On wheat and death.

Several months ago, I happened upon this little review about the connection between wheat (and other grains) on inflammation, which was pretty interesting.

It reports that there are plausible physiological mechanisms linking wheat to inflammation, that there is some animal and some human evidence available to back them up, but also that population-based studies and human trials have either not shown a significant effect, or haven’t been controlled in such a way to properly isolate the question of whether wheat and its inflammatory effects have measurable, significant health outcomes on people.

The evidence is suggestive in some respects, but not conclusive by any stretch – meaning that the basic dietary advice given to the general population stands: eat a variety of foods, including whole grains, provided you can tolerate them. If you can’t, you probably already know that by now. If you aren’t sure, go see a doctor (preferably an allergist and/or gastroenterologist) to get assessed, and see a dietitian for appropriate nutrition advice. (And beware of geeks bearing IgG tests.)

What follows is a selection of quotes from the review about the limitations of the research in humans:

  • “It should be noted that whole grains contain phytochemicals, like polyphenols, that can exert anti-inflammatory effects which could possibly offset any potentially pro-inflammatory effects of gluten and lectins [73].”
  • “Most of the intervention studies mentioned above attempted to increase whole grain intake and were using refined grain diets as controls, thereby making it very difficult to draw any conclusions on the independent role of cereal grains in disease and inflammation.”
  • “There are few studies that investigate the influence of a paleolithic type diet comprising lean meat, fruits, vegetables and nuts, and excluding food types, such as dairy, legumes and cereal grains, on health.”
  • “Because these [paleolithic diet] studies are confounded by the presence or absence of other dietary substances and by differences in energy and macronutrient intake, factors that could all affect markers of inflammation, it is difficult to make a concise statement on the impact of cereal grains on these health outcomes.”

The authors call, as most reviews of this nature do, for more research, preferably of the randomized controlled trial variety, or population studies that do a better job of controlling for confounders.

In other words: don’t panic. There’s a whole lot we still don’t know, and no one is taking anyone’s wheat away.

One thing that is missing in this discussion, so far, however, is acknowledgement of the cultural and practical importance of wheat and other grains in our diets. It always concerns me when this is left out, because whether we want to believe it or not, tradition, cultural foodways, and plain old accessibility probably inform the average person’s eating habits to a much greater extent than biochemical considerations of the inflammatory response provoked by selected components of a given staple.

Even though we might not want this to be true, it is true – and even though we might not want this to be important, it is important. We are humans. We are omnivores. We eat lots of different things, and not all of them for reasons of pure biochemistry.

It is difficult to overstate wheat’s importance in feeding the people of the world, both in a biological sense and in a cultural sense. Wheat forms the basis for cultural food staples spanning from bread to noodles to couscous to pastry to beer to gravy to breakfast cereals.

Wheat, a grass that today feeds 35 percent of the earth’s population, appeared as a crop among the world’s first farmers 10,000 years ago. It increased in importance from its initial role as a major food for Mediterranean peoples in the Old World to become the world’s largest cereal crop, feeding more than a billion people in the late twentieth century (Feldman 1976: 121).

Cambridge World History of Food, Volume 1

Which means you are going to need seriously strong evidence to impugn a food source that supports a huge proportion of our world’s nearly seven billion people. If there really were something nutritionally catastrophic about wheat, it would be a major concern – but, again, extraordinary claims require extraordinary proof. And this paper is not it.

Aside from its pure biological importance, the cultivation of wheat also marks a technological milestone in human evolution —

…with the domestication of wheat, humankind began the shift from hunting and gathering food to producing it. This change in lifestyle set humans on a new evolutionary course, and their society and environment were never the same after farming was established.

-Ibid.

— making it not only an extraordinarily important food source, but an extraordinarily symbolic food. Wheat is one of the pivotal crops of modernity. Though its first cultivation well predates the modern era, it set us on the path that led to the industrialized food production systems many of us rely on today, for better or worse.

Wheat and similar grains also require more intensive processing to be edible, compared to many fruits and vegetables that can be eaten whole and raw, compared to dairy, which is often processed for either safety (pasteurization) or preservation (cheese), but which is still consumable in raw form, and even meat and fish which, at its simplest, requires killing, butchering, and cooking (and sometimes not even cooking.)

From an early time, wheat was harvested, milled into flour, stripped of various parts of its grain, and further combined with other ingredients, then boiled or baked to produce edible products. Or the grain was fermented and/or distilled for alcoholic beverages. In modern industrialized food systems, wheat and other grains provide the basis for many highly-processed, and profitable, food products that are shelf-stable, very palatable, and very cheap.

I don’t think this fact of processing is lost on people, even people who don’t routinely think much about where their food comes from. Humans are masters of symbolic thinking, and I believe there is some level of awareness that wheat and other grains are subject to high levels of processing and refining which, depending on how you view those activities on a social and moral level, imbues the food product itself with either a sense of purity and goodness, or contamination and risk.

I regularly speak with people who are concerned about “nutrients being stripped from, and then sprayed back on” wheat products like enriched flour. There is a sense that all the good things have been taken away through refining, and suspect, man-made substitutes sneaked back in to fool everyone into thinking the food is nutritious. And yet, it is this same enriched flour that has significantly reduced the incidence of vitamin deficiencies and neural tube defects in the decades since its implementation in Canada and the U.S.

Humans are naturally both curious and suspicious of their food, in a sort of Hegelian dialectic referred to by food scholars (namely, Claude Fischler and Paul Rozin) as “the omnivore’s paradox.” We express anxiety about this paradox in a variety of different ways, including, in my opinion, through popular food fads – both positive fads, where some food is (usually temporarily, and often misleadingly) awarded the health halo and exalted to superfood status, and negative fads, where a former superfood or a perfectly neutral-seeming dietary staple is blamed for all human misery and misfortune.

I believe this is happening currently with several foods, the most notable, to me, being wheat. I believe this is due to several factors: our natural suspicion about food and its potential contamination or toxicity, combined with an increasing cultural discomfort with the products of modernity which has focused largely on industrialized food production and its discontents, as well as a growing awareness of Celiac disease, food allergy and intolerance, and non-Celiac gluten sensitivity.

Add to this our frustration with the fact that, despite all our technological advances, there still exist medical conditions that defy treatment or explanation, our ever-present fear of death, our idealization-bordering-on-worship of perfect biomedical health, our vulnerability to placebo and nocebo effects, and a soupçon of trendiness derived from evolutionary nutrition theories, and you get a heady cocktail intoxicating enough to produce a damn-near religious conversion.

If wheat doesn’t work for you, for whatever reason, you don’t have to eat it. You can find ways to live well without it, though it will take some effort and some money.

But if you’re looking for something to believe in, something to resolve existential angst, the discomfort of ambiguity and not-knowing, and the fear of your own mortality, avoidance of wheat is probably not going to do you much good.

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