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Submit Search. No demographic has escaped the weight gain crisis. The bigger your wheat belly, the more inflammatory responses that are triggered: Intestines are not meant to be freely permeable. Wheat naturally evolved to only a modest degree over the centuries, but it has changed dramatically in the past fifty years under the influence of agricultural scientists.
Show related SlideShares at end. WordPress Shortcode. Published in: Full Name Comment goes here. Are you sure you want to Yes No. Be the first to like this. However, the weight loss effects of wheat elimination are not immediately clear from clinical studies.
Many celiac sufferers are diagnosed after years of suffering and begin the diet change in a severely malnourished state due to prolonged diarrhea and impaired nutrient absorption. Underweight, malnourished celiac sufferers may actually gain weight with wheat removal thanks to improved digestive function. But if we look only at overweight people who are not severely malnourished at the time of diagnosis who remove wheat from their diet, it becomes clear that this enables them to lose a substantial amount of weight.
Food variety, incidentally, can still be quite wide and wonderful after wheat is eliminated, as I will discuss. Advice to consume more healthy whole grains therefore causes increased consumption of the amylopectin A form of wheat carbohydrate, a form of carbohydrate that, for all practical purposes, is little different, and in some ways worse, than dipping your spoon into the sugar bowl.
Wheat is the principal source of gluten in the diet, both because wheat products have come to dominate and because most Americans do not make a habit of consuming plentiful quantities of barley, rye, bulgur, kamut, or triticale, the other sources of gluten.
For all practical purposes, therefore, when I discuss gluten, I am primarily referring to wheat. Gluten allows the pizza maker to roll and toss dough and mold it into the characteristic flattened shape; it allows the dough to stretch and rise when yeast fermentation causes it to fill with air pockets.
The distinctive doughy quality of the simple mix of wheat flour and water, properties food scientists call viscoelasticity and cohesiveness, are due to gluten.
While wheat is mostly carbohydrate and only 10 to 15 percent protein, 80 percent of that protein is gluten. Wheat without gluten would lose the unique qualities that transform dough into bagels, pizza, or focaccia. Glutens are the storage proteins of the wheat plant, a means of storing carbon and nitrogen for germination of the seed to form new wheat plants. The gliadins, the protein group that most vigorously triggers the immune response in celiac disease, has three subtypes: Like amylopectin, glutenins are large repeating structures, or polymers, of more basic structures.
The strength of dough is due to the large polymeric glutenins, a genetically programmed characteristic purposefully selected by plant breeders. The gluten proteins produced by einkorn wheat, for example, are distinct from the gluten proteins of emmer, which are, in turn, different from the gluten proteins of Triticum aestivum.
Twenty-eight-chromosome emmer, containing the A genome with the added B genome, codes for a larger variety of gluten. Forty- two-chromosome Triticum aestivum, with the A, B, and D genomes, has the greatest gluten variety, even before any human manipulation of its breeding. Hybridization efforts of the past fifty years have generated numerous additional changes in gluten-coding genes in Triticum aestivum, most of them purposeful modifications of the D genome that confer baking and aesthetic characteristics on flour.
It is also potentially the source for many of the odd health phenomena experienced by consuming humans. Beyond gluten, the other 20 percent or so of nongluten proteins in wheat include albumins, prolamins, and globulins, each of which can also vary from strain to strain.
In total, there are more than a thousand other proteins that are meant to serve such functions as protecting the grain from pathogens, providing water resistance, and providing reproductive functions. Many bakers also add soy flour to their dough to enhance mixing and whiteness, introducing yet another collection of proteins and enzymes.
Treatment is simple: In short, wheat is not just a complex carbohydrate with gluten and bran. Wheat is a complex collection of biochemically unique compounds that vary widely according to genetic code. I will discuss why wheat is unique among foods for its curious effects on the brain, effects shared with opiate drugs.
