In The Great Cholesterol Con, I devote a chapter to "Heart Frauds" - supposedly heart-healthy agents that have in fact never been shown to prevent even a single heart attack. First cab off the rank in that chapter is cereal fiber. We've been told incessantly that if only we'd all eat more fiber-rich whole grains we could greatly reduce our risk of CHD, colon cancer, and diabetes.
It's all nonsense, of course, but whole grain propaganda is still annoyingly pervasive. Even educated people who should know better still fall hook line and sinker for the totally unfounded whole grain health claims. Recently, I received an email from one Jane Karlsson, PhD, vigorously asserting that whole grains were wonderfully healthy foods that could immensely benefit humankind. I wrote back and told Jane she was wrong and challenged her to back her assertions with some real clinical evidence. The following exchange is reprinted below.
Jane Karlsson writes:
Dear Mr Colpo,
If you think Loren Cordain is wrong, as I do, why do you eat white rice? Whole grains contain enough minerals to activate enzymes that deal with the so-called toxins. Look up 'The activation of intestinal peptidases by manganese', and ask yourself how likely it is that whole grains would cause coeliac disease. White flour has had nearly all its manganese removed. White rice, over half.
These same minerals activate enzymes of carbohydrate metabolism (that's why the plant puts them there), and they also prevent iron-induced oxidative stress. I expect you are tired of hearing how IP6 from whole grains and legumes protects against iron overload, but you may not have heard that manganese does the same thing.
So does copper. Ignorance about copper explains why people think saturated fat causes heart disease: rats given copper do not develop heart disease on a high-saturated-fat diet.
The problem is that Cordain has had too much work on his plate. Digging out all the information he needs to exonerate whole grains and legumes takes a lifetime. I know, I've spent a lifetime (well, 30 years) doing it.
Jane Karlsson PhD
I explained clearly why I eat white rice on my website, but evidently you missed it, so I'll briefly recap: it is yet another option that allows me to bump up my carbohydrate intake to meet my high-carb requirements, has a low anti-nutrient content, low allergenicity, and is free of that troublesome protein, gluten. And, when combined with my lovingly brewed pumpkin soup, it tastes damn good.
I'm not sure what my consumption of white rice has to do with the fact that much of what Loren Cordain writes is factually incorrect. Whether or not I personally choose to eat white rice does not in any way change the fact that Cordain's stance against saturated fats is scientifically untenable, nor does it excuse his dubious reporting of the Dauncey et al study and his nonsensical claim it shows "You can lose 20 to 30 pounds in a year with utterly no change in the quantity of food you eat or even any change in your exercise habits.”
As for its high GI (which is shared by brown rice) this is easily tempered by mixing it with lower GI vegetables and a small-moderate amount of fat.
Regarding your comment, "and ask yourself how likely it is that whole grains would cause coeliac disease." - I think you need to read up on celiac disease. Grains do not "cause" celiac disease ... celiac disease is a pre-existing genetic intolerance to gluten, the adverse effects of which are triggered upon ingestion of gluten-containing grains and food products.
Are you, in all seriousness, claiming that celiacs can eat gluten-containing whole grains with impunity? If so, could you please provide the clinical evidence (not theoretical musings about the role of certain minerals, but hard clinical evidence with real live human beings) for this stunning revelation?
"I expect you are tired of hearing how IP6 from whole grains and legumes protects against iron overload"
Yes I am, because there is no clinical evidence that whole grains and legumes protect against anything, including iron overload. As an example, let's take a look at cancer. In the FeAST trial, patients who underwent phlebotomy to reduce their iron stores were 35% less likely to develop cancer. Among the study participants who did develop cancer, those in the iron reduction group had 61% lower cancer-specific and 51% lower all-cause mortality, respectively. And that was with a woefully inadequate reduction of serum ferritin to only 80 mcg/dl (it was supposed to have been reduced to near-deficiency levels).
So we know that blood withdrawal does lower iron and that it reduces the risk of cancer. There is a paucity of data examining the effect of IP-6 on cancer prevention or treatment in humans. However, in rodent studies, purified IP-6 dramatically reduces tumor incidence, whereas high cereal fiber diets providing a similar amount of IP-6 do not[2-4]. In human trials, increased wheat fiber intake has failed miserably to protect against colon cancer or adenomatous polyp formation.
As a disease prevention strategy, the consumption of whole-grains fails miserably. Yeah, I know, you can cite a million-and-one epidemiological studies showing that whole-grains are associated with lower rates of every known ailment under the sun. However, a fundamental rule of science (that many PhDs evidently forget the minute they graduate) is that association is not the same as causation. Due to their uncontrolled nature, epidemiological studies are hopelessly prone to confounding from a vast array of variables. Controlled clinical trials, a far more reliable form of evidence, routinely show whole-grains to do a whole lot of nothing when it comes to disease prevention and amelioration.
As for your absurd claim that whole-grains contain enough minerals to negate the "so-called toxins" ... where do I begin? First of all, your dismissive description of "so-called toxins" indicates an unwillingness to acknowledge the very real and well-documented anti-nutrient content of grains and legumes. I strongly suggest you read up on the existence and effects of phytate, lectins, enzyme inhibitors, and the vitamin-blocking glucosides that exist in these foodstuffs.
You claim whole grains have sufficient minerals to negate their toxic effects. Pity that the high phytate content of whole grains binds to minerals such as iron, calcium, magnesium, and zinc in the gastrointestinal tract, significantly reducing their absorption by the body[6-8]. While they increase the dietary content of zinc, iron, magnesium and calcium when compared to refined grains, they also promptly increase the excretion of these minerals from the body. The end result is that overall mineral status improves only marginally, remains unchanged, or even worsens[7-12]. If you want to increase your mineral intake, whole grains are a pretty poor way to do it. Far better choices would be fresh non-cereal, non-leguminous plant foods, mineral-rich waters (look for a high magnesium:calcium ratio), ionic mineral solutions such as those sourced from Utah's Great Salt Lake, and highly bioavailable mineral supplements such as those complexed to citrate, picolinate, etc.
