You don't say it, but imply, that if you had not exercised, your blood sugar would have been higher than if you had not exercised. My question is how much higher? How much of the reduction is due to the exercise and how much is just normal blood sugar lowering over time? Thanks!

One caveat. If you have diabetes, you may see your blood glucose levels go *up* right after strenuous exercise. This is because the body sees that as stressful, and the stress hormones cause insulin resistance.

This is especially true if you start exercising when the BG levels are relatively low, say in the 80s. My BGs can go up to 140 if I'm moving heavy furniture or pushing a heavy mower up a steep hill. I once saw a post by a high-powered cyclist who measured the BG of his fellow racers after a race and found that they also went up to about 140. But then they came down quickly. His stayed high.

However, later, the BG levels should go down as the body refills glycogen stores that have been deplete.

I'm wondering if fasting blood sugars play a role here.  My experience confirms what you pointed out in an earlier post:  if I wake up with blood sugar of 85, then for example a banana won't take me that high 30 mins later. But if I wake up at 98, then with a banana first thing in the morning I'll hit 140 in 30 minutes, before it goes down.

What I can't explain is why some days I wake up at 85 and other days at 98.  Could exercise be the reason? If so, then maybe the timing of exercise -- whether it's after a meal or not -- is less important than whether it happens and brings down fasting glucose, which in turn brings down Post-prandial glucose.  

Just thinking aloud.

If one can reduce their blood sugar down to an acceptable level of say 80-90 mg/dl by exercising after indulging in something like banannas, would this be an acceptable way of enjoying a favorite treat without negative consequinces?

Kent

Great insight.

Dr. Davis,

Thanks for another thought provoking post.  BTW, what glucose meter do you use?

Thanks,
Justin

When I had GD, and religiously tracked my post-prandial blood sugars, one of the highest readings I had came after I took some exercise between the end of the meal and the one hour reading.  The exercise was in the form of about 15 minutes on the mini-trampoline.  Perhaps the form of exercise makes a difference, I don't know.  I never tried that experiment again (didn't want the hopelessly conventional nurse I was required to report to to yell at me).

I decided to test this out.  For breakfast this morning, I had roast beef in tomatoes.  My postprandial blood glucose(1 hr) was 114 (11:02 am).  After a short, moderate walk, my blood was 85 (11:22 am).

Wow!

Does exercise *always* reduce blood sugar, or does it instead regulate blood sugar.  Richard at Free The Animal states that exercise increases his blood sugar when he is in a fasting state.  

http://freetheanimal.com/2008/01/fasting-and-blo.html

from personal experience, i completely agree with this post.

from everything i've read and studied, worrying about macronutrient ratios is pointless in the context of a whole food diet (my bias toward paleo) when we get adequate exercise.

perhaps, instead of sweating about our intake of apples and tubers and sitting on our butts, we should sweat a bit and take a brisk evening walk and lift some weights.

Dr.  Davis,
This post further reinforces my view that "insulin resistance" is a nature body reaction to how much fuel (glycogen/glucose) is in the muscles and liver (if they are full, no more room) as much as other often mentioned factors.  When the muscles are full there is no place for the blood sugar to go except into fat cells under the influence of elevated insulin.  With exercise the fuel supply in the muscle is reduced so that there is room for more fuel.  This would seem to be what happened in your case.  If this is the case then the amount of muscle one uses during exercise would have a most profound effect on the blood sugar level (i.e. jogging good, weight training better).  
Maybe your "index of the adequacy of exercise" could be used to finally provide a better objective method to rate exercise methods (instead of oxygen uptake, etc.).  This would allow for comparisons of the intensity, duration and other variables that are constantly thrown around when discussing aerobic vs. anaerobic, long distance vs. intervals, etc. (might adversely affect infomercial exercise equipment sales however)   Could it be that the height of the blood sugar spike isn't as important as the duration and the duration of the spike can be significantly reduced if exercise is part of the lifestyle and properly timed.  Also, maybe this measure could be used to better define how exercise and eating cycles should be structures for optimum health, weight loss, etc.  Are there other health indicating measurements that might benefit from this same sort of post-meal/exercise analysis?  Maybe it’s been done and I haven't stumbled across (or did and it didn't stick).  Very thought provoking post.  Thanks.

