Book Review: Dangerous Grains

Dangerous Grains is about the health hazards of gluten grains. It's co-written by James Braly, an M.D. who specializes in food allergies, and Ron Hoggan, a celiac patient who has written widely on the subject.

Celiac disease is a degeneration of the intestinal lining caused by exposure to gluten. Gluten sensitivity is a broader term that encompasses any of the numerous symptoms that can occur throughout the body when susceptible people eat gluten. The term gluten sensitivity includes celiac disease. Gluten is a protein found in wheat, its close relatives (kamut, spelt, triticale), barley and rye. Wheat is the most concentrated source.

Dangerous Grains is a good overview of the mountain of data on celiac disease and gluten sensitivity that few people outside the field are familiar with. For example, did you know:

• An estimated one percent of the U.S. population suffers from celiac disease.
• Approximately 12 percent of the US population suffers from gluten sensitivity.
• Gluten can damage nearly any part of the body, including the brain, the digestive tract, the skin and the pancreas. Sometimes gastrointestinal symptoms are absent.
  
• Both celiac and other forms of gluten sensitivity increase the risk of a large number of diseases, such as type 1 diabetes and cancer, often dramatically.
• The majority of people with gluten sensitivity are not diagnosed.
• Most doctors don't realize how common gluten sensitivity is, so they rarely test for it.
  
• Celiac disease and other symptoms of gluten sensitivity are easily reversed by avoiding gluten.

Twelve percent of Americans have gluten sensitivity! That's an enormous disease burden coming from a single type of food. I suspect the true incidence may actually be higher. There are preliminary data suggesting that most people may mount an immune response to gluten that does not require antibodies (through the innate immune system). This type of gluten sensitivity would be overlooked by the typical antibody tests, but could still result in damage.

Dangerous Grains also discusses the opioid-like peptides released from gluten during digestion. Opioids are powerful drugs, such as heroin and morphine, that were originally derived from the poppy seed pod. They are strong suppressors of the immune system and quite addictive. There are no data that conclusively prove the opioid-like peptides in gluten cause immune suppression or addiction to wheat, but there are some interesting coincidences and anecdotes. Celiac patients are at an increased risk of cancer, particularly digestive tract cancer, which suggests that the immune system is compromised. Heroin addicts are also at increased risk of cancer. Furthermore, celiac patients often suffer from abnormal food cravings. From my reading, I believe that wheat causes excessive eating, perhaps through a drug-like mechanism, and many people report withdrawal-like symptoms and cravings after eliminating wheat.

I know several people who have benefited greatly from removing gluten from their diets. Anyone who has digestive problems, from gas to acid reflux, or any other mysterious health problem, owes it to themselves to try a gluten-free diet for a month. Gluten consumption has increased quite a bit in the U.S. in the last 30 years, mostly due to an increase in the consumption of processed wheat snacks. I believe it's partly to blame for our declining health. Wheat has more gluten than any other grain. Avoiding wheat and all its derivatives is a keystone of my health philosophy.

Another notable change that Sally Fallon and others have pointed out is that today's bread isn't made the same way our grandparents made it. Quick-rise yeast allows bread to be fermented for as little as 3 hours, whereas it was formerly fermented for 8 hours or more. This allowed the gluten to be partially broken down by the microorganisms in the dough. Some gluten-sensitive people report that they can eat well-fermented sourdough wheat bread without symptoms. I think these ideas are plausible, but they remain anecdotes to me at this point. Until research shows that gluten-sensitive people can do well eating sourdough wheat bread in the long term, I'll be avoiding it. I have no reason to believe I'm gluten sensitive myself, but through my reading I've been convinced that wheat, at least how we eat it today, is probably not healthy for anyone.

I'm not aware of any truly healthy traditional culture that eats wheat as a staple. As a matter of fact, white wheat flour has left a trail of destruction around the globe wherever it has gone. Polished rice does not have such a destructive effect, so it's not simply the fact that it's a refined carbohydrate. Hundreds, if not thousands of cultures throughout the world have lost their robust good health upon abandoning their traditional foods in favor of white flour and sugar. The medical and anthropological literature are peppered with these stories. I'm aware of one healthy culture that traditionally ate sourdough-fermented whole grain rye bread, the Swiss villagers of the Loetschental valley described in Nutrition and Physical Degeneration.

Overall, the book is well written and accessible to a broad audience. I recommend it to anyone who has health problems or who is healthy and wants to stay that way!

Book Review: "The Human Diet: Its Origins and Evolution"

I recently read this book after discovering it on another health site. It's a compilation of chapters written by several researchers in the fields of comparative biology, paleontology, archaeology and zoology. It's sometimes used as a textbook.

I've learned some interesting things, but overall it was pretty disappointing. The format is disjointed, with no logical flow between chapters. I also would not call it comprehensive, which is one of the things I look for in a textbook. Here are some of the interesting points:

• Humans in industrial societies are the only mammals to commonly develop hypertension, and are the only free-living primates to become overweight.
  
