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.
Supermarkets and buggy whips

Supermarkets and buggy whips

Will supermarkets eventually phase out, joining the history books as a phenomenon of the past? Or are supermarkets here to stay, an emblem of the industrialization of our food--easy access to foods that are convenient, suit the undiscriminating masses, stripped of nutritional value despite the prominent health claim on the package front?

Anna left an insightful comment on the last Heart Scan Blog post, Sterols should be outlawed, along with some useful advice on how to avoid this trap for poor health called a supermarket:


I rarely shop in regular supermarkets anymore (farm subscription for veggies, meat bought in bulk for the freezer, eggs from a local individual, fish from a fish market, freshly roasted coffee from a local coffee place, etc.). What little else I need comes from quirky Trader Joe's (dark chocolate!), the fish market, farmer's markets, a small natural foods store, or mail order.

When I do need to go into one of the many huge supermarkets near me, not being a regular shopper there, I never know where anything is, so I have to ramble a bit around the aisles before I find what I'm looking for (and I almost always can grab a hand basket, instead of a trolley cart).

It's almost like being on another planet! There's always so many new products (most of them I hesitate to even call food). It's really a shock to the senses now to see how much stuff supermarkets sell that I wouldn't even pick up to read the label, let alone put in a cart or want to taste. I'm not even tempted by 99% of the tasting samples handed out by the sweet senior ladies in at Costco anymore (only thing I remember tasting at Costco in at least 6 mos was the Kerrygold Irish cheese, because I know their cows have pasture access and it's real food).

What's really shocking to me is how large some sections of the markets have become in recent years. While Americans got larger, so did some sections of the supermarket (hint - good idea to limit the consumption of products from those areas). Meat and seafood counters have shrunk, though. Produce areas seem to be about the same size as always (but more of it is pre-prepped and RTE in packaging.

But the chilled juice section is h-u-g-e! And no, I don't think there is a Florida orange grove behind the cases. Come on, how much juice do people need? Juice glasses used to be teeny tiny, for a good reason. To me it looks like a long wall stocked full of sugar water. Avoiding that section will put a nice dent in the grocery expenses.

The yogurt case is also e-n-o-r-m-o-u-s! Your 115 yo Bulgarian "grandmother" wouldn't know what to make of all these "pseudo-yogurts"! Chock full of every possible variety, but very little fit to eat. The only yogurts I'll look at are made with plain whole milk, without added gums, emulsifiers, or non-fat milk solids, and live cultures (I mostly buy yogurt now and then to refresh my starter culture at home). I can flavor them at home if needed. The sterols are showing up in processed yogurts, too, along with patented new strains of probiotic cultures (I'll stick to my old fashioned, but time-proven homemade lacto-cultured veggies and yogurt instead).

I found the same "cooler spread" in the butter & "spread" section. The spread options were just grotesque sounding. Actually, the butter options weren't much better, as many were blended with other ingredients to increase spreadability, reduce calories or cholesterol/saturated fat, etc. A few plain butters were enhanced with "butter flavor" - say what? And on no package could it be determined if the butter came from cows that were naturally fed on pasture or on grain in confined pens.



Well said, Anna.

There's a huge supermarket about 1 mile away from my house similar to the one Anna describes with aisle after aisle of eye-catching cellophane-wrapped foods. I go there about every 3 or 4 months, and then I only go to get something I need in a pinch. Every time I go, I too am reminded just how many products there are that look more like junk food than real food.

But there's no real money in real food. Who gets rich off of selling green peppers, tomatoes, and eggs?

Supermarkets sell these modern industrial foods because people buy it: Look around you. You don't get to be a 250 lb 5 ft 2 inch-woman by eating too many cucumbers.

Like Anna, I drive an additional several miles to Trader Joes', buy at farmers' markets whenever possible, buy some odds and ends like wine and cheese and raw nuts at specialty stores. I grow my own basil in a big pot I keep in the kitchen and we are just about to start turning over the soil in the back yard for our vegetable garden. I don't need nor do I miss having the choice among 40 different chips, 25 brands of ready-made microwavable dinners, an entire aisle of breakfast cereasl (all of which are virtually the same with different names and labels), or 75 varieties of salad dressing.

