Chris Kresser: Okay, so you probably hear the scorn in my voice. This is an example of everything bad about epidemiological observational nutritional research. This is full of confounding potential. This study was not designed to determine any causality, and yet they’re making recommendations as if it were. That’s very concerning, but it’s not surprising because it’s done all the time. The implication here is that whole grains are some kind of magic food that reduces heart disease. Do we think that is more plausible given that whole grains were not consumed in the vast majority of our evolutionary history of 2.3 million years, whole grains only started to be consumed in any kind of meaningful regular way in the last 11,000 years? When we look at hunter-gatherer populations like the Tsimane who were recently studied, they had the lowest risk of heart disease that’s ever been measured, far lower than in industrialized people eating whole grains, and they don’t eat whole grains. Or is it more likely that people who eat more whole grains are probably just generally more aware of health, and they’re making other choices that lead to more health like exercising more, not smoking as much, not drinking as much, and eating more fruits and vegetables? I think you could much more easily support the latter than the former, but that’s not even mentioned as a possibility here in this study. I actually addressed this question in a Q&A recently, and I think I even did a podcast on it, people who go on a gluten-free diet what they might end up eating more of is rice and rice flour. Rice, as I’ve written, has arsenic, and arsenic is inflammatory and could increase the risk of heart disease. People on sort of the standard American gluten-free diet, which means they avoid gluten, but they just continue eating a lot of other gluten-free processed and refined foods. They actually may end up eating more stuff that is not healthy and beneficial for that reason. I think that part of it is true, but this does not in any way refer to people that are on the kind of diets that we’re recommending, which are nutrient-dense Paleo types of diets and especially for a patient with nonceliac gluten sensitivity. If they go on that kind of diet, they’re going to experience a dramatic decrease in inflammation, and there are many other studies that show that nonceliac wheat sensitivity can contribute to heart disease. This is not convincing at all to me, and it’s an irritating example of poor nutritional epidemiology.