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.