The supermarket for me--and I hope for many of you--has become a place rarely frequented, and only for the odd forgotten item. Oh, I forgot the dog chewies the grocery does have--my dogs love them. So perhaps they are good for something after all.

Comments (17) -

  • Anonymous

    3/17/2009 1:15:00 PM |

    A nice thought, to demodernize and go back to the days of a different shop and source for every grocery item, but even when trying to live clean, supermarkets can still win out budget-wise during these troubled times.  I'm mostly living off of frozen vegetables and lots of canned salmon etc.  The food *ideal*?  No.  But it's not trash, either.

    Don't throw out the baby with the bath water!

  • Brock Cusick

    3/17/2009 1:56:00 PM |

    The first and most important problem with grocery stores is that they're allowed to take bribes from the food vendors. That means they really work for the food vendors with the greatest degree of vertical integration, organization & bargaining leverage (e.g., Coca-Cola, Kellogs, the Florida Orange Growers Association, etc.) and not for the customers that shop the aisles.  This perverse incentive explains almost everything that's wrong with supermarkets today.

    The second biggest problem is that those same parties I mentioned above have taken control of the political process that governs nutritional disclosure, creating barriers of ignorance between "customers" at the grocery stores and truly useful information.

  • JPB

    3/17/2009 4:07:00 PM |

    Comment to Brock:  Your comment could also apply directly to the medical profession with a little editing!

  • Anonymous

    3/17/2009 5:37:00 PM |

    Anna is lucky to be able to find all these natural, organic, pasture raised produce, but some of us are not lucky enough to afford or find space for large freezers in our tiny apartment sized fridges. It's still winter here so no markets with fresh produce, no free range hens grazing in the snow and below zero temperatures. However, I do frequent the halal and polish meat markets whenever possible. We don't have a trader joe's and the 2 organic markets here may as well post a sign on the door "only millionaires can afford to shop here." Supermarkets are ok if you know what sections to shop in and what to buy. They are also starting to stock organic products like cheese made with raw milk (which is banned in Canada btw).

    Sorry about the rant but not everyone is as fortunate as others.

  • Lola

    3/17/2009 10:00:00 PM |

    Supermarkets will exist as long as there are people who are simply too busy or don't have the energy to get to all those different stores. In the old days when "main street" could still be counted on, you could go to the grocer, butcher, fishmonger, baker etc all within a short distance of each other. Now you often have to drive, bus, walk all over town to get to them.  For most low income people, this is not an option. Working two minimum wage jobs doesn't leave much time or energy except to get in and out of a supermarket as quickly as possible. A disabled person may not even have good access to some of these places. [When my hypothyroidism was at the height of its untreated awfulness, going to more than one store in a day was unthinkable.] Bear in mind also that many low-income people live in areas where the only food stores are a crappy supermarket and fast food outlets and no other places will open because they know nobody can afford it.

    If we *really* want to improve peoples' health, then we need to work on eradicating the causes and effects of poverty. It's no good if we get an organic market to open in the ghetto or rural town if people can't afford to go there or aren't able to get there. Perhaps instead of all the food subsidies going to Big Farming, we could subsidise business owners that wanted to open in low-income areas. But somehow when the government uses money that will help the poor it's Evil Pinko Commie Welfare but when giving the same money to big business it's fine and dandy. That's why I don't think the government (and it doesn't matter whether Democrat or Republican) doesn't actually care about health despite all the bleating about obeeeeeesity.

  • baldsue

    3/17/2009 10:53:00 PM |

    Nope, I didn't slim down from size 14 to size 2 by walking the aisles of my local supermarket.  Instead I rode my bike to the farm down yonder for my fruits and veggies and I hopped into my car to drive to Trader Joes and Whole Foods for the rest of my nutrients.  And that's the way it's going to stay for me.

  • vin

    3/18/2009 10:55:00 AM |

    I buy all my fresh greens, fruits, fish and nuts from my supermarket. Frozen and canned foods are useful in the winter months.

    Rest of the food asiles are simply not interesting.

    Local green grocer's shop has usually little choice and very often unripe food.