It explains why some people experience incredible difficulty removing wheat from their diet. People who eliminate wheat from their diet typically report improved mood, fewer mood swings, improved ability to concentrate, and deeper sleep within just days to weeks of their last bite of bagel or baked lasagna.
They are also subject to the placebo effect—i. I am, however, impressed with how consistent these observations are, experienced by the majority of people once the initial withdrawal effects of mental fog and fatigue subside. It is easy to underestimate the psychological pull of wheat. J ust how dangerous can an innocent bran muffin be, after all? There is no doubt: For some people, wheat is addictive. And, in some people, it is addictive to the point of obsession.
Some people with wheat addiction just know they have a wheat addiction. Or perhaps they identify it as an addiction to some wheat-containing food, such as pasta or pizza. It can influence behavior and mood.
It can even come to dominate thoughts. A number of my patients, when presented with the suggestion of removing it from their diets, report obsessing over wheat products to the point of thinking about them, talking about them, salivating over them constantly for weeks.
I dream about bread! There is, of course, a flip side to addiction. When people divorce themselves from wheat- containing products, 30 percent experience something that can only be called withdrawal. Complete relief is achieved by a bagel or cupcake or, sadly, more like four bagels, two cupcakes, a bag of pretzels, two muffins, and a handful of brownies, followed the next morning by a nasty case of wheat remorse.
Abstain from a substance and a distinctly unpleasant experience ensues; resume it, the unpleasant experience ceases—that sounds a lot like addiction and withdrawal to me. There is a scientifically plausible reason for both the addiction and withdrawal effects. Not only does wheat exert effects on the normal brain, but also on the vulnerable abnormal brain, with results beyond simple addiction and withdrawal. Studying the effects of wheat on the abnormal brain can teach us some lessons on why and how wheat can be associated with such phenomena.
Schizophrenics lead a difficult life. They struggle to differentiate reality from internal fantasy, often entertaining delusions of persecution, even believing their minds and actions are controlled by external forces. Thankfully, violent behavior is unusual in schizophrenics, but it illustrates the depth of pathology possible.
Once schizophrenia is diagnosed, there is little hope of leading a normal life of work, family, and children. A life of institutionalization, medications with awful side effects, and a constant struggle with dark internal demons lies ahead.
So what are the effects of wheat on the vulnerable schizophrenic mind? The earliest formal connection of the effects of wheat on the schizophrenic brain began with the work of psychiatrist F. Curtis Dohan. Dohan journeyed down this line of investigation because he observed that, during World War II, the men and women of Finland, Norway, Sweden, Canada, and the United States required fewer hospitalizations for schizophrenia when food shortages made bread unavailable, only to require an increased number of hospitalizations when wheat consumption resumed after the war was over.
Dohan observed a similar pattern in the hunter-gatherer Stone Age culture of New Guinea. Prior to the introduction of Western influence, schizophrenia was virtually unknown, diagnosed in only 2 of 65, inhabitants.
As Western eating habits infiltrated the New Guinean population and cultivated wheat products, beer made from barley, and corn were introduced, Dr. Dohan watched the incidence of schizophrenia skyrocket sixty-five-fold. Dohan and his colleagues decided to remove all wheat products from meals provided to schizophrenic patients without their knowledge or permission. This was in the era before informed consent of participants was required, and before the infamous Tuskegee syphilis experiment became publicized, which triggered public outrage and led to legislation requiring fully informed participant consent.
Lo and behold, four weeks sans wheat and there were distinct and measurable improvements in the hallmarks of the disease: Remove wheat again, patients and symptoms got better; add it back, they got worse.
Dohan and others suggest that wheat is associated with measurable worsening of symptoms. Another condition in which wheat may exert effects on a vulnerable mind is autism. Autistic children suffer from impaired ability to interact socially and communicate.
