COMMENTARY

Brawn, Brains, and Grains of Truth

David L. Katz, MD, MPH

Disclosures

April 03, 2014

In This Article

Reaping and Sowing, Forest and Trees

Selectively seeking, finding, or citing the sources that affirm what we already believe and wish to be true is not scholarship.[29] It does not qualify as research. It does not even meet standards for homework of any respectable pedigree. From my perspective, this vapid variety of pseudo-erudition is New Age charlatanism.[29]

There have always been good charlatans and bad; the good ones are the problem. Bad charlatans make up indefensible nonsense. They may manage to get 15 minutes of fame and fortune but rarely more than that. Sunlight does its disinfecting work, and the charlatans with overtly indefensible claims wither and disappear.

Good charlatans are, and always have been, far more subtle and pertinacious. Good charlatans don't make up nonsense; they tell the truth. Generally, the truly good ones tell nothing but the truth. They just very assiduously avoid telling anything like the whole truth[30] -- perhaps, giving the benefit of doubt, because they don't know it and mistake the part for the whole. So, the arguments they make not only seem erudite, but up to a point actually are.

However, it's like a trial that is all defense and no prosecution, or vice versa. It's a handpicked version of the truth, spared the test of challenge. For anyone doubting the need to hear both sides of a case before reaching a verdict, it's time to rewatch 12 Angry Men.

The popular case against grains, or more expansively carbohydrates, obscures the diversity of carbohydrate (eg, everything from lentils to lollipops is a "carb") and ignores the association between "high-carbohydrate" diets and excellent health outcomes. The literature linking high-carbohydrate, plant-based diets inclusive of whole grains to risk-factor amelioration, chronic disease prevention, regression of atherosclerosis, longevity, and vitality is vast and comparably consistent in findings as diverse in methodology.[31] The Grain Brain argument ignores the demonstration that high-carbohydrate, plant-based diets inclusive of grains even favorably alter gene expression,[32,33,34] and as noted, figure prominently among the factors producing the longest-lived, most vital (and yes, least dementia-prone) populations on the planet.

When fragments of truth are misrepresented as the whole truth, they might just as well be a lie. The result either way is distortion, deception, and the propagation of misunderstanding. Even a professional readership is misled and misguided by highly selective citation, cagey non sequiturs, and innuendo, accompanied by the occasional assertion that is simply fallacious. A general audience is ill-served by the now time-honored formula for best-selling health and diet books: implicate a single scapegoat, even if the "fine print" acknowledges that there is more to the story; hint at conspiracy theories; assert or imply that this is a truth all others have failed to see, so thank goodness a renegade genius has come along to save us all; and disparage the conventional wisdom.

In the end, this formula is nothing less than tragic, forestalling progress in public health nutrition -- literally taking years from life and life from years. Rather than focus on the well-established common ground of better eating for better health, this penchant has drawn the public into competing factions and sequential passions, while creating lucrative opportunities for "big food" to exploit a parade of "lipstick on a pig" opportunities.[35] We have lost decades to "just cut this, just cut that, just add this, just avoid that" nutrition guidance -- whereas if we had committed to "eating food, not too much, mostly plants,"[36] we might be well on our way to the 80% reduction of chronic disease we know to be within reach.[37]

As we move into the "grains are the cause of all our ills" era almost before exiting the "fructose is the cause of all our ills era," I am very nearly tempted to cry at the squandered opportunities and the attendant human costs.

Whether about wheat or meat, sugar or starch, calories or carbohydrates, this fat or that fat, we seem to have an insatiable appetite for mere grains of truth about diet and health rather than the complete recipe.[38] Planting such seeds, we are reaping just what we are sowing: more heat than light, unending opportunities for food industry abuses, stunning lack of public health progress, and the very kind of trees that make the forest impossible to see.[39]

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