Wheat Belly Research and Review

Recently, one of my friends decided to go gluten-free.  She has the autoimmune disease lupus, and after reading the book Wheat Belly, began a gluten-free diet to see if it would alleviate her symptoms.  I was surprised, because I was under the impression that going gluten-free was more of a fad than anything else, one of those trends that everyone follows because you hear about celebrities doing it.  But my friend didn’t seem like the type to go gluten-free just because Miley Cyrus raved about her gluten-less diet.  So I went ahead and picked up a copy of Wheat Belly from the library, to find out what all the fuss was about.

Anything that Looks Like Food is Off Limits

I’m a few chapters into the book, and there are a few things that bother me.  One of the biggest issues with the text, which is also prevalent throughout the the diet/nutrition industry, is that I’m sick of people demonizing a single category of food.  The latest books and movies are all about why sugar is the devil, or as this guy says, “it’s not sugar, it’s wheat.”  In the past it’s been fat (eating fat will make you fat and give you a heart attack), cholesterol (don’t eat eggs, it’ll raise your cholesterol you’ll die), GMOs (don’t eat anything genetically modified, you’ll turn into a monster), high fructose corn syrup (you’ll die), white rice (worse than sugar), brown rice (contains arsenic, which is poison, and you’ll die), fish (has mercury, you’ll die), non-organic food (you’ll ingest pesticides and die), milk (it has hormones, you might grow man boobs and start PMSing), soy (man boobs again), red meat (you’ll have a heart attack and die), even fruit (you’ll get fat and die).  And that’s hardly an exhaustive list.  

So which food/groups should we actually eliminate, if any at all?  I don’t know.  It honestly sounds like no one knows for sure.  But a lot of the “evidence” people cite is hardly conclusive.  For the newest trends, “blame sugar and wheat”, they use the exact same data.  In the past few decades there has been a huge spike in obesity.  One blames wheat, one blames sugar.  Anti-sugar campaigns say that Americans are ingesting far more sugar than ever before, which they back up with charts and numbers.  The author of Wheat Belly says the recent genetic modification of wheat and the copious amounts ingested are the cause for all of our problems.  Both advocates of removing sugar and wheat say the foods induce the same, if not stronger effects, as opiates on the brain suggesting the potential of addiction.  

I’m not an expert in nutrition, but I do feel a certain amount of skepticism toward anyone that takes a very narrow and sensationalist view on the effects of food on our health, even if they do have an M.D. after their name.  

“Do these citations make me look smart?”  Misrepresenting Data from Clinical Trials

Remember that time in middle school when you wrote a research paper and saved all the citations for the very end, only to realize you couldn’t figure out what information came from where?  Or maybe that other time when you had to read a scientific paper you didn’t understand and had to write a summary on it anyway?  Either the author of Wheat Belly experienced one of the above scenarios or, more plausibly, he misrepresented data to try and make his point seem legitimate.  

Here's what Doctor Davis says:

Binge eaters were confined to a room filled with food for one hour...Participants consumed 28 percent less wheat crackers, bread sticks, and pretzels with administration of naloxone [an opiate-blocking drug] (50).

The claim in Wheat Belly is that wheat is addictive like drugs (opiates), so people constantly crave it, and overeat foods that contain wheat.  The author tries to prove this point by saying people ate less wheat after they were given the opiate-blocking drug.

So if you’re like me, you would have assumed the title of the study would probably contain the keyword wheat.  However, the study title is:

Naloxone, an opiate blocker, reduces the consumption of sweet high-fat foods in obese and lean female binge eaters. (Emphasis my own).

The study isn’t really about wheat, it’s about sugar, fat, and binge eating.  Using this study hardly supports the conjecture on addictive properties of wheat.  The original study states, “naloxone suppressed hedonic preference ratings for sugar and fat mixtures” (4).  According to the findings, sugar and fat may have addictive properties; wheat is not mentioned anywhere.   

Wheat Belly goes as far as to completely misrepresent the findings in hopes of adding one line of credibility by citing a clinical trial.  Below is a graph from the study. It shows which foods participants were given and how much they ate when given a placebo vs naloxone.  Values over 100 means the participants ate more of that food after they were given naloxone.

 

Take a minute to re-read the passage from Wheat Belly:

Binge eaters were confined to a room filled with food for one hour...Participants consumed 28 percent less wheat crackers, bread sticks, and pretzels with administration of naloxone.

And take a look back at the table.  Sure, people ate fewer wheat crackers and pretzels, but they ate a lot more breadsticks. In fact, out of the sixteen snacks, breadsticks showed the greatest increase in consumption after taking naloxone.  And just so we’re all clear,  the first ingredient for the (Stella D’oro brand) breadsticks is Enriched Flour (Wheat Flour, Malted Barley Flour, Niacin, Reduced Iron, Thiamine Mononitrate {Vitamin B1}, Riboflavin {Vitamin B2}, Folic Acid).