    Just look around in the supermarket and you can find almost everything you need to stay healthy.

  • Kipper

    3/18/2009 11:35:00 AM |

    Supermarkets are to some extent what you make of them. I end up at Safeway fairly often due to my schedule, but I couldn't tell you what was in most of the interior aisles or freezer cases.

  • Anne

    3/18/2009 1:08:00 PM |

    There's no fishmongers or butchers which sell organic produce near me, and no greengrocers which sell organic produce either, nor farmer's markets, but I hardly ever set foot in a supermarket ! Instead I shop online in the comfort of my living room from them ! I buy organic meat, fish, fruit and veggies, tea and coffee, and household items, from my supermarket, but because I buy online I don't have to pass shelves and shelves of junk food and get a headache from the bad atmosphere there. The prices are the same whether online or in store and there's no delivery charge because I get my shopping mid week - it's a fantastic deal which saves stress, time and money Smile

    Anne

  • Anonymous

    3/18/2009 2:37:00 PM |

    Good points made in the above comments!

    I would LOVE a Trader Joe's or a farmers market, or even a Whole Foods market in my area... they aren't here in the suburbs where I live... all are 20 miles away in the city, or simply non-existent here.

    It just doesn't make sense to drive that far for my food (utilizing some of the outlets quoted by Dr. Davis in his blog post), and only patronizing some of these type outlets frankly sounds a bit elitist... and quite expensive, too.

    Rather, the commitment to good health requires some resourcefulness... I'm into figuring out what I CAN healthfully eat from Randall's (Safeway), Kroger, H*E*B, and Costco... stores reasonably close.  I'm into planting my own fresh herbs, and a small "victory" garden of vegetables we enjoy... it's fun, challenging, and good exercise, too.

    But I am fortunate... I have a generous food budget, I live in a reasonably populated area, with excellent weather and growing conditions most of the year, and access to fresh produce and quality supermarket foods year round.  Just mostly stay away from the center of the supermarket, be knowledgeable and selective while there, and you will be fine... that's my advice... oh, and if people don't continue to buy junk, the "supers" won't be stocking it for very long.

    madcook

  • Gretchen

    3/18/2009 3:24:00 PM |

    I agree with some others that not everyone can afford to shop at upscale organic markets. Not everyone has access to locally produced farm produce.

    We have to work with what's available, and unfortunately, the people who need the most help nutritionally are the ones who can't afford fresh food.

    We need to educate people about how to find better food at a supermarket.

  • scall0way

    3/18/2009 3:47:00 PM |

    OK, I shop at a supermarket! But I'm mostly a "perimeter shopper" - produce, dairy, meats, etc. But it's convenient because I can buy things like paper goods, detergents, light bulbs, all those other non-food items that supermarkets carry. The place is only a little over a mile from my house. I save on gas and energy. I do love the local farmer's market - but it's only open June-November. I do love Trader Joe's - but there are none nearby. It's a haul to get to one, so I limit my trips. I love Whole Foods, but it's too expensive other than for certain special items.

    But I would not even give my *dogs* food or treats from a supermarket. We get our food and treats from a pet store whose philosophy gibes pretty well with my own. Founded to: "provide our customers with the healthiest foods, best products and highest quality of pet-animals ever assembled in one store...We believe that animals should eat what nature intended them to eat, along with a variety of natural supplements."

    LOL, not only is my own health better these days, but so is the health of my pets. Smile

  • Monica

    3/19/2009 8:44:00 PM |

    Pet snacks from the supermarket?!  Smile

    OK, I have to admit that made my eyebrows go up.  I happened upon healthy eating for myself by first figuring out what was healthy for my pets when the pet food scare happened a few years ago.  I doubt dog chewies contain melamine, and perhaps they aren't a routine in many households, but they're not an evolutionarily appropriate food for dogs.  The only pet snacks I get at the supermarket are the big chunks of raw meat that get thrown to my dog and cats daily... the food they were designed to eat.  (I can almost hear people exclaim how expensive this is but it's way cheaper because the meals themselves are treats because they take 15-30 minutes to eat.)

