More on Grains

On September 12, a reader commented on a conversation we were having about my post Grains vs. Meat. I was waiting to get some time to properly respond, and I’m glad I did because a review on grains and cardiovascular disease was just published.

Comment:

Sure it’s possible to be healthy and still consume grains. It’s also possible to be healthy and eat doughnuts and drink Pepsi every day, or smoke marijuana every day. That doesn’t mean that doughnuts or marijuana are particularly healthy though. Grains are basically just empty calories, and are basically just less unhealthy versions of cookies. You say that they have beneficial effects on blood sugar, but that’s definitely false. Grains have a huge glycemic load, so their effect on blood sugar is not much better than cookies. And I don’t see why binding to cholesterol in the bloodstream is a good thing, the pregnenolone derived from cholesterol is necessary to create testosterone, so I think dietary cholesterol is very healthy. Considering there’s no connection between dietary cholesterol and cardiovascular disease, decreasing your intake of cholesterol has no benefits. Some people say that grains are a good source of fiber and nutrients, but you’d have to consume a ton of calories from grains to get the same amount of fiber and nutrients that you could get from a small amount of fruits and vegetables. Sure it’s possible to be healthy while consuming grains, but I don’t see why anybody would. They’re just empty calories and are better replaced with protein, fruits, and vegetables.

Response:

A literature review on many of these subjects just came out by Harris and Kris-Etherton, Effects of whole grains on coronary heart disease risk (1). In it, Table 1 lists the benefits that have been found from various whole grains:

Wheat – Improves glycemic control and insulin sensitivity, decreases inflammatory markers, decreases blood pressure

Oats – Lowers LDL and total cholesterol, improves glycemic control and insulin sensitivity, decreases blood pressure

Barley – Lowers LDL and total cholesterol, decreases visceral fat

Rye – Improves glycemic response

> Grains are basically just empty calories,

While I agree with you that there are much more nutrient dense foods than grains, whole grains are not just empty calories. They have small amounts of many nutrients, and some have large amounts of some nutrients. The much maligned corn is quite high in folate and potassium. All whole grains have decent amounts of magnesium (though the fiber and phytate will decrease its absorption somewhat). Barley is a decent source of a range of nutrients.

But even a cup of white spaghetti, while not having many vitamins and minerals without enrichment, has 8 grams of protein along with a lot of slowly absorbed glucose which I personally like before and after a workout.

> And I don’t see why binding to cholesterol in the bloodstream is a good thing, the pregnenolone derived from cholesterol is necessary to create testosterone, so I think dietary cholesterol is very healthy.

Judging by my receding hairline, I don’t know if I need any more testosterone. Seriously, what make you think you need, or can even produce, more testosterone by having more dietary cholesterol?

> Considering there’s no connection between dietary cholesterol and cardiovascular disease, decreasing your intake of cholesterol has no benefits.

Here is what Harris and Kris-Etherton say:

Beta-glucan is a type of viscous fiber in barley and oats that increases fecal loss of bile acids, which are derivatives of cholesterol. About 90% of the bile acids entering the small intestine for fat absorption are reabsorbed in the ileum. Beta-glucan reduces the reabsorption of bile acids, thereby increasing bile acid excretion, lowering the bile acid levels in the liver, and increasing the conversion rate of cholesterol to bile acids. The liver obtains the additional cholesterol by upregulating LDL receptors and increasing LDL particle uptake, thus reducing circulating LDL-C. A viscous fiber intake of 10–25 g/d is recommended by the National Cholesterol Education Program’s Adult Treatment Panel III as an additional diet option to decrease LDL-C. An intake of 5–10 g/d lowers LDL-C by about 5%.

> Sure it’s possible to be healthy and still consume grains.

My point was, if you enjoy eating them and they are not harming your health, then why not do it? And according to the research above (and the research I linked to in my original post), whole grains might help prevent diabetes and heart disease.

1. Harris KA, Kris-Etherton PM. Effects of whole grains on coronary heart disease risk. Curr Atheroscler Rep. 2010 Nov;12(6):368-76.

9 Responses to “More on Grains”

  1. Edanator Says:

    I get the impression that paleo-diet proponents believe that grains are a very recent addition to the human diet. However, humans have regularly been eating grains for at least 30 thousand years. It was an important enough food source that they devoted valuable time at finding and grinding grains.

    http://www.nature.com/news/2010/101018/full/news.2010.549.html

    Anti-grain proponents often claim we have not evolved to eat grain. However, some human groups developed lactose tolerance in less than 10 thousand years, showing that it’s possible to evolve beneficial traits within a relatively short time-span. Three times shorter than the time we have been eating grains, in fact…

    http://blogs.smithsonianmag.com/food/2009/04/07/lactose-tolerance-and-human-evolution/

  2. Laura Says:

    I think a lot of the anti-grain sentiment comes from people who have immune reactions to them.
    After a hypoallergenic elimination diet in 2003, I did food challenges with common food allergens. After eating anything in the grass family (wheat, barley, oats, rice, corn, millet) I got very sick: a groggy stupor would come over me 1-2 hours after eating, and I would stay sick for about 4 days, with joint pains the following day, and a lot of emotional reactions like depression, rage, tension and paranoia. It also happened with milk, citrus and apples.
    Because of that and some lab tests, I think I probably have celiac disease. Grains have proteins that are similar to gluten, and a lot of celiacs can’t eat grains. Also, celiacs tend to develop immune reactions to foods they eat often, even if they’re not related to gluten. Later on I found more reactions to many different foods, and 7 years later, my food reactions are fading away but still make me feel pretty woozy and out of it. Lemongrass tea also made me sick; it doesn’t take a large amount of a food.
    I think a lot of people have some problem with gluten grains or grains in general, that might become obvious if they did an elimination diet; and they recognize subtle problems after eating grains, even without doing an elimination diet. A lot of people have elevated IgG antibodies to gluten. There’s a lab http://enterolab.com that analyzes stool samples for IgA antibodies to gluten and tissue transglutaminase. They call people with high antibody levels “gluten-sensitive” and say that many people have somewhat elevated antibodies.
    And soy is a major allergen too. You can see how many people would have problems with a vegan diet if it means eating a lot more grains and soy. I’m almost entirely vegan, without eating grains, legumes or other foods that I’m sensitive to.

