Thursday, January 5, 2012

Book Review: "Wheat Belly" by William Davis, M.D.

Readers of this page will know that, in the last fifteen months or so, I've been directing my OCD laser beam on issues of sports nutrition.  It's turned out to be a fascinating and engagingly reticulated field to study, and one with surprisingly few certainties, at least on a prescriptive level.  Michael Pollan has singlehandedly waged a pretty effective public-relations war on the corn industry, long thought to be an innocuous source of staple food products.  Michelle Obama took a lead public relations role in replacing the established, if deeply misguided, food pyramid with something called "My Plate" that, according to certain pundits, has been a spectacular failure.  In each case, the modern thinking is not only different from what the government had advocated previously, it is almost directly contrary to it, implying that the previous advice that consumers were given would actually have hurt them if followed.

Diets are, if anything, even worse.  There are innumerable ones out there, from Atkins to Paleo, South Beach, Weight Watchers, Dean Ornish, Blood Type, Zone, and even Subway.  Consumers could be forgiven for concluding that any dietary approach will lead to weight loss except their present one.   Everyone has an opinion on the right way to eat, and it's not hard to marshal facts in support of virtually any approach when outlets like CNN are reporting breathlessly that a professor of human nutrition lost twenty-seven pounds in two months eating nothing but a Twinkie every three hours.
Apparently no one chooses My Plate.

Despite the overwhelming amount of often-contradictory information out there, I've come to think that there are right answers, or at least better and worse answers.  I overhauled my diet pretty thoroughly last year, dropping ten pounds while building lean muscle in the process, and my race results showed it.  I think that further improvements are always possible, however, and in any case, I simply can't stop myself from cramming as much information into my head as I can find.  And so it was that I heard a podcast interview with William Davis, MD, the author of "Wheat Belly," who argued broadly that, for countless reasons, wheat in its modern form is a pernicious, toxic substance that is substantially responsible for a wide range of modern disorders and diseases ranging from obesity to diabetes, and including perhaps even arthritis and autism.  Davis's argument seemed somewhat overstated to me, which made sense -- he was trying to sell a book, after all.  But, on the chance that there was something to it, I quickly picked up the book and got stuck in.

There's a lot to say, but here's the main thing: If you care about your health, I would put this book very firmly in the "must read as quickly as possible" column.  I've rarely come across a book that so decisively changed my perspective on a food or even methodology.  Until now, I thought of wheat as a grain whose proteins trouble certain people but that otherwise was fairly benign, if not particularly nutritious.  I hadn't been eating much of it when I was on a strict nutrition plan because it was a source of relatively empty calories, but I certainly indulged in pasta before races, pizza at finish lines, and cake on special occasions.  After reading this book, at least for the foreseeable future, I will do none of those things, and I predict that anyone who reads it with an open mind will be very tempted to make a similar decision.

The book starts with a simple, but fairly devastating, fact: whole wheat bread, long thought to be a staple of healthy living, spikes blood sugar levels far more than just about any other substance, including table sugar.  In carbohydrate terms, wheat is basically rocket fuel.  Biochemically, a spike in blood sugar causes the body to release a flood of insulin, which is disturbingly effective at converting that blood sugar to visceral fat, which accumulates around the midsection.  Visceral fat is a particularly bioactive and harmful type of fat that releases triglycerides and even estrogen, thus causing Gynecomastia, i.e., "man cans," on some unfortunate souls.  Chronically high levels of insulin can cause the liver to become desensitized to it, thus causing the pancreas to emit yet more to rid the blood of sugar, which leads to a cycle that culminates in diabetes.  It is therefore no surprise that obesity and diabetes are strongly correlated.  And it is also no surprise that the skyrocketing rates of diabetes (up 500 percent since 1980) and obesity are also correlated with a marked rise in the quantity of wheat consumed.

When I listened to the podcast, one objection I had was that, look: people have been eating wheat for thousands of years, even back to biblical times, and it's a staple of countless religious traditions, so it can't really be so toxic.  But the book anticipates and smacks this point down pretty thoroughly, explaining that the modern variety of high-yield "dwarf" wheat is substantially different, both physically and chemically, from anything that existed before the late twentieth century.  It is simply not the same plant that our ancestors ate: its glycemic index (the amount by which it raises blood sugar) is far higher, and its gluten is more pronounced so as to support the processing into baked goods and countless other products.  There is therefore little reason to draw comfort from past experience -- although Davis also argues that there is no variety of wheat, regardless of how old, that gets around many of the problems that the book sets forth.

The problems are legion.  Wheat has been linked to, among other things, osteoporosis, irritable bowel syndrome, anemia, cancer, fatigue, sores, rheumatoid arthritis, lupus, multiple sclerosis, and various other autoimmune diseases.  Gluten, furthermore, is linked to many psychiatric and neurological diseases, including anxiety, depression, schizophrenia, dementia, migraines, epilepsy, neuropathy, and even autism.  This page, compiled by another physician,  discusses some of the problems.  Davis includes perhaps twenty clinical anecdotes of chronically ill patients without outward signs of celiac disease or gluten intolerance, but who nonetheless were quickly and sometimes completely cured simply by eliminating wheat from their diets.

For me, certain parts of this hit close to home, at least on a potential level.  Since my college days, I've suffered from bouts of cluster headaches about which the less is said, the better -- suffice it to say that I can think of few less pleasant sensations.  These headaches have come and gone seemingly without reason.  I noticed this fall, though, that it had been over a year since I'd last had a symptom, a period that corresponded rather directly to my dietary reforms, one of which was a virtual elimination of wheat for most of 2011.  In that time, I hadn't felt a stitch of discomfort, whereas I'd previously suffered a couple of weeks' affliction a couple of times each year.  In December of 2011, however, after Cozumel, I allowed myself a month of "normal" eating that included pizza, bread baskets, and lots of sandwiches around the holidays.  And, starting late last week, i.e., around New Year's Day, the headaches came back, and I've been fighting them ever since.  I'm back on the dietary wagon now, though, so it will be interesting to see whether wheat is indeed a contributing factor.

In all, I think anyone who takes health and nutrition seriously should pick this book up and devour it forthwith.  Endurance athletes, in particular, should be quite concerned if Dr. Davis's thesis is correct, because many indulge in virtually limitless bread, pasta, pancakes, bagels, and other wheat-based foods in the belief that it's acceptable, and perhaps even necessary to support the training load.  I've personally found that not to be the case, and this book confirms that there is every reason to doubt the wisdom of a grain-based diet.

The book is written in a highly accessible manner, is full of concrete anecdotes, and is well-sourced.  In the later chapters, some of the biochemical explanations for observed phenomena are quite detailed and technical, and I can't honestly say that I followed it all.  Still, I appreciated that the proposed causal chain is set forth should I want to invest the time to understand it down the road.  I also found that, toward the end, the anecdotes began to blend together, but only because they all fell into the pattern of "serious diseases cured merely through excising wheat from the diet."  On the whole, I suppose that, if they're true, such anecdotes can't be offered too often.