In search of wheat: We bake einkorn bread

With the assistance of dietitian and health educator, Margaret Pfeiffer,MS RD CD, author of Smart 4 Your Heart and very capable chef and breadmaker (previously, before she gave up wheat), we made a loaf of bread using Eli Rogosa's einkorn wheat. Recall that einkorn wheat is the primordial 14-chromosome wheat similar to the wild wheat harvested by Neolithic humans and eaten as porridge.

The essential question: Has wheat always been bad for humans or have the thousands of hybridization experiments of the last 50 years changed the structure of gluten and other proteins in Triticum aestivum and turned the "staff of life" into poison? I turn to einkorn wheat, the "original" wheat unaltered by human manipulations, to figure this out. While einkorn wheat is still a source of carbohydrates, is it something we might indulge in once in a while without triggering the adverse phenomena associated with modern wheat?   

Here's what we did:

This is the einkorn grain as we received it from Eli's farm. This was enough to make one loaf (approximately 3 cups).











The einkorn grain is a dark golden color. I tried chewing them. They taste slightly nutty. They soften as they sit in your mouth.





Here's Margaret putting the einkorn grain into the electric grinder.









We tried to grind the grain by hand with mortar and pestle, but this proved far more laborious than I anticipated. After about 15 minutes of grinding, this is what I got:



Barely 2 tablespoons. That's when Margaret fired up the electric grinder. (I can't imagine having to grind up enough flour by hand for an entire family. Perhaps that's why ancient cultures were thin despite eating wheat. They were just exhausted!)

We added water, salt, and yeast, then put the mix into an electric breadmaker to knead the dough and keep it warm.

We let the dough rise for 90 minutes, much longer than conventional dough. The einkorn dough "rose" very little. Margaret tells me that most dough made with conventional flour rises to double its size. The einkorn dough increased no more than 20-30%.

The einkorn dough also distinctly smelled like peanut butter.





After rising, we baked the dough at 350 degrees F for 30 minutes. This is the final product.

Because I want to gauge health effects, not taste, the bread we made had no added sugar or anything else to modify taste or physiologic effect.

On first tasting, the einkorn bread is mildly nutty and heavy. It had an unusual sour or astringent taste at the end, but overall tasted quite good.

Next: What happens when we eat it? I'm going to give the einkorn bread (I've got to make some more) to people who experience acute reactions to conventional wheat and see if the einkorn does the same. I will also assess blood sugar effects since, after all, hybridizations or no, it is still a carbohydrate.



Margaret Pfeiffer's book is available on Amazon:

Ezekiel said what?

Some people are reluctant to give up wheat because it is talked about in the Bible. But the wheat of the Bible is not the same as the wheat of today. (See In search of wheat and Emmer, einkorn and agribusiness.) Comparing einkorn to modern wheat, for example, means a difference of chromosome number (14 chromosomes in einkorn vs. 42 chromosomes in modern strains of Triticum aestivum), thousands of genes, and differing gluten content and structure.

How about Ezekiel bread, the sprouted wheat bread that is purported to be based on a "recipe" articulated in the Bible?

Despite the claims of lower glycemic index, we've had bad experiences with this product, with triggering of high blood sugars, small LDL, and triglycerides not much different from conventional bread.

David Rostollan of Health for Life sent me this interesting perspective on Ezekiel bread from an article he wrote about wheat and the Bible. David argues that the entire concept of Ezekiel bread is based on a flawed interpretation.

"I Want to Eat the Food in the Bible."


Are you sure about that?

Some people, still wanting to be faithful to the Bible, will discard the "no grain/wheat" message on the basis of biblical example. After all, God told Ezekiel to make bread, he gave the Israelites "bread from heaven," and then Jesus (who is called the "Bread of Life"!) multiplied bread, and even instituted the New Covenant with what? Bread and wine! If you're going to live the Bible, it seems that bread and/or wheat is going to play a part.

But this is unnecessary. Sure, the Bible can and does tell us how to live, but this doesn't mean that everything in the Bible is meant to be copied verbatim. Applying the Bible to our lives requires wisdom, not a Xerox machine.

The Bible was written in a historical context, and the setting happened to be an agricultural one. Because of this, the language used to describe blessing spoke of things like fields full of grain, or barns overflowing with wheat. Had the Bible been written in the context of a hunter-gatherer culture, the language describing blessing probably would have been about the abundance of wild game, or baskets full of vegetables. Whatever is most valuable in your time and in your culture is a blessing. God accommodated His message to the culture as it existed at the time. This is done throughout Scripture.

There is a danger, then, in merely copying what the Bible says, instead of extracting the principles by which to live. Take the above example of Ezekiel, for instance. There's a whole product line in health food stores called "Ezekiel Bread" that supposedly copies the recipe given in Ezekiel 4:9. This is from the website:

"Inspired by the Holy Scripture verse Ezekiel 4:9., 'Take also unto thee Wheat, and Barley, and beans, and lentils, and millet, and Spelt, and put them in one vessel, and make bread of it...'"

Believing that this "recipe" has some kind of special power just because it's in the Bible is ridiculous. How ridiculous is it? I'll tell you in a moment, but first let me say that this is why it's so important not to confuse descriptives with prescriptives. Is the Bible telling a story, or is it telling us to do something? We would be well-advised not to confuse the two.

In the case of the Ezekiel Bread, what is going on in the passage? There's a siege going on, with impending famine, and Ezekiel is consigned to eating what was considered back then to be some of the worst possible food. It was basically animal chow. But that's not the worst thing going on in this passage. Apparently, when the makers of Ezekiel Bread were gleaning their inspiration for the perfect recipe, they stopped short
of verse 12:

"And thou shalt eat it as barley cakes, and thou shalt bake it with dung that cometh out of man, in their sight."

Um...what? Well, there was a good reason for this. God was judging His people, and by polluting this really bad bread with dung (which was a violation of Mosaic law; Lev. 5:3), He was saying that they were no different from the unclean Gentiles.

