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Yet Another Half-Baked Grain Study
Posted By Mark Sisson On September 4, 2007 @ 6:04 pm In Big Agra,Carbs,Health,Hype,Nutrition,Prevention | 15 Comments
If you’re anything like me you get a little tired of staring at a monitor for hours on end. I spend a good deal of my time reading the major health and science journals, so I often print out the latest studies and work through them while catching some sun and fresh air in the backyard. (It’s a nicer vista than Vista…)
It was early Saturday that I read a study so obscenely stupid and so ridiculously far-fetched in its conclusion, I nearly choked on my coffee. PLoS posted a cohort study and review  (a meta-analysis) of dietary intake of whole grains vs. refined grains and the corresponding impact upon type 2 diabetes. Unfortunately, it’s yet another half-baked study, and possibly one of the least intelligent conclusions on grains that I’ve seen to date. Not only are there at least a half-dozen glaring problems en route to the conclusion, but the entire study works from an internally flawed premise.
I’ll explain the study and the inherent problems momentarily, but first, allow me to offer you an analogy for the sake of comparison.
Take cigarettes. Unfiltered. The government conducts a study (or several thousand, if you like) and finds – no surprise here – that tobacco is toxic and increases the risk of lung cancer. From this study, the government’s research team concludes that the problem is the lack of filtering – not the tobacco. New studies of filtered cigarettes are conducted, and a meta-analysis comes next. (By now I hope you see where I am going with this.) Our team finds that filtered cigarettes are marginally safer than unfiltered cigarettes, reducing the risk by – say – a statistically significant 20%. The government concludes that filtered cigarettes are healthy, and makes the according recommendations. …Ludicrous, to be sure.
Unfortunately, that’s exactly what’s going on with our federal government’s role in making dietary recommendations in regard to grains and our type 2 diabetes epidemic.
The review drew information from the Nurses’ Health Studies and several other cohort studies (for a total of 268,125 participants). The conclusion just baffles me: consuming whole grains prevents type 2 diabetes. Nothing could be further from the truth. Even if you make the assumption and take on good faith that all the findings from the different cohorts and the nurses’ questionnaires are accurate, the entire study is based on a fallacy.
First, the major issues with drawing any sort of conclusion here:
Everyone in the low-whole grain quintile had:
– a high BMI (let’s accept that metric for the sake of this post)
– a family history of diabetes
– virtually zero exercise expenditure
– further, twice the alcohol consumption, twice the processed meat consumption, and twice the incidence of tobacco abuse
…as the higher whole grain group! I don’t know how you could possibly extrapolate from all these glaring risk factors that the type of grain consumed has the greater bearing on whether or not a person is going to be at a greater risk for diabetes. I’m hard-pressed to see how anyone free of the behaviors and risk factors of the above list would escape the clutches of diabetes simply because he or she ate 2 extra servings of whole grain a day. And it’s just nuts to conclude that individuals who do fit the above list could possibly avoid diabetes simply by switching the type of grain consumed. The conclusion ought to be clear enough: couple an unhealthy lifestyle with an established family history of type 2 and you’re quite likely to get it. I want to know how, specifically, the authors corrected for these differences and were able to ascertain that the consumption of whole grain by the higher quintile – and not the absence of these other factors – mitigates the risk of type 2 effectively.
To quote Mark Twain who was quoting Benjamin Disraeli: “There are three kinds of lies: lies, damned lies, and statistics.”
I’ll make this even simpler. If what the researchers are saying is correct, for every five people who got diabetes consuming whole grains, there would be six people who got diabetes not consuming whole grains. Doesn’t anyone think we might want to consider not consuming grains, period? It just gets better. The authors admit that calculating accuracy of the whole grain intake, and the actual effect of the whole grain intake, “was hard”. Awww. They “reassure” us, of course, by stating that they really don’t think this affected anything too seriously. Though they do concede that the people who ate whole grains were probably healthier in general – it is funny how exercising, not smoking, not being an alcoholic, not eating carcinogenic cured meats, and not being obese will do that.
Another quote: “Follow the money.” (Bob Woodward, of course.)
This study was funded by research grants from the National Institutes of Health. The authors declared no bias and the study explicitly states that the NIH did not design or influence the study. And yet…the initial assumption upon which the study rests belies this. Maybe I’m just cynical, but it’s well known that the NIH are partial to policies that favor Big Agra and the FDA. And how could it not be? The food pyramid – the one that recommends eating 6-11 grain-based foods every single day – is under no serious scrutiny. If you conduct a review with the prior assumption that grains are healthy, then certainly, it shouldn’t come as any surprise that grains containing a little fiber and protein by way of the bran or germ (or both) would be better than, oh, pure crap.
But what if we turn this entire thing on its head and conduct a study comparing minimal grain consumption with whole grain consumption? I’ll be the first man in line to lay good money on the outcome of that study. Grains are not great, folks.
Grain silos. What we need more of.
My Carb Pyramid 
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 PLoS posted a cohort study and review: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0040261&ct=1
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