Conclusion: The naloxone study cited Wheat Belly does not support the author’s claims, and the quotation is misleading.

Bonus: Here’s some food for thought, “chocolate has been described as the single food most often ‘craved’ by women, and binges on chocolate and other sweet desserts figure prominently in clinical reports of eating binges in bulimia nervosa and the binge-eating disorder” (6).  Not a wheat-containing product.  

 

Generalizations and Over-Simplification

Another problem I do have with his book is the author pushes his point, but fails to address any counterarguments.  He’ll say “the problem is wheat, not sugar” but won’t say anything to prove the statement.  He also talks a lot about the Glycemic Index (GI) and how bread, whole wheat or white, have a higher number than two tablespoons of sugar.  But there are standard limitations to the Gl that he never mentions, such as how much you would be ingesting at one time (Glycemic Load), or the spike in blood sugar will change depending on the contents of your entire meal, not the single item you looked up in the GI.  There’s also a failure to look at the overall nutritional content of items in the Glycemic Index.  My guess is that your whole wheat bread will have a more nutrients than two tablespoons of pure sugar.  Plus, your whole wheat varieties of bread do have more fiber than their white counterparts, it’s just that the insoluble fiber doesn’t affect the Glycemic Index, despite having other beneficial health properties.

You’re not the expert you think you are:  Lessons from life and psychology

The following passage is Wheat Belly, titled “Bread is my crack!” (pp. 44-45).

Wheat can dictate food choice, calorie consumption, timing of meals and snacks. It can influence behavior and mood. It can even come to dominate thoughts. A number of my patients, when presented with the suggestion of removing it from their diets, report obsessing over wheat products to the point of thinking about them, talking about them, salivating over them constantly for weeks. “I can’t stop thinking about bread. I dream about bread!” they tell me, leading some to succumb to a wheat-consuming frenzy and give up within days of starting.
There is, of course, a flip side to addiction. When people divorce themselves from wheat-containing products, 30 percent experience something that can only be called withdrawal.
I’ve personally witnessed hundreds of people report extreme fatigue, mental fog, irritability, inability to function at work or school, even depression in the first several days to weeks after eliminating wheat. Complete relief is achieved by a bagel or cupcake (or, sadly, more like four bagels, two cupcakes, a bag of pretzels, two muffins, and a handful of brownies, followed by the next morning a nasty case of wheat remorse). It’s a vicious circle: Abstain from a substance and a distinctly unpleasant experience ensues; resume it, the unpleasant experience ceases- that sounds a lot like addiction and withdrawal to me.

For a doctor, William Davis is not very good at classifying disorders, not even the ones he invokes.  He does however, do an excellent job of belittling binge eating - which is a legitimate eating disorder and should be stated as such - into something he calls “addiction and withdrawal” so that he can place all the blame on the “addict” and wheat, rather than to the psychological and emotional factors from trying to give up something you like.

The source of binging isn’t the wheat, or the “I feel tired from not eating wheat and wheat will make me feel better.”  It’s “I’m telling myself I can’t have something that I like, which is mentally exhausting. It makes me think about it want it even more because I can’t have it.”  It then turns into “What’s wrong with me, why can’t I not eat X?  Why don’t I have any self control?  I’m a failure.”  Then, after some newfound determination, “I can do this. It’s not so hard, it’s just X.” Rinse and repeat.  This is the type of situation that shows up continually in psychology books, and the cause is not simply wheat.  It’s from deprivation, and exhausting yourself from saying no all the time.*

There’s a threshold for the number of times you can say no to something you want within a period of time, and once it’s exceeded, you cave.  The way around this “addiction” is to find a source of motivation that makes you genuinely, wholeheartedly not want to the product.  A classic example is the vegan who doesn’t feel deprived because they’re upholding personal and moral values by avoiding animal products, not because some doctor said so.  Ask a meat lover to give up meat because you think it’s a good idea, and that might not go over very well either.       

As for feeling low on energy after removing gluten products, perhaps nutrient deficiencies, and not simply “addictive properties” could also play a role.  I’m sure some of his points have validity - food can certainly be addictive, but this kind of simplistic reduction of situations to try and prove a point is not acceptable. 

Bottomline

Wheat Belly is an interesting read, but it’s sketchy and self-serving.  Proceed with caution.

 

Sources

Wheat Belly by William Davis

Naloxone Study: http://ajcn.nutrition.org/content/61/6/1206.long

Nutritional Data for Breadsticks: http://www.wegmans.com/webapp/wcs/stores/servlet/ProductDisplay?productId=355271&storeId=10052&langId=-1

 


*I took notes on this from one of the psychology books I read this year, unfortunately I can’t find the exact citation at the moment (I’m having a middle school moment. I don’t even remember which book it was.)  But I will update accordingly if/once I find my notes.  In the mean time, if anyone knows the name of the principal or has any additional information, please share in the comments.