So why would we take this story and extrapolate a bread recipe from it? Beats me. If you were going to be consistent, though, here's what you'd have to end up with:



Let that be a lesson to you. We don't just go and do everything that we see in the Bible.

Low-carb gynecologist

I met infertility specialist, Dr. Michael Fox, on Jimmy Moore's low-carb cruise just this past March.

Dr. Fox is quiet and unassuming, but had incredible things to say about his experience with carbohydrate restriction in female infertility and pregnancy. While readers of The Heart Scan Blog already know that I advocate a diet free of wheat, cornstarch, and sugar for heart health and correction of multiple lipoprotein abnormalities, it was fascinating to hear how a similar approach seems to yield extraordinary benefits in this entirely unrelated area of female health. Obviously, female infertility and pregnancy are unrelated to heart health, but the extraordinary benefits witnessed by Dr. Fox in this area suggest that some fundamental lessons in human physiology can be learned. The results are so incredible that we are all sure to hear more about this approach as experience grows.

So I tracked Dr. Fox down in his busy Jacksonville, Florida practice to fill us in on some details.

WD: Dr. Fox, could you tell us something about yourself and what led you to use carbohydrate restriction in your female patients?

MF: I have been in practice as a reproductive endocrinologist for 15 years. During that time, I have seen our specialty move from a broad based practice of reproductive endocrinology to a narrow IVF [in vitro fertilization] focus, with patients being pushed through IVF in a cookie-cutter fashion without any emphasis on non-medical therapy.

Our focus has been to remain as a broad practice where we individualize care and attempt in every case to achieve pregnancy short of IVF. Five years ago, this continued quest for better care led us into the insulin resistance, low-carbohydrate metabolic world that has transformed our practice, although our practice offers all aspects of reproductive endocrinology including sub-specialized minimally invasive surgery, and all available infertility options.


WD: I have been intrigued by your comments about improved fertility with the low-carb diet. Could you elaborate on this?

MF: Yes, five years ago, as more information regarding Polycystic Ovarian Disease or Syndrome (PCOD/S) and its relationship to insulin resistance (high insulin levels) was emerging, we had a simple realization. As we've known for some time, insulin stimulates excess male hormone levels in the ovary, which disrupts ovulation and fertility. Then our job was to lower or virtually eliminate high insulin levels. Again, in simple fashion, we looked at physiology and realized that insulin is released only in response to dietary carbohydrates. Thus, elimination of carbohydrates should resolve the problem. This, in fact, is the effect that we have seen.

In our previous approaches to PCOD, we utilized oral ovulation medicines generating pregnancy rates in the 40% range overall. Now, with the nutritional approach, for those patients that follow our recommendations, our pregnancy rates are over 90%! This has dramatically reduced the need for in vitro fertilization in these patients.

To extend this idea further, we first started with relative low-carbohydrate diets, such as the South Beach diet, but quickly realized this didn't produce a metabolic effect. Over time, it has borne out that only the very low-carbohydrate diet (VLCD) approach produces significant metabolic change. Our impression then was that the current U.S. nutritional exposure probably increases insulin levels and that this has a detrimental effect on fertility.

To counter this effect, we now recommend the VLCD to all fertility patients and their spouses. The pregnancy rates do seem much better overall, as well as seeing a reduction in miscarriage rates. For the first time at our national meeting last year, there were three articles that showed improved pregnancy rates in patients without PCOD or insulin resistance in IVF when Glucophage was used. This drug decreases insulin. This supports the idea that our entire population is subjected to fertility-reducing high-carbohydrate diet.

WD: Do you see any other changes in these patients on the diet?

MF: Yes. All metabolic parameters, as well as many common complaints, improve. Cholesterol and triglyceride levels improve, while "good" HDL cholesterol levels increase. Weight drops at a pace of 12 lbs per month very steadily and we have many many patients who have experienced 50lb wt loss. Blood pressure decreases steadily in these patients and we are often able to get them off of cholesterol and blood pressure medicines. Common symptoms such as anxiety, sleep disturbances, decreased energy, migraine headaches and depression all dramatically improve. Again we can often get patients off depression and migraine suppression medications. So this approach helps in a multitude of areas.



WD: I was also interested in hearing more about your experience with morning sickness and the effects of a low-carb diet. Could you tell us more about this? Also, any thoughts on why this happens?

MF: As we continued to expand our thoughts about VLCD and fertility/pregnancy, we began to extend the nutritional approach into pregnancy. We know that pregnancy hormones dramatically worsen insulin resistance that is responsible for the condition, gestational diabetes. If insulin resistance is worsened, then reactive hypoglycemia is worsened. One of the biggest symptoms of hypoglycemia is nausea. So, in response to this, we have counseled our patients on the diet in pregnancy and have found a dramatic reduction in nausea. We recommend snacking every two hours in pregnancy.

The other "traditional" issue in pregnancy are cravings. These also likely stem from hypoglycemia. I have had many husbands tell us later that their wives, in contrast to friends etc, were calm and not moody or anxious during their pregnancies. Hypoglycemia probably is a serious issue for the fetus as well and may be the "signal" that turns on the insulin-resistant gene. Many theorists feel this might be an activated gene during the pregnancy.


WD: Do you use any unique approaches to the low-carbohydrate approach, e.g., inclusion of dairy, meal frequency, "induction" strategies (i.e., induction to the diet, not of labor!), etc.?

MF: Yes. As I'm sure everyone who works in the VLCD world does, we also have some tricks to make this work better. My biggest push, although hard to get patients to agree, is to see a counselor along with our follow-up in order to deal with "addictive behaviors" and "stress eating" that so many of our patients relate to us. Good stress management and cognitive behavioral therapy go a long way in helping this become a permanent change.

We also really push frequent calorie intake or "snacking." I think again that hypoglycemia produces an inborn drive to "cure" or "fix" starvation and leads to dramatic overeating. We have a short list of snacks that we recommend. The concept of hunger is offered as a failure of the program. We aim to eliminate hunger, as it represents hypoglycemia. The analogy I use is, if you drove your car until you ran out of gas before you ever sought to find gas, your life would be miserable. So it is the same with your metabolic engine: If you let it run out, the measures your system takes to fix it are very detrimental to life and certainly to nutritional health.

