What is wheat?

Wheat is a grass.  Humans have eaten some version of wheat dating back to the start of agriculture, perhaps ten thousand years ago.  What was wheat then?  A fourteen chromosone grass.  This wheat contains the “A” genome.  We call it einkorn.  A farmer not far from my home grows einkorn. 

Hybrid wheats, Kamut and Emmer

By design or by accident, einkorn was hybridized with wild grass, resulting in twenty-eight chromosone new versions called emmer and kamut.  Emmer is the wheat of the bible.  It contains both genomes “A” and “B”.

Hybridized again, Spelt

Spelt was yet another hybrid that added the “D” genome with fourteen more chromosones for a total of forty-two.  It was widely cultivated through the middle ages.  Over time, strains adapted to specific habitats developed and were grown well into the twentieth century,

Gluten, Glutenin, and Gliadin in the "D" genome

In recent times, the “D” genome has been manipulated, producing unique glutens, glutenins, and gliadins.  It is within those genes that most of the problems lie.  These new genetically manipulated strains resulted in dwarf wheat that has texture (elastic bread), agricultural productivity, and other characteristics that are highly desired.  As with pharmaceuticals, there are side effects.  It is those modern strains that grew on wheat acreage that I owned.

Dave

To Be Continued

Photo by Dave Carsten

 Why weight loss?

Why would I lose fat with out really making an effort, other than avoiding wheat?
I didn’t feel hungry so it wasn’t calorie deprivation.  I hit the books and the literature.  What did I find out?  Many very interesting facts about wheat and why I lost weight.

Science

1. Wheat is much more glycemic than table sugar (sucrose).  It stimulates insulin about 50% more.  Just avoiding wheat products and bread would decrease my circulating insulin.  More insulin to store fat.  When eating wheat I was more likely to have an insulin trough that creates hunger.
 2. Modern wheat has gliadin protein.  When the protein is broken down, it results in opiate analogues that attach to opiate receptors in the body.  Besides creating a craving, it also makes people hungry.  Hungry?...is that why wheat is in so many products??
3. People that eliminate wheat eat 400 less calories per day on average.

To be continued...

Dave

Could wheat be bad to eat? 

I certainly didn’t think so.  I thought it was one of those rare allergies that troubled a few unlucky people. In my practice I had a number of patients that had celiac disease.  If they ate wheat, they would get sick.  I now know that about 1-2% of the population have celiac disease, most often diagnosed when they are 65, having anemia, osteoporosis, digestive problems, malabsorption problems, and atherosclerosis from eating wheat.  I have seen those people.  They all told me that they got a lot healthier and lost weight when they eliminated wheat.  OK, that’s true for them.  I really like sour dough bread.

Multiple Sclerosis

One of my patients had a diagnosis of multiple sclerosis.  She had all the symptoms.  She had it for about ten years, having been diagnosed shortly after getting married.  She had been advised to be very cautious about becoming pregnant so they had no children.  She told me that she read that some people with the MS diagnosis actually had a sensitivity to wheat gluten.  She told me that it occurred to her that it would be worth a try. How hard could it be?  I saw her 6 weeks after she stopped eating wheat, wheat related, or wheat containing products.  My mouth dropped open in shock.  She had dropped weight and she looked healthy!  I asked her what happened and she told me what she had done.  That got me to look in the literature and read that some people acquired neurologic disease by consuming wheat, multiple sclerosis being a misdiagnosis of some of those people.  About three months later, she was pregnant.  Still, that didn’t get me to give up my bran flakes.

Hay Fever

A friend had been diagnosed with gluten sensitivity.  Her husband, in support of his wife, he also went gluten free.  In a period of about a year, all his allergies faded away.  No more hay fever.  He was very enthused because no more allergy meds and more time outside in comfort.  Interesting...but I still really enjoyed my bran muffins.

Gluten Sensitivity

My wife and I have always been careful, trying to eat healthy.  We had gradually shifted to eating organic food and became more motivated when we had a child.  We tried to be very careful with introducing food to him and were very observant what happened when we introduced food.  There were a few things that we avoided.  Some testing had suggested that wheat might not be good.  He would get irritation around his mouth sometimes and it seemed to be related to eating bread.  We decided to mostly eliminate wheat for him.  It reduced my consumption but I still ate some.  He did do better and for me, I felt the same.  After about six months, my wife and I thought, perhaps we should just go 100% gluten free.   We did it with only the idea that it might be a good thing and an interesting experiment.  I was a little reluctant but why not?  I could go back to eating my bran flakes and whole wheat bread after the experiment.

