirds of adults in the US, are sick and overweight, and of the vast majority whom are also without celiac disease, wheat allergy or wheat sensitivity, then I strongly recommend that you include these good starches—wheat, barley and rye—in your diet because these foods are known to cause desirable weight loss and medical benefits.

Wheat Belly: Theory with a Dash of Low-Carb

– See more at: http://calorielab.com/news/2012/07/11/wheat-belly-william-davis/#sthash.sjPBzhIJ.dpuf

Wheat Belly, Busted

When Wheat Belly, by William Davis, M.D., came out in August 2011, it was an instant hit. It became a New York Times bestseller.  Praise faroutweighed criticism. Especially in the gluten-free community, it enjoyed rave reviews. The book was received essentially as gospel. Why?

In my opinion, there are three main reasons:

• It’s written by an M.D., which adds a patina of credibility to the book’s claims,
• It’s filled with endnotes of citations that reference scientific peer-reviewed publications, and
• Its message—to “lose the wheat, lose the weight, and find your path back to health”—already agrees with the world view of many in the GF community (that wheat and gluten equals bad).

But as you’ll see, those three factors are dangerous. They build a facade of trust and credibility. They cause us to let down our guard; to cease being the critically-thinking readers that we ought to be. And sometimes, that means we fail to question information that is suspect; we unknowingly accept and perpetuate a myth; we fall victim to false information.

I didn’t set out to write a review of Wheat Belly. I had been heavily researching another unrelated project. Coincidental timing then played a key role. After reading a number of prominent medical studies involving wheat, gluten, weight loss, and celiac disease, I found myself readingWheat Belly, in which Davis cites some of those exact same studies.

Except that there was one major problem: Davis’ claims—and his conclusions based on the research studies he cites—were exactly the opposite of what I’d been reading in those very studies. Here are several important examples:

Consider Chapter 3, Wheat Deconstructed, page 36 of the hardcover edition. Davis writes “if we look only at overweight people who are not severely malnourished at the time of diagnosis who remove wheat from their diet, it becomes clear that this enables them to lose a substantial amount of weight.” He supposedly backs up this claim in the very next sentence by continuing, “A Mayo Clinic/University of Iowa study of 215 obese celiac patients showed 27.5 pounds of weight loss in the first six months of a wheat-free diet.” Sounds pretty impressive and compelling … until you realize he’s wrong.

First of all, the study didn’t examine 215 obese patients. Body Mass Index for study participants ranged from underweight to normal to overweight to obese. Secondly, only 25 of those 215 patients lost weight, and the weight loss was not restricted to the obese subset of participants. (Further, 91 of the 215 patients gained weight, but I’ll return to the issue of weight gain among obese celiacs in a moment.) You can read the full text of the study as reported in the original American Journal of Clinical Nutrition article here.

Next consider Chapter 5, The Wheat/Obesity Connection, page 66 of the hardcover edition. Here Davis invokes a study reported in the American Journal of Gastroenterology. He claims that of newly diagnosed celiac disease patients, 39 percent start overweight and 13 percent start obese. Next Davis writes that “by this estimate, more than half the people now diagnosed with celiac disease are therefore overweight or obese.”

Not quite. Actually, the study noted that overweight and obese patientstogether accounted for 39 percent of diagnoses. The 13 percent obese patients were a subset of the overweight group. By Davis’ questionable math, underweight, normal weight, overweight, and obese celiac disease patients would account for 114% of diagnoses, which is impossible.

At the start of the very next paragraph, he invokes a familiar line nearly identical to that from Chapter 3: “If we focus only on overweight people who are not severely malnourished at the time of diagnosis, celiac sufferers actually lose a substantial quantity of weight when they eliminate wheat gluten.”

I call B.S. You know that study Davis just cited in the previous paragraph of his book to build his case? The same study from which he errantly claimed more than half of newly diagnosed celiacs are overweight? Here is what researchers actually found, and I quote directly: “Of patients compliant with a gluten-free diet, 81 percent had gained weight after 2 years, including 82% of initially overweight patients” (emphasis mine).