Our other big push is fat. People can wrap themselves around protein and vegetables, but they totally miss the high-fat (animal fat) part of the conversation. We have to really push that aspect. In regards to dairy, we allow for non-processed cheeses and minimal milk. An alternative is to mix about 4 oz whole milk with 4 oz of heavy whipping and 4 oz of water to create a "milk" with less sugar. Similarly, shakes and smoothies can be made with heavy whipping cream with pure whey protein powder added to create a liquid meal for those who "don't have time" to cook.


WD: Thanks, Dr. Fox. We look forward to hearing more about your approach in future.

Contact information:

Michael D. Fox, MD
Jacksonville Center
Reproductive Medicine
www.JCRM.org
Phone 904-493-2229

Track Your Plaque reduces healthcare costs 35%

Allow me to wear my Track Your Plaque hat for this post.

Mr. Richard Rawle is CEO of Utah company, Tosh, Inc. Mr. Rawle has been an avid follower of the Track Your Plaque program and has introduced the program to company employees. Here's what he has to say about the experience:

“Our company has been utilizing the principles of TYP [Track Your Plaque] for over a year and has experienced great results that have positively impacted the lives of our employees and our health care costs.

Since we began our wellness program, we have presented the TYP diet and lifestyle guidelines to all of our employees and their families. Although the overwhelming majority of our employees do not have cardiovascular issues, the preventative nature of TYP is too important not to be utilized. The TYP principles along with our increased focus on healthy living have already changed our group’s blood chemistry. HDL levels in particular have increased significantly and resulted in a large percentage of our employees having HDL levels of 60 or higher. Vitamin D levels have substantially increased and LDL levels have significantly decreased in the majority of our employees. Subsequently, in the 12 months just ended, our health care costs are some 35% less than other groups of comparable size and age.

I believe the TYP program has been an integral part of the success of our company's vast improvement in employee health/wellness, resulting in significant health care cost reductions."

Richard Rawle
CEO Tosh Inc.


Track Your Plaque saves lives. Track Your Plaque also saves money . . . lots of it. Despite the upfront costs of some additional blood testing and a heart scan, the dramatic reduction in need for medications, reduced heart attack, diabetes, and many other chronic conditions add up to a huge cost savings, much as Tosh, Inc. employees have enjoyed.

The Federal government has been looking towards large hospital systems to lead the way in healthcare delivery, systems that employ their physicians and possess economies of scale. But I say the answer to reducing healthcare costs will NEVER be found in hospital systems. Healthcare cost savings will be realized by delivering truly effective health solutions directly to people themselves, much as we do in Track Your Plaque.

In search of wheat

Many people ask: "How can wheat be bad if it's in the Bible?"

Wheat is indeed mentioned many times in the Bible, sometimes literally as bread, sometimes metaphorically for times of plenty or freedom from starvation. Moses declared the Promised Land "a land of wheat, and barley, and vines, and fig trees, and pomegranates; a land of oil olive, and honey" (Deuteronomy 8:8).

Wheat is a fixture of religious ceremony: sacramental bread in the Eucharist of the Christian church, the host of the Holy Communion in the Catholic church, matzoh for Jewish Passover, barbari and sangak are often part of Muslim ritual. Wheat products have played such roles for millenia.

So how can wheat be bad?

What we call wheat today is quite different from the wheat of Biblical times. Emmer and einkorn wheat were the original grains harvested from wild growths, then cultivated. Triticum aestivum, the natural hybrid of emmer and goatgrass, also entered the picture, gradually replacing emmer and einkorn.

The 25,000+ wheat strains now populating the farmlands of the world are considerably different from the bread wheat of Egyptians, different in gluten content, different in gluten structure, different in dozens of other non-gluten proteins, different in carbohydrate content. Modern wheat has been hybridized, introgressed, and back-bred to increase yield, make a shorter stalk in order to hold up to greater seed yield, along with many other characteristics. Much of the genetic work to create modern wheat strains are well-intended to feed the world, as well as to provide patent-protected seeds for agribusiness.

What is not clear to me is whether original emmer, einkorn, and Triticum aestivum share the adverse health effects of modern wheat.

Make no mistake about it: Modern wheat underlies an incredible range of modern illnesses. But do these primitive wheats, especially the granddaddy of them all, einkorn, also share these effects or is it a safe alternative--if you can get it?

I've ordered 2 lb of einkorn grain, unground, from Massachusetts organic farmer, Eli Rogosa, who obtained einkorn seed from the Golan Heights in the Middle East. We will be hand-grinding the wheat and making einkorn bread. We will eat it and see what happens.

Super-carbohydrate

Wheat starches are composed of polymers (repeating chains) of the sugar, glucose. 75% of wheat carbohydrate is the chain of branching glucose units, amylopectin, and 25% is the linear chain of glucose units, amylose.

Both amylopectin and amylose are digested by the salivary and stomach enzyme, amylase, in the human gastrointestinal tract. Amylopectin is more efficiently digested to glucose, while amylose is less efficiently digested, some of it making its way to the colon undigested.

Amylopectin is therefore the “complex carbohydrate” in wheat that is most closely linked to its blood sugar-increasing effect. But not all amylopectin is created equal. The structure of amylopectin varies depending on its source, differing in its branching structure and thereby efficiency of amylase accessibility.

Legumes like kidney beans contain amylopectin C, the least digestible—hence the gas characteristic of beans, since undigested amylopectin fragments make their way to the colon, whereupon colonic bacteria feast on the undigested starches and generate gas, making the sugars unavailable for you to absorb.

Amylopectin B is the form found in bananas and potatoes and, while more digestible than bean amylopectin C, still resists digestion to some degree.

