Hot Off the Press: A New “China Study” Links Wheat with Weight Gain

You’re going to hate me. This isn’t the wheat post, which means I’ve broken my “wheat is next” promise for the 80th time and should never be trusted with anything again ever. But during my nightly Pub(Med) crawl, I saw this nearly-new gem of a study glimmering in the dust and said to myself, “Wow. Wow! Wow.” By the third wow, a blog post was inevitable. So here it is. I promise this is truly interesting (not that me promising things matters anymore).

But first, some background.

A few years ago, a study hit the stands with the audacious title Vegetable-rich food pattern is related to obesity in China. The paper showed that among four diet patterns—“macho” (meat and alcohol), “sweet tooth” (sugary drinks and cake), “traditional” (rice, vegetables, pork, and fish), and “vegetable-rich” (vegetables, wheat, whole grains, and fruit)—only one had any relationship to obesity: the vegetable-rich pattern.

The study didn’t exactly receive a lot of press, probably because no one wants to think vegetables make people fat (including the researchers, who hummed and hawed their way to a half-baked conclusion—check out this post by Michael Eades). And as Stephan Guyenet explained, the study really showed a trend between wheat intake and weight gain, with the pounds rising as wheat replaced rice as a staple.

I mention this because the new study is actually a follow-up to the old one. It tracked changes in the participants’ weight over the span of five years, using the same method of divvying up food consumption into distinct diet patterns. In fact, here’s the table with their “factor loading” system, showing how various foods were weighted to determine adherence to each diet pattern. (Go ahead, click on it. You know you want to.)

I’m going to explain this study point-by-point before getting to the good stuff, because it’s a little complicated (but totally worth understanding).

Note that only two patterns use wheat as a factor: the “traditional” and “vegetable-rich” diets. The traditional pattern loaded inversely on wheat flour and positively on rice, whereas the vegetable-rich pattern loaded inversely on rice and positively on wheat. In simpler terms, that means the “traditional” pattern is rice based and the “vegetable-rich” pattern is wheat based. These two patterns are polar opposites in terms of their staple grain. The “macho” and “sweet tooth” patterns don’t take grain consumption into account.

After the researchers schemed up these diet patterns, they divided everyone into quartiles of adherence. Folks in the first quartile of any pattern had the lowest adherence to it, whereas folks in the fourth quartile ate diets most in line with that particular pattern. The paper only gives a detailed breakdown of the “traditional” diet quartiles and smaller summaries of the other three, but you can still see how food intake changes from quartile to quartile:

From the paper:

A clear increasing trend of the intake of fat was seen across quartiles of the ‘traditional’ pattern from low to high. Participants in the first quartile of this pattern had the highest intake of wheat flour and dietary fibre compared with the other groups. … There was a significant negative association between the ‘traditional’ pattern and energy density.

Darn right. The first quartile boasts an average wheat intake of 298 grams per day, versus only 21 grams in the fourth quartile. And fat intake rises from 75 to 87 grams per day from the first to fourth quartile. Energy density (calories per gram of food) also drops, although the researchers don’t mention that total energy intake (calories) is actually highest in the fourth quartile.

The researchers also note that “across quartiles of the ‘vegetable-rich’ pattern, the intake of energy, wheat flour and vegetable oil increased.” Most of that info didn’t make it into any tables, so we’ll just have to take their word for it.

Now here’s where it gets interesting.

The following table shows the five-year weight change for the different quartiles of each diet pattern. Remember that the “traditional” and “vegetable-rich” diets are the only ones defined—at least in part—by wheat consumption (or lack thereof). (A) is the traditional pattern, (B) is the macho pattern, (C) is the sweet-tooth pattern, and (D) is the vegetable-rich pattern.

What stands out here? How about this:

After adjustment for age, sex and baseline weight, the ‘traditional’ dietary pattern was inversely associated with weight gain, while the ‘vegetable-rich’ pattern was positively associated with weight gain. … No significant associations of the ‘macho’ and ‘sweet tooth’ patterns with weight gain were found.

What interests me is that the largest change in weight out of any of the graphs—1.4 kilograms—occurs between the first and second quartile in the “traditional” pattern. This corresponds with a drop in average wheat intake from 298 to 40 grams per day. (Without knowing the actual per-quartile numbers for the “vegetable-rich” pattern, it’s impossible to say how changes in wheat consumption match up with that graph, although the researchers already stated that wheat consumption rises throughout the quartiles.)

The inverse relationship between the “traditional” pattern and weight (and therefore wheat and weight) doesn’t seem to be confounded by other factors, either:

In the stratified multivariate analyses, an inverse association between the ‘traditional’ dietary pattern and weight gain was present in subjects aged < 40 years and ≥ 40 years, in non-smokers and smokers, in overweight and normal-weight subjects, in alcohol drinkers and non-drinkers, and in men and women. There were no significant interactions between any of the above factors and the ‘traditional’ dietary pattern with weight gain.