The effect of phytate on mineral status is why I abandoned IP-6 supplementation and switched to phlebotomy instead, and why I made a point of taking IP-6 on an empty stomach away from meals first thing in the morning when I did take it.
The pitfalls of cereal grains don't end with phytate. Thanks to pyridoxine glucoside, B6 from cereal grain products is absorbed with far less efficiency than that from animal foods. Researchers who fed young men different foods containing pyridoxine glucoside found that as dietary glucoside levels increased, the vitamin B6 status of the subjects decreased. Again, increased wheat fiber consumption merely worsens the situation; B6 from whole wheat bread is five to ten percent less available than that from white bread, and the addition of wheat bran to the diets of young men reduced the availability of B6 by seventeen percent[15,16].
Cereal grains not only contain no detectable vitamin D, but also actively encourage deficiency of this important vitamin by impairing its absorption. It has long been recognized that high cereal grain consumption induces vitamin D deficiency in various animal species, including primates, our closest animal relatives[17,18]. By studying the fate of radio-labelled vitamin D, researchers observed significantly increased excretion of vitamin D in healthy human volunteers fed sixty grams of wheat fiber daily.
Vitamin D deficiency is common, especially during the winter months. Professor Michael Hollick and his colleagues from the Boston University School of Medicine observed that a third of healthy Boston adults aged 18-29 were vitamin D deficient by the end of winter. The risk of deficiency rises in the elderly and among dark-skinned individuals; forty-two percent of African American women and eighty-four percent of black elderly folks throughout the U.S. were vitamin D deficient by the end of winter.
Poor vitamin D status has been linked to increased risk of breast, prostate and colon cancers, osteoporosis and other bone disorders, Type 1 diabetes, arthritis, infertility, PMS, chronic fatigue and depression, Seasonal Affective Disorder, multiple sclerosis, musculoskeletal pain, and heart disease[20-34].
The effect of cereal fiber on vitamin D absorption may help explain why purified phytate fights cancer in rodents while an equivalent amount delivered via cereal fiber has little to no effect.
The numerous nutritional shortcomings of whole-grains may also help explain why the only randomized clinical trial to have ever examined the hypothesis that wheat fiber reduces CHD actually found a small increase in coronary and overall mortality. Lowered antioxidant defenses may have been a possible contributor: when type 2 diabetics consumed a low-wheat fiber diet and a high-wheat fiber diet containing bran-rich bread and breakfast cereal for three months each, LDL cholesterol oxidation was increased during the high-wheat fiber phase. You can wax prosaic about manganese and copper all you like, but none of it even begins to change the fact that under tightly controlled conditions whole cereal grains show no positive effect; in fact, when they do exert a detectable effect it is typically negative.
Given all the available evidence, I cannot consider the pro-whole grain hype as anything other than yet another bad joke promulgated by our clueless, corrupt, and industry lobby-influenced health authorities. It's truly sad that university-educated PhDs like yourself are so easily taken in by such rubbish.
I'm really not sure what the purpose of your email is. My comments on Cordain and white rice seemed to have raised your ire. Yet you have not even begun to refute my criticism of Cordain's absurd reporting and interpretation of the Dauncey study, nor have you provided any reason as to why I should not eat white rice or any evidence that white rice consumption is harmful. The Japanese, for whom white rice is a staple, don't seem to be doing too badly ... Like the Japanese, I do not subsist solely on white rice, I eat a variety of antioxidant- and nutrient-rich foods which by the way contain, among other things, manganese and copper.
One minute you state you believe Cordain is wrong, the next you are excusing his inaccurate information by saying he has "too much work on his plate". So do I, but I still endeavour to make sure what I write is factually correct. If I don't have time to thoroughly research a nutrition or health topic and provide an accurate report on it, I leave it alone. As for your statement "Digging out all the information he needs to exonerate whole grains and legumes takes a lifetime"...um, are you aware that Cordain actually wrote a paper highlighting the adverse impact of grains, much of it devoted to the effects of whole grains?
And as for your statement, "I know, I've spent a lifetime (well, 30 years) doing it." I hate to break this to you, but given the lack of tightly controlled evidence showing health benefits for humans, you've wasted a lot of precious time. There are researchers who've devoted a lifetime to researching and promoting the lipid hypothesis of heart disease, but that does not even begin to change the fact that this hypothesis is utter nonsense.
As stated, I am a busy individual with too much to do and far too little time to do it. If you wish to continue this correspondence, please do so only if you can supply tightly controlled clinical evidence showing positive health benefits from whole grain consumption (trials where increased whole grain consumption was part of a multifaceted intervention won't cut it, as there's no way of knowing exactly which intervention/s produced the positive changes. And please don't even begin to waste my time with further hypothetical speculations about minerals or whatever, such speculations have been the cause of billions of dollars of wasted funds and countless hours of scientific manpower over the decades). If you cannot supply such concrete clinical evidence, I kindly suggest you take your pro-grain sentiments elsewhere.
Jane Karlsson replies:
Many thanks for your reply.
Coeliac disease is thought to be caused by failure of 'oral tolerance', in which the immune system is instructed not to react to food proteins. See this paper for the role of regulatory T cells in coeliacs.
Immune cells use a lot of glutamine for fuel, like gut cells do. Glutamine is made by glutamine synthetase, which is activated by magnesium and manganese. Therefore, deficiencies of Mg and Mn are expected to cause problems with the immune system and gut. These two metals also activate intestinal peptidases.
'.. your dismissive description of "so-called toxins" indicates an unwillingness to acknowledge the very real and well-documented anti-nutrient content of grains and legumes.'
Most of the antinutrients are proteins, and should be broken down in the gut. All food contains things you could call antinutrients. Beef, for instance, has enormous quantities of highly-available iron and zinc, and hardly any copper or manganese. That means, beef contains 'antinutrients'. If you want to eat a lot of beef, eat it with beans and brown rice. Then it won't contain any antinutrients. Phytate, I should add, binds zinc better than copper, and iron better than manganese.