The most digestible is amylopectin A, the form found in wheat. Because it is the most readily digested by amylase, it is the form that most enthusiastically increases blood sugar. This explains why, gram for gram, wheat increases blood sugar to a much greater degree than, say, chickpeas.

The amylopectin A of wheat products, “complex” or no, might be regarded as a super-carbohydrate, a form of highly digestible carbohydrate that is more efficiently converted to blood sugar than nearly all other carbohydrate foods.

Emmer, einkorn, and agribusiness

10,000 years ago, Neolithic humans did not obtain wheat products from the bagel shop, grocery store, or Krispy Kreme. They obtained wheat by locating a nearby wild-growing field of wild emmer or einkorn wheat grass, then harvesting it with their stone sickles.

Neolithic humans, such as the Natufians of the Fertile Crescent, carried their freshly-cut wheat home, then ground it by hand using homemade mortar and pestle. As yeast-raised bread was still some 5000 years in the future, emmer and einkorn wheat was not used to bake bread, but was consumed as a porridge in bowls. Einkorn has the simplest genetic code of 14 chromosomes, while emmer has 28 chromosomes.

A third variety of wheat appeared on the scene around 9000 years ago, a natural hybridization between emmer and goat grass, yielding the 42-chromosome Triticum aestivum species. Egyptians learned how to cause wheat to rise around 3000 BC, yielding bread, rather than the unleavened flatbreads of their predecessors.

From the original three basic varieties of wheat available to Neolithic man, over the past 30 years wheat has exploded to over 25,000 varieties. Where did the other 24,997+ strains come from?

In the 1980s, thousands of new wheat strains arose from hybridization experiments, many of them conducted in Mexico. Then, in the late 1980s, genetic engineering quietly got underway in which geneticists inserted or deleted single genes, mostly designed to generate specific characteristics, such as height, yield per acre, drought resistance, but especially resistance to various pesticides and weed killers. The fruits of these efforts were introduced into the market in 1994. Most of the genetically modified foods were thought to be only minor modifications of the unmodified original and thus no safety testing in animals or humans was conducted.

We now have many thousands of wheat strains that are different in important ways from original emmer, einkorn, and Triticum aestivum wheat. Interestingly, it has been suggested that einkorn wheat fails to provoke the same immune response characteristic of celiac disease provoked by modern wheat gluten, suggesting a different amino acid structure in gluten proteins. Another difference: Emmer wheat is up to 40% protein, compared to around 12% protein for modern wheat.

In other words, the wheat of earlier agricultural humans, including the wheat of Biblical times, is NOT the wheat of 2010. Modern wheat is quite a different thing with differing numbers of chromosomes, different genes due to human manipulation, varying gluten protein composition, perhaps other differences.

Somewhere in the shuffle and genetic sleight-of-hand that has occurred over the last 30 years, wheat changed. What might have been the "staff of life" has now become the cause of an incredible array of diseases of "wheat" intolerance.

Near-death experience with nattokinase

This is a true story that I personally witnessed.

A 60-some year old man heard that nattokinase "thinned the blood." So he had been taking it for the past 6 months.

One week before he came to see me, he abruptly became quite breathless. He was unable to walk more than 20 feet or bend over to tie his shoes due to the breathlessness.

He came to see me in the office. I was alarmed by how breathless he was without signs of heart failure or other obvious explanation. I sent him for an immediate CT pulmonary angiogram. Within 30 minutes, we had the diagnosis: a large "saddle" pulmonary embolus, meaning a large blood clot that straddled the right and left main pulmonary arteries. One wrong move and . . . bang! He would have been dead within a couple of minutes, since a large clot can completely occlude the large arteries feeding the lung, essentially corking any blood circuiting through the lungs and back to the left side of the heart. (Causing, incidentally, electromechanical dissociation, in which the heart keeps beating for a few minutes but no blood is being pumped. CPR can keep you alive for a few minutes, then it's over.)

When I advised the patient of the diagnosis (after initiating the REAL anticoagulants), he said, "But I was taking nattokinase!"

Exactly. Blood clots are no laughing matter. They are potentially fatal events. Betting your life on some company's advertisement is nothing short of foolish.

Anyone who reads The Heart Scan Blog knows that I am an avid supporter of nutritional supplements. I even write articles and consult for the supplement industry. But I truly despise hearing unfounded marketing claims that some supplement companies will make in the pursuit of a fast buck.

There is no doubt that we need better, safer methods to deal with dangerous blood clots, whether in the lung, pelvis, or other areas. But, before anyone takes a leap based on the extravagant marketing claims made by a supplement manufacturer, you want to be damn sure there are real data--not marketing claims, REAL data--before you use something like nattokinase in place of a proven therapy.

Don't confuse the very interesting, though unpalatable, natto with nattokinase. Natto contains vitamin K2 and some other interesting compounds, including nattokinase.

Blame the gluten?

Wheat is among the most destructive components of the human diet, a food that is responsible for inflammatory disease, diabetes, heart disease, several forms of intestinal diseases, schizophrenia, bipolar illness, ADHD, behavioral outbursts in autistic children . . . just to name a few.

But why?

Wheat is mostly carbohydrate. That explains its capacity to cause blood sugar to increase after eating, say, a turkey sandwich on whole wheat bread. The rapid release of sugars likely underlies its capacity to create visceral fat, what I call "wheat belly."

But neither the carbohydrate nor the other components, like bran and B vitamins, can explain all the other adverse health phenomena of wheat. So what is it in wheat that, for instance, worsens auditory hallucinations in paranoid schizophrenics? Is it the gluten?

First of all, what is gluten?

Gluten protein is the focus of most wheat research conducted by food manufacturers and food scientists, since it is the component of wheat that confers the unique properties of dough, allowing a pizza maker to roll and toss pizza crust in the air and mold it into shape. The distinctive “doughy” quality of the simple mix of wheat flour and water, unlike cornstarch or rice starch, for instance, properties that food scientists call “viscoelasticity” and “cohesiveness,” are due to the gluten. Wheat is mostly carbohydrate, but the 10-15% protein content is approximately 80% gluten. Wheat without gluten would lose its unique qualities that make it desirable to bakers and pizza makers. Gluten is also the component of wheat most confidently linked to immune diseases like celiac.

