Today, whole grains are under fire. Grain-based foods are the new demons. The so-called “experts” tell us to consume them, but what do they know? Talk about guidelines, official recommendations, and widely held mainstream dietary belief. It’s all a big lie, isn’t it? Well, it is, if you believe some of the books that have been published recently.
If you look through the health or diet section of your nearest bookstore, I’m quite sure you will find a recent book that demonized whole grains. Some of these are bestsellers like Dr. William Davis’ Wheat Belly and Dr. David Perlmutter’s Grain Brain, and last week I stumbled across a newborn, Whole Grains, Empty Promises written by Anthony Colpo.
Dr. Perlmutter believes that grains destroy our brains. I’ve dealt with his dramatic approach in another blog post and will not repeat it here. Now, Anthony Colpo welcomes the readers of his new book with the words: “Get ready, ladies and gentleman, as you’re about to learn why the belief whole-grain cereals are healthy is a total sham.”
For those of you not sure what whole grains are, they are cereal grains that contain the germ, endosperm, and bran, in contrast to refined grains, which contain only the endosperm. Examples of whole grains are wheat, oat, barley, maize, brown rice, rye, spelt, and buckwheat.
What We Have Been Led to Believe
Whole grains contain a carbohydrate package rich in fiber, healthy fats, vitamins, minerals, plant enzymes, hormones, and hundreds of other phytochemicals. They have a tough, fibrous outer layer called bran. Inside is the starchy endosperm containing the germ, the seed’s reproductive kernel. The germ is rich in vitamins, minerals, and unsaturated oils.
Industrialized roller mills which became available in late 19th century changed the way we consume grains. Milling strips away the bran and germ and pulverizes the endosperm, making the grain easier to chew and digest. But there’s a price to be paid for refined grains in terms of theeir nutritional value. The refining process strips away many vitamins and virtually all of the fiber.
A lot of scientific data indicates that selecting whole grains and not refined grains may improve our health in a variety of ways and decrease the risk of many disease conditions. Many studies link whole grain consumption with reduced risk of heart disease. Most of this data comes from epidemiological research.
Whole grains lower our blood cholesterol levels, LDL-cholesterol (the “bad” cholesterol) in particular. Lowering LDL-cholesterol is usually associated with less risk of heart disease. In the so-called Nurses’ Health Study, women who ate 2 to 3 servings of whole-grain products (mostly bread and breakfast cereals) each day were 30 percent less likely to have a heart attack or die from heart disease over a 10-year period than women who ate less than one serving per week. A meta-analysis of seven major studies showed that cardiovascular disease was 21 percent less likely in people who ate 2.5 or more servings of whole-grain foods a day compared with those who ate less than two servings a week.
A very large prospective cohort study showed that women who ate most whole grains were 30 percent less likely to develop type 2 diabetes than those who rarely ate whole grains. More recent data from the Nurses’ Health Study and Health-Professionals Follow-up Study suggests that swapping whole grains for white rice may lower diabetes risk.
A report from the Iowa Women’s Health Study linked whole grain consumption with fewer deaths attributed to inflammatory diseases.
Anthony Colpo’s View on Whole Grains
According to information from the Kindle version of his book; ‘Whole Grains, Empty Promises: The Surprising Truth about the World’s Most Overrated ‘Health? Food’, Anthony Colpo is a certified fitness professional. According to his website, he was born in Adelaide, Australia. He has written at least a couple of books before, and he appears sincerely interested in the effects of diet and lifestyle in general on health and disease.
In the first part of his recent book, Colpo gives a summary of the work of the great Irish surgeon and scientist, Denis Parsons Burkitt (1911-1993). While serving in Uganda in the 1950’s Burkitt described a swelling, relatively common among African children, located on the neck and around the jaw. This tumor, known today as Burkitt’s lymphoma was found to be caused by the ubiquitous Ebstein – Barr virus.
