COMMENTARY

Is Avoiding Grains a Mistake?

Neal D. Barnard, MD

Disclosures

February 26, 2014

In This Article

Does Gluten Matter?

What about gluten -- the protein found in wheat, barley, and rye? Is it harming your brain? Not likely. Here's what you need to know.

Roughly 1% of the population has celiac disease. They produce antibodies against a part of gluten called gliadin, which damages the intestinal tract and causes fatigue and mental fuzziness that disappear when gluten is avoided. A larger group of people -- perhaps around 6% or 7% -- have gluten sensitivity. For them, gluten causes no visible change in the intestinal lining but nonetheless does cause digestive and mental symptoms. They do well to avoid gluten, too.

But the vast majority of people -- more than 90% -- have no adverse reaction to gluten at all. For them, a gluten-free diet is the nutritional equivalent of omitting the 13th floor from a hotel architectural plan.

What About a Mediterranean Diet, or Maybe Paleo?

Many people are turning to "Mediterranean diets" or "Paleo diets," terms that are so appealing and meaningless that they have attracted millions of adherents.

"Mediterranean" conjures up summery images of yachts and glasses of wine by the seaside. But the Mediterranean region is vast and diverse, extending from Spain across southern Europe to Turkey, Lebanon, and Israel, and across North Africa. The culinary traditions in these regions vary dramatically. For one person, a "Mediterranean diet" might mean more olive oil. For another, it means pasta. For someone else, it's red wine, or maybe chickpeas or fresh fruit.

What these variants have in common is a reduced emphasis on animal-derived foods, which is in fact a step in the right direction. A traditional Asian diet would reduce animal products further, and a plant-based diet would remove them altogether -- both more powerful than a "Mediterranean" pattern.

"Paleo" brings images of our loincloth-clad forebears whose mastodon-conquering adventures are far more exhilarating than microwaving a frozen dinner while listening to NPR. The Paleolithic period is popularly understood as the band of human history beginning with the advent of stone tools and ending before the development of agriculture. So following a "Paleolithic diet," we get to eat meat, but we shun grains and anything else that requires a green thumb.

However, human evolution extends back much further than the Paleolithic period. Our primate ancestors were largely (or entirely) vegetarians, and our bodies are essentially pre-Stone-Age bodies that have never adapted to a meaty diet.

The most effective diet, by far, is plant-based. A plant-based diet reopens narrowed arteries, trims waistlines, lowers blood pressure, and is more powerful against diabetes than any other regimen. And it's surprisingly easy. When patients get good information and a bit of support, they benefit dramatically.

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