The structure of gluten proteins has proven frustratingly elusive to characterize, as it changes over time and varies from strain to strain. But an understanding of gluten structure may be part, perhaps most, of the answer to the question of why wheat provokes negative effects in humans.

The term “gluten” encompasses two primary families of proteins, the gliadins and the glutenens. The gliadins, one of the protein groups that trigger the immune response in celiac disease, has three subtypes: a/ß-gliadins, ?-gliadins, and ?-gliadins. The glutenins are repeating structures, or polymers, of more basic protein structures.

Beyond gluten, the other 20% or so of non-gluten proteins in wheat include albumins, prolamins, and globulins, each of which can also vary from strain to strain. In total, there are over 1000 other proteins that serve functions from protection of the grain from pathogens, to water resistance, to reproductive functions. There are agglutinins, peroxidases, a-amylases, serpins, and acyl CoA oxidases, not to mention five forms of glycerinaldehyde-3-phosphate dehydrogenases. I shouldn’t neglect to mention the globulins, ß-purothionin, puroindolines a and b, tritin, and starch synthases.

As if this protein/enzyme smorgasbord weren’t enough, food processors have also turned to fungal enzymes, such as cellulases, glucoamylases, xylanases, and ß-xylosidases to enhance leavening and texture. Many bakers also add soy flour to enhance mixing and whiteness, which introduces yet another collection of proteins and enzymes.

In short, wheat is not just a simple gluten protein with some starch and bran. It is a complex collection of biological material that varies according to its genetic code.

While wheat is primarily carbohydrate, it is also a mix of gluten protein which can vary in structure from strain to strain, as well as a highly variable mix of non-gluten proteins. Wheat has evolved naturally to only a modest degree, but it has changed dramatically under the influence of agricultural scientists. With human intervention, wheat strains are bred and genetically manipulated to obtain desirable characteristics, such as height (ranging from 18 inches to over 4 feet tall), “clinginess” of the seeds, yield per acre, and baking or viscoelastic properties of the dough. Various chemicals are also administered to fight off potential pathogens, such as fungi, and to activate the expression of protective enzymes within the wheat itself to “inoculate” itself against invading organisms.

From the original two strains of wheat consumed by Neolithic humans in the Fertile Crescent 9000 years ago (Emmer and Einkorn), we now have over 200,000 strains of wheat virtually all of which are the product of genetic manipulations that have modified the protein structure of wheat. The extraordinary complexity of wheat proteins have therefore created a huge black box of uncertainty in pinpointing which protein causes what.

But there's an easy cure for the uncertainty: Don't eat it.

Glycemic gobbledygook

The concept of glycemic index is meant to help determine what foods raise blood sugar a lot vs. what foods raise blood sugar a little. Dr. Jennie Brand-Miller's searchable database can be found here.

I have to admit that glycemic index provided me with a sense of false assurance for some years. It screwed up my health until I came to understand the issues a lot better.

For those of you just starting out in nutritional conversations, glycemic index (GI) represents a comparison of the blood glucose area-under-the-curve (AUC) over 2 hours after consuming 50 grams of the food in question compared to the AUC of glucose or white bread. Volunteers involved in developing these values are healthy people who are generally of normal weight.

Glucose, by definition, has a GI of 100. An equal quantity of sucrose (50% glucose, 50% fructose) has a GI of 60, lower than glucose. An equal quantity of whole wheat bread has a GI of 68-77 (Yes: The GI of whole wheat is higher than sucrose). Non-carbohydrate foods, such as eggs or avocado, have no GI since they do not impact on blood glucose.

Because the GI is also sensitive to how much carbohydrate is contained, the concept of Glycemic Load (GL) was introduced:

GL = (GI x amount of carbohydrate) / 100

GL is therefore the GI that incorporates the glycemic potential of the food of interest. GI does not vary with portion size; GL varies with portion size.

Let's take whole wheat pasta, a food regarded by most people as a healthy choice. Whole wheat pasta has a GI of 55--fairly low--and a GL of 29. A serving of 180 g (approximately 6 oz cooked) provides 50 g carbohydrates.

People who advocate that low-glycemic index foods would say that this is a desirable profile and should therefore replace high-glycemic index foods.

I say WRONG. First of all, most of us are not slender 20-somethings. We will therefore not show the same response as a young, slender person (like the GI volunteers), but will show exagerrated blood sugar responses. So this much low-glyemic index whole wheat pasta will typically yield a blood sugar of 120-200 mg/dl in non-diabetic people, high enough to trigger glycation. Sure, a high-glycemic index food, such as white flour birthday cake with plenty of sugary icing, might trigger a blood sugar of 140-250 mg/dl, much worse. But that doesn't make the lower blood sugar following pasta any less bad--it's still terrible.

Another issue: GI is assessed over a 2-hour timeline. What if blood sugar remains high in a sustained way, say, over 6 hours? That's precisely what whole wheat pasta will do: Keep blood sugar high for an extended period.

So not only does a low-glycemic index food like pasta increase blood sugar in most of us extravagantly, it does so in a sustained way.

Lastly, low-glycemic index pasta still triggers small LDL particles to an extreme degree, as I discussed in the previous Heart Scan Blog post, Small LDL: Complex vs. simple carbohydrates.

Don't be false reassured by the notion of low GI or GL. In fact, I'd go so far as to say that NO glycemic index is a GOOD glycemic index (or load). The foods we want to dominate our diet are the foods that aren't even listed in the GI database.
Wheat belly

Wheat belly

You've heard of "beer bellies," the protuberant, sagging abdomen of someone who drinks excessive quantities of beer.

How about "wheat belly"?

That's the same protuberant, sagging abdomen that develops when you overindulge in processed wheat products like pretzels, crackers, breads, waffles, pancakes, breakfast cereals and pasta.