No Diet Weight Loss

In six weeks I lost 25 pounds.  I made no effort to diet other than avoid gluten containing products.  I then very rarely had gas and I felt different.  That got my attention.  How could this be??  I started to read the scientific literature.  (to be continued)

--Dave

photo by Dave Carsten

Obesity and diabetes are becoming increasingly common. The rates of both are exploding.  Obesity is becoming the new “normal”. The consequences are grave. Both conditions involve the regulation of sugars and fats in the body by means of insulin.  I will try to simplify for the sake of understanding the principles.

Insulin
Insulin allows cells to take up sugar.  Fat cells and muscle cells are big users.  
Brain cells and liver cells don’t use insulin so they take sugar out of the blood stream if it is available.  Insulin stimulates the liver to produce fats from available sugar.  First glycogen is stored, then as that rises to a maximum, fat is produced.  The fat is sent into the blood.Insulin also suppresses the breakdown of fat.  Fat cells are stimulated to produce glycerol from sugar molecules which combine with the circulating fatty acids to produce triglycerides.  Triglycerides are stored, swelling the fat cells.  Insulin encourages the body to burn sugar and keep fat.  Fat that is consumed and circulating can also be stored.


Diabetes
Type I diabetes involve the destruction of insulin producing cells, usually by an autoimmune process.  It is treated by insulin replacement.  Uncontrolled Type I diabetics can become painfully thin if their disease gradually reduces insulin production.

Insulin and Obesity
Type II diabetes is insulin resistant, involving a reduction of insulin receptors.  Insulin is often at a normal or high level.  This can be caused by a diet that is high in simple sugars which maintains a high blood sugar level.  Over time, the receptors decrease in response to excessive sugar.  Muscle and brain cells can only consume a limited amount of sugar.  Liver and fat cells are not so limited.  With abundant sugar and plenty of insulin, they breakdown the sugar into fat and store it.  Not  everyone develops diabetes from excessive sugar intake but many do.  Some people simply get fat.  Drugs that increase circulating insulin to decrease blood sugar can also stimulate the liver to create fat and stimulate fat cells to store it.  Excess insulin creates fat.  Excess consumed sugar creates fat.  Excess consumed fat in the presence of insulin causes fat cells to get bigger too.

Diet Choices
There can be imbalances in the control systems that lead people to become obese while consuming otherwise healthy diets. Bad choices are not the only reason. Rising levels of obesity and clinical experience would lead us to suspect that predominantly, fatness is caused by choices.

Our paleolithic ancestors ate perhaps 10 to 15 pounds of simple sugars per year.  Americans commonly exceed 150 pounds of sugar per year.  Our metabolisms weren’t built for this.

The question becomes, “Have people been lead to make the poor choices?”

--Dave

Photo by Dave Hutt, www.dmddigitalphoto.com

This may seem complicated but let’s try to simplify.
All rancid oils are bad.  If it smells bad , it probably is bad.
Some people are more talented than others at detecting rancidity
but smell is not a guarantee.  Chemicals can be added that deodorize the oil.
Heat makes oils go rancid.  Some oils are more sensitive.

Healthy oils
Flax(unrefined)--high omega 3, quickly goes rancid so keep cold
Hemp--contains GLA(only anti-inflammatory omega 6)
Olive--very low omega 6, high flavanoids, often counterfeit (be careful of source)
Butter(grass fed)--conjugated linoleic acid (good), low omega 6,
                             if clarified it has smoke-point of 500o F
Lard (non-hydrogenated) and Duck fat--moderate mono-unsaturated fat, low omega 6
Avocado--high in omega3 and omega 9
Macadamia--high omega 3 and omega 9 plus unique anti-oxidants
Coconut(unrefined)--high in good saturated fat (lauric acid), low in omega 6
Almond, Peanut, Pecan, Hazelnut (refined), Apricot kernel(refined)--tolerate moderate temperatures, contain mono-unsaturated fats, eat in moderation

Unhealthy oils
Butter--grain fed--high in “bad” saturated fat and omega 6
Canola--may have pesticide traces, high heat processing damages omega 3”s
soybean--high omega 6
corn--high omega 6
Pumpkin seed--high omega 6, goes rancid easily
Walnut--high temperature processing damages omega 3’s
             high in omega 6, goes rancid easily.  eat the whole walnut
Sesame--high omega 6
Grapeseed--high omega 6
palm and palm kernel--high omega 6
Cottonseed--high omega 6, very low omega 3
Margarine, Hydrogenated Coconut, and Shortening--contain trans fats with are very bad