Interesting, but what about anaroebic exercise, i.e. weight lifting fairly heavy for moderate reps, for instance? Studies always cite 'exercise' when it is really not one monolothic activity. Could clean and pressing a 50 lb dumbbell for x time give you the same blood glucose benefit of your 15 minute walk?....

I'm not sure it's that simple, and maybe it depends on whether you're starting fed or empty (with higher glucose levels or from baseline).  I've measured post exercise blood sugars and they're usually higher than when I started- like today, started at 95 and went to 128 after a slow 4.5 mile jog.  I interpret that as the normal action of epinephrine and glucagon to produce glucose from liver glycogen during exercise, but I was surprised to see it that high when I was intentionally keeping the intensity down.  After 45 min rest, it had come down to 101. I don't know what would happen if I had started with a high blood glucose though (I usually don't eat much before running).

Thanks for your stimulating ideas and discussion.

Cynthia

The effects of physical activity on blood sugar are, indeed, more complex than a simple exercise, blood sugar goes down.

However, in the specific situation of light exercise in the immediate postprandial period, there is, as a rule, a marked reduction in blood glucose.

Had I not exercise, my blood glucose would have more than likely stayed around the 130-140 range for a couple of hours, given the mix of foods I consumed.

Dr Davis,

If you want to keep blood glucose level low would it make sense to work out before we eat a fixed amount of food or to eat after a work out?
Thanks,

Walter

In my experience a glass or two of wine with a meal has the result of reducing post prandial blood glucose levels - presumably it inhibits the liver's production of sugar whilst it is busy removing the alcohol out of the blood stream.  Don't take my word for it - use your meter and note the difference it makes.

Now as to whether that's a good thing or not?  Might go a little way to explaining why moderate alcohol consumption appears to have some health benefits.

Paul Anderson

I am in good shape, lean, and generally have postprandial BG less than a 100 eating the right breafast, lunch and dinner for me.

A good hard aerobic 45 min workout spikes me to 120 area and slowly comes down - something my meals don't do!

I wonder if I should time this differently?

@ www
Two bouts of exercise before meals, but not after meals, lower fasting blood glucose.

Thanks a lot for this explanation. I enjoyed reading this article.

Hmm that's amazing but frankly i have a hard time figuring it... Sure, I see the point, but it's still abit challenging... wonder how others think about this..

Well... that's very interessting but to be honest i have a hard time seeing it...  wonder what others have to say..

Thanks for sharing such a useful article. From personal experience i agree with you.
Beside all you said there's something in my mind.. Isn't yoga good for blood sugar patients?

For those with significant IR, your intraday, between-meal BG is mainly governed by gluconeogenesis - the formation of glucose from amino acids released by continued protein digestion.  A bout of exercise will only briefly reduce your BG to fasting levels, after which it will climb back again to higher levels due to continued protein digestion.

So exercise can't be used in any simply way to "fix" high post-meal BGs.  Rather, it's benefit comes mainly from building more muscle mass, which then results in generally lower BGs.

Exercise is very useful and good for the body and general health.This with a well balanced diet is a perfect solution towards good health.

I am really thankful to the author of this post for making this lovely and informative article live here for us. We really appreciate your effort. Keep up the good work. . . .


aerobics

Exercise also influences blood sugar. Diabetics understand this best: Exercise reduces blood sugar 20, 30, 50 or more milligrams. A starting blood sugar, for instance, of 160 mg/dl can be reduced to 80 mg/dl by jogging or riding a bicycle. (I recently had brunch at an Indian restaurant with my family. Blood sugar one-hour postprandial: 134 mg/dl. I was sleepy and foggy. I got on my stationary bike and pedalled at a moderate clip for 60 minutes. Blood sugar: 90 mg/dl.)