(By the way, this image, borrowed from the wonderful people at Wikipedia, is that of a teenager, who supplied a photo of himself.)

It represents the excessive visceral fat that laces the intestines and triggers a drop in HDL, rise in triglycerides, inflames small LDL particles, C-reactive protein, raises blood sugar, raises blood pressure, creates poor insulin responsiveness, etc.

How common is it? Just look around you and you'll quickly recognize it in dozens or hundreds of people in the next few minutes. It's everywhere.

Wheat bellies are created and propagated by the sea of mis-information that is delivered to your door every day by food manufacturers. It's the same campaign of mis-information that caused the wife of a patient of mine who was in the hospital (one of my rare hospitalizations) to balk in disbelief when I told her that her husband's 18 lb weight gain over the past 6 months was due to the Shredded Wheat Cereal for breakfast, turkey sandwiches for lunch, and whole wheat pasta for dinner.

"But that's what they told us to eat after Dan left the hospital after his last stent!"

Dan, at 260 lbs with a typical wheat belly, had small LDL, low HDL, high triglycerides, etc.

I hold the food companies responsible for this state of affairs, selling foods that are clearly causing enormous weight gain nationwide. Unfortunately, the idiocy that emits from Nabisco, Kraft, and Post (AKA Philip Morris); General Mills; Kelloggs; and their kind is aided and abetted by organizations like the American Heart Association, with the AHA stamp of approval on Cocoa Puffs, Cookie Crisp Cereal, and Berry Kix; and the American Diabetes Association, whose number one corporate sponsor is Cadbury Schweppes, the biggest soft drink and candy manufacturer in the world.

As I've said many times before, if you don't believe it, try this experiment: Eliminate all forms of wheat for a 4 week period--no breakfast cereals, no breads of any sort, no pasta, no crackers, no pretzels, etc. Instead, increase your vegetables, healthy oils, lean proteins (raw nuts, seeds, lean red meats, chicken, fish, turkey, eggs, Egg Beaters, low-fat yogurt and cottage cheese), fruits. Of course, avoid fruit drinks, candy, and other garbage foods, even if they're wheat-free.

Most people will report that a cloud has been lifted from their brains. Thinking is clearer, you have more energy, you don't poop out in the afternoon, you sleep more deeply, some rashes disappear. You will also notice that hunger ratchets down substantially. Most people lose the insatiable hunger pangs that occur 2-3 hours after a wheat-containing meal. Instead, hunger is a soft signal that gently prods you that it's time to consider eating again.

You will also make considerable gains towards gaining control over your risk for heart disease and your heart scan score, a crucial step in the Track Your Plaque program.

Comments (31) -

  • JT

    7/23/2007 1:42:00 PM |

    Ahhhhh.... a picture of an average American, fat and round.  I don't mean to say that in a negative way about my countries people but looking around I've noticed how many obese people there are in the USA.  Being overly thin at 6' and 145lbs makes me stick out and that's no fun.  I wish more Americans would take better care of their health, avoid high glycemic foods like wheat, and become thin.  If that happened then I could look like an average American.

  • ortcloud

    7/23/2007 10:23:00 PM |

    I did it, I am off wheat and sugar and it wasnt easy, its very addictive and its everywhere.

    So, the consensus is I feel GREAT !!

  • Stan

    7/23/2007 11:18:00 PM |

    100% true!  Especially the brain fog part!

    Heretic

  • Anne

    7/24/2007 11:03:00 AM |

    Convincing others that wheat may be contributing to their health woes is an uphill battle. I have found most people refuse to consider that food may be affecting their health. They usually tell me that their medication is working and they could never give up foods with wheat.  

    I am not only wheat free, but gluten free and so much healthier than I was when I was eating breads. It was not easy to give up my favorite food, but well worth it.

  • Dr. Davis

    7/24/2007 12:59:00 PM |

    I believe that we can only set examples for others to follow.

    If you are a clear-thinking, energetic, slender person, free of wheat products, eventually the wheat bellies around us will ask why. That's your opportunity to instruct.

  • Bix

    7/25/2007 12:08:00 PM |

    Wheat bellies Smile

    I agree with anne, especially the uphill battle part.  My experience: people nod in agreement but silently dismiss the no-wheat message, thinking, "It can't be my Shredded Wheat!"

    Please excuse my icon.

  • JT

    7/26/2007 12:55:00 PM |

    These are two reports I do not enjoy reading this morning.
    JT  

    Panera Bread reports 28 per cent revenue boost

    By Karen Willmer


    Industry develops whole grain 'action plan'
    Panera raises outlook after strong Q3 results
    Panera holds up against higher costs
    Panera Bread to acquire 23 bakery-cafes
    Strong growth for Panera Bread offset by high costs?




    News Archives

    All news for July 2007
    All news for June 2007

    26/07/2007 - Panera Bread said yesterday second quarter revenues for 2007 increased 28 per cent over the same period last year, but operating profit fell by 3.4 per cent.

    Operating profit was $18.9m (€13.8m) for the quarter compared to $21.4m (€15.6) the previous year.

    The company said this was due to shifts within the product ranges and the high prices of raw materials.

    "While second quarter results are somewhat disappointing, we are pleased to see some of our investments in the bakery-cafes pay off with higher comp store sales increases," said chief executive Ron Shaich.

    Bakery-café sales increased 2.1 per cent during the period, and Panera Bread expects this to increase by 3.6 to 3.9 per cent over the four weeks up to July 24.

    The company also predicts bakery sales growth of 2.25 to 4.75 per cent following the opening of 39 new bakery-cafes and the acquisition of a further 32 bakery cafes during this last quarter.

    Bakery-café sales revenue increased from $157m to $209m for the second quarter of 2007, forming 82.9 per cent of the company's total revenues. Bakery-café sales formed 79.7 per cent of total revenue during the same quarter the previous year.

    "We look forward to continuing our positive sales trends while at the same time addressing the margin issues currently impacting our results," Shaich said.