'Vitamin D deficiency is common ..' What do you mean by vitamin D deficiency? Do you mean, low blood vitamin D levels? This is indeed common, and is probably caused by mineral deficiency. Ask me if you want details.
'As for your statement "Digging out all the information he needs to exonerate whole grains and legumes takes a lifetime"...um, are you aware that Cordain actually wrote a paper highlighting the adverse affects of grains, much of it devoted to the effects of whole grains?'
Yes, indeed I am. What I meant was, if Cordain read some more, he would realise the literature actually exonerates whole grains and legumes.
The studies you want don't exist, but that doesn't mean the information doesn't exist, it does. It just takes time to find and assimilate it all.
I greatly appreciate the time and trouble you have taken to answer my email.
you are now resorting to some rather absurd semantics in order to wiggle your way out of a deeply flawed argument. To classify red meat, a food humans have been eating with great success for millions of years, as an anti-nutrient is so ridiculous it defies comprehension. Zinc and iron are not anti-nutrients - they are essential minerals of which insufficient amounts will promptly send your health to hell in a hand basket. In contrast, phytates, lectins, enzyme inhibitors and glucosides that block the absorption of important vitamins are not essential to human health and have in fact repeatedly been shown to produce adverse physiological effects.
To state that zinc and iron are toxic in excessive amounts does not in any way mean that they or foods containing them are anti-nutrients. It is a well-documented fact that water, when consumed in excessive amounts, can be fatal due to excessive dilution of electrolytes (do a Google search for "hyponatremia"). So, using your distorted logic, we would therefore class water as an anti-nutrient...which of course is ludicrous.
"If you want to eat a lot of beef, eat it with beans and brown rice. Then it won't contain any antinutrients."
Actually, beef never contained any anti-nutrients in the first place. The beans and brown rice, however, contain anti-nutrients regardless of whether they are consumed with or without bovine flesh.
Here's a far better idea, one that conforms more closely to the diet that humans evolved on: discard the anti-nutrient-rich beans and brown rice, and instead eat foods that supply copper and manganese without the unwanted baggage.
Organ meats, especially liver, are rich in copper. Crab, lobster, oysters, nuts, mushrooms, buckwheat (technically not a grain), and coconut are other good sources. Based on the values for venison, wild game meats would appear to be a much richer source of copper than the equivalent amount of grains.
Pineapple, nuts, chestnuts, tea, raspberries, sweet potato, spinach, coconut, buckwheat, are good sources of manganese.
As for rice, neither the white or brown varieties are particularly rich sources of copper. A visit over to the USDA website shows that one cup of cooked regular long-grain white rice contains 0.109 mg of copper and 0.746 mg of manganese. The equivalent figures for a cup of long-grain brown rice are 0.195 mg of copper and 0.1765 mg of manganese. If you're eating a copper- deficient diet, a switch from white to brown rice is hardly going to correct the problem. Brown rice does have reasonable amounts of manganese, but as stated there are better foods from which to obtain this mineral.
I should also point out that with the advent of widely available modern food supplements, there is simply no excuse for eating nutritionally inferior whole grains in order to obtain adequate amounts of minerals like copper and manganese.
You seem to be missing an essential point about nutrition - a healthy diet involves consumption of a variety of nutrient-rich foods, and when selecting foods it should be kept in mind that humans evolved over literally millions of years eating primarily fresh meats, tubers, vegetables, fruits, berries and nuts. Cereal grains and legumes were not consumed in any meaningful amount until as recently as 10,000 years ago with the advent of agriculture, when the combination of diminishing wild game availability and rapidly expanding population growth meant that humans had to begin seeking alternate food sources. And that was in the Middle East where it all began - other regions did not adopt agriculture until thousands of years later (which is why the prevalence of celiac disease tends to increase the further north-west you travel from the Middle East - these populations have had even less time to make the necessary genetic adaptations to gluten-containing grain consumption). Lactose intolerance, by the way, shows the opposite pattern, as dairy was first consumed in the Scandinavian regions.
You seem hell bent on defending grains and legumes even though the archaeological/Paleontological record clearly shows they are historically a very recent addition to the human diet and humans have not completely adapted to them. I've already mentioned the problems with anti-nutrients, which you have not even begun to adequately address. You simply attempted to shun the issue with an absurd red herring-style claim about beef, zinc and iron.
Cereals such as wheat, rye and barley also contain gluten, a troublesome protein for both celiacs and non-celiac gluten sensitive individuals . And irrespective of whether you suffer celiac disease or gluten allergy, wheat starch can prove problematic. Studies with healthy folks show almost all of them fail to break down an appreciable amount of wheat starch, explaining why symptoms such as bloating, belching, flatulence and abdominal discomfort are so commonly associated with cereal grain consumption. Cereal grains, especially the whole grain variety which have a far higher concentration of anti-nutrients, are a poor choice when seeking optimal human nutrition. That's why humans resorted to them only as a last resort when population growth and diminishing wild game availability forced the onset of agriculture:
[Circa 10,000 years ago in the Near East: Two alpha-male tribe leaders are heading a dejected group of hunters back to camp after yet another day's unsuccessful hunting...
"This food situation is driving me nuts, mate."
"Yeah, me too. Everyone in the tribe's pissing and moaning, Martina is always on my case, complaining that the kids don't have enough food. I haven't had any nooky for a week, goddamnit!"
"Tell me about it, mate. Ulma won't let me hear the end of it."
Bok and Rok walk past a field of wheat, then dwindle to a halt. The rest of the group stop behind them. They stare at the wheat for a few moments, then turn to each other.
"Rok, you thinking what I'm thinking?"
"This awful-tasting straw stuff that we've been ignoring for the last 2.4 million years...looks like we're gonna have to start eating it."