Jolly's post interests me. I suspect she's right. I'm sure the body moves blood sugar levels to a desirable range when under physiologic stress, be it higher or lower. Just for most Americans, that means lower.

I've really enjoyed having a look around your blog today, keep up the good work!

It's great when you are just surfing the web and find something wonderful like this!

I was actually searching the web to see if I was really weird or not. (still not sure) When I exercise i often see a dramatic spike in my blood sugar. Yesterday after a 4 mile run I was 260ish and have tested into the 160's-200 on several occasions after exercising....is this as bizarre as it seems? I'm young (in my 20s), healthy, and not-diabetic.

Dr Davis,

I can highly recommend Nairns Oatcakes if you want another, and its quite a tasty  way,  way to eat oats. They replace english muffins and crackers in my diet.

Best,
Jim

Dr Davis
I took fish oil (6/day) and red rice yeast for several months and my cholestral score went up a few points tp 278. I had a CTScan done and have palque (stage 2). I really don't want to take Lipitor etc because of side effects. any suggestions???

The Track Your Plaque website, www.trackyourplaque.com, is devoted to answering that question. You're welcome to take a look and see if it's right for you.

My husband and I are both in our
50's and have incorporated lots of wheat in our diets, which we thought was wonderful for us but now we have our doubts, we feel we had been getting too much! We have switched to oats and reduced our
gluten intake by 75%. We feel less gasy, bloated and more energy. Any other baby boomers bloated?  
overwheated in Wisconsin.

Regardless, both oats and wheat are healthy. One should not stick to just one.

I started adding lots of oat bran to my oatmeal after you pointed out that it's an excellent cholesterol lower.  I became anemic.  I read that oat bran can interfere with iron absorption, so I discontinued the oat bran and the anemia went away.

Now, this was a study conducted under the somewhat artificial circumstances of a study. But imagine this sort of habitual intake continues, not for just three months, but for years. After all, wheat has expanded and metastasized to all three meals, snacks, every day, 7 days a week in most Americans' diet.

Hello Dr. Davis, I had no idea about either you or your book 2 1/2 years ago when I entirely removed gluten from my diet but I wanted to say I experienced all of the positive responses you spoke about. No more migraines, acid reflux, sore painting shoulder, lost 35 lbs without feeling I was dieting. I was also able to incorporate a morning Yoga program every morning and find that I'm naturally more disciplined in thought and action. I would bet that I'm effectively 20 years younger. Thanks for speaking out, it will be worth it if we can do anything about diabetes!

I heard this interview!  The "debate" was pathetic. The argument by Dr. Whiting amounted to "but what you are talking about is an Atkins diet, so your conclusions don't matter.  Nothing matters except that you are promoting an Atkins diet"  She had NO new information, and nothing to back up her asertions that you can't be right.  I was embarassed for her, but more convinced than ever that there is no sound arguement to spport eating wheat.
I gave up wheat in April of this year.  I have lost 35 pounds, and 5 1/2 inches on my waist.  I have been eating more, not less calories.  I went from being almost couch bound several days of the week from severe "fibromyalgia" symptoms, to forgetting I even had problems which left me in a fog most days. I see no reason to eat wheat.  After the fact, I am reading your book and discovering the "why" behind my miracle.  I purhcased your book so I can read it, pass it around to everyone I know, and tell them to buy one and do the same!  
Thank you, Dr. Davis!

I'm rather chuckling mentioning this, but as you probably picked up I enjoy the 90s group Nirvana.  What originally attracted me to the group was the band's song writer having a bad stomach problem, similar to mine.  I recall reading after he committed suicide, and by the note he left that was due to the stomach problem and drugs being taken to deaden the pain,  that Kurt had worked on avoiding different foods.  He did this with the hope of improving the condition.  Never did see him mention avoiding wheat.  Oranges were a concern of his as "they made his gums bleed."  There were other items he stayed away from too.