After spending many years in Africa, on his return to Britain in 1966, Burkitt began comparing the pattern of diseases in African hospitals with Western diseases. He concluded that many Western diseases which were rare in Africa were the result of diet and lifestyle. Burkitt wrote a book about his theories called ‘Don’t Forget Fibre in your Diet’.
Colpo believes that Burkitt was responsible for introducing the belief that “whole grain cereals are healthier than their refined offspring“. Colpo’s opinion is that this is a serious misconception that can be traced to wrong interpretations of epidemiological data. He doesn’t hold epidemiological research in high regard; “… the field of epidemiology has long since degenerated into a dredging, cherry-picking free-for-all, one responsible for some of the most absurd and counter-productive nonsense ever contrived in the fields of nutrition and medicine “.
I was a bit surprised by the methods Colpo applies to discredit Burkitt’s research. He writes: “The evidence that inspired Burkitt to kick of the fiber phenomenon was a load of crap. As in, it was literally a load of crap”.
Strangely Colpo tries to make the reader belive that “Burkitt, apparently, had a rather bizarre fascination for human excrement. In addition to the cartoons that graced his articles and book, Burkitt was well known for his collection of photos of human feces taken on his early morning walks in the African bush”. And he goes on (some would say it’s funny but some might call it a bit naïve); “Burkitt’s obsession with doo-doo was …..”
Studies of kidney function often rely on studying urine, so why shouldn’t the composition of stools be of interest to a scientist studying the function of the gastrointestinal organs.
However, thankfully Colpo becomes more professional as you read on. He does a very good job of explaining the problems with epidemiological research and the difference between correlation and causation. It’s obvious that he has spent a lot of time studying the available scientific literature on the association between whole grains and health. I admire his scientific approach to the matter at hand, although I don’t always agree with his interpretation of the data.
Colpo underscores the importance of randomized clinical trials (RCT) to study whether a certain intervention works or not. However, although important, such studies are difficult to perform in the field of diet and nutrition. Although the effects of whole-grains have been studied in RCT’s, these have often been small, short-term studies. As rightly pointed out by Colpo, these studies are much less in favor of whole grains than the epidemiological studies. However, we can’t just allow us to totally dismiss the epidemiological data and consider them useless as Anthony Colpo does.
There’s one statement I have to mention because Colpo’s not the first to bring it forward, and because it’s misleading and in fact completely wrong. Let me quote: “Again one of the major reasons modern primary prevention of heart disease and cancer has been such a monumental failure, as reflected by the fact that incidence rates of these diseases have remained virtually unchanged despite years of anti-fat, anti-cholesterol, anti-red meat and pro-whole-grain propaganda, is because of the modern infatuation with epidemiology“.
Research shows that mortality from coronary heart disease has, in fact, declined dramatically during the last 3-4 decades in most “high-income” countries (1, 2, 3, 4, 5, 6, 7). The reason for the decrease includes a reduced burden of risk factors related to cardiovascular disease, a lower incidence of coronary heart disease, and improved survival as a result of better treatment.
The Bottom Line
Notwithstanding all this, whole grains and grain based foods are here to stay. We will not be able to feed the rapidly growing population of our world without grains. It may be true that evidence on the beneficial effects of whole grains from randomized clinical trials is lacking. However, although the epidemiological studies don’t prove causation, their results can’t be ignored. Furthermore, there is no evidence that whole grains are harmful.
In my clinical experience, carbohydrate restriction with increased consumption of fat is an effective tool for many obese individuals and those with the metabolic syndrome. Of course, those adopting this approach should avoid grains of any kind, whole grains or refined. Otherwise, I see no reason not to recommend whole grains. In fact, I tend to agree with the main-stream agenda on this issue. I also believe that we should choose whole grains rather than refined grains whenever possible. William Davis, David Perlmutter and Anthony Colpo haven’t succeeded in changing my mind although I’m generally more flexible than stubborn.
Through the years I’ve met many people who feel worse when they eat grains. Of course, these individuals will and should avoid grain based foods. However, most people have no problem with whole grains, and no reason to avoid them either. Of course, this is a matter of preference for us who have the luxury of being able to choose.