"I guess anything's better than starving, mate...and living with an angry wife who gives me no nooky."
"Awright, I guess I'll break the news when we get back to camp..."
And so the widespread human consumption of cereal grains began. Cereal grains have been embraced so widely around the world for reasons of practicality, not nutritional superiority.
As for celiac disease, once again you go off on a tangent to avoid the consequences of your original incorrect statement, but I will reiterate: celiac disease is determined by genetic susceptibility, regardless of the behaviour of T-cells, glutamine, manganese, or the alignment of the planets on Chinese New Year. The symptoms of celiac disease are triggered by the consumption of gluten, whether it be from whole grains, refined grains, or non-cereal food products to which gluten or gluten-containing flour has been added. In particularly sensitive individuals the consumption of food that has been processed in the same equipment as gluten-containing foods can trigger symptoms. None of this, I repeat none of this, is changed one iota by your diversionary and largely irrelevant discussions of "oral tolerance", T-cells, glutamine, magnesium, manganese, intestinal peptidases, yadayadayada. Once again: celiac disease is genetically determined, and its symptoms are triggered by the consumption of gluten. Period.
"'Vitamin D deficiency is common ..' What do you mean by vitamin D deficiency? Do you mean, low blood vitamin D levels? This is indeed common, and is probably caused by mineral deficiency. Ask me if you want details."
Complete nonsense. It is caused by lack of sun exposure, as evidenced by the fact that D deficiency is more common in winter, in Northern latitudes, and in dark-skinned people.
"Yes, indeed I am. What I meant was, if Cordain read some more, he would realise the literature actually exonerates whole grains and legumes."
I'm not sure how the scientific literature, in which clinical trials show a higher rate of CHD death with brown bread consumption, higher LDL oxidation, and higher rates of adverse effects in colon cancer trials in any way "exonerates" whole grains?!
Jane, I'm glad you enjoyed my original response, but I detect a very familiar pattern here, one of which I've experienced countless times before and one I really do not care to encourage. Namely, you started the correspondence with some factually incorrect claims, I effectively countered those claims and asked you to kindly not continue the correspondence unless you had solid clinical evidence to back your arguments. You have just admitted you have no such evidence, but have decided to continue the discourse anyway, using evasive side-stepping, transparent semantics and irrelevant red herrings.
You still have not provided me with a good reason as to why I shouldn't eat white rice, you still have not explained what my consumption of white rice has to do with Cordain's dubious statements on protein and weight loss, and you have not provided an ounce of tightly controlled clinical evidence to back your pro-whole grain claims. Perhaps these types of exchanges are fun for you, but they really are a waste of time for me considering my current workload. Given your inability to supply the evidence requested and your inability to provide straight answers to my questions, I think we should end the exchange right here.
All the best in your future endeavours and I do hope you consult the references I have cited,
Jane Karlsson replies:
OK, let's end this now. I was just trying to help. I've spent all this time reading the literature, and I keep hoping I'll find someone who can benefit from it. I'll go on looking.
BTW, I've read as much of your cholesterol book as I can get online, and it's excellent. Did you know homocysteine metabolism requires copper?
if you really wish for people to benefit from your knowledge, then you must ensure it is correct. At present, your beliefs about grains are way off base - they are based on popular prejudice and health authority hyperbole rather than scientific fact. You must stop looking at grains through a biased filter, take off your blinders and acknowledge the very real fact that not only is their nutrient profile quite weak when compared to meats and non-cereal plant foods, but they are well-documented to contain numerous agents that exert unfavorable effects on human health. This is not my personal opinion but something that has been repeatedly shown in tightly controlled clinical research. I have cited some of this research for you to check out for yourself, I strongly recommend you do so.
The reality is that, using important criteria such as overall nutrient density, low anti-nutrient content and low allergenic potential, then fresh meats, tubers, vegetables and fruits absolutely blow whole grains away any day of the week.
In fact, I find the entire health authority obsession with whole grains to be nothing short of mind-boggling:
"Hey guys, let's take this food group that humans were never designed to eat, that is riddled with problematic anti-nutrients, of which the glutinous varieties are especially troublesome and even downright toxic to a significant portion of the population - and let's make it the centerpiece of our dietary recommendations!! Yep, let's tell people to consume it every day in larger quantities than any other food group!"
"Gee, what a fantastic idea! Why didn't we think of that?!"
This is the kind of idiotic logic that mainstream health authorities routinely apply, not only to whole grains, but to so many other areas of nutrition. Hence, the 20th Century has produced some of the most bizarre fads that would leave a visitor from another planet shaking their head in dismay. Take for example, the vilification of perfectly natural meats, eggs, butters and tropical oils, and the patently stupid exaltation of linoleate-rich seed oils and industrially-produced trans-fat-laden margarine (a rank grey sludge that had to be deodorized, bleached and coloured to give the appearance of butter...). Or how about the advent of phytoestrogen-laden soy burgers and sausages that taste like prophylactics...all in the name of avoiding the non-existent adverse effects of real, nutritious meat?
The field of mainstream nutrition has long been a complete joke, and a very bad one at that.
Thank you for your kind comments about my book. If you can apply the same open-minded attitude towards the topic of cereal grains as you evidently have towards cholesterol, then your knowledge on that topic will grow exponentially.
As for copper and HcY, the relationship may not necessarily be a positive one:
Bessede G, et al. Efficiency of homocysteine plus copper in inducing apoptosis is inversely proportional to γ-glutamyl transpeptidase activity. FASEB Journal, 2001; 15: 1927-1940.
Rodent studies have found contrasting effects of copper on homocysteine levels:
Tamura T, et al. Folate and homocysteine metabolism in copper-deficient rats. Biochimica et Biophysica Acta, May 24, 1999; 1427 (3): 351-356.
Uthus EO, et al. Copper deficiency decreases plasma homocysteine in rats. Journal of Nutrition, 2007; 137: 1370-1374.