I recall even then, middle 90s, thinking that Kurt probably was a celiac, could have found some pain relief avoiding wheat, and probably would be with us today if he had done so.  Looking back I should have taken my own advice!  I had tried eating wheat free back then, found some relief, but never enough to continue eating that way I thought.  What I didn't realize was that it took more than a month to find significant gut relief.  And it probably would have helped if I had support encouraging me to continue from doctors and family.    

So, anyway!   This is the 20th anniversary year of when Nirvana's famous album came out.  And with that has come a release of digitally remastered album plus new songs.  I was laughing at the lyrics to this tune, School.  I can relate when witnessing internet debates!    

Nirvana - School
http://www.youtube.com/watch?v=0xCgwXWEQ10

Yes, sad when the solution may have been so simple: Just avoid the food that all "official" agencies tell us to eat more of.

That's great, Arlene! 5 1/2 inches off your waist is fabulous.

I, too, was kind of embarassed for her. I don't think she knew what she was getting into!

Hi, Tracey--

I'm happy you've found this solution. However, you and I remain in the minority. There are people struggling with all manner of health problems, sometimes disabling, not getting answers from their doctors . . . and the solution can be as simple as removing all wheat. So this is a message worth repeating over and over and over again.

Dr Davis

Read your book with great interest. I am a type 2 diabetic and have taken all the steps to control levels. (exercise, weight loss, low carb, etc). My one concern is the elimination of oats. I have received excellent H1N results while consuming my favorie morning oatmeal porridge. Should I stop?

Jim

I get sad thinking about how so many people in my life have suffered.  My Mother had Parkinsons with dementia diagnosis and suffered terribly for 7 years til she died.
I suspected Diabetes because she had peripheral vascular disease and poor wound healing but the blood test always showed her sugar within normal ranges.
She craved pastries and acted like a crack addict begging for them, then would spend hours in a carb induced coma after eating them.  She died at 89 but suffered many years of her life, she tried to commit suicide before I was born and spent a year in hospital getting electric shock treatments.  She had yearly seasonal depression after that, crying for months in the winter.
My father lived to be 94 but he had 4 major heart diseases and needed 4 nitroglycerine tabs just to get dressed in AM.  He always said he felt best when he didn't eat.  Now in hindsight I know better.  I have struggled my whole life with stomach pain.  I had a small bowel biospsy 15 years ago but it was negative for celiac.  I facilitated a support group for celiac at a local hospital and lived gluten free for several years but was never one hundred percent better, now I realize because I was drinking soda and gaining weight eating all the gluten free products.  I had surgery this past December and had great difficulty recovering, symptoms of fatigue and chronic muscle pain returned to my life again.   Thanks for your book Dr. Davis, it has reminded me to go wheat free for good.  I know I feel better wheat free, dairy free and sugar free.  I gained 20 lbs after my surgery
due to inactivity from muscle pain and eating fast food carb meals.  I was caught in a vicious cycle of feeling aweful.  Fibromyalgia symptoms to the extreme, my thyroid function is low and my Vitamin D was at 14.  I have started wheat free for a week now, lost 4 lbs and feeling much better but still residual muscle pain.  I have a doctors appointment to persue thyroid treatment, I have been seeing a Natropath who gave me thyroid and adrenal gland supplements and I feel better but not 100% after 2 months of taking them.  Is it possible for thyroid function to return to normal after a time period of staying strictly wheat free?  I hate the thought of taking medicine the rest of my life.
Everyday I think of a friend, family member or celebrity that has died who might have been spared by going wheat free.  RIP...Mom, Dad, my husband Joe(non smoker lung cancer, major sugar/wheat addiction) Chris Farley, Steve Jobs (an article I read said he didn't eat animal products).Patrick Swazy. Linda McCartney (vegetarian frozen meals).  I know many of these people have had other vices like drugs and alcohol but I strongly believe that wheat is a gateway substance that can lead to addiction.  My husband drank beer every evening and ate ice cream everyday for 26 years that I knew him.  He was thin and worked hard everyday thus didn't ever see he had a problem.  He had chronic pain, allergies, skin rashes. Addicted to beer, could not stop drinking it even with cancer diagnosis and chemo treatments.  Finally quite when radiation tx damaged his throat but was too late for him.  Sorry to ramble on but just am overwhelmed with all the connections I'm suspecting.  Thanks for having a place to vent.

