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Wheat Belly Total Health

William Davis

New York, Rodale, 2014, 416 pp., $26.99 hardcover

In his 2011 book, Wheat Belly, William Davis, MD, presented a new perspective on low carbohydrate nutrition.1 He argued that the high glycemic index and high glycemic load of grains, especially wheat, were primary drivers of overweight, obesity, and type 2 diabetes. The so called “healthy whole wheat” increased hunger through elevated blood sugars and the pouring out of insulin, causing people to eat about 30% more calories. In addition, he argued that the inflammatory protein complex gluten in wheat, barley, and rye is associated with a large burden of disease in multiple organ systems.

Dr Davis is a cardiologist practicing near Milwaukee. As he describes in his follow-up book, Wheat Belly Total Health, he was obese, had type 2 diabetes, and dyslipidemia with an HDL cholesterol of 27. All of this reversed when he gave up eating grains.

After Wheat Belly, Davis used social media to create a dialogue on his web site, wheatbellyblog.com and on Facebook. He became further educated by the “wisdom of the crowd,” and Wheat Belly Total Health is the result. It is much denser, delving into the principles and practice of functional medicine and their approach to nutrition.2 All grains become the target, and Davis argues that non-gluten seeds of grasses such as oats, corn, and rice are as inflammatory to the human body as gluten.

Wheat Belly Total Health is divided into three parts: No grain is a good grain, living grainlessly, and be a grainless overachiever. The clear organization stops there as the text becomes scattered. Problems with the GI tract, nervous system, and thyroid are presented multiple times with varying degrees of detail. While Wheat Belly Total Health has more nutritional depth than Wheat Belly, its lack of coherency makes it a more frustrating read, especially for patients lacking a background in nutrition and inflammatory health problems.

Low carbohydrate and anti-inflammatory nutrition are trends that have mounting scientific evidence and should be part of the teaching of medical students, residents, and physicians in practice. There is now well-
documented high-quality evidence that a low carbohydrate diet is superior to the low fat diet the American Heart Association has recommended for decades.3 Evidence for the inflammatory effects of gluten in non-celiac patients has accumulated in observational studies from around the world.4,5 Like other popular books promoting a certain nutrition, Davis exaggerates the evidence. From the beginning of the book, he boasts from a one-sided perspective. There is no expression of humility and little expression of a need for more evidence. Evidence of benefit from grain-based fiber is dismissed outright. Despite these limitations, the book is important and worth recommending to learners and patients. I recommend reading Wheat Belly first as an introduction and then Wheat Belly Total Health for a deeper dive into grain-free nutrition.

The most valuable parts of Wheat Belly Total Health are the explanations of why some people do not lose weight with the elimination of grains. There is a good explanation of thyroid function, especially the conversion of the storage hormone T4 into the active hormone T3 that may be blocked by chronic ingestion of grains. I am now ordering more Free T3 tests with TSH in overweight and obese patients. When the Free T3 is low, an addition of T3 in the treatment may result in rapid weight loss. Deficiencies of iodine and vitamin D are also discussed in detail.

There is a large, inconvenient truth emerging in the nutrition science that food many Americans enjoy, bread, cookies, cakes, bagels, and tortillas, are unhealthy. Grains have been hybridized to become much more energy dense than the original forms found in nature. The high glycemic consequences are seen in an overweight and obese society. Coupled with the burden of disease postulated from inflammatory foods, there is much to be said for going grain free. William Davis, along with neurologist David Perlmutter6,7 and family physician Mark Hyman,8 are committed physician authors grounded in functional medicine and well worth making part of the educational dialogue of nutrition science.

Joseph E. Scherger, MD, MPH

Eisenhower Medical Center

Rancho Mirage, CA

 

References

  1. Davis W. Wheat belly. New York: Rodale, 2011.
  2. Institute for Functional Medicine. www.functionalmedicine.org.
  3. Bazzano LA, Hu T, Reynolds K, et al. Effects of low-carbohydrate and low-fat diets: a randomized trial. Ann Intern Med 2014;161:309-18.
  4. Hadjivassiliou M, Sanders DS, Grunewald RA, et al. Gluten sensitivity; from gut to brain. Lancet 2010;9:318-30.
  5. Volta U, Bardella MT, Calabro A, et al. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Med 2014;12:85.
  6. Perlmutter D. Grain brain. New York: Little, Brown & Co., 2013.
  7. Perlmutter D, Loberg K. Brain maker. New York: Little, Brown & Co., 2015.
  8. Hyman M. The blood sugar solution 10 day detox diet. New York: Little, Brown & Co., 2014.

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