The connection between wheat and weight was so prominent in this study that the researchers (who carefully tiptoed around the subject in their 2008 writeup) couldn’t beat around the bush any longer. They slammed the “discussion” section with a giant wall of wheat text. Since I’m not sure how long the study will be available for free, I’ll quote the relevant parts right here (interspersed with some commentary):

A large difference in the intake of rice and wheat flour was found across quartiles of the ‘traditional’ dietary pattern. It represented two different sub-patterns with two different staple foods in inverse proportions, i.e. rice and wheat.

(No quibbles there. But the next part is where they try painfully hard to rationalize the wheat-weight connection.)

Rice is a low-energy food that contributes to the bulk of the traditional diet. Compared with wheat, rice absorbs more water when cooked. In addition, different cooking methods are used in preparing these two staple foods. For instance, steamed rice contains twice the amount of water and half of the energy compared with steamed bread(17). Thus, the energy density of the rice staple diet is usually lower than the one based on wheat.

(Regardless of energy density, the fourth quartile for both diet patterns show that the rice-based pattern had a higher average calorie intake than the wheat-based pattern, yet lower five-year weight gain—0.0 kilograms versus 1.6 kilograms.)

Since the content of wheat was only predominant in the first quartile of this dietary pattern, this may partly explain the negative association between the ‘traditional’ pattern and weight gain in the present study.

(Ding, ding, ding. But is it because wheat has lower water content, as they suggest, or does our favorite grain somehow wreak metabolic havoc? The weight changes in the “traditional” pattern echo wheat consumption more consistently than total energy intake.)

Also, this association could not be explained by fat intake, since a higher intake of the ‘traditional’ pattern was associated with a higher intake of fat. Intake of fibre was the highest among people in the first quartile of the ‘traditional’ pattern. Thus, the benefit of weight maintenance of the traditional dietary pattern was not related to dietary fibre.

(Blasphemy! How did such nonsense pass peer-review?)

The reason I find this so fascinating is that it perfectly corresponds with the patterns in the Oxford-Cornell China Study, which showed that wheat was the single biggest contributor to BMI out of any diet variable. Calories didn’t matter. Fat didn’t matter. Weight followed the wheat.

I recommend reading the full study before the Powers That Be shove it behind a pay wall (or before the wheat industry files a lawsuit). And I’d say my real wheat/heart disease post is coming up next, but I don’t want to jinx myself. It’s on the way, though. I promise (?).

New Interview and More Sucky Science

I’m back from a blogging hiatus that you probably didn’t know about because I never told anyone. Sorry! But what better time to return than on World Vegan Day?

First of all: I recently had the pleasure of doing an interview at “Let Them Eat Meat” about my experience with veganism, thoughts on its healthfulness, my overwhelming adoration for the American Dietetic Association, and—because I’m forever branded as That China Study Girl—some final thoughts on a certain book we all know and love.

In case you haven’t heard, Let Them Eat Meat is the brainchild of Rhys Southan, a non-disgruntled ex-vegan who applies his stellar writing skills to the subject of veganism. If you haven’t already stumbled across this site, please stumble there now—you’ll find some fantastic interviews with former (and current) vegans, discussions of related health and moral topics, and a critical look at the arguments for avoiding animal products—including a recent deconstruction of vegan ethical tenets. Even if you don’t have personal experience with an all-plant diet, you might find the material there fascinating from a psychological perspective. So go peruse.

In other news, it looks like bad science—or at least bad reporting—is still alive and well. Case in point:

Fellas: is saturated fat lowering your sperm count? If you believe the flurry of recent articles, it sure sounds like men who eat more saturated fat have fewer—and less virile—swimmers. A Harvard study presented at a reproductive conference last week spawned some gems like these:

High saturated fat intake ‘damages’ sperm

Diets High in Saturated Fats Can Lower Sperm Count, Researchers Say

Eating saturated fat can damage your sperm

Are the meat and dairy industries actually massive government-funded schemes for population control? Is humankind’s history of meat consumption the reason we’re verging on extinction?

Interestingly, when you actually read the articles above, you’ll see that saturated fat wasn’t the only type of fat the researchers linked with sperm problems. From here:

According to the study, an increased intake of saturated fats and monounsaturated fats—which are commonly found in meats, butter, and dairy products—may result in a lower sperm concentration.

(Isn’t it cute how they don’t list the common sources of monounsaturated fat? No one wants to diss olive oil. That’s what the Mediterraneans eat!)

And from here:

The researchers found that men with the highest intake of saturated fat had 41% fewer sperm than men who ate the lowest amount of saturated fat. And men with the highest intake of monounsaturated fat had 46% fewer sperm compared with men with the lowest intake of monounsaturated fat.