Dr. Davis,
Go get 'em!   Maybe you can get on the Dr. Oz show!  You and Gary Taubes can sit on the couch while Dr. Oz eats whole grain cereal with Soy Milk!

Dr. Davis--

I think someone has taken you up on your book.  Her name is Melissa McEwen.  I read her article this morning.  You might find it interesting: http://huntgatherlove.com/content/wheat-belly

Take care,
Kane

I struggled my way through this review ... a bewildering rambling rant that goes nowhere with plenty of distracting irrelevant fillers thrown in for good measure. The pervasive derisive mocking tone is also off-putting. It’s this kind of “noise” that blurs and dilutes an important message unfortunately.  One case in point (amongst a myriad) in the review is the dismissive incoherent treatment of the high glucose and high insulin impact of wheat. Personally this is the one key aspect of Dr Davies thesis that really impressed me, after seeing how one slice of wheat bread caused my blood sugar level to go through the roof. I also have plenty of anecdotal evidence (and growing) that Dr Davies is onto something.

"Attributes" which get cured......

Have you seen unintended consequences?

Maybe it has nothing to do with any modification of the plant but maybe the plant itself???

http://www.livescience.com/14194-egyptian-mummy-heart-disease.html

I've been a Registered Dietitian for 7 years and I'm appalled when I look back at my incredibly biased education.  An hour on PubMed disproves a majority of the conventional "wisdom" I was force fed, especially the ongoing demonization of saturated fat.  Its a joke. I'm glad to see more medical practitioners like yourself speaking out.  The studies showing the damaging effect of gliadin on the intestenial wall in supposedly health, non-celiac individuals is alarming to say the least. Keep it up!

The USDA has just published an evaluation that the "new varieties" of broccoli have the same vitamin and mineral content of the older ones.
http://www.ars.usda.gov/is/pr/2011/111013.htm

The headline and first paragraph of the web page are given below. When will they do "wheat"?

USDA Research Demonstrates New Breeds of Broccoli Remain Packed with Health Benefits
By Sharon Durham
October 13, 2011

WASHINGTON—Research performed by scientists at the U.S. Department of Agriculture (USDA) and published recently in the journal Crop Science has demonstrated that mineral levels in new varieties of broccoli have not declined since 1975, and that the broccoli contains the same levels of calcium, copper, iron, magnesium, potassium and other minerals that have made the vegetable a healthy staple of American diets for decades.

http://www.ars.usda.gov/is/pr/2011/111013.htm

Good for you, Daniel!

I am waiting for your and your colleagues to stage a revolt. Let me know and I will hold up the placards and yell with you!

Hi, Cynthia--

If you mean unintended consequences of wheat removal, yes: the withdrawal phenomenon. This affects somewhere around 30% of people. It is harmless, though no fun to experience.

Hi, Kane--

I found this about as interesting as saying to someone, "I don't like your face."

I've stumbled on her blog from time to time and found it interesting and insightful. I was surprised by this blatant "I don't like it because it's stupid" kind of criticism with no real substance. Maybe she had a bad day.

It is absolutely ovewhelming, isn't it, Mary, when you stop and think how many people may have had serious brushes with the wheat demon, yet nobody ever suspected?

