My letter to the Wall Street Journal: It's NOT just about gluten

The Wall Street Journal carried this report of a new proposed classification of the various forms of gluten sensitivity: New Guide to Who Really Shouldn't Eat Gluten

This represents progress. Progress in understanding of wheat-related illnesses, as well as progress in spreading the word that there is a lot more to wheat-intolerance than celiac disease. But, as I mention in the letter, it falls desperately short on several crucial issues.

Ms. Beck--

Thank you for writing the wonderful article on gluten sensitivity.

I'd like to bring several issues to your attention, as they are often neglected
in discussions of "gluten sensitivity":

1) The gliadin protein of wheat has been modified by geneticists through their
work to increase yield. This work, performed mostly in the 1970s, yielded a form
of gliadin that is several amino acids different, but increased the
appetite-stimulating properties of wheat. Modern wheat, a high-yield, semi-dwarf
strain (not the 4 1/2-foot tall "amber waves of grain" everyone thinks of) is
now, in effect, an appetite-stimulant that increases calorie intake 400 calories
per day. This form of gliadin is also the likely explanation for the surge in
behavioral struggles in children with autism and ADHD.
2) The amylopectin A of wheat is the underlying explanation for why two slices
of whole wheat bread raise blood sugar higher than 6 teaspoons of table sugar or
many candy bars. It is unique and highly digestible by the enzyme amylase.
Incredibly, the high glycemic index of whole wheat is simply ignored, despite
being listed at the top of all tables of glycemic index.
3) The lectins of wheat may underlie the increase in multiple autoimmune and
inflammatory diseases in Americans, especially rheumatoid arthritis and
inflammatory bowel diseases (ulcerative colitis, Crohn's).

In other words, if someone is not gluten-sensitive, they may still remain
sensitive to the many non-gluten aspects of modern high-yield semi-dwarf wheat,
such as appetite-stimulation and mental "fog," joint pains in the hands, leg
edema, or the many rashes and skin disorders. This represents one of the most
important examples of the widespread unintended effects of modern agricultural
genetics and agribusiness.

William Davis, MD
Author: Wheat Belly: Lose the wheat, lose the weight and find your path back to health

Comments (7) -

  • HS4

    2/7/2012 11:08:16 PM |

    Fantastic, Dr Davis!  I read the article earlier today and was thinking of sending in my own response but yours is ever so much better and comes with greater credibility which is important.   I hope they publish your letter.

  • Dr. William Davis

    2/8/2012 3:02:38 AM |

    Thanks, HS4!

    But don''t hesitate to add your voice. The more they hear this message, the more likely others hear it, too.

  • Scott Hamilton

    2/10/2012 4:01:24 PM |

    There were some comments in past postings regarding ancient vartieties of wheat, such as Emmer and Einkorn. Although these types still pose problems from a total health perspective I was thinking perhaps an original form of barley might also provide better health benefits with less metabolic damage than the newer varieties.

    There are recipes where the addition of grains in relatively small amounts can improve texture and flavor and I have used barley for this purpose extensively in the past.


    Are ther sources of information or supply of older or alternative forms of barley?

  • Ronnie

    2/11/2012 6:53:52 PM |

    Go Doc!

  • farida

    8/7/2012 7:23:42 PM |

    I would like to know if Dr Davis would be interested in doing a 30 min tele lunch and learn workshop, we own a wellness company with 000's  of users on our health portal.  It would be a great way to promote his books/blogs.

  • Magnesium citrate versus glycinate

    8/15/2012 8:12:45 PM |

    [...] wheat from your diet. Give it a try for 2 or 3 weeks and see how you feel.    Here's why:  My letter to the Wall Street Journal: It’s NOT just about gluten | Track Your Plaque Blog  "1) The gliadin protein of wheat has been modified by geneticists through their work to [...]

  • [...] I'm suggesting.   What about WHEAT?  Wheat has been a Frankenfood for the last 40 years, bcfromfl:  My letter to the Wall Street Journal: It’s NOT just about gluten | Track Your Plaque Blog  "1) The gliadin protein of wheat has been modified by geneticists through their work to [...]

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Letter to New York Times

Letter to New York Times

All right. I sent a Letter to the Editor to the New York Times. No word from them; it's no longer news.

So here is what I tried to convey.

While the authors overall did a credible job of talking to my colleagues and laying out the issues, they made the crucial and boneheaded mistake of confusing CT heart scans with CT coronary angiograms. Sadly, many people who may have been considering having a simple screening heart scan may be scared away by the confused authors, Alexn Berenson and Reed Abelson.

They do correctly point out that, while CT coronary angiograms are fascinating examples of technology and a way of visualizing coronary arteries, this test all too often is being subverted into the "let's make money from high-tech testing" medical model. It's also a test that frequently leads to the "real" test, heart catheterization, since the "time bomb" you have in your arteries might "need" a stent.

CT coronary angiograms are also virtually useless for purposes of tracking disease, since they are not longitudinally (along the length of the artery) quantitative, nor should anyone be exposed to this much radiation repeatedly.

A simple heart scan, on the hand, provides a longitudinal summation of coronary plaque volume. Radiation exposure is sufficiently low that repeated scanning can be performed for purposes of tracking . . .yes, track your plaque.