    Panera Bread operates 1,027 bakery-cafes across US, 391 are company owned, and 696 franchised, all producing speciality breads and bakery products.

    The company's focus on the bakery-cafes helped increase revenues, however fresh dough sales to franchises were down 2.1 per cent of total revenue to $26m and revenue from franchise royalties was down to 6.7 per cent of total revenue to $17m.
    ___________________________________

    Researchers: Obesity Can Be Contagious in Social Circles

    Wednesday, July 25, 2007

    LOS ANGELES —  If your friends and family get fat, chances are you will too, researchers report in a startling new study that suggests obesity is "socially contagious" and can spread easily from person to person.

    The large, U.S.-funded study found that to be true even if your loved ones live far away. Social ties seem to play a surprisingly strong role, even more than genes are known to do.

    "We were stunned to find that friends who are hundreds of miles away have just as much impact on a person's weight status as friends who are right next door," said co-author James Fowler of the University of California, San Diego.

    The study found a person's chances of becoming obese went up 57 percent if a friend did, 40 percent if a sibling did and 37 percent if a spouse did. In the closest friendships, the risk almost tripled.

    On average, the researchers calculated, when an obese person gained 17 pounds (7.7 kilograms), the corresponding friend put on an extra 5 pounds (2.3 kilograms).

    Gender also had a strong influence. In same-sex friendships, a person's obesity risk increased by 71 percent if a friend gained weight. Between brothers, the risk was up by 44 percent and 67 percent between sisters.

    Researchers think it is more than just people with similar eating and exercise habits hanging out together. Instead, it may be that having relatives and friends who become obese changes one's idea of what is an acceptable weight.

    Despite their findings, the researchers said people should not sever their relationships.

    "There is a ton of research that suggest that having more friends makes you healthier," Fowler said. "So the last thing that you want to do is get rid of any of your friends."

    The study was published in Thursday's New England Journal of Medicine and funded by the National Institute on Aging.

    Researchers analyzed medical records of people in the Framingham Heart Study, which has been following the health of residents of that Boston suburb for more than a half century. They tracked records for relatives and friends using contact information that participants provided each time they were examined over a 32-year period.

    In all, 12,067 people were involved in the study.

    After taking into account natural weight gain and other factors, researchers found the greatest influence occurred among friends and not among people sharing the same genes or living in the same household. Geography and smoking cessation had no effect on obesity risk.

    Indiana University statistician Stan Wasserman said while the study was clever, it had its limitations because it excluded relationships outside of the Framingham group.

    Obesity is a global public health problem. About 1.5 billion adults worldwide are overweight, including more than 400 million who are obese. Two-thirds of Americans are either overweight or obese.

    Much of the recent research focus has been on the intense hunt for obesity genes involved in appetite or calorie burning.

    The findings could open a new avenue for treating this worldwide epidemic. The researchers said it might be helpful to treat obese people in groups instead of just the individual.

    "Because people are interconnected, their health is interconnected," said lead author Dr. Nicholas Christakis, a Harvard sociologist.

  • Dr. Davis

    7/26/2007 1:47:00 PM |

    Yes--connect the dots. Our overweight friends and relatives who eat at Panera and similar wheat-prmooting establishments don't realize that the inches they pack on fatten someone elses' wallet.

    What I find puzzling is the focus in the second article on genetics as a cause:

    Much of the recent research focus has been on the intense hunt for obesity genes involved in appetite or calorie burning.

    It ain't the genes. It's the food.

  • JT

    7/26/2007 5:28:00 PM |

    I agree,  

    The way I see it, we live in a pc era.  If one makes a judgment in the general pubic concerning why someone is overweight chances are the pc police will attack.  It is easier to blame something else, like genes, as being the cause.

  • Cindy Moore

    8/4/2007 3:30:00 AM |

    I've been using the beer belly as an example recently and I'm amazed that people think a beer belly is from the alcohol, not the carbs! That's when I explain the difference in appearance, etc between a big belly due to cirrhosis and one from too many carbs....and how it's not where the carbs come from, but the levels.

    Until recently I thought most of my co-workers thought I was nuts, and many still do, but lately I've had a couple of conversations with a few that are trying to get healthy and they've been listening! There are now a few of us that discuss things, compare diets and share articles. It's nice to see people questioning the dietary advice that the "experts" promote.

    I've been off sugar for over 22 weeks...and wheat is the next thing I'm cutting out. I'm hoping cutting wheat will bring my triglycerides down to where I want them. Last checked they were 146! My doc was happy, but I'm not!

  • Dr. Davis

    8/4/2007 3:36:00 AM |

    My prediction: You will be amazed at the results in plummeting triglycerides, weight loss, clearer thinking, increased energy.

  • Jerome

    12/24/2007 1:46:00 PM |

    Being a 32 y/o male and just having finished nursing school, I can say that in the past year I have gained 32#'s.  I was attributing this to my mediterrainian diet of pasta/starches, vegetables, meat, pasta, bread and pasta but must also now add beer.  A drink surely given to us by the gods that I had abstained from consumption until the past 1.5 years.  I can really tell you that I have noticed not only weight gain but definate truncal expansion.  When discussing it with some close friends and trusted sources of info (over a pint of the good stuff) we all can say we notice that it is becoming more prominant especially since we enjoy so much of the wheat based product.  All though I cannot say I can guarantee I can break from the wheat stronghold entirely, I can surely start making a change and see how that effects my life, health, weight.

  • Syera

    6/11/2008 2:11:00 PM |

    I've heard vegetarians blaming these protuberant paunches on meat of all things - it's nice to see someone on the Interwebs actually pointing a finger in the right direction for once.  Smile

  • DrBee

    7/15/2008 7:23:00 PM |

    What about other sources of processed carbs?  I'm mainly thinking of things like rice and corn-based products that are presented as alternative to wheat.