I thought part of the problem with today’s wheat is that it is far removed from the Wheat of biblical times.
Reading this review of Wheat Belly(https://www.fathead-movie.com/index.php/2011/08/30/book-review-wheat-belly/) I noticed this comment “Dr. Davis recounts an experiment he conducted on himself to compare the different impacts of ancient wheat and modern wheat on his blood sugar. He managed to find some einkorn wheat and made bread from it. Two slices of that bread raised his blood sugar from 86 mg/dl to 110. Not bad. Then he made bread from modern whole wheat – you know, the stuff the USDA says is the key to great health. Two slices raised his blood sugar from 84 mg/dl to 167. That’s diabetes territory.”
I suffer from type 1.5 diabetes, so I do as you suggest – avoid all grains, otherwise I couldn’t control my glucose levels without drugs. That said, isn’t wheat turning instantly into sugar in one’s mouth a bad thing, as sugar seems to be the culprit behind many diseases? It is addicting stuff, I can say that from personal experience. Or do you think the nutrients outweigh the sugar issue?
I’m also curious about the study that showed women were 30% less likely to have heart attacks if they ate whole grains than those who didn’t. Were they comparing those women to women who ate refined grains or to women who ate no grains at all? My guess would be that those who ate no grains at all would do better than the ones who ate whole grains.
Thanks for the interesting article!
Thanks Mark.
This was a large epidemiological study. Women with the highest whole grain consumption had less risk of coronary artery disease than those who consumed less. Although this inverse association implies a statistical correlation, it doesn’t prove that whole grain consumption protects against coronary heart disease. Although there are some exceptions (like for example the relationship between smoking and lung cancer), it is usually not possible to draw conclusions about causation from epidemiological data.
Science requires DEEP EDPLANATION. We need to learn how cells work much better. Studies like Lyon aDiet Heart explain NOTHING
Here is an interesting article that explores whether wheat causes coronary heart disease: https://freetheanimal.com/2014/03/coronary-heart-disease.html
The author has an interesting hypothesis that the whole grains are not a homogenous group. In particular, he argues that oats and rice may be protective, whereas processed whole grain products like breads and pastas may increase the risk.
He also has a good point about the delay in diagnosis of celiac disease in the US, which is 11 years. 11 years of suffering from celiac disease is a huge burden of illness when it can be completely avoided by simply not consuming grains and grain products.
Anyway, thanks for the counterpoint!
I agree with the idea that if you do eat grains and can tolerate them, then whole grains (real whole grains NOT refined grains with stuff added back) are the way to go… same as with any other food — real, whole food; as opposed to processed, packaged, refined, industrial food-like substances. As has been pointed out, there is also the question of modern varieties of grains (chiefly wheat) compared to those of just a few decades ago… again we need to step back from lumping all “whole grains” into the same category — in much the same way that not all fats are the same.
Doc, I agree with you that we can’t ignore the epidemiologic evidence that whole grains may be protective against heart disease. Agree with your actionable points, too.
I remember reading a study from the Mayo Clinic (4 years ago?) that documented the apparent decreased incidence of coronary heart disease in the U.S. If memory serves me, it was an autopsy study.
-Steve
Thanks Steve.
In fact there are a number of papers reporting a marked decline in mortality from coronary artery disease. That is true for the U.S. and many European countries. The decrease in mortality is partly due lower incidence and partly due to petter prognosis of those affected (less case fatality rate).
This is a partially accurate answer. The incidence is lower and the better prognosis is because of improved screening of younger persons; improved surgical techniques; and better insurance coverage. It is not due to better diet. One might argue that improved medical treatment has helped us all in spite of the way we eat.
I agree Axel. One can also look to historical data. Great civilizations such as the Mayan, Roman and Chinese had diets that relied heavily on whole grains. They could hardly have been as dangerous as they are made out to be currently. While the incidence of gluten sensitivity seems to be increasing, this MAY have to do with genetic engineering of wheat, so that it differs significantly from the wheat so many of our ancestors thrived on. I think the jury is still out here. But overall, I believe that eating unprocessed food as much as possible is the way to improve health.