  3. Brian Says:

    Jack – I think it was covered before, but maybe I missed it. Is there really *zero* connection between the amount of cholesterol eaten and heart disease? Seems like that is what your reader attests, and the respose only went into LDL. Thanks

  4. Jack Norris RD Says:

    Laura,

    You need to be careful when considering elevated blood levels of IgG to be indicative of a food allergy. If you have elevated IgG levels to a variety of foods, it probably indicates a leaky gut in which undigested proteins are getting into the blood stream, thus causing the body to mount a reaction to them in order to clean them out. You would natrually have more IgG antibodies against the foods you eat most often.

  5. Jack Norris RD Says:

    Brian,

    Eating cholesterol can raise cholesterol levels. Here is a meta-analysis:

    Clarke R, Frost C, Collins R, Appleby P, Peto R. Dietary lipids and blood cholesterol: quantitative meta-analysis of metabolic ward studies. BMJ. 1997 Jan 11;314(7074):112-7. Link

    .10 mmol/l of cholesterol is equal to 3.9 mg/dl. So, you could say that in an average diet, reducing your cholesterol intake by 200 mg/day would reduce your LDL (bad) cholesterol levels by 3.9 mg/dl. That is a connection, though not a real big one.

    Here is what the American Heart Association says.

  6. Laura Says:

    Jack,
    I meant it as a speculation, that people with high IgG antibodies to gluten may be gluten sensitive. People do say that testing for IgG antibodies helps them locate hidden food sensitivities, although I’ve always relied on elimination diets and food challenges. If I get really sick after eating a food I know I should avoid it. I think there was a study where people with IBS were helped by eliminating foods that they had high IgG antibodies to.
    Part of the reason I think it likely that grain (and food in general) sensitivities are common is that I’ve heard they are, from food intolerance experts like Dr. Fine who runs Enterolab and Dr. Brostoff. Also because it would explain a lot. It would explain why a lot of people find a paleo diet helps them: a lot of the food allergens like grains, legumes, dairy are eliminated on a paleo diet. It might be part of why low-carb diets appeal to some people. Also all the raw vegans I know avoid grains and say they had severe problems with gluten grains.
    It’s not on the basis of high IgG antigliadin AB that I think I probably have celiac disease. It’s a lot of different things taken together.
    Like a lot of people, I went on an elimination diet, I had bad reactions to grains. I thought maybe I had celiac disease, so I went to a gastroenterologist. He did blood tests, but by that time I’d been totally gluten free for 6 weeks and almost completely gluten free for 3 months. The tests were negative except for high IgG antigliadin antibodies. That doesn’t mean I don’t have celiac disease, because the blood tests need to be done when one is eating gluten. I did have high sed rate and C reactive protein, and the gastroenterologist said “something inflammatory is going on, but I don’t know what it is”. I was sick around the time the blood tests were done, from food challenges. He said I could do a “gluten challenge”, meaning eat enough gluten for a month or two to mess up my body again, then get a biopsy. But I felt SO much better without the gluten and I would have been SO sick doing a gluten challenge, there was no way I was going to do it. So I got tested by Enterolab, I had 10x normal of IgA antigliadin antibodies and 8x normal IgA tissue transglutaminase antibodies. Similarly high anti-casein antibodies. The TtG antibodies are autoimmune antibodies. It’s not a standard test, but after that I thought it looks like I should be avoiding gluten. I also have Hashimoto’s, autoimmune hypothyroidism.
    People still often don’t realize that *before* doing an elimination diet, they should get tested for celiac disease. If they have a bad gluten reaction, it would be extremely unpleasant to go back to eating gluten just to get tested!

  7. Jack Norris RD Says:

    Laura,

    I didn’t mean to imply that you don’t have celiac. I’m glad you figured it out. And if someone has elevated IgG against only one or two foods, it would indicate an allergy more than IgG against multiple foods.

  8. Laura Says:

    Hi Jack,
    I actually don’t know if I have celiac or not. Just that my body is making an autoimmune reaction, the TtG antibodies, of a kind that is stimulated by gluten. So I think I’d better avoid it. I might have a leaky gut for some other reason also, I don’t know.
    There might be variants, problems that are related to celiac disease but a bit different. The whole subject of food sensitivities and variants of gluten sensitivity seems to be very little understood. For example, it seems not to be really known what is going on when people have this groggy stupor after eating a food. It’s a typical celiac reaction to gluten but people have it from other foods also.
    The pseudograins quinoa and amaranth are extremely nutritious and I’ve luckily never developed a reaction to them.
    By the way, I came across your website and blog because I was concerned about someone I know. I sent her the url’s of your articles on B12, iodine and raw diets. I’m quasi-vegan myself. Thanks for the information you have out there, I really appreciate your taking the trouble and it could help other people a lot.

  9. Laura Says:

    Gliadin (in gluten) might cause leaky gut even if it doesn’t stimulate an autoimmune reaction: see http://www.ncbi.nlm.nih.gov/pubmed/16635908

Leave a Reply

*