This finding is not buried deep in the report somewhere. It’s important enough that researchers also call it out directly in the top-level abstract. When Davis claims that initially overweight celiac disease patients lose a significant amount of weight on a gluten-free diet, how does he explain the fact that 82% of those patients gained weight … in one of the very studies he uses to back up his questionable claim?

To me this appears to be more than an innocent, but careless, oversight; it is more than a case of blissful ignorance. Those results are front and center in the study, and they directly contradict his claim. It would take an act of willful omission to leave it out; it’s audacious that he cites the study to bolster his claim.

For a third and final example, consider Chapter 4, The Addictive Properties of Wheat, page 50 of the hardcover edition. Here, Davis writes about gluten exorphins, opiate-like compounds created when stomach enzymes take a crack at partially digesting gluten. Researchers are continuing to study how they impact the human body in myriad ways. One branch of such studies uses the drug naloxone, an opiate blocker, to cancel the potential effect of gluten exorphins and other related compounds.

Davis makes the claim that gluten exorphins are addictive like morphine (another opiate), and that those addictive properties cause you to eat more calories and gain weight. As the theory goes, block the gluten exorphins with naloxone, and you block the addictive properties of wheat-based foods. To back up his boast, he then cites a study, published in theAmerican Journal of Clinical Nutrition, in which binge eaters were left in a room filled with a variety of foods for one hour. Davis writes “participants consumed 28 percent less wheat crackers, bread sticks, and pretzels with the administration of naloxone.” And there you have it! See? Naloxone blocked the evil action of gluten exorphins, and those binge eaters ate fewer calories as a result! Except that’s not what happened.

Here’s the truth: While naloxone appeared to have an impact on the consumption of high fat and high sugar foods, it had no effect that correlated with gluten. In fact, while Davis claims that participants consumed 28 percent fewer wheat crackers, bread sticks, and pretzels, they actually consumed 40 percent more gluten-containing bread sticks.

The three examples I’ve noted are hardly the sum total of the problems I found with the book. There are many others, though I’ve already made my point.

Those of us in the gluten-free community want to agree with Wheat Bellybecause Davis’ message resonates with us. But it’s an overly simplified message, at times built on tenuous claims. And how would we ever know? He’s an M.D. He’s the expert, right? And he cites all those sexy research studies.

If I had read this book at another time in my life, I likely would have been none the wiser. I would have read the book, peeked at the citations, and been satisfied. But perhaps serendipity of a certain sort is at work here … that I read this book at precisely that moment in my life when I was best equipped with the knowledge I needed to critically evaluate it. I now pass that evaluation along to you.

For certain, some of what Davis writes is valid. And I have some GF blogging colleagues/friends who know Davis personally. They say he’s a very nice man, which may indeed be true.

But I’m more than disappointed with Davis and Wheat Belly; I’m downright angry. This book can and should be better. We, the gluten-free community, deserve as much. It does an injustice to the very legitimate case against wheat and gluten, and it is insulting to us, the readers. Sadly, Wheat Belly looks polished from a distance, but upon closer inspection it goes belly up. Sections of the book amount to propaganda, fallacies, and unsubstantiated claims. For me, Wheat Belly is a bust.

Are wheat and gluten a health problem? For many of us, undoubtedly. But there’s much more to the story than meets the eye, and you’re not always getting the straight story in Wheat Belly.

–Pete

Animal-based diets may contribute to the development of inflammatory bowel disease, according to a Harvard study published this week in Nature. Eleven healthy volunteers consumed either animal-based or plant-based diets for five days. The volunteers on the animal-based diet had an eight-fold increase in the gut population of a bacterium that may cause inflammatory bowel disease, Bilophila wadsworthia. Growth of this bacterium may be stimulated by the digestion of dairy products. In contrast, the gut population of B. wadsworthia fell three-fold in the plant-based diet group. In addition, gut concentrations of a compound linked to liver cancer, deoxycholic acid, rose in the animal-based diet group. The authors note that diet may contribute to the development of inflammatory bowel disease via changes in gut microbes.

David LA, Maurice CF, Carmody RN, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature. 2013;505:559-563.