• The adoption of grains as a primary source of calories correlated with a major decrease in stature, decrease in oral health, decrease in bone density, and other problems. This is true for wheat, rice, corn and other grains.
• Cranial capacity has also declined 11% since the late paleolithic, correlating with a decrease in the consumption of animal foods and an increase in grains.
• According to carbon isotope ratios of teeth, corn did not play a major role in the diet of native Americans until 800 AD. Over 15% of the teeth of post-corn South American cultures showed tooth decay, compared with less than 5% for pre-corn cultures (many of which were already agricultural, just not eating corn).
  
• Childhood mortality seems to be similar among hunter-gatherers and non-industrial agriculturists and pastoralists.
  
• Women may have played a key role in food procurement through foraging. This is illustrated by a group of modern hunter-gatherers called the Hadza. While men most often hunt, which supplies important nutrients intermittently, women provide a steady stream of calories by foraging for tubers.
• We have probably been eating starchy tubers for between 1.5 and 2 million years, which precedes our species. Around that time, digging tools, (controversial) evidence of controlled fire and changes in digestive anatomy all point to use of tubers and cooked food in general. Tubers make sense because they are a source of calories that is much more easily exploited than wild grains in most places.
• Our trajectory as a species has been to consume a diet with more calories per unit fiber. As compared to chimps, who eat leaves and fruit all day and thus eat a lot of fiber to get enough calories, our species and its recent ancestors ate a diet much lower in fiber.
  
• Homo sapiens has always eaten meat.
  

The downside is that some chapters have a distinct low-fat slant. One chapter attempted to determine the optimal diet for humans by comparing ours to the diets of wild chimps and other primates. Of course, we eat more fat than a chimp, but I don't think that gets us anywhere. Especially since one of our closest relatives, the neanderthal, was practically a carnivore.
They consider the diet composition of modern hunter-gatherers that eat low-fat diets, but don't include data on others with high-fat diets like the Inuit.

There's some good information in the book, if you're willing to dig through a lot of esoteric data on the isotope ratios of extinct hominids and that sort of thing.

Book Review: Blood Sugar 101

I just finished reading "Blood Sugar 101" by Jenny Ruhl. It's a quick read, and very informative. Ruhl is a diabetic who has taken treatment into her own hands, using the scientific literature and her blood glucose monitor to understand blood sugar control and its relationship to health. The book challenges some commonly held ideas about diabetes, such as the notion that diabetics always deteriorate.

She begins by explaining in detail how blood glucose is controlled by the body. The pancreas releases basal amounts of insulin to make glucose available to tissues between meals. It also releases insulin in response to carbohydrate intake (primarily) in two bursts, phase I and phase II. Phase I is a rapid response that causes tissues to absorb most of the glucose from a meal, and is released in proportion to the amount of carbohydrate in preceding meals. Phase II cleans up what's left.

In a person with a healthy pancreas, insulin secretion will keep blood glucose under about 130 mg/dL even under a heavy carbohydrate load. The implications of this are really interesting. Namely, that blood glucose levels will not be very different between a person who eats little carbohydrate, and one who eats a lot, as long as the latter has a burly pancreas and insulin-sensitive tissues.

Most Americans don't have such good control however, hence the usefulness of low-carbohydrate diets. This begs the question of why we lose blood sugar control. Insulin resistance seems like a good candidate, maybe preceded by leptin resistance. As you may have noticed, I'm starting to think the carbohydrate per se is not the primary insult. It's probably something else about the diet or lifestyle that causes carbohydrate insensitivity. Grain lectins are a good candidate in my opinion, as well as inactivity.

Diabetics can have blood glucose up to 500 mg/dL, that remains elevated long after it would have returned to baseline in a healthy person. Ruhl asserts that elevated blood sugar is toxic, and causes not only diabetic complications but perhaps also cancer and heart disease.

Heart attack incidence is strongly associated with A1C level, which is a rough measure of average blood sugar over the past couple of months. It makes sense, although most of the data she cites is correlative. They might have seen the same relationship if they had compared heart attack risk to fasting insulin level or insulin resistance. It's difficult to nail down blood sugar as the causative agent. More information from animal studies would have been helpful.

Probably the most important thing I took from the book is that the first thing to deteriorate is glucose tolerance, or the ability to pack post-meal glucose into the tissues. It's often a result of insulin resistance, although autoimmune processes seem to be a factor for some people. Doctors often use fasting glucose to diagnose diabetes and pre-diabetes, but typically you are far gone by the time your fasting glucose is elevated!

I like that she advocates a low-carbohydrate diet for diabetics, and lambasts the ADA for its continued support of high-carbohydrate diets.

Overall, a good book. I recommend it!