I’d give the ol’ “correlation isn’t causation” reminder, but in this case, it might not even be necessary. It looks like the figures cited are the unadjusted ones, because according to this Medscape article (which has more details about the study than the others):

The association between fat intake and semen quality parameters was made with linear regression while adjusting for total energy intake, age, abstinence time, body mass index, smoking status, and intakes of caffeine and alcohol. The results showed that saturated fatty acid levels in sperm were inversely related to sperm concentration (r = −0.53); however, saturated fat intake was unrelated to sperm levels.


So basically, men with higher levels of saturated fat in their sperm tended to have poorer semen quality—but actual dietary intake of saturated fat wasn’t implicated after adjusting for confounders. At least that’s what I’ve pieced together from the available articles, since a quest for the original study yielded nada. Regardless, this is a prime example of the media skewing headlines to fit conventional nutrition wisdom and assuming an association between variables proves cause-and-effect.

And in case anyone’s wondering what’s going on with “The China Study” Suckypedia Wikipedia article that’s now moderated by a vegan editor: Along with pruning out all mention of my critique, gone also are the criticisms from Science Based Medicine’s Dr. Harriet Hall (here and here) as well as the fabulous critiques from Chris Masterjohn (here and here). The only one still up is a brief mention of Loren Cordain. And in case that’s not enough, the “Criticism” section has now been changed to “Reception and criticism,” so half of it is dedicated to praise.

Go figure.

And at the risk of sounding like The Girl Who Cried Wheat Entry, the wheat entry really is coming next! I promise. In the meantime, here’s a new study that shows we have microorganisms in our mouth that can actually degrade gluten. Might this play a role in how folks at risk for celiac respond to wheat? Seems possible.

Lastly, I’d like to thank everyone who’s contributed to the (oft-informative) discussions unfurling on previous entries. I haven’t had time to jump in myself, but I’m grateful to all of you who’ve taken the time to share your thoughts here and engage in what has generally been civil discourse. You people are awesome.

Interview and Updates and I Promise Wheat is Next

For anyone waiting for Wheat Post 2, sorry—this isn’t it. But it’s coming! Pinky swear!


1. Killin’ la vida China Study. The fabulous Jimmy Moore recently invited me to be on The Livin’ La Vida Low Carb Show, which—if you’re not yet aware—is a podcast-goldmine not only for low carbers, but for anyone interested in health. You can listen to my interview with him here. Despite recording at 8 AM, it was a blast—thanks, Jimmy!

2. “The China Study” dies another death. Up until recently, my biggest beef with Campbell’s casein research was his attempt to extrapolate casein’s effects to all forms of animal protein, despite demonstrating that plant proteins can behave the same way. But now a bigger, stronger, beefier beef has hoofed its way into the picture. Sherlock Holmes Chris Masterjohn did some sleuthing and made some very interesting discoveries about what the casein research really showed. If you haven’t read this article yet, please do so. Now.

3. Campbell speaketh. If you’re going through Campbell withdrawal, fear not: He just published a new article over on The Huffington Post called “Low Fat Diets are Grossly Misrepresented.” You can probably guess what it’s about from the title.

I actually agree with one of the article’s implications, which is that not all “low fat” diets are actually low fat, especially in the case of clinical studies—kind of like we saw with that recent low-carb flapdoodle. A diet with 30% fat isn’t representative of Ornish any more than a diet with 30% carbohydrates is representative of Atkins, but the “low fat” label is often used by researchers to misleadingly describe a moderate fat intake.

Although my last blog post criticized the inaccurate titling of a not-very-low-carb study, the same could be said of many so-called low-fat studies. No matter what side of the diet fence you’re on, from a scientific standpoint, it’s important to be equally critical of all research and not automatically assume studies are well-designed just because their results sound good.

4. Ned Kock does heart disease. A couple weeks ago, Ned did some number-crunching on the China Study II data in relation to heart disease mortality, cholesterol, wheat, and rice. Check out his posts The China Study II: Cholesterol seems to protect against cardiovascular disease and The China Study II: Wheat flour, rice, and cardiovascular disease.

(Big apologies to those who left comments on the last briefly-existent post! I decided to delete some stuff I wrote about my “suspicious connection” to the Weston A. Price Foundation because it came off sounding snarkier than intended, but then I ended up trashing the whole thing so I could post this with a different URL.)

A more substantial wheat entry is comin’ up next.

The China Study, Wheat, and Heart Disease; Oh My!

(Not only is this woefully, frustratingly, absurdly belated, but it’s also not yet finished. But I hate being a blog tease, so here’s part one!)

If you’ve been following along with the previous China Study entries (and the wild drama that ensued), you know that I’ve been promising an entry on wheat for a while now, mostly because this little snippet snagged so many eyes:

Correlation between wheat flour and coronary heart disease: 0.67

That’s a value straight from the original China Study data. Could the “Grand Prix of epidemiology” have accidentally uncovered a link between the Western world’s leading cause of death and its favorite glutenous grain? Is the “staff of life” really the staff of death? Bwah ha ha.