Exploring the sense and nonsense of food and health

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The recent gluten-free food fad has some nutritionists concerned. When people eat gluten-free foods, they may be missing some important nutrients. It is generally recommended that if you do not have celiac disease, you do not need to avoid gluten. However, some people have given up wheat and other grains due to a real or perceived benefit. Many report that their digestive symptoms improve or “they just feel better.” Non-celiac gluten sensitivity or gluten intolerance has been suggested but as yet there is no definitive test for its diagnosis.

Research has shown that avoiding FODMAPS can help people with irritable bowel syndrome (IBS). Wheat and other grains (rye, barley) (containing gluten) are sources of fructans that aggravate symptoms of IBS. So it is advised to eliminate these grains for a time from the diet to see if symptoms improve. See a previous post HERE.

If you choose gluten-free foods, you should definitely read the Nutrition Facts Panel as well as the ingredient lists.



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Sourdough Bread?

If you are avoiding wheat due to real or perceived intolerance to gluten, you may give sourdough bread a try. It is not recommended if you have been diagnosed with celiac disease, since it still contains gluten.

Avoid commercial sourdough since most will not be authentic. Try local bakeries and ask for a list of ingredients. Or you can make your own (with some patience and time) from a recipe found HERE.


For more information on sourdough click HERE.

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What’s the Problem with Wheat?


What is the problem with wheat?  The question is growing with few answers.  Best selling books by two physicians have brought the problems to light; a search on PubMed has revealed  more questions; and now there’s a  documentary on the issue.  What is going on? People have been eating wheat for centuries, so what has changed?  It does not appear that gluten is the whole story. Now other issues are emerging.

Wheat flour is everywhere and is abundantly used in processed foods indicated in the list of ingredients. If you find that cutting down on wheat helps your digestive or other health problems,  please don’t self-diagnose but seek the advice of your doctor,  a registered dietitian or other health professional trained in digestive health.


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Gluten Sensitivity?

Wheat is the third most produced cereal crop

Wheat is the third most produced cereal crop (Photo credit: Wikipedia)

It appears that the gluten-free trend is continuing to grow as more products are generated by  the food companies.  Although celiac disease is real, is gluten sensitivity real?  This article attempts to explore this debate.  Many people just report they feel better when they give up wheat but is it just a placebo effect or a trendy fad?  Results of a recent study gives us some answers.  The study population was small, however and one study does not “prove” anything.  Wheat itself has some inherent problems such as wheat allergy and is a common source of fructans that cause digestive difficulties in some people.


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For many people suffering from the gastrointestinal symptoms, gluten-free may not be the answer.  Here is an excellent article on another dietary approach.  Please see my previous post HERE.


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Celiac Disease or Gluten Sensitivity?

Gluten-free beer

Gluten-free beer (Photo credit: Wikipedia)




May is Celiac Awareness Month!   Gluten-free is the latest fad diet for those who think they have symptoms resembling celiac disease.   Celiac disease is a serious disease that must be diagnosed by a physician.  Gluten sensitivity is less serve but can cause IBS -like digestive problems, headaches, and other more vague symptoms.  Please do not self-diagnose or avoid gluten until you have a confirmed diagnosis.




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Is This Our Brain on Carbohydrates?

English: PET scan of a human brain with Alzhei...

English: PET scan of a human brain with Alzheimer’s disease (Photo credit: Wikipedia)

English: Gallays silver stain in a brain tissu...

English: Gallays silver stain in a brain tissue specimen displaying a neuritic plaque in the center (black, Gallyas stain) (Photo credit: Wikipedia)

Have you heard of the latest anti-grain book titled Grain Brain: The surprising truth about wheat, carbs, and sugar; your brain’s silent killers,  written by a neurologist, Dr. David Perlmutter?  This is the second major book attacking grains in a couple of years.  The first one is Wheat Belly, written by Dr. William Davis, a cardiologist..  Check out my previous post on Wheat Belly here.

A great article published in The Atlantic written by James Hamblin, MD, senior editor of the Atlantic provides us with a comprehensive critique about Grain Brain..  The article is a long one – 15 printed pages, so I’ve attempted to sort out some of the most important highlights for you.

Dr. Perlmmutter has also produced a companion PBS special, Brain Change. He is a fellow of the American College of Nutrition and holds a medical doctorate from the University of Miami School of Medicine.  His practice is endorsed by Mehmet Oz who reports he has sent many patients to Dr. Perlmutter with “wonderful results”.

In his book and in interviews, Dr. Perlmutter states that carbohydrates, even the whole grain carbs, are the cause of almost every modern neurological disease – dementia, decreased libido, depression, chronic headaches, anxiety , epilepsy, ADHD and  Alzheimer’s disease.  In an interview with Dr. Hamblin: “Most grain foods whether we’re talking about quinoa, amaranth, the very popular grains of the day, the reality is that they still have a fairly high glycemic index are associated with a carbohydrate surge with a blood sugar rise that is detrimental to the brain”.  He says: “the best recommendation I can make is to completely avoid grains”.  The heart of his diet recommendation is “good fats like olive oil, avocado, wild fish, organic nuts and nutrient-dense vegetables and NO Grains!!