My prediction: Wheat will prove to be among the most powerful provokers of gastrointestinal cancers. Everyone was falsely lulled by comparing whole grains to white flour that showed a relative reduction in risk. Replace something bad with something less bad, the less bad thing looks good. Flawed logic.

Well, it depends on what you mean by excellent H1N (HbA1c?).

I aim for HbA1c of 5.0% or less, a level at which glycation is not occurring faster than the normal endogenous rate.

There is a theory that the glutamates in wheat fill a crutial roll in wheat related intestinal porosity .....glutamate prepares epithelial tTg for attachment by wheat-surfafe HWP1.

Do you have an opinion?

Hi, Cynthia--

Not being a biochemist, I believe that is true, though I don't believe it is an effect unique to wheat, but shared by other foods.

Boy, I hope that didn't sound like I was defending wheat!

Dear Dr :

We have been vegans culturally - born and brought up in a Lacto-ovo Vegan society.  Recently, during routine annual blood tests, my husband has been diagnosed with more number of smaller particle sized LDL cholestrol.  He is at 95% level with very high risk.  Rest of the factors - triglycerides, HDL/LDL, overall cholestrol are all normal.  Also, sugar levels are normal.  He has been advised to take the suppressants due to high risk of particle size.  We have never tested this parameter before though.  Wheat, rice and burritos, pizzas and all the stuff you mention here are a part of our daily diet! We also eat Eggs, drink lots of full fat milk, homemade yoghurt .   I also use Coconut oil for most of the cooking which is for most part oil free!  We are worried about whether to wait and watch or start the medication.  If we wait - what is the optimal period to wait and what do we do during the wait period....

Thanks for any help and a wonderful blog - helps many people like us!

Hi, Vasu--

The solution for excessive quantities of small LDL particles is diet, not drugs. Please search "small LDL" on this blog and you will see dozens, if not more, posts on just this issue.

I had been trying for a full year to shake free of wheat, but couldn't do it because my fix was always available in the kitchen. My husband, though he has a small wheat tummy, didn't want to quit eating wheat.

Then we both came down with a gastrointestinal complaint, maybe something we ate? Nausea and loose stools and lack of appetite meant that for several days we drank lots of fluids and only ate to live. We both feel fine now, but thanks to the short period of illness during which time we COULDN'T eat wheat or sugars, we basically skipped the withdrawal period, and we no longer crave wheat.

I highly recommend quitting wheat during a gastrointestinal illness; for us it was incredibly easy.  

Dr. Davis:  After reading Wheat Belly and being wheat/glute-free for 2 months.  I've definately noticed less inflammation with my moderate osteoartritis of the knees & less abdominal bloating.  Friend, recently told me about UC Berkeley's Health Newsletter that disputes Wheat Belly.  WHAT DO YOU THINK OF THEIR RESPONSE?  Here's the article:

Wheatophobia: Will Avoiding Wheat Really Improve Your Health?
  
Wheat has long been a dietary pariah for the millions of people who have jumped on the low-carb-diet bandwagon or who think they’re allergic (or at least sensitive) to the grain. Now even more people are hesitating about eating wheat after reading the claims made by Dr. William Davis, a cardiologist and author of the bestseller Wheat Belly, which is subtitled “Lose the Wheat, Lose the Weight, and Find Your Path Back to Health.” Not only does wheat make us fat, he says, it is addictive and causes everything from heart disease, diabetes, and obesity to arthritis, osteoporosis, cognitive problems, and cataracts. In fact, it has caused “more harm than any foreign terrorist can inflict on us.”
Wouldn’t it be great if there was a single villain behind the chronic health problems plaguing us, and if all it took to reverse them was to stop eating wheat? Don’t bet on it.