Dave

Photo by Dave Hutt, www.dmddigitalphoto.com

There are two fats that are essential to humans.  Alpha linolenic (Omega 3) and linoleic (omega 6) are required in our diet because our bodies can’t make them.  Other fats that are "conditionally essential" include, gamma-linolenic acid (an omega-6 fat), lauric acid (a saturated fat), and palmitoleic acid (a monounsaturated fat).  Conditionally essential means that most people do not make enough for health.  There are other omega fatty acids such as omega 7 and omega 9.  They are not required in the diet but do play a role.  (To a chemist, the omega followed by a number means that we start counting carbon atoms at the end of the carbon chain and the number is the point that we find the unsaturated spot.  The unsaturated spot has what we call a “double bond” between the carbons instead of having hydrogen atoms attached.)  Interesting to note, omega 7 break down products create “old person smell”.

Balance omega 3 and omega 6
In essence, the omega 3 and omega 6 play  “yin and yang” roles.  Omega 6’s are involved in inflammatory reactions in the body and omega 3’s are involved in anti-inflammatory reactions.  Both are needed but there needs to be a balance.  The current estimate of a proper balance is perhaps 4 parts omega 6 to one part omega 3.  Scientists estimate that our prehistoric ancestors ate a diet that was closer to 2 to 1 or even 1 to 1 rather than 4 to 1.  Scientists also estimate that most Americans eat a diet that may have as much as 60 times more omega 6 than necessary and not nearly enough omega 3.  Most people have a ratio between 15 and 20 to 1.  

Consequences from too much omega 6
What is the consequence of so much omega 6?  A huge problem is that omega 3 and omega 6 are processed by the same enzymes.  That means they are competitive.  In effect, excess omega 6 erases the potential benefit of omega 3.  We end up with nothing to shut off inflammatory processes.  Most disease has an underlying inflammatory component or even cause.  This imbalance has been implicated in higher rates of diabetes, cancer, heart disease, stroke, arthritis and skin disorders. 

Why so much omega 6?  
Commonly used oils such as peanut, sesame, safflower, sunflower, canola, rice bran, and corn oil are heavy in omega 6.  Also, most grains have a very high omega 6 content, the most obvious being wheat.  Animals that eat grass or algae have fat that contains omega 3.  That would mean grass fed herbivores (cattle, deer, etc.) and sea creatures (both algae eaters and the animals that eat them).  Olive oil and flax oil are omega 3 heavy.  Macadamia and avocado are also good sources.  Grape seed oil, coconut oil and clarified grass-fed butter are good oils for high temperatures.

Omega recommendation
Omega 3 consumption is recommended by health organizations around the world.  The public confusion seems to lie with omega 6.  The clear solution is to avoid omega 6 as much as you can.  Omega 6 is in so many food items that you will eat plenty no matter what you do.

--Dave

photo by Dave Hutt, www.dmddigitalphoto.com

Diagnosis Diabetes

The diagnosis of diabetes can be very upsetting for anyone.  It is certainly inconvenient.  It can be deadly.  Diabetes can mean pills, injections, blood tests, doctor visits, big changes in diet, and big changes in lifestyle.  That assumes that the patient decides to address the disease.

Common Sense Medicine
A friend and colleague recently got that diagnosis.  As I have observed, my medical and dental friends are no less likely to be in denial than anyone else.  They do have a better idea of the consequences.  He asked me what he should do.  I have seen many patients that were suffering the effects of diabetes, my relatives included.  I know from the current science that it is not inevitable to go blind, have kidney failure, lose sensation, and lose limbs.

Anti-Inflammatory Diet
I told him what I knew.  Nothing I invented.  It is in the scientific literature.  It is almost common sense.  Avoid grains(high glycemic and contain high omega 6), eat high quality protein, avoid chemicals that have bad side-effects, eat food that decreases inflammation, eat fiber, eat only small amounts of simple sugars, and get a moderate amount of regular exercise. Test what you eat by checking blood sugar often.  Everyone is a little different.  He did exactly that.  In about three weeks, he lost 15 pounds.  His blood sugar readings have dropped into normal range.  He is excited to find out what his lipid tests and HbA1c will look like in a couple months.  

Empathetic Healthy Doctor
This experience will make him a better doctor and his health may well be better than if he maintained his habits and didn’t get the diagnosis of diabetes. He will certainly have greater empathy for his patients that have diabetes. A blessing in disguise.  Pray it is.