He promotes diets that resemble the current popular Paleo diets with 75% fat, 20% protein, and 5% carbs.  He allows for up to 50-80 grams of carbohydrates daily which he says is contained in one serving of fruit.  NOT TRUE!!!  For example, one apple only contains around 25 grams of carbohydrate.  He may have read a nutrition label on a can of fruit with extra heavy syrup or looked at a gigantic apple.

Dr. Perlmutter, on his web site, claims support from an article published in the highly peer-reviewed journal, New England Journal of Medicine (August 8, 2010).  The conclusion from the authors is: “Our results suggest that higher glucose levels may be a risk for dementia, even among persons without diabetes”.  Another reliable source published support in the Proceedings of the Mayo Clinic reports that gluten can be related to a risk for dementia. Although these results may sound impressive, may contain some truth and thu  and should be given attention, it seems to me that it’s a stretch from those conclusions to an all-out demonetization of all carbohydrates as causative agents of neurological diseases.

I am currently reading another book called Do You Believe in Magic?  The Sense and Nonsense of Alternative Medicine  by a Pennsylvania pediatrician, Dr. Paul Offit.  His book addresses and debunks alternative medical myths that promise all kinds of cancer and other disease cures, aging miracles, etc. etc. etc. Unfortunately, none have been successful when put to the test.  His book has never reached the New York Times Best Seller list, but should be replacing Dr. Perlmutter’s tome of nonsense.  In my opinion, his book is very valuable for the medical consumer.

Dr. Hamblin consulted and interviewed Chris Kresser, an integrative medicine practitioner and author of Your Personal Paleo Code.  Kresser reports that his patients often ask him about this latest book, Grain Brain.  He tells them: “just because a low-carb diet can help treat some neurological disorders it doesn’t mean that carbs caused the disorder in the first place”  I assume he may be referring to the success with some epileptic patients using the ketogenic diet (a low carb, very high fat diet – about 80%).

Kresser also brings up some important epidemiological evidence.  Some cultures do just fine on high carbohydrate diets.  He points out that  The Hadza of Tanzania and the Kuna of Panama consume a diet high in natural sugars like fruit, starchy foods and honey and are still free from the diseases Perlmutter claims are due to high glycemic carbs.  There are also the Kitava of the Pacific Islands who eat an abundance of yams, bananas, and papaya containing high percentages of carbohydrates.  Also the Okinawans (one of the longest living populations on the planet have a diet extremely high in sweet potatoes.  Even the well-known and highly touted Mediterranean diet is very heavy on grains, primarily whole grains. “All of these cultures, Kresser notes, are fit and lean with practically non-existent rates of neurological disorders and other modern chronic disease”.

Dr. David Katz was also interviewed by Dr. Hamblin concerning Grain Brain. He is the founder director of Yale University’s Prevention Research and has published some respected works in nutrition, namely Nutrition in Clinical Practice and the author of Disease Proof: The remarkable truth about what makes us well.

His conclusion among many:  “ I also find it sad that because his book (Perlmutter) is filled with a bunch of nonsense, that’s why it’s a best seller…… because that’s how you get on the bestseller list.”   He also makes it clear that he has always respected and liked Dr. Perlmutter and acknowledges that he does some innovative work in the area of  neurodegenerative disease.

Dr. Hamblin then offers his own conclusions.  He hopes that these kinds of books do not turn off people in the areas of nutrition science, due to the fact of no one can actually know what to believe and give up on legitimate nutrition advice.  I think he offers the bottom line – that when you advocate eliminating a major macro-nutrient (in this case, carbohydrates), you need to offer a tremendous amount of research that supports your claims.  I agree – this book appears to only offer evidence that he has chosen and only that supports his premise and ignores good science.  I must admit I have not read his book, but when I do, it will be with great caution and skepticism.  So many times, these types of books are written with such self-proclaimed authority that they falsely become the current conventional wisdom.  Nothing could be further from the truth in this case.

Here is the link to the original Atlantic article, This is Your Brain on Gluten” – long but containing a lot of critical thinking that all of should be aware of when assessing these types of “diet books”

I direct you to an excellent and humorous blog post by a colleague titled “12 Steps to Writing a Best Selling Diet Book”  Please take a quick look!!   Grain Brain meets many of these criteria, unfortunately.  Please click here.

I am often disturbed by these types of books that promote nutritional cures and Dr. Perlmutter uses this term much too often.  Dr. Perlmutter’s book should not be taken too seriously, although it does provide “food for thought” – pardon the pun.  These books offer promises that while appealing are not quite “ready for prime time”.

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