The condition has increased in frequency over the past forty years, from rare in the mid-twentieth century to 1 in children in the twenty-first. However, responses are often muddied due to sensitivities to other components of diet, such as sugars, artificial sweeteners, additives, and dairy. But why in the world are schizophrenia, autism, and ADHD exacerbated by wheat?
What is in this grain that worsens psychosis and other abnormal behaviors? Christine Zioudrou and her colleagues at the NIH subjected gluten, the main protein of wheat, to a simulated digestive process to mimic what happens after we eat bread or other wheat-containing products.
The dominant polypeptides were then isolated and administered to laboratory rats. These polypeptides were discovered to have the peculiar ability to penetrate the blood- brain barrier that separates the bloodstream from the brain. This barrier is there for a reason: The brain is highly sensitive to the wide variety of substances that gain entry to the blood, some of which can provoke undesirable effects should they cross into your amygdala, hippocampus, cerebral cortex, or other brain structure.
The investigators speculated that exorphins might be the active factors derived from wheat that account for the deterioration of schizophrenic symptoms seen in the Philadelphia VA Hospital and elsewhere. Even more telling, the brain effect of gluten-derived polypeptides is blocked by administration of the drug naloxone. You get knifed during a drug deal gone sour and get carted to the nearest trauma emergency room.
So these nice people strap you down and inject you with a drug called naloxone, and you are instantly not high. Through the magic of chemistry, naloxone immediately reverses the action of heroin or any other opiate drug such as morphine or oxycodone. In lab animals, administration of naloxone blocks the binding of wheat exorphins to the morphine receptor of brain cells. Yes, opiate-blocking naloxone prevents the binding of wheat-derived exorphins to the brain.
The very same drug that turns off the heroin in a drug-abusing addict also blocks the effects of wheat exorphins. In a World Health Organization study of thirty-two schizophrenic people with active auditory hallucinations, naloxone was shown to reduce hallucinations.
In this case, had naloxone shown benefit in wheat-consuming schizophrenics, the unavoidable conclusion would have been to eliminate wheat, not prescribe the drug. The schizophrenia experience shows us that wheat exorphins have the potential to exert distinct effects on the brain.
It also highlights how wheat is truly unique among grains, since other grains such as millet and flax do not generate exor-phins since they lack gluten , nor do they cultivate obsessive behavior or withdrawal in people with normal brains or people with abnormal brains. So this is your brain on wheat: It induces a form of reward, a mild euphoria. When the effect is blocked or no exorphin-yielding foods are consumed, some people experience a distinctly unpleasant withdrawal.
What happens if normal i. In a study conducted at the Psychiatric Institute of the University of South Carolina, wheat-consuming participants given naloxone consumed 33 percent fewer calories at lunch and 23 percent fewer calories at dinner a total of approximately calories less over the two meals than participants given a placebo. The Biggest Gainer Participants consumed 28 percent less wheat crackers, bread sticks, and pretzels with administration of naloxone.
Predictably, this strategy is being pursued by the pharmaceutical industry to commercialize a weight loss drug that contains naltrexone, an oral equivalent to naloxone. The drug is purported to block the meso-limbic reward system buried deep within the human brain that is responsible for generating pleasurable feelings from heroin, morphine, and other substances. Pleasurable feelings can be replaced by feelings of dysphoria, or unhappiness. Naltrexone will therefore be combined with the antidepressant and smoking cessation drug bupropion.
From withdrawal effects to psychotic hallucinations, wheat is party to some peculiar neurological phenomena. To recap: Wheat, in fact, nearly stands alone as a food with potent central nervous system effects. Outside of intoxicants such as ethanol like that in your favorite merlot or chardonnay , wheat is one of the few foods that can alter behavior, induce pleasurable effects, and generate a withdrawal syndrome upon its removal.
And it required observations in schizophrenic patients to teach us about these effects. It never made sense to him: He exercised, often to extremes.
A mile bike ride was not unusual, nor was a mile walk in the woods or desert. As part of his work, Larry enjoyed the terrain of many different areas of the United States. His travel often took him to the southwest, where he hiked for up to six hours.
