Book Review: Wheat Belly

Wheat Belly.  A wheat-free diet.

Wheat Belly, By William Davis, MD

Wheat Belly, by William Davis, MD, a self-described “preventive”cardiologist in Milwaukee.  Released August 20, 2011; Rodale Books. On NY Times bestseller list for 45 weeks as of March 2013.  Also check out the WheatBelly Blog. A cook book is now available as well.

THE ONE MINUTE REVIEW: Any book that provokes enough interest in people to consider major shifts in their diet should be considered a success, and, as such, this book and the diet it promotes certainly does.  “Gluten-free” diets are now more common than low carb or low fat diets in the USA, has now become a common label on food products in grocery stores and meals in restaurants, and it appears that thousands of people have found varying degrees of benefit by following the principles in this book, even without being diagnosed with celiac disease (also known as gluten enteropathy), giving credence to a growing literature on a new diagnosis of “gluten sensitivity”.  There are now several reviews and double-blinded studies (also here) that provide scientific validity to going “gluten-free.” The topic is increasingly covered in the media (1,2, 3) as well.

While the book provides lots of hyperbole, and appears excessively “wheatcentric”, the diet promotes alot more than just the elimination of wheat(see the last paragraph). So, while many may indeed be sensitive to wheat, and would benefit from its elimination, the Wheat Belly diet eliminates many other possibly troublesome foods, for which further benefits may be gained.

It remains hard to say if it is specifically modern wheat (as a genetically modified aberration) that may not be good for us, or if it is just wheat or just gluten in any form that is implicated, although it is clear that today’s wheat products are more processed than ever, and Western populations eat tons of it, even as filler in many foods.

It also remains to be seen just how much wheat or just refined foods impact mental illnesses like schizophrenia, autism, and depression, but there is increasing evidence of carbohydrate addiction, especially with refined carbs. Of course, obesity is more complicated than being just about the new, genetically modified variants of wheat (there are wheat-consuming populations that have not developed obesity, and there are historical populations that have not thrived on more traditional forms of wheat), although for many, a general reduction in refined carbohydrates will help many lose weight and improve several biomarkers of disease. More than just the elimination of wheat, this is really a low-carb book, pitching a whole-foods approach to eating, and its strength, perhaps inadvertently, is in helping readers understand that our refined food diet is a significant factor in many health problems.  There is probably no such thing as a healthy baked good, but that may have as much to do with refined sugar, refined oils as well as modern, refined grain products like wheat.  The good news is that there are no health risks in avoiding wheat or refined foods, so anyone can experiment with this to see if it helps them in some way.  Is it easy to give upwheat?  Probably not for most people.  But given how many have done so, with remarkable results, there seem to be a large number of our patients who are willing to work hard to improve their health when they buy into a dietary plan.  And it is hard to argue with someone who has had success with this approach..

Other authors have argued for the complete elimination of wheat and products containing wheat as a useful experiment to assess wheat sensitivity, and no doubt some people will benefit from the experiment.  However, Wheat Belly is alot more than the elimination of just wheat to be healthy.  Davis excludes:

…cornstarch and cornmeal (tacos, tortillas, breakfast cereals, corn chips, corn bread, sauces and gravies thickened with cornstarch), snack foods (potato chips, rice cakes, popcorn), desserts including cakes, cookies, ice cream, chips, dry roasted peanuts, fruit fillings, granola and granola bars, licorice, nut bars, pies, tortilla chips, trail mix), rice (all types to less than 1/2 cup per day), potatoes, legumes (all beans, chickpeas and lentils to less than 1/2 cup per day), gluten-free food, fruit juices and soft drinks, dried fruits, bulger, kamut, barley, triticale, and rye, quinoa, sorghum, buckwheat, millet, oats, amaranth, teff, chia, etc to less than 1/2 cup a day, cured meats (sausages, bacon, hot dogs, salami, deli meats, etc.), self basting turkey, canned meats, Fruit (though you’re allowed small amounts – 8-10 blueberries, 2 strawberries, a few wedges of apple or orange – but markedly limit bananas, pineapple, mango, and papaya), dairy products (cottage cheese, yogurt, milk and butter to no more than 1 or 2 servings daily), soy products, fried foods, sugary condiments or sweeteners including ketchup, malt vinegar, soy sauce and teriyaki sauce, beer, scotch, wine coolers, vodka, flavoured teas, blue cheese, hydrolyzed and textured vegetable protein, energy, protein and meal replacement bars, and veggie burgers and mock meat products.  