I am also aware that HcY requires B6 for its metabolism - and that cereal fiber (you know, the kind found in whole grains) inhibits B6 absoprtion (see earlier email).
Whatever...if researchers really want to conquer heart disease then they need to start paying far closer attention to iron. That's the grand-daddy of CHD promoters right there.
Jane Karlsson replies:
I entirely agree, iron is the problem, and the data on copper and Hcy are mixed.
'.. your beliefs about grains are way off base - they are based on popular prejudice and health authority hyperbole rather than scientific fact.'
No, they aren't. They are based on full time reading of the literature for 25 years. In fact I tried very hard to influence the health authorities myself, and failed. Now, they are coming round to my point of view. Not because of me, I hasten to add. Nobody has ever really listened to me. I regard that as a great compliment.
I agree with you, of course, that there are many papers showing adverse effects of components of whole grains. What I do not accept is that these papers show that whole grains are a bad food for humans.
You asked about the non-protein antinutrients, like B6 glucoside. I don't see what the problem is here. Yes, it inhibits B6 absorption, but not that much, and some or even most of it can be converted to B6 and utilised. And as for fibre inhibiting B6 absorption ... a measly 17%? You may not be aware that the micronutrient uptake systems in the gut are enormously flexible, and can be up- or down-regulated on several different levels. You have to try very hard if you want micronutrient deficiencies.
What you really need to watch out for is trace metal uptake, because an excess of one metal can inhibit absorption of another. For instance, absorption of manganese can be much lower if you have high iron stores, because iron/manganese transporters get down-regulated. This may not matter very much, because if you absorb less Mn you will excrete less. But if your diet is very high in iron, you could have problems. You'd never know, because nobody thinks Mn deficiency is important.
For example, one of my email correspondents has found that many of his patients on a paleo diet have problems with blood sugar, and also with cortisol. He was not aware that cortisol makes the liver release Mn, and that Mn is needed both for gluconeogenesis and for synthesis/secretion of insulin. These patients probably need to balance their iron/Mn ratio. It may be that phlebotomy is the best way to do this, but at the very least it suggests something is not quite right with the paleo diet.
It's possible that ancient people understood this. There is evidence that Neanderthals collected grain, and other evidence shows that people were using grinding stones long before agriculture began. I'm told the Maasai eat their meat together with herbs high in tannins, which inhibit iron absorption like phytate does.
About homocysteine. You will be aware that Hcy is a risk factor for Alzheimer's as well as heart disease, and may have seen the recent report of success with B vitamins from the Oxford group. But other trials have not succeeded, and what people really need to do is address the iron overload, and also zinc overload. Alzheimer brains have both, correlating with pathology, and a a very recent paper shows that the Amyloid Precursor Protein is a (copper-dependent?) ferroxidase responsible for iron export, and it's poisoned by zinc.
Have a look, it's pretty sensational: http://www.alzforum.org/new/detail.asp?id=2562
Here in the UK, the top nutritionist Patrick Holford tells Alzheimer patients to take zinc supplements. This despite a report in Science in 1994 that a trial of zinc in Alzheimer patients made them so much worse it had to be stopped in a matter of days.
I thought we agreed to end this exchange?
I'm glad we at least we agree on iron, because it truly is the biggest show in town as far as CHD is concerned. I'm absolutely dismayed at the almost total lack of attention it receives from the mainstream. If I were to re-write my book, I'd make iron the centerpiece. I get a little disheartened when I read reviews of my book and people gush on about n-3s, blood sugar, stress, exercise, etc but make no mention of iron. If you pay attention to all those things but ignore your high bodily iron stores, an early demise from CHD is still a very real possibility. I guess lowering iron isn't as simple for most people as taking a few fish oil tablets, so they basically ignore it. Pity, because it's the single most important factor most people should pay attention to if they wish to avoid CHD.
Pre-menopausal women have long enjoyed very low rates of CHD, despite widespread poor nutritional and lifestyle habits - luckily for them, nature was taking care of their iron disposal needs via monthly bleeding. When this stops at menopause, their CHD mortality rate promptly rises to match that of men the same age.
As for the rest of our exchange, it's still going nowhere fast, your comment below is a case in point:
"I agree with you, of course, that there are many papers showing adverse effects of components of whole grains. What I do not accept is that these papers show that whole grains are a bad food for humans."
You do not see the striking contradiction within that statement?
The fact that a significant portion of the population is gluten sensitive and even celiac, the fact that under controlled clinical conditions wheat starch causes digestive disturbances in most subjects, the fact that grains are nutritionally weak foods that routinely crowd out far more nutritious foods from the diet,and the fact that whole grains - by virtue of retaining the anti-nutrient-rich outer husk - have a far higher concentration of anti-nutrients, clearly does not register with you. You've made up your mind that whole grains are wonderful and that's it, no-one's going to change your mind come hell or high water. Never mind that they are clearly a very poor food choice for a significant portion of the population.
Fresh meats, tubers, fruits and vegetables are the foods humans evolved on and constitute far more nutritious food choices than whole grains. If one desires extra variety in their diet, or needs and additional source of carbohydrate dense foods, then refined grains mixed with green and orange vegetables constitute a lower-GI and more nutrient-dense plant food choice than whole grains alone.
You write: "I'm told the Maasai eat their meat together with herbs high in tannins, which inhibit iron absorption like phytate does."
You are switching contexts: herbal teas are not cereal grains. Both commonly consumed black and green teas contain tannins, but they rarely incite bloating, flatulence, gluten sensitivity nor trigger symptoms of celiac disease.
Unlike cereal grains, there is a rapidly growing body of clinical evidence showing green and black teas enhance health.
Interestingly, a study with green tea showed that it lowered bodily iron in rodents while enhancing zinc and selenium status. Whether green tea exerts such an effect on humans is unknown, but needless to say cereal grains do not exert this effect.
By the way, when preparing loose leaf tea, the tannin concentration can be kept to a minimum by steeping the tea for no longer than 60-90 seconds. After this, you've extracted the maximum amount of flavor from the leaves and steeping for any longer will only cause the tannin content to rise, giving the tea an increasingly bitter taste.