The Mediterranean diet doesn’t have whole grains in it at all. It’s a myth. They eat refined grains which are easier to digest.(go to Italy and they don’t eat whole wheat pasta, they think it’s nasty) They never eat the husks of the rice and neither do the Japanese. The husks are high in arsenic. You don’t eat spaghetti by itself btw, you eat it with high fat foods like cheese and meat which slows the absorbtion of refined grain. I don’t think the Romans ate whole grains either. BTW the real mediterranean diet was high in fat. The Greeks eat high fat greek yogurt, and high fat cheeses.
Because the evidence is thin, I don’t think you can attribute major health benefits to grains. If you remove grains and health does not degrade but improve, then you have to question the validity of the grain claims. Cigarettes don’t cause cancer in everyone, but it does in some, so we tell people to not smoke. Grains might not cause problems in everyone, but it does in some, so why do we recommend that everyone needs to eat it or else! I think the current push to demonize wheat is just to let everyone know that wheat isn’t a health panacea, that it can cause you problems. Yes, there is obviously some hyperbole, but some people need that to get to the point of self experimentation which is what we need in this country. More people taking responsibility for their health. Wheat cause me a lot of problems, and I’m glad I stopped eating it on a daily basis.
Doc,
I am a bit perplexed over your fascination to cover every nonsense book by random, confused and pathologically denialist lay authors.
Sure, if RCT’s would be such a bullet-proof idea in research to lifestyle, why on earth the 3 trials that I am aware of that tested the hypothesis that smoking cessation would lower the risk of lung cancer mortality failed to produce statistically significant findings despite reporting significant reductions in smoking prevalence in the group that received counselling on smoking cessation. These trials include the Whitehall Study, the Lung Health Study, and MRFIT, which included in total over 20,000 participants and up to 20 years of follow-up. This makes these trials considerably larger in both in terms of participant size and length of follow-up than the trials that focused on replacing primarily saturated fats with polyunsaturated fats. The largest of these 3 trials found that the number of lung cancer deaths were actually 15% greater, albeit not statistically significant in the group that received counselling on smoking cessation.
https://onlinelibrary.wiley.com/doi/10.1002/1097-0142(20001201)89:11+%3C2422::AID-CNCR16%3E3.0.CO;2-E/full
The relative failure of these smoking cessations trials can be considered a very good example of why all forms of evidence need to be considered when evaluating a hypothesis, not just a few data points from a few randomized controlled trials. The lack of statistically significant favourable findings in the group that received counselling on smoking cessation has been explained by a lack of follow-up time sufficient to achieve the maximum benefits of smoking cessation (which is believed to be more than 2 decades), lack of participant size, a smaller than anticipated number of participants in the group that received counselling that quit smoking, and a greater than anticipated number in the group that did not receive counselling that quit smoking. These limitations are very similar to those that plague the trails that attempted to test the diet-heart hypothesis.
https://www.youtube.com/watch?v=iZFePVU18lQ&index=12&list=PLDBBB98ACA18EF67C
“I am a bit perplexed over your fascination to cover every nonsense book by random, confused and pathologically denialist lay authors.”
If you had bothered to read the review, you’d have understood why. Axel exposed Colpo’s cherry-picking quite nicely. Colpo dismisses epidemiological studies most likely because they don’t support his findings and instead uses whatever RCT (most, of course, short-term risk marker studies) he thinks supports his stance, ignoring the fact that most of these studies have VERY little statistical power or show contradicting results in many of the risk markers (of which Colpo just picks the one he prefers). That’s not science, that’s an attempt to justify a preconceived notion.
And yes, when dealing with large RCTs you have to remember what they show and what they don’t. Just because the findings of e.g. the benefits of a certain intervention in reducing the risk to disease X are disappointing, it doesn’t necessarily mean that the mechanisms are invalid. In most cases the lack of statistical significance and/or clinical significance are due to problems in reaching the treatment targets – which means that the problem is in the intervention not being practical enough to carry out. And in the things you mentioned.
