COMMENTARY

Brawn, Brains, and Grains of Truth

David L. Katz, MD, MPH

Disclosures

April 03, 2014

In This Article

A Grain of Truth

There is, then, predictably, a grain of truth in the assertion that dementia and other forms of cognitive decline and neurodegeneration may at times owe something to grain consumption.[5] There is a similar grain of truth in the assertion that epidemic obesity owes something to the ingestion of wheat.[6] That truth derives from what we generally do with wheat and other grains: We turn them into bagels and biscuits, muffins and macaroni, Danish and donuts. America, as we know, runs on Dunkin'.

But the grain of truth is no larger than that. The rest of the Grain Brain[5] story is one of brawn, not brain -- the raw power of pop culture repetition, not the staying power of truth. Whole wheat does not make us fat; whole grains do not make us stupid.[7]

In fact, no one food, food group, or nutrient is responsible for the prevailing ills of modern epidemiology, any more than just one thing can fix it all. Rather, our adulteration of grains is part of a larger story in which much of our food is willfully engineered to maximize the calories it takes to feel full,[8] propagate something akin to addiction,[9] and amplify profit at the expense of public health. In contrast, whole-grain consumption is consistently associated with better overall health outcomes,[10,11] figures prominently in the diets of the longest-lived and most vital peoples on the planet, and can even provide an ostensibly advantageous approach to reducing the glycemic load of the diet.[12]

As for the particular neurologic scourge of modern times, dementia of the Alzheimer type, its origins overlap with those of coronary disease[13] and type 2 diabetes. The latter association is of sufficient robustness to support the contention that Alzheimer disease is "type 3 diabetes," the end result of insulin resistance of the brain.[14,15,16,17] The beneficial influence of whole-grain consumption on insulin, glycemic control in diabetes, and coronary risk indices[18] is thus clearly germane, and a rather direct refutation of the Grain Brain hypothesis.

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