  • Ricardo Carvalho

    9/12/2008 4:10:00 AM |

    I think this can be called Paleodiet: www.thepaleodiet.com, www.marksdailyapple.com, www.staffanlindeberg.com, en.wikipedia.org/wiki/Paleolithic_diet, www.totalhealthbreakthroughs.com/2007/11/start-running-your-body-on-the-right-fuel/

  • Anonymous

    9/19/2008 9:32:00 PM |

    Wow, look at those PECS, he must work out a LOT!

    I heard you had to eat a lot to gain muscle, and some of it is fat. So WOW!

  • Anonymous

    3/9/2009 3:47:00 AM |

    Let's not forget that nearly ANYTHING done out of balance can cause problems. Eat enough carrots (like tons) and you go … a bit orange. Eat nothing but fats and … Well, you get it. ANY diet that's far our in ANY direction will cause problems. Heck, even eating a balanced diet but loaded with snacking and no exercise… right back where we started. So while Wheat can be a bad guy, it's far from the only one.

    Erik

  • Gardener Cath, mum of some

    11/5/2009 4:14:31 AM |

    Is it wheat specifically or other grains also?

    I have had a battle (lately lost) to control my weight but always knew that if I cut carbs I lost weight very quickly. Never maintained the weight loss because whenever I went back to a normal diet (and I eat a well balanced vegetarian diet and always have, not a snack-ridden processed one) the weight crept back on.

    Recently dropped wheat (and all other cereals) after stumbling across this site and already shedding excess baggage.

    When I get back to the size I like to be can I include some non-wheat grains and carbs?

  • Anonymous

    6/9/2010 1:39:50 PM |

    I've been on low-carb (no wheat , no processed sugar ) since November. I feel GREAT ! I have lose my wheat belly ( lost 23 lbs. ) and no more acid reflux. This is a great change. I do feel more mentally clear.  No more IBS since giving up the glueten. I am convinced this is the way to go.

  • ADVENTUREinPROGRESS

    7/26/2010 12:46:34 PM |

    I hear what you are saying, but I don't think you can necessarily blame wheat. I think the problem is refined foods in general and lack of fresh fruit/vegetable consumption. It just so happens that wheat is in most of those processed foods, and thus looks like the culprit. I would posit that we would see exactly the same problems if any other refined starch were used as the base.

    Eating some whole grains and starches (including wheat) - and I am not talking about flour based - like rolled/steel-cut oats, sweet potatoes, etc. can be a very healthy part of a good diet.

  • Dorothy Minichiello

    8/19/2010 2:03:52 PM |

    Great article that most folks need to read.  I must also point out with all due respect to the young man who supplied the photo that just by observation alone, he has had excessive exposure to xenoestrogens which can come from plastic, herbicides, pesticides etc. (that's just the tip of the iceberg and a whole other subject) - this is something he should also address in his diet makeover and would be another great health improvement in his life.  

    Great article I will certainly repost!!

  • buy jeans

    11/2/2010 7:45:04 PM |

    As I've said many times before, if you don't believe it, try this experiment: Eliminate all forms of wheat for a 4 week period--no breakfast cereals, no breads of any sort, no pasta, no crackers, no pretzels, etc. Instead, increase your vegetables, healthy oils, lean proteins (raw nuts, seeds, lean red meats, chicken, fish, turkey, eggs, Egg Beaters, low-fat yogurt and cottage cheese), fruits. Of course, avoid fruit drinks, candy, and other garbage foods, even if they're wheat-free.

  • roberto cavali

    11/19/2010 11:08:27 PM |

    Hello to all Smile I can�t understand how to add your site in my rss reader. Help me, please

  • O Primitivo

    1/28/2011 5:17:31 PM |

    Low density lipoprotein cholesterol is inversely correlated with abdominal visceral fat area: a magnetic resonance imaging study. - http://www.ncbi.nlm.nih.gov/pubmed/21247428

  • Margaret

    7/10/2011 11:05:16 PM |

    After being off all grains and being healthier would eating oatmeal once in a while be permitted? Also should dairy be eliminated and what about Soy or Rice milk?
    I find some advice confusing.
    Margaret

  • melissa

    7/15/2011 4:33:16 AM |

    Am I wrong, or is it pretty much impossible to establish a wheat-free diet AND maintain a vegetarian one? Sure seems like that would be the case.

  • JLC

    8/6/2011 10:36:12 PM |

    Question. I have only been doing this a week but it sounded like I would see results like "1 pound a day for the first 10 days". I am not seeing that. I went cold turkey and have not had any grains, processed foods, or sugars in that time and intend to continue. Should I be concerned? I lost 5 pounds after the first few days, and now seem to have gained it back. Not sure what's going on. I HAVE NOT CHEATED!
    Thanks for any advice or help. Maybe I just need to stick with it? I have tested and am not in ketosis judging by the strips, my blood sugars never seem to go above 100 or 105 even 1 hour after a meal. Thanks again.

  • Dr. William Davis

    8/8/2011 12:07:02 AM |

    Hi, J--

    More than likely there's something in your diet that is booby trapping your weight loss or you are hypothyroid.

    Hypothyroidism is incredibly common and underdiagnosed.

  • JLC

    8/8/2011 1:15:21 AM |

    Please another question. The only thing I can think of is a scotch after dinner. Does alcohol sabotage this process? Can't wait to get the book. I'm sure it will be great. Just put it on my wish list on amazon and it said it would be delivered to my ipad (kindle app) Aug 30.

  • Anna D.

    9/28/2011 11:31:31 PM |

    Alcohol can absolutely sabotage any weight loss. Although one or two drinks should not cause weight gain, many people say that a day they consume ANY alcohol is a day that they will not lose any weight. So you want to limit drinking to 1-2 days per week, and limit the number of drinks to 2-3. Elimination of alcohol consumption, or limiting to only special occasions would however be most ideal.

  • Carole

    11/6/2011 5:41:00 PM |

    Please clarify regarding the use of the following foods on the Wheat Free plan- brown rice pasta, brown rice bread, spelt bread. I have had success on the program losing 20 lbs in 6 weeks but wanted to know if I could have small quantities of the above mentioned products and still avoid the perils of wheat! Thanks

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