Yes Mike,
I guess you are right. Good article by Doc. I wonder what Colpo and Taubes think about physical inactivity, exposure to Asbestos and benefits of seat belts, none of these have been shown to decrease life-span in large scale trials adhering to the stringent standards that have been set for modern drugs.
Whole grains… It is interesting to read comments by people like Dr McDougall to the effect they have been the staple of humanity for thousands of years therefore must be great for health… Yet anthropologic evidence shows that “Early farmers were markedly shorter than their ancestors. In Turkey and Greece, for example, pre-agricultural men stood 5 feet 9 inches tall and women 5 feet 5 inches. By 3000 B.C., the average man had shrunk to 5 feet 3 inches, and the average woman to 5 feet.” (Loren Cordain, The Paleo Diet). Dental cavities, jaw difformities and diabetes, virtually non-existant in hunters-gatherers, became common. As far as vitamins and minerals, grains are a lousy source when compared to fruits, vegetables and meats… Vitamin deficiencies were common in early agriculturalists and unless grain is strongly enriched in vitamins, deficit is near certain. “…reliance on one or few plants, such as rice in Asia, wheat in temperate Asia and Europe, millet or sorghum in Africa, and maize in the New World. These plants, especially when consumed in large quantities, offer a poor nutritional base. In maize, for example, presence of phytate reduces iron bioavailability and deficiency of essential amino acids (lysine, isoleucine, and tryptophan) results in poor growth. Thus, populations heavily dependent on this plant show a tendency for high levels of iron deficiency anemia and shortened stature”. (Spencer, Clark, 1998). An even more interesting point is the archeological evidence that they are strongly linked to heart disease. The Horus study put in a CT scan mummies of various neolithic ancient cultures and frozen cadavers of modernized Unangans who were called hunter-gatherers, though these poor people lived on a modern man’s diet. What is fascinating is that a very strong proportion of mummies of all ancient cultures showed important atherosclerosis and horrible dental health. The researchers were bewildered and tried to explain this by saying that only the rich were rich enough to be mumified (true) THUS ate more “red meat laden with artery-clogging cholesterol and saturated fat” (false and false). The rich in Egypt seldom ate red meat. Cattle cannot graze sand. They did eat animal protein, either fish or birds. But very little red meat. On the other hand, they ate a lot of wheat (Egypt) or corn (Americas) and, for Egypt, honey and sweet fruits (figs and dates). Though the glycemic index of ancient varieties of wheat was much lower than that of modern goatgrass, known as modern wheat, this cereal was a huge source of carbs and with constant stimulation of insulin production, could have contributed to atherosclerosis. Grains certainly have been the staple of humanity for thousands of years, but at what cost?
The Agricultural revolution brought with it civilization. Hunter Gatherers could not over eat because they were living hand to mouth. The Agricultural revolution brought the possibility of overeating with the abundance of food. BTW since when does being tall equate with good health? Short people are healthier. Hunter gatherers were huge because they were hunting mammoth, which is bad for the health too. BTW small dogs are much healthier than large dogs. Small horses are healthier than large horses too. https://www.bustle.com/articles/92269-do-short-people-live-longer-4-things-being-petite-predicts-about-your-life
Your statement disagreeing with regarding epidemiological studies and heart disease is incorrect. You’re rebuttal to it Colpo’s quote doesn’t apply to the quote at all. Sure, perhaps mortality has decreased, thanks to modern emergency medicine (which we generally knock out of the park–that’s the strength of our medical system), but INCIDENCE hasn’t decreased, which is what the quote states. In layman’s terms, the same amount of people are having these diseases, they just don’t kill them as much as they used to because our ER’s have advanced.
Kyle.
This is a common misunderstanding. Both mortality and incidence have fallen in most countries.
