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Big Ideas in Nutrition: Three Books Worth Knowing

Wheat Belly

William Davis

New York, Rodale Inc., 2011, 292 pp., $25.99, hardcover

 

Grain Brain

David Perlmutter

New York, Little, Brown and Company, 2013, 323 pp., $27, hardcover

 

Whole: Rethinking the Science of Nutrition

T. Colin Campbell, Howard Jacobson

Dallas, BenBella Books, 2013, 328 pp., $26.95, hardcover

 

Let food be thy medicine and medicine be thy food—Hippocrates

No disease that can be treated by diet should be treated by any other means—Maimonides

Much has happened in food science since the recommended four food groups of the 1950s. With emerging evidence about heart disease caused by atherosclerosis and the role of cholesterol, low saturated fat diets were promoted. Unfortunately, many people replaced saturated fats with high glycemic carbohydrates, and the overweight, obesity, and type 2 diabetes epidemics took off in 1980. Robert Atkins first promoted a low carbohydrate diet in the 1972 book, Dr Atkin’s Diet Revolution. Food pyramids and many other diets followed.

Three recent books are reviewed here that may have a major impact on how we can use nutrition to combat the burden of disease. The lack of nutrition education in medicine is well known. Emerging information from nutrition science calls on medicine to heed the admonitions of Hippocrates and Maimonides.

William Davis, MD, is a preventive cardiologist in Milwaukee and in his practice promotes a wheat-free diet to lose weight and restore health. The book is well referenced and stays focused on two areas where wheat causes health problems. First, he argues that modern engineered wheat with its 42 chromosomes is much different from the 14-chromosome einkorn wheat man began to eat 10,000 years ago and until the last century. Modern wheat is energy dense with the highly glycemic amylopectin A causing blood sugars to rise rapidly and remain high, even more so than many other sweets. The resulting rise in insulin levels causes the deposition of fat, especially central fat.

The second problem with modern wheat is the protein complex known as gluten. Gluten is actually a variety of proteins unique to wheat, barley, and rye. Gliadins and glutenins are the two main types of protein in gluten, and we measure antibodies to these to test for gluten sensitivity. Inflammatory reactions to gluten are common, and Davis argues that this is likely a basis for much auto-immune disease such as inflammatory arthritis and hypothyroidism. Direct inflammatory reactions to gluten may play a leading role in esophageal reflux, irritable bowel disease, acne, and rosacea. In Wheat Belly, most chapters are focused on the impact of wheat on different organ systems. The evidence here is suggestive and the references are given, and much work needs to be done to nail down what is true.

In Grain Brain, David Perlmutter, MD, a neurologist in Naples, FL, with a graduate degree in nutrition, argues that wheat and other high glycemic sugars are the basis of many neurodegenerative diseases such as multiple sclerosis, Parkinson Disease, and Alzheimer’s dementia. He argues that the inflammatory nature of gluten and the toxicity of hyperglycemia damage the nervous system. The problem with this book compared with Wheat Belly is that it loses focus, and Perlmutter lapses into a promotion of eating saturated fats and taking many supplements.

T. Colin Campbell, PhD, is a highly respected nutrition scientist from Virginia Tech and then Cornell, most famous for a large epidemiologic study in Asia called The China Study.1 Campbell is well published in scientific journals but went public to get his information better known. He argues for a whole-food, plant-based diet and that animal proteins correlate with many cancers. Casein, the protein in cow’s milk, seems to be the worst, especially correlating with breast and prostate cancer.

Campbell is a champion of many vegans, and Bill Clinton has become an advocate. In Whole: Rethinking the Science of Nutrition, Campbell and Jacobson reiterate the data from The China Study and argue why reductionist science alone cannot give the answers we need in nutrition. He uses the example of the synergy in an apple when eaten whole gives far more anti-oxidant activity than any of its known ingredients individually. His argument against taking supplements that confuse the body and lack the synergy of whole foods is especially powerful.

Taken together, these three books provide important information about nutrition. We are what we eat, and medicine continues to lack sufficient education in food science.

Personally, I have benefitted from these books as have my patients. Despite being a marathon runner, for the past 15 years I had a body mass index of 26 and a 36-inch waist (I had a 32-inch waist my first 15 years of adult life, and a 34-inch waist the second 15 years). I enjoyed bread and whole grain cereals. Three months after giving up wheat, my waist is 33 inches and I lost 15 pounds, with a body mass index of 22. Interestingly, the emerging rosacea on my nose went away. My patients that become wheat free and do not replace wheat with other starches report similar weight loss and health benefits. And, I am now drinking almond milk.

I hand out information on all three books to patients, with my strongest recommendation for Wheat Belly. Many find it as helpful as I have in losing weight and reducing some health problems. Grain Brain reinforces the problems of an elevated blood sugar and inflammatory proteins on neurologic function, but I warn patients not to take the recommendations for intake of saturated fats or supplements. I recommend Whole to patients with cancer or who have an interest in how nutrition might prevent cancer. Medical students in the office find the books very informative, and our residents are reading them and generating good discussion topics. It is rewarding to fill the gap of nutrition in medical education.

Joseph E. Scherger, MD, MPH

Eisenhower Medical Center, Rancho Mirage, CA

 

Reference

 
 
  1. Campbell TC, Campbell TM II. The China Study. Dallas, TX: BenBella Books, 2004.

Copyright 2018 by Society of Teachers of Family Medicine