Kernels of half-truth
Here are some of Dr. Davis’s key points—and our counterpoints:

Claim: Most grains are bad, but modern wheat is the worst because it has been altered over the years via selective breeding and is now a virtual “Frankengrain.” It is loaded with amylopectin A (a starch unique to wheat), which is “worse than table sugar,” Dr. Davis says, boosting blood sugar dramatically and stimulating appetite. Modern wheat also contains other components with adverse effects, and its gluten (a protein) is more likely to trigger reactions than that in older wheat.

Fact: For well over a century, food scientists have developed hybrid varieties of wheat to be sturdier and have higher yields, better quality, and greater resistance to disease and insects. That’s true of most food crops. There’s no clinical evidence that differences between today’s wheat and older varieties have adverse effects on our health. It’s all supposition on Dr. Davis’s part, and feeds into pervasive fears of modern agricultural methods. We think this particular fear is unfounded.

Claim: Wheat is the main culprit behind the obesity epidemic.

Fact: Wheat is a staple in most parts of the world, and there’s little or no correlation between regional intakes (as a proportion of daily calories) and rates of obesity. Per capita wheat consumption in the U.S. has actually dropped since 2000, but there’s no sign that is slowing the expansion of our waistlines. In fact, a century ago Americans ate much more wheat than we do today, and very few were obese (granted, diets and lifestyles differed in many ways then). In any case, the obesity epidemic certainly can’t be attributed to any single factor.

What about Dr. Davis’s claims that when he told his patients to avoid wheat they lost weight and become healthier? As with nearly all diet books, this is only anecdotal evidence, but it’s not surprising. Had he told his patients to cut out all meat or all sugary snacks, for instance, they might have done as well or better. Nearly all diets work for a while (especially in supervised settings), usually by getting people to avoid whole categories of foods and thus tricking them into cutting calories. Keep in mind, too, that Dr. Davis basically recommends a low-carb diet, and well-designed studies have found that such diets work no better than other diets in the long term.

Claim: Wheat has played an outsized role in surging rates of diabetes, heart disease, and other chronic disorders.

Fact: There’s no evidence that wheat bears special blame for these. Blood sugar does rise after eating bread, pasta, and other wheat products. But that’s true of any foods containing carbohydrates—even those in gluten-free products—especially if the grains are refined.
The effect of carbohydrate-rich foods on blood sugar, which is ranked by the “glycemic index” (GI), depends on many factors, including how much fiber is in the food, how the food is processed and prepared, and what else is in the meal. Wheat ranks moderately high on the GI. But research looking at the effect of a high-GI diet on weight control and the risk of diabetes and heart disease has had inconsistent results.

Refined wheat, like other starchy or sugary foods, can also have adverse effects on blood cholesterol and triglycerides—for instance, increasing levels of the small, dense LDL cholesterol particles that are most damaging. To avoid this, you needn’t avoid all wheat or go on a very-low-carb diet. Just choose healthier wheat products that are minimally refined or unrefined, and don’t go overboard.

Claim: Whole wheat isn’t much better than refined wheat, so overweight people and those with chronic diseases should avoid it as well.

Fact: Many studies have linked higher intakes of whole grains (including whole wheat) with a reduced risk of diabetes, heart disease, and stroke, as well as improvements in blood cholesterol, blood pressure, and blood sugar control. Other studies have found that whole wheat can help people control their weight and/or lose body fat, especially when they eat it in place of refined-wheat products. Thus, the Dietary Guidelines for Americans, American Heart Association, American Diabetes Association, and most nutrition experts recommend foods made from 100% whole grains.

BOTTOM LINE: Unless you have celiac disease or another type of gluten intolerance or sensitivity (see box above), there’s no reason to avoid wheat. No doubt many Americans eat too much refined wheat, usually in the form of cakes, cookies, pizza, and other foods loaded with added sugar and/or fat (which can double or triple the calorie count), as well as lots of sodium. Cutting down on such wheat products can help people lose weight and improve their overall diet, provided they substitute lower-calorie foods. But 100% whole-wheat and other whole-grain products can fit well into a healthy diet, as can many refined-wheat dishes that include nutritious ingredients, such as pasta with vegetables. As with so many dietary matters, moderation is the key.