--Dave

Death by Soda
Soda and other sweetened drinks cause180,000 deaths around the world each year, according to research presented at the American Heart Association's Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2013 Scientific Sessions.  They contribute to obesity which increases diabetes, cardiovascular disease, and cancer.

AHA Recommendations
Mexico has the highest consumption of sugary beverages and the highest death rate linked to sugary beverages, at 318 deaths per million adults.  Japan has the lowest consumption of sugary beverages and the lowest death rate at 10 deaths per million adults.  Based on various scientific studies, the American Heart Association recommends that adults consume no more than 450 calories per week from sugar-sweetened beverages.  Please realize that means 3 cans per week.  Each can typically has about 40 grams of sugar.

Artificial Sweeteners
That does not mean that artificial sweeteners are better.  Many of the sweeteners have been shown to spike blood insulin levels.  People that consume artificial sweeteners become fatter than people that consume sugared drinks for several reasons.  Drink water.

--Dave

PS  If you are going drink soda, drink something really good.  I must admit that
I enjoyed the soda in the picture.

Christina Warinner, Ph.D. had a fascinating TED talk this past January 2013.  She is a post-doctoral fellow at the University of Oklahoma.  Ostensibly, she was debunking the “Paleo” diet as described in popular culture.  She had some very valid points that she could back up with some good science.  

Paleo food
She pointed out that most of the food available to modern people is a modern agricultural construct.  Boccoli, almonds, tomatoes, chicken eggs, etc. did not exist in paleolithic times.  The paleolithic versions often were very small, they were seasonal, and they contained toxins that limited consumption.  Many foods that could support a small population of hunter/gatherers cannot support a modern, large, static population. A solution for modern people has been that the current food supply is often full of preservatives that inhibit bacterial growth. What does that do to the healthy bacteria that needs to live in our systems? We don’t know.

Ancestral diets
What do we know about real paleolithic diets and people? The available resources varied widely throughout the world.   It was fresh.  It was the whole food.  Generally, it was not highly processed.  It often had a high level of fiber.  They ate very lean meat.  They also ate the bone marrow and the organs.  Many populations ate some grain and legumes but it was limited to the time of year and not a large quantity. They ate much, much less simple sugar.  She pointed out that one 32 ounce soda contains approximately the same amount of sugar as 8.5 feet of sugar cane.  A paleolithic person couldn’t possibly eat that much.  

Diet diversity
Most paleolithic people ate a diet that was very diverse. It was also seasonal.  People today eat a large portion of their diet focused on three species, corn, wheat, and soy.

Healthy eating
The conclusion she finally came to was that we can learn from what paleolithic people ate but we cannot possibly duplicate it.  What I heard from her is that the premise of eating what our ancestors ate in concept is correct, but the popular interpretation, the “cave man diet”, is a distortion.  High diversity, high quality lean meat, high fiber, whole food, with a low carbohydrate content is consistent with what is known about paleolithic diets and what is known to be healthy.

--Dave

Photograph by Dave Hutt, www.dmddigitalphoto.com

A study was very recently published in The Lancet reporting on atherosclerosis in pre-industrial mummies.  They studied the preserved remains of people from Egypt, Peru, ancestral Puebloans, and Unangans from the Aleutians.  They found that in all cases there was cardiovascular disease.  It should be noted too that Ötzi, the 5000 year old frozen man from the Alps, also had cardiovascular disease.  In their conclusion, they state that this may well invalidate the idea that indigenous diets would protect people against cardiovascular disease.  I disagree.  All of the mummies studied, with the exception of the Unangans, were from cultures that engaged in agriculture and ate grains.  The Unangans were the only hunter/gatherers in the sample.  There were five Unangan mummies studied and of that, three had cardiovascular disease.  The confounding factor is that they lived in such a cold, windy climate that their homes were thick earthen mounds that continuously had fires for warmth.  They were extremely sooty.  Breathing soot will cause atherosclerosis.  The authors suggest that atherosclerosis “is an inherent component of human aging and not characteristic of any specific diet or lifestyle.”  They also go on to say that there may be factors that we do not understand.  That may be true.  I would say that the study suggests that the advent of agriculture and or environmental factors (soot for instance) could be the primary causes in the development of cardiovascular disease.  These mummies have both of those factors in common with contemporary people.

--Dave

www.thelancet.com    Published online March 10, 2013    http://dx.doi.org/10.1016/S0140-6736(13)60598-X