    90% of the stuff in the grocery store isn't fit for human consumption, that's true.  However, it's still very handy for many things.  You can completely avoid the unhealthy stuff with a little effort.  That's not even remotely possible in the pet aisle in which every single product is a derivative piece of frankenfood.  

    Throw your dog or cat a raw meaty bone and some organ meats now and then.  They will thank you with good health once they have been getting real food long enough.  You will never need a $300 tooth cleaning at the vet, that is for sure.

  • Rob

    3/19/2009 9:30:00 PM |

    From what I have seen of TJ's and Whole Foods, you can do yourself a lot of the same harm in the center of these stores as the local MegaMart.   Stick to the outsides no matter which store you shop in.  Although! I will say that I recognize most of the ingredients in JT's inner aisle food, not so true of the supermarket! And I like the sardines at TJ's.

  • Anna

    3/21/2009 7:48:00 AM |

    Great comments, everyone.  Yes, it's true, we all have different circumstances, different locations and climates, different food budgets, and different ways of coping with our food sourcing options.   The most important thing is to find what works best with the resources/options one has (assuming one knows all the resources).  But so many don't even ever consider looking "outside the box" or think about how to do it without relying on a supermarket.  I am continually amazed at how many terrific resources are out there, not just here in So Cal, but in many communities, practically in people's own backyards, but they don't know about it or take advantage.

    Even the 99 cents store has some good options, if one can avoid the minefields of cheap sugars, starches and processed foods.  That's were I go to shop for  my donations to the local food pantry, where they mainly want non-perishables in unbreakable packaging.  I buy canned and pouched salmon, sardines, and tuna there, because I know so few complete protein foods are donated.  

    I do think it's possible to eat pretty well from a supermarket *if* one is disciplined, truly informed and willing to forgo convenience for real food, but there are so many hazards at the supermarket that many can't easily avoid or don't know to avoid (especially if they are paying attention to mass media nutrition advice).  I'm sure it didn't save me any time to shop there way back when and it certainly wasn't very enjoyable.  I know I spent more money there for food that wasn't as good for us (I was too easily tempted and distracted too often), despite ironically trying very hard to pinch pennies with coupons, sale circulars, buyer's cards, and shopping around.  

    We *are* fortunate with our mild local climate and long growing season, but I know people in Madison, WI and upstate NY who have great produce from their CSAs, too, just in a shorter time frame (though many practice traditional food storage methods, like root cellaring and lacto-fermentation to extend the harvest).  Some CSAs allow for a trade of labor instead of payment, too.  My neighbor and I take turns on pickups for our biweekly CSA boxes, so I only have to make a 14 minute (round trip) drive once a month for most of my produce, a huge timesaver (I do understand there are transport issues for some people and I know I'm fortunate to have a car, but I *could* (but don't very often) ride a bike to get my food at stores or the CSA spot, too - I have two shopping baskets that easily detach from the rear rack).  My CSA pickup point is in the other direction of the stores, but only a tiny bit farther and in a somewhat rural, natural part of town, far more pleasant than the long cashier lines, parking lots,  and stop-& go traffic hazards near the stores.

    I'm probably going to host a new pickup point next quarter at my house, so now our community will then have east, west, *and* a central pickup location, making this CSA even more convenient for more people who want to join (there's a waiting list).  The CSA can to expand from 1500 to 2000 members if they add some new pickup spots.  New CSAs with slightly different membership models have started up in recent years offering even more choices for people, too.

    But is it more expensive?  My CSA's large biweekly box costs $30 (there are two sizes, with weekly or biweekly options and any number of boxes can be canceled in advance before the start of a quarter, with 2 allowed cancelations with notice during the quarter - so it's quite flexible).  Members pay for their boxes in advance for a quarter year (though if I host a weekly pickup spot in the future, I'll get a box for free); I think $15 a week for the generous amount of high quality, just picked produce is *very* competitive with any store of any caliber in my area (except maybe the super low prices at the 99 cent store are less, but even then it would be close in cost; the variety and quality of the 99 cent store produce doesn't even come close).  I know people who spend that much or more on a delivery pizza or takeout for one meal for their family (or dvd rentals for the weekend).  I think I could only do better if I grew it all myself (instead, I put my edible gardening efforts into "special" crops or lazy things like bananas, fig and citrus trees).