A paper by Mann et al back in the 60s reported that on the days the Masaii eat meat, which was not a daily occurrence but something that happened every few days (the staple daily food was high-fat Zebu cow milk) they would co-ingest a herbal tea they believed helped digest the ungodly amounts they ate. I'm unaware of the tannin content of this tea - at any rate, it comprised a miniscule proportion of their diet and one must consider the potential contribution of this tea towards inhibiting iron absorption as compared to the Masai's prodigious lactoferrin consumption (from milk) and highly active lifestyle - both factors that would likely have a far greater impact on their iron status.
As for Neanderthal consumption of grains, you claim "There is evidence that Neanderthals collected grain, and other evidence shows that people were using grinding stones long before agriculture began."
And my answer to that would be: so what?
A few years ago, Weiss et al published findings pushing back the earliest evidence for grain consumption to around 23,000 years ago. It must be emphasized that this evidence does not show that agriculture, and hence widespread consumption of cereal grains, began over 20,000 years ago. All the evidence still points to that happening around 10,000 years ago.
In their 2004 Nature paper, they write:
"Here we report the earliest direct evidence for human processing of grass seeds, including barley and possibly wheat, in the form of starch grains recovered from a ground stone artefact from the Upper Palaeolithic site of Ohalo II in Israel. Associated evidence for an oven-like hearth was also found at this site, suggesting that dough made from grain flour was baked. Our data indicate that routine processing of a selected group of wild cereals, combined with effective methods of cooking ground seeds, were practiced at least 12,000 years before their domestication in southwest Asia."
These findings do little to change the overall picture regarding the unsuitability of ceral grains for much of the population. It still leaves the earliest consumption of cereal grains rooted in the Middle East, so does little to change the increasing North-West trajectory of grain intolerance. And, like 10,000 years before present, 23,000 years BP is still a blip on the 2.4 million-year time line of human evolution and still only a fraction of the time our species has had to adapt to meats and non-cereal, non-leguminous plant foods. Regardless of these findings, the widespread incidence of cereal intolerance and gluten sensitivity, as well as the prolific occurrence of anti-nutrients in whole grains, is still an undeniable reality.
A more recent paper by Mercader argues for grain consumption as far back as 105,000 years BP at the Mozambican cave site of Ngalue in South Africa. Mercader's argument is predicated entirely on the discovery of Sorghum starch granules found on the surfaces of Middle Stone Age stone tools at the site. Reports in the popular press have intimated that Mercader's findings show that grains were an important part of the Stone Age diet, and Mercader himself claims they show "that early Homo sapiens relied on grass seeds starting at least 105,000 years ago".
But relied on grains for what, exactly? Unlike the Ohalo findings, there is no actual evidence that the grains were in fact being eaten by the Ngalue residents. The lack of associated collecting and cooking apparatus would suggest that, if sorghum was consumed, it was hardly in large amounts and more likely as an emergency strategy in the face of wild game and non-cereal plant food availability. And that's if it was in fact eaten; some have suggested that the sorghum may have been used for non-dietary purposes such as the preparation of paint pigment. Hopefully further findings will clarify the issue, but as it currently stands the Ngalue findings constitute rather poor evidence for regular consumption of cereal grains 105,000 years ago.
So to reiterate yet again...regardless of when humans began eating grains, a large number of humans do not respond well to these foods and whole grains are laden with components that actively work against the attainment of optimal nutrition. That you continue to insist they are superior foods defies logic.
I have asked you to provide a tightly controlled clinical study that can show health benefits as a direct result of increased whole-grain consumption, and you have been unable to cite even a single one - a rather startling incapability for someone who claims to have been researching the health benefits of whole grains for 30 years. In contrast, I have presented a number of studies showing poorer health outcomes as a result of increased whole grain/cereal fiber consumption, and you've pretty much ignored them.
"You asked about the non-protein antinutrients, like B6 glucoside. I don't see what the problem is here. Yes, it inhibits B6 absorption, but not that much, and some or even most of it can be converted to B6 and utilised. And as for fibre inhibiting B6 absorption ... a measly 17%?"
So when beef supplies plentiful zinc and iron, that somehow bizarrely qualifies it in your mind as an anti-nutrient...but when whole grains worsen B6 status by 17% you flippantly dismiss the finding as insignificant?
Consumption of beef significantly improves intake of B6, as well as B12, zinc, iron, niacin, phosphorus, and potassium...but in your mind beef is an anti-nutrient, while whole grains are lovely wonder-foods?!
I repeat, your thinking on this matter is way off-base.
"You have to try very hard if you want micronutrient deficiencies."
You've got to be kidding. Despite plentiful food and calories, vitamin and mineral deficiencies are common among Western populations. Here are a few examples to mull over:
- The median intake of magnesium among US adults is below the RDA:Ford ES, Mokdad AH. Dietary magnesium intake in a national sample of US adults. Journal of Nutrition, Sep, 2003; 133 (9): 2879-2882.
- Recent NHANES data showed less than 3% of the population consumed the recommended level or more of potassium and 55% consumed less than the recommended amount for magnesium:Nicklas TA, et al. The role of dairy in meeting the recommendations for shortfall nutrients in the American diet. Journal of the American College of Nutrition, Feb, 2009; 28 ( Suppl 1): 73S-81S.
- Over 50% of surveyed Canadian male teens consumed inadequate amounts of vitamin A and vitamin B6, and greater than 75% of subjects consumed inadequate amounts of magnesium, phosphorus and zinc:Schenkel TC, et al. Evaluation of energy, nutrient and dietary fiber intakes of adolescent males. Journal of the American College of Nutrition, Jun 2007; 26 (3): 264-271.