We all know that death rate from coronary heart disease has dropped significantly in most countries during the last 40 years. Data on incidence are harder to find, particularly in the US, but evidence from many European countries suggests that incidence has fallen as well.
So, fewer people are diagnosed with coronary heart disease and fewer people are dying from it.
You can see numbers from the UK in this report here.
Nonetheless, the prevalence of heart disease is still very high. The population is aging and people often live with existing heart disease for decades.
Something still doesn’t add up here. Incidence of heart disease has decreased while obesity and diabetes have skyrocketed.
On the one hand we’re told that CHD has reduced due to “following the dietary guidelines” yet on the other we are told that diabetes has increased because we are “NOT following the dietary guidelines”. So which is it?
Finally, what about dwarf wheat? The variety that has become ubiquitous since just before the time the diabetes and obesity levels rose. There are hundreds of articles saying that dwarf wheat is lower in nutrients yet higher in gluten and starch than the wheat human’s ate for millennia. Whole grain or not, that is the wheat in your bread today.(as well as sugar, soy, molasses, stabilizers, gums, flavor enhancers, more soy, di-glyceride this and mono-gyceride that and finally, a bit more soy)
Anthony Colpo is not science literate. He is an abuser of science. Anybody whoever was Saul Perlmutter’s student WOULD LAUGH at his nonsense. Kyle is not science literate either….
Correlations do not mean anything in science, UNLESS THERE IS AN UNDERLYING PHYSICAL PRINCIPLE WHICH E X P L A I N S THE CORRELATIONS…..
Colpo cannot even begin to compete with Saul Perlmutter. Colpo is a fraud posting nonsense and PHOTOSHOPPED HEAD GRAFT PHONY PIFTURES of himself. I had over 4 photography experts analyze his phony pucture. UNANIMOUS CONCLUSION…IT IS DEFINITELY ALTERED,
The moron, Colpo, ignores that the world population has INCREASED DRAMATICALLY since the start of the health policies around 1978 or so. The man is a Total FRAUD. His critical thinking skills PALE in comparison to Feynman……….. Colpo is INCREDIBLY DIMWITTED.
Hey there,
I state upfront, I’m a fan of Colpo. I haven’t read his whole grain book yet, although I am aware of his preference for refined grains (when grains are eaten at all) from The Fat Loss Bible and articles on his site. It’s a stance I tend to agree with, and think is supported by the science.
While I thought this was a decent review of the book, I was a bit puzzled by this line- “However, although the epidemiological studies don’t prove causation, their results can’t be ignored.” Upon seeing this, I did a quick search for the MONICA study on your site (with 10 million subjects, it’s far and away the largest epidemiological study ever conducted). I didn’t see it referenced in a single article, while the Nurses Health Study (about 1/60 the size of MONICA) was mentioned frequently. Just wondering if there was any reason you were ignoring the results of this particular study? Or maybe you weren’t aware of it?
Thanks for the comment John.
I’m aware of the MONICA study, at least some parts of it. I don’t think it addressed the effects of diet or whole grains on the incidence of cardiovascular disease. Correct me if you think I’m wrong though. So, probably, I’ve never had a specific reason to refer to it in my blog posts.
Anthony Colpo mentions, on heart disease, it’s what is classified as heart disease that has led to the decline, also there is some unknown factor because it seems that heart disease started to decline in the 1960’s. Better emergency treatment is another factor which he separated out from what I wrote above.
BTW the touted Mediterranean diet and the French diet contain refined white bread and pasta. IMO it’s the amount that is the problem. Adding gluten and High fructose corn syrup to everything is not a good idea. Oh and then there are the Japanese who eat refined rice. In fact, Mediterraneans do not eat brown rice, and I won’t either, because there’s a reason they are removing the husk.
Hi Dr. Sigurdsson,
For people who has NO insulin resistance but has mild atherosclerosis, is eating whole grains consisting of brown rice, barley, buckwheat and red beans beneficial, neutral or harmful to health and heart health?
Many thanks for your expertise,
Quin