Poorly-informed reporters can do a lot of damage. As always, you and I must dig a little deeper for the truth.




Dear Editor,

Re: Weighing the Costs of a CT Scan’s Look Inside the Heart

The Times featured an article on June 29th that discussed rapidly expanding use of CT scans for the heart:
Weighing the Costs of a CT Scan’s Look Inside the Heart.

The authors, Alex Berenson and Reed Abelson, stated that CT heart scans “expose patients to large doses of radiation, equivalent to at least several hundred X-rays, creating a small but real cancer risk.”

I’d like to offer a clarification.

Though the authors discuss both CT heart scans and CT coronary angiograms, they confuse the two and use the terms interchangeably.

A heart scan is a simple screening test for coronary atherosclerotic plaque. It detects the presence of calcium in the heart’s arteries, provided as a “score.” (Because calcium occupies 20% of total plaque volume, knowing the amount of calcium tells you how much total coronary plaque is present by applying this simple proportion.) Just having a high score should not prompt heart procedures, since people undergoing simple screening heart scans are without symptoms. However, a stress test may yield some useful information.

On present-day CT devices, heart scans expose a patient to 0.4 mSv of radiation on an electron-beam, or EBT, device, and on up to 1.2 mSv on a 64-slice multi-detector, or MDCT, device, compared to 0.1 mSv during a standard chest x-ray. CT heart scans are therefore performed with about the same quantity of radiation as a mammogram done to screen women for breast cancer, or about the equivalent of four chest x-rays on an EBT scanner, up to 12 chest-xrays on a MDCT scanner.

CT coronary angiograms, while performed on the same devices as heart scans, require x-ray dye to fill the contours of the coronary arteries. It also requires up to several hundred times more radiation. While new engineering innovations are being introduced that promise to reduce this exposure, the current devices being used today do indeed require a radiation dose equivalent to 100 to 400 chest x-rays (usually in the range of 10-15 mSv), a value that equals or exceeds that obtained during a conventional heart catheterization.

While heart scans are most useful to detect and quantify plaque that can help determine the intensity of a heart disease prevention program, CT coronary angiograms are generally used as prelude to hospital procedures like catheterizations, stents and bypass surgery. That’s because they are performed to look for (or rule out) “severe” blockages.
CT heart scans and CT coronary angiography are therefore two different tests that yield two different kinds of information, and yield two entirely different levels of radiation exposure.

This confusion from a major and respected media outlet like the New York Times is unfortunate, because it could persuade millions of people who otherwise could benefit from simple heart scans to avoid them because of misleading information on radiation exposure of a different test.

Thank you.

William Davis, MD

Comments (9) -

  • mike V

    7/3/2008 1:23:00 PM |

    Dr Davis:
    I wonder if you had seen this?
    "Coronary artery calcium screening predicts mortality in the elderly"
    June 23, 2008 | Michael O'Riordan

    http://www.theheart.org/article/877625.do

    MikeV

  • Jake

    7/3/2008 2:41:00 PM |

    The medical reporters and editors of the the New York Times are breathtakingly incompetent.
    They are so bad, it seems that they are deliberately sabotaging their reader's health. Fortunately for America, readers are deserting the paper in droves and the paper is near bankruptcy.

  • Peter

    7/3/2008 3:34:00 PM |

    The Times doesn't like to print letters that are that long.

  • Stephan

    7/3/2008 4:53:00 PM |

    Thanks, I was hoping you'd comment on that.  Didn't you post a study a while back showing a nice correlation between Ca score and heart disease risk?

  • Anonymous

    7/3/2008 9:55:00 PM |

    I Emailed the reporters, and got this answer from one of them:

    "If you take a look at the story, including the accompanying graphic, you'll see the piece clearly distinguishes between the two types of scans and focuses on the use of the ct angiogram."

  • Anonymous

    7/3/2008 10:33:00 PM |

    MikeV's URL was truncated. See: www.theheart.org/article/877625.do

    While looking for the above article, I found this: "Estrogen hampers Lp(a) use for risk prediction" June 30, 2008,
    www.theheart.org/article/879103.do
    Taking estrogen seems to obliterate the predictive effect of Lp(a).

    Lynn

  • Anonymous

    7/4/2008 10:52:00 PM |

    Dr. Davis,

    You should get in contact with Tara Parker Pope at the Times, who does their Health blog.

    She is younger and less hide-bound than the others there.  You have a much better shot with her.

  • Jeanne Shepard

    7/6/2008 10:28:00 PM |

    There was a article today in Parade Magazine (Sunday paper) about the danger of too many tests because of exposure to radiation. They state that CT scans have the equivalent of 100 conventional X-rays of radiation. This would scare me away.
    I'm 52 and would like a baseline, though my triglycerides are only 37. But am not sure I would feel good about it now.

  • Anonymous

    7/7/2008 5:01:00 PM |

    How about this article on Cholestorol screening for kids as young as 8, so they can be prescribed statins early: http://www.nytimes.com/2008/07/07/health/07cholesterol.html?ex=1216094400&en=4cb38625b310cc97&ei=5070&emc=eta-1

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