- In France, the estimated portion of people consuming inadequate magnesium is 72% among males aged 15-92 years and 83% among females aged 10-90 years. For iron: females aged 15-54 years (71.1%); and for vitamin C, females aged 15-54 years (66.2%):Touvier M, et al. Vitamin and mineral inadequacy in the French population: estimation and application for the optimization of food fortification. International Journal for Vitamin and Nutrition, Nov, 2006; 76 (6): 343-351.
- A sample of young adults in Loiusiana reported intakes of vitamins A, B6, E, D, and C, folacin, magnesium, iron, zinc, and calcium were most likely to be inadequate compared with the RDA, with more females than males reporting nutrient intakes less than two thirds of the RDA:Zive MM, et al. Marginal vitamin and mineral intakes of young adults: the Bogalusa Heart Study. Journal of Adolescent Health, Jul, 1996; 19 (1): 39-47.
And don't get me started about selenium...OK, I will get going on Se, because it is so important. When you go around the world and compare mean Se intakes with cancer rates, you see a very consistent inverse correlation. Most Western countries, including Australia, the UK, and the USA have woefully low Se levels in their soil, and the problem is getting worse thanks to progressive depletion of soil mineral content. In China, where Se levels vary markedly from one region to another, researchers have found a positive relationship between soil Se (and manganese) and longevity.
Eating more whole-grains isn't the solution, because plant and animal flesh content of Se is closely linked to soil Se levels. Japan has a higher Se intake due to their higher seafood intake, and correspondingly lower cancer rates. Venezuelans have even higher Se intakes thanks to their Se rich soil, and even lower cancer rates again.
Because Se soil levels are generally low and because this trace mineral is far too important to risk deficiency, I recommend people strongly consider supplementation. Large clinical trials in China and the USA have produced significant declines in cancer incidence and mortality via Se supplementation, while a small trial found reduced cardiac mortality in the Se supplemented group[46-49].
The reality is many people fail to achieve adequate intakes of important vitamins and minerals, without having to try very hard at all.
Jane, I will kindly ask once again - this conversation is going nowhere fast, so please let it rest. You still have not explained what my consumption of what rice had to do with Cordain's fallacious comments about protein and weight loss, you still have not justified your original angst against white rice, a low-allergenic foodstuff that does not cause anywhere near the problems that whole grains do and is in fact a staple of one of the longest-living countries in the world. Nor have you provided any clinical evidence showing health benefits for whole grain consumption.
It is obvious that you are unwilling or unable to provide any of this requested information, so once again, please respect my time and wishes and find someone else to converse with on the topic of whole grains.
Jane Karlsson replies:
You are not respecting my time or wishes, so why should I respect yours? You do not have to read what I write.
'You do not see the striking contradiction within that statement?' Now Anthony, you can't really mean this. You know perfectly well that feeding isolated components of foods is very different from feeding the whole food. I have a scientist friend who feeds his cat almost exclusively on liver. The cat has diabetes. Does that mean liver is a bad food for cats? No.
I repeat, nearly all the so-called antinutrients of grains are proteins, and should be broken down with no difficulty. Tell me about other antinutrients, and I will tell you why they are not a problem.
'The fact that a significant portion of the population is gluten sensitive and even celiac, the fact that under controlled clinical conditions wheat starch causes digestive disturbances in most subjects..'
What kind of subjects? Are they people who have eaten refined food all their lives? How can conclusions be drawn from this uncontrolled experiment? If you have a damaged digestive system you will have digestive problems. Even more so if you are given wheat starch without its micronutrients.
'You've got to be kidding. Despite plentiful food and calories, vitamin and mineral deficiencies are common among Western populations.'
Of course Western populations have deficiencies. They eat refined grains. If removing most of the micronutrients from grains doesn't count as trying very hard to get deficiencies, I don't know what does.
How can it have escaped you that the missing micronutrients are required for processing the macronutrients? Why do you think the plant goes to such a lot of trouble to put them there? The seed digests its macronutrients during germination using the same metabolic pathways we use. The same enzymes, activated by the same vitamins and minerals. And you think it's OK to eat white rice.
BTW, The Maasai use Acacia nilotica bark to flavour their meat soups, according to Timothy Johns. Look it up, it's very high in tannins.
"You are not respecting my time or wishes, so why should I respect yours? You do not have to read what I write."
How precious. You incited this exchange of your own volition, challenging my statements on Cordain and white rice, yet have not justified your angst with anything resembling evidence or even a coherent, logical argument.
The fact remains you are yet another argumentative time-waster who remains oblivious to my arguments. You initiated this conversation and have imposed upon my time, so it is only fair I end it. This will be the last email I send to you. You've at least got one thing right - I am under no obligation to read your evasive and circular correspondence, so after this I will be placing your email address on my spam filter. I really don't have the time to be arguing with close-minded individuals who feel the need to argue the same point over and over while repeatedly ignoring evidence that refutes their arguments.
Once again, you've not even attempted to take on board what I have written, you repeatedly fail to address the research I cite disproving your false assertions, and you blatantly ignore the abundance of evidence showing whole grains to be anything but healthful.
You insist that the toxic anti-nutritional factors found in abundance in whole grains are not harmful to humans, and that whole grains are in fact beneficial to human health. I have asked for a tightly controlled clinical study that supports this assertion, and you have failed to cite even one.
In contrast I have cited numerous studies showing whole-grains to be anything but healthy.
Let's take a quick recap:
The Diet And Reinfarction Trial examined the effect of either increasing fish or fish oil intake, replacing saturated fat with polyunsaturated fat, or increasing cereal fiber consumption among over 2,000 male heart attack survivors. The men in the fiber group increased their consumption of wholemeal bread, high-fiber breakfast cereals, and wheat bran. According to your pro-whole grain rantings, they should have suffered a greatly reduced rate of CHD mortality.
In reality, they suffered the highest death rate in the study. No change in mortality was noted in the fat advice group, while a reduction in mortality was noted in those instructed to eat more fish or use fish oil.
I have already cited this study  and your response was...silence.