    We love eggs and consume a lot each week in many varied dishes.   The eggs I buy via my neighbor's co-worker are $1 cheaper per doz than the eggs I would buy in the store(thankfully my neighbor doesn't mind transporting several doz eggs once a week to me).   Prior to that, I had a "backyard" egg source that was even cheaper (half the store price), *and*  (maybe this is the elitist aspect) they delivered them to a cooler on my front porch because they were already delivering meat, eggs, and goat milk to a local alternative health institute (until the couple split up and ended their "backyard" farm business).  

    One of the few places I do get take-out now and then is the local, family owned (non-franchise) rotisserie chicken place.  I make salad and veggie sides at home, though.  Great chicken using marinade  ingredients I might use at home if I were roasting the chicken;  5 quarters (an extra leg) when you buy a whole chicken for $10 (it's the only thing I buy there, our family of three can eat off it for at least 2 meals, plus soup, and it doesn't have the chemical injections that the cheaper grocery store rotisserie chickens contain).   I watch other families spend $20-30 for a single meal every time I go there.  I often ask for 5 pieces to be legs because I know they always have lots legs (and they have more flavor and moisture), since nearly everyone else requests the "healthy" chicken breast combos.  Sometimes they have extra cooked whole chickens in their cooler for $4 (from earlier in the day or the night before), so I always get one or two extra when available.  And the old guy at the counter is always happy to make up a huge container of wings, backs, and meaty scraps for me, for my chicken broth; it makes really great mineral-rich flavorful broth.   So I have a cheap streak that wants to eke out everything but the cluck Wink.  I know families that throw away more food than my family eats.

    So clearly, I don't think putting a priority on wholesome unconventionally sourced food is necessarily really expensive, nor is it "elitist" at all  - we don't drive fancy cars and make other decisions that allow eating good food easier (both my husband and I grew up in families where money was quite scarce for significant periods of time, but both our mothers were extremely resourceful when it came to nourishing, economical food - so we are *very* mindful of how fortunate we are).  The  "elitism" charge that often comes up in food issue discussions distracts from the real issues.  I'm not suggesting there aren't considerable barriers to eating well for some people, there are, and some are very hard to overcome.  I donate regularly to the local food pantry and am very aware of local "food insecurity" issues, which of course have worsened  lately.  I'm also aware of how difficult it is to get fresh, nutrient dense food into the hands of those most needing it.

    But not everyone is in that sort of position, and some non-supermarket options can sometimes actually work better for people with difficulties sourcing good food, though of course, that will vary to situation to situation.  I'm just suggesting that it can be worth looking for alternatives; there *are* other options "outside the box" in many, if not most places; it sometimes just takes the desire and creativity to find and access them.  And sometimes it requires shifting priorities, which can be hard to do (especially if lacking support from significant others).  Believe me, my husband and I have shifted some of our priorities (financial as well as lifestyle considerations) to accommodate good food (and sitting down to meals together most nights) being high on our list of priorities.  We want to eat well, but that doesn't necessarily mean extravagantly.

  • Dr. William Davis

    3/21/2009 5:55:00 PM |

    Thanks for the well-thought out description of your experience, Anna.

  • Trinkwasser

    3/21/2009 7:50:00 PM |

    A big AMEN!!! from over here. I treat most of the supermarket as a toxic waste dump. Mother likes it because it's cheap and the floor is level. The rest of the town is on a hill and she has difficulty with hills so I get the rest of the stuff from the local shops.

    Mind you, the Organic Shop is something of a toxic waste dump too if you're trying to avoid carbs. And the supermarket is better than many others I've used in the past (Co-Op), they have Fairtrade stuff and the veggies aren't that bad. When I worked full time it was nearly as good as shopping around, you traded quality for convenience to a degree but you need discipline to work one properly.

    Can't beat locally grown meat, fish and veggies for quality though and sometimes they're not that much more expensive and occasionally cheaper, plus the money goes to local businesses rather than to anonymous shareholders: don't forget that supermarkets get their low prices by screwing their suppliers.

Loading