He also prided himself on following a healthy diet: But his blood work was another issue. In short, it was a disaster: Larry was also, at 5 feet 8 inches and pounds, about 80 pounds overweight. I exercise like nobody you know. I really like exercise. But I just cannot—cannot— lose the weight, no matter what I do. They all resulted in a few pounds lost, only to be promptly regained.
He did admit to one peculiar excess: I try to graze on the good stuff, like whole wheat pretzels and these multigrain crackers I have with a yogurt dip. After a big sigh, he agreed to give it a go. With four teenagers in the house, clearing the shelves of all things wheat was quite a task, but he and his wife did it. Larry returned to my office six weeks later. He reported that, within three days, his nighttime cravings had disappeared entirely.
He now ate dinner and was satisfied with no need to graze. He also noticed that his appetite was much smaller during the day and his desire for snacks virtually disappeared. He also admitted that, now that his craving for food was much less, his calorie intake and portion size was a fraction of its former level. But how about law-abiding citizens like you and your family? But ingesting wheat means you have been unwittingly ingesting the most common dietary mind-active food known.
In effect, wheat is an appetite stimulant: It makes you want more—more cookies, cupcakes, pretzels, candy, soft drinks. More bagels, muffins, tacos, submarine sandwiches, pizza. It makes you want both wheat-containing and non-wheat-containing foods.
And, on top of that, for some people wheat is a drug, or at least yields peculiar drug-like neurological effects that can be reversed with medications used to counter the effects of narcotics.
Provided you can tolerate the withdrawal while unpleasant, the withdrawal syndrome is generally harmless aside from the rancor you incur from your irritated spouse, friends, and coworkers , hunger and cravings diminish, calorie intake decreases, mood and well-being increase, weight goes down, wheat belly shrinks. Understanding that wheat, specifically exorphins from gluten, have the potential to generate euphoria, addictive behavior, and appetite stimulation means that we have a potential means of weight control: Lose the wheat, lose the weight.
When are you due? Gulp … Yes, indeed. Why does wheat cause fat accumulation specifically in the abdomen and not, say, on the scalp, left ear, or backside? And why would elimination of wheat lead to loss of abdominal fat?
Dimpled or smooth, hairy or hairless, tense or flaccid, wheat bellies come in as many shapes, colors, and sizes as there are humans. But all share the same underlying metabolic cause. It explains why modern athletes, such as baseball players and triathletes, are fatter than ever.
Blame wheat when you are being crushed in your airline seat by the pound man next to you. Sure, sugary soft drinks and sedentary lifestyles add to the problem. Something happened starting in her mid-forties, and even without substantial changes in habits, she gradually ballooned up to pounds. As a professor of modern art, Celeste hung around with a fairly urbane crowd and her weight made her feel even more self-conscious and out of place.
So I got an attentive ear when I explained my diet approach that involved elimination of all wheat products. Over the first three months she lost twenty-one pounds, more than enough to convince her that the program worked.
Celeste stuck to the diet, admitting to me that it had quickly become second nature with no cravings, a rare need to snack, just a comfortable cruise through meals that kept her satisfied. She noted that, from time to time, work pressures kept her from being able to have lunch or dinner, but the prolonged periods without something to eat proved effortless.
I reminded her that healthy snacks such as raw nuts, flaxseed crackers, and cheese readily fit into her program. Not only could she fit into size 6 dresses again, she no longer felt uncomfortable mingling with the artsy set. No more need to conceal her sagging wheat belly under loose-fitting tops or layers.
She could wear her tightest Oscar de la Renta cocktail dress proudly, no wheat belly bulge in sight. Americans are now fat. According to the CDC, Most data collected on BMI that we have for comparison prior to the twentieth century come from body weight and height tabulated by the US military.
Weight grew at the fastest pace once the USDA and others got into