The country first became obsessed with fat and cholesterol during the Carter administration, and our government published the food pyramid guidelines which suggested that the "bread, cereal, rice and pasta group" (6 to 11 servings per day) should constitute the foundation of a healthy diet.

The country first became obsessed with fat and cholesterol during the Carter administration, and our government published the food pyramid guidelines which suggested that the "bread, cereal, rice and pasta group" (6 to 11 servings per day) should constitute the foundation of a healthy diet. Within 10 years after this publication, the explosion of obesity and diabetes had begun to eclipse fat and cholesterol as drivers of the ongoing epidemic of heart disease. Then "healthy whole grains" became the focus of the new My Food Pyramid that was rolled out in 2005. By that time the importance of the glycemic index and glycemic load had begun to be widely known. But, the swing of the pendulum had already been made clear in the summer of 2002, when the New York Times Magazine published a cover story entitled “What if Fat Doesn’t Make You Fat?” Some people were beginning to wonder if "healthy whole grains" might not be an oxymoron. We have learned a lot, in the last 15 years, about diet and its effects on health, but it is important to distinguish between what we know and what is opinion.

There are three main components or macronutrients in the food we eat -- proteins, fats and carbohydrates -- and carbohydrates can be broken into two broad types, simple carbohydrates and complex carbohydrates. Sugars, like glucose and table sugar are simple carbohydrates. They are small to medium size molecules that are easily digested and quickly enter the blood stream, raising the sugar level in the blood. The starchy foods like potatoes and bread are composed mostly of large molecules that are complex carbohydrates, and after cooking these also are easily broken down into simple sugar components that quickly enter the blood stream and raise the sugar level in the blood. In fact, gram for gram, white bread raises the blood sugar level faster than table sugar. It is the rapidity of this rise in blood sugar that triggers rapid rises in insulin, and these in turn promote excessive fat deposition and causes the insulin resistance that leads to Type 2 diabetes (T2DM). The glycemic index is a measure of how fast the blood sugar rises for a meal of different foods. A standardized meal of 50 grams of glucose and water is the reference, and that has a glycemic index (GI) of 100. Table sugar has a GI of 65, white bread has GI of 75 and one brand of whole grain bread (Natural Ovens) is said to have a GI of 51. This is one of the reasons that whole grains are better for you, because they cause less of a spike in blood sugar and therefore less of a spike in insulin and all that that entails. (See www.glycemicindex.com and others.)

Without a doubt, besides the starches, there are things in grains that are very bad for some people. There are more and more people who are allergic to various grains, with wheat being the most common allergen, but corn is also a common offender. In these people exposure to these allergens can cause a skin disorder like eczema, a rash or a severe anaphylactic reaction that can be fatal. Much is made, by some authors, of the fact that grains are from various grasses and our ancestors never ate any part of any grass until the last 10,000 years or so. This is similar to the debate about partially hydrogenated fats, such as Crisco -- a topic for another day. It seems reasonable to suppose that since the human body has not evolved to ingest these items as food, we might be prone to develop problems, such as allergies to grains or unstable fatty plaques in our arteries when we eat Crisco. These grain allergies are separate and apart from the reaction that some people have to gluten and the related compounds in wheat, barley and rye. We will examine gluten and gluten sensitivities in more detail next week.

This article is intended to provide general information only, and is not to be taken as medical advice. For advice about a particular case or situation, consult your own physician or other trusted health professional.

Dr. Bundrant is the chief of Staff of Ballinger Memorial Hospital. The Health and Wellness Coalition of Runnels County now meets every second Thursday at 7 pm. The next meeting will be April 12 at 7 pm in the conference room next to Keel Drug, 2001 Hutchins Ave. and will focus on the implementation of the Guideline for Prescribing Opioids. All interested healthcare professionals are invited.