Gluten for punishment
There’s one very good reason to avoid wheat: if you are allergic to gluten because of celiac disease, also known as gluten-sensitive enteropathy or nontropical sprue. Gluten is a protein in wheat that makes dough elastic and smooth; it’s also in rye, barley, and certain other grains.

In people with this genetic disorder, gluten provokes an autoimmune response that damages the small intestine and may cause symptoms such as diarrhea, bloating, cramps, abdominal pain, weight loss, fatigue, and loss of appetite. Celiac disease has become more common in the past 50 years for largely unknown reasons. It’s now estimated that about 1 in 100 people in the U.S. and Canada have it. If you have a parent or sibling with the disease, your risk rises to 1 in 22; having an aunt, uncle, or grandparent with it increases your risk to 1 in 39.

Celiac disease can begin at any age and occurs more often in people of European descent and in women. Many people with it go undiagnosed or are misdiagnosed, however, because there may be no gastrointestinal symptoms—and when there are symptoms, they’re often nonspecific (that is, they could be caused by many disorders). Celiac disease causes malabsorption of key nutrients, notably calcium and iron, so it can lead to osteoporosis, anemia, and other serious health problems. People with it are also more likely to have other autoimmune disorders, such as psoriasis, lupus, Crohn’s disease, and certain types of thyroid disease.

Confusing matters, about 6 percent of Americans are thought to be gluten-sensitive but don’t have celiac disease, according to the Center for Celiac Research at the University of Maryland. There’s much debate about this condition, sometimes called “nonceliac gluten sensitivity,” and about how prevalent it is. Because so many people now believe they are sensitive to gluten, rightly or wrongly, “gluten-free” has become one of the fastest growing sectors of the food industry.

Before giving up gluten, get tested
If you have chronic indigestion or other symptoms suggestive of gluten sensitivity, consult your doctor and get tested for celiac disease before going on a gluten-free diet. (Long-term avoidance of gluten can interfere with the diagnostic tests for celiac disease.) A positive result on the blood test should be followed by a biopsy of the small intestine to confirm the diagnosis. If celiac disease is ruled out and you continue to have problems, you can be tested for nonceliac gluten sensitivity via an “elimination and provocation” diet.

If you have a family member with celiac disease, you should be tested even if you have no symptoms, since diagnosing and treating the disease can help prevent intestinal damage and serious complications. Many gastroenterologists advise initially having a simple genetic test for predisposition to celiac disease.

Few people are properly diagnosed for gluten problems, however, according to a paper in the Annals of Internal Medicine earlier this year, which warned that many are undoubtedly going on highly restrictive diets unnecessarily.

It’s best to consult an experienced registered dietitian if you have celiac disease. You can—and should—eat other healthy grains, including corn, rice, oats, buckwheat, quinoa, and amaranth. Look for “certified gluten-free” on labels, since products can be cross-contaminated with gluten. Keep in mind, most “gluten-free” packaged products are made from refined flour (albeit gluten-free flour) and are not particularly nutritious, and many are junk food.

For more information, you can contact the Celiac Disease Foundation or the Celiac Sprue Association.
Issue: August 2012

Whoever wrote this clearly did not read the book with an open mind. ALL the questions are addressed in the book.

This is the stuff that the dietitians are arguing, a "rebuttal" based on conventional notions of wheat.

Rather that have to pick each argument apart to debate with people who clearly do not want to change their opinions, please just read the book.

I don't know if you're right or wrong (about wheat being worse than other starch sources), but am going to give you the benefit of the doubt, remove it, and see what happens.
P.S. Listened to the debate between you and Timothy Caulfield. What an embarrassing hack he was.

The lowest mortality is correlated with HbA1c between 5.0 and 5.4%.