Another group of British researchers tested the hypothesis that dietary fiber might protect against the development of CHD via reductions in platelet aggregation and blood clotting. They fed volunteers white bread for three weeks and brown and wholemeal breads for a further three weeks each. No change was seen in platelet function. A further experiment in which the subjects were fed an additional thirty-six grams per day of pectin (a soluble fiber found in oat bran and vegetables) showed that, while serum cholesterol concentrations were significantly lowered, platelet aggregation, platelet fatty acid composition, blood clotting times, and bleeding times remained unchanged.
Canadian researchers took twenty-three type 2 diabetic men and women and had them complete two 3-month phases in a randomized crossover study. In the test phase, high-fiber bread and breakfast cereals were provided, giving an extra nineteen grams per day of cereal fiber. During the control phase, only four grams per day of additional cereal fiber was given. No differences were seen in body weight, fasting blood glucose or glycated hemoglobin (a measure of long-term glycemic control). No favorable effect was found for any of the following CHD risk markers: serum lipids, apolipoproteins, blood pressure, serum uric acid, clotting factors, homocysteine and C-reactive protein. Oxidation of LDL cholesterol was actually higher in the fiber-rich phase than during the low-fiber phase, indicating poorer antioxidant status. Again, I have already cited this study  in a previous email and again your response was...silence.
As a CHD prevention strategy, cereal fiber is about as effective as a bullet-ridden condom.
I also cited a review of the complete lack of evidence for the claim that cereal fiber protects against colon cancer and your response was...drum roll please...silence.
In fact, some of these trials noted worse outcomes in the treatment groups. In the four-year Polyp Prevention Trial, colorectal cancer was diagnosed in 10 subjects from the high fiber group, and only 4 from the low-fiber group. Even after excluding those diagnosed within the first year of the study, the results were similarly unfavorable; four cases in the intervention group as compared to 2 in the control group. Polyp recurrence was virtually identical between the two groups.
In the three-year double-blind Phoenix Colon Cancer Prevention trial, there was a significantly higher proportion of subjects with three or more recurring polyps in the high-fiber group. Seven cases of colon cancer were reported in the high-fiber group, but only 2 in the low-fiber group. Those who have abandoned cereal grains and relished the subsequent improvements in gastrointestinal function would not be at all surprised to learn that the incidence of nausea, abdominal pain, diarrhea, constipation, intestinal gas, and abdominal bloating was significantly higher among those receiving the high-wheat fiber diet.
I cited a controlled study showing that wheat starch was poorly tolerated by most healthy subjects, causing gastrointestinal distress, bloating and flatulence and your response was...(sorry folks, no prizes for guessing the answer)...silence.
You absurdly describe nutrient-dense beef as an "anti-nutrient", yet cereal grains - whole or refined - are nutritional weaklings. They contain no vitamin C, no vitamin D, no B12, no vitamin A and (with the sole of exception of yellow maize) no beta-carotene. While important nutrients like carnitine, creatine, carnosine, taurine, vitamin B12, and the omega-3 fatty acids EPA and DHA can only be found in animal foods, there is not a single vitamin, mineral or trace element found in cereal grains that cannot be supplied either by animal products or non-cereal plant foods like vegetables, fruits and nuts. As mentioned, whole cereal grains truly do contain contain high concentrations of anti-nutrients, including phytate, enzyme inhibitors, glucosides, and lectins.
You initially assert it is very difficult to achieve nutrient deficiencies, but when I cite evidence showing they are in fact quite common, you suddenly do an about face:
"Of course Western populations have deficiencies."
You then blame these deficiencies on the consumption of refined grains. Yes, refined grains comprise far too much of the Western diet, but the solution is to eat more nutrient-dense foods such as meats, tubers, vegetables, fruits, nuts, along with judicious nutrient supplementation (and/or sun exposure in the case of vitamin D).
Switching to whole grains, in contrast, will do little to correct these deficiencies. Exactly how are deficiencies of vitamins A, B6, D, and C going to be corrected when whole grains either do not contain these nutrients or, in the case of vitamins D and B6, contain substances that actually block their absorption?
Exactly how do whole grains constitute an ideal source of zinc, iron, magnesium, calcium, etc, when they are documented to impair the absorption of these minerals?
Your entire pro-whole grain argument is built on nothing more than wishful thinking and willful evasion of the abundant evidence showing they are in no way the nutritional panacea that health authorities portray them to be.
I think we have clearly established by now you are unable to supply the evidence backing your pro-whole grain stance, but are intent on nevertheless arguing the point until the cows come home. Sorry, but I just don't have the time for this - I entertained your antics up to this point in the vain hope I could get through to a PhD who is presumably in a position to influence others, but it appears your inculculation by mainstream propaganda has become far too ingrained.
"And you think it's OK to eat white rice."
You bet I do, but as I have clearly explained, only as part of a dish that contains nutrient-rich and lower-GI foods. I guess you'll never experience the mouth-watering delicacy that is pumpkin soup and rice, or a tasty Indian dish of rice and vegetables spiced with antioxidant-rich herbs such as turmeric. Brown rice just doesn't work the same as white for such dishes - something that cultures all around the world clued into a long time ago.
"BTW, The Maasai use Acacia nilotica bark to flavour their meat soups, according to Timothy Johns. Look it up, it's very high in tannins."
They do indeed use Acacia nilotica for soup and medicinal purposes. Which, of course, does little to change the facts I've reported about cereal grains.
As for your stance on whole grains and celiac disease, that a supposed PhD would ignore the relationship between gluten and celiac disease (news flash: if you are celiac and eat gluten-containing grains, you are not going to experience good gut health!) is truly astounding. I sincerely hope you are not in a position where you are able to influence the eating habits of celiac individuals. Your ignorance at that point becomes dangerous.
Anthony Colpo is an independent researcher, physical conditioning specialist, and author of the groundbreaking books The Fat Loss Bible and The Great Cholesterol Con. For more information, visit TheFatLossBible.net or TheGreatCholesterolCon.com
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