And the diet appears quite restrictive, if followed to the letter.  What you are allowed to eat is a very short list: Vegetables, cheese, oil, eggs, raw nuts, uncured meats, non sugary condiments, ground flaxseed, avocado, olives, coconut, pickled vegetables, raw seeds, herbs and spices.

Several comprehensive reviews have been written.  Most rip up the details and the hyperbole, but do not really discredit the value of this diet:

Melissa McEwen writes on sustainable agriculture, has written a thorough review here.

An even more thorough and referenced review, from food industry professional and cereal grain scientist  Julie Jones review is here.

Evolutionary Psychiatrist Dr. Emily Deans reviews some of the mental health claims in Wheatbelly on her blog, here.

Or see Dr. Yoni Freedhoff’s page on his Weighty Matters blog, here.

Or listen to an interview with Jian Ghomeshi on CBC, here.

Obesity researcher, nutritional sciences PhD candidate and blogger Chris Masterjohn’s well-referenced take, here.

Huffington Post review of gluten intolerance, by Chris Kresser, here.

 

For those interested in a true gluten-free approach to eating, check out the Gluten Free Society website.  One of their pages outlines a possible relationship with gluten and psoriasis–Check it out here.

Other authors have weighed into the potential toxicity of wheat:

Check out the links at Green Med Info, written by author Sayer Ji, discussing the dark side of wheat, here, and on the critical role of Wheat Lectin, here.

 

References:

Spectrum of gluten-related disorders: consensus on new nomenclature and classification. Anna Sapone, Julio C Bai, Carolina Ciacci, Jernej Dolinsek, Peter HR Green, Marios Hadjivassiliou, Katri Kaukinen, Kamran Rostami, David S Sanders, Michael Schumann, Reiner Ullrich, Danilo Villalta, Umberto Volta, Carlo Catassi, and Alessio Fasano  BMC Med. 2012; 10: 13 Published online 2012 February 7. doi:  10.1186/1741-7015-10-13 PMCID: PMC3292448

Non-celiac wheat sensitivity diagnosed by double-blind placebo-controlled challenge: exploring a new clinical entity. Carroccio A, Mansueto P, Iacono G, Soresi M, D’Alcamo A, Cavataio F, Brusca I, Florena AM, Ambrosiano G, Seidita A, Pirrone G, Rini GB. Am J Gastroenterol. 2012 Dec;107(12):1898-906; quiz 1907. doi: 10.1038/ajg.2012.236. Epub 2012 Jul 24.

Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial. Biesiekierski JR, Newnham ED, Irving PM, Barrett JS, Haines M, Doecke JD, Shepherd SJ, Muir JG, Gibson PR. Am J Gastroenterol. 2011 Mar;106(3):508-14; quiz 515. doi: 10.1038/ajg.2010.487. Epub 2011 Jan 11.

Irritable bowel syndrome and gluten sensitivity without celiac disease: separating the wheatfrom the chaff. Ferch CC, Chey WD. Gastroenterology. 2012 Mar;142(3):664-6. doi: 10.1053/j.gastro.2012.01.020. Epub 2012 Jan 24.

Gluten- and casein-free dietary intervention for autism spectrum conditions. Whiteley P, Shattock P, Knivsberg AM, Seim A, Reichelt KL, Todd L, Carr K, Hooper M. Front Hum Neurosci. 2012;6:344. doi: 10.3389/fnhum.2012.00344. Epub 2013 Jan 4.

Can an Increase in Celiac Disease Be Attributed to an Increase in the Gluten Content of Wheatas a Consequence of Wheat Breeding? Donald D. Kasarda  J Agric Food Chem. 2013 February 13; 61(6): 1155–1159. Published online 2013 January 11. doi:  10.1021/jf305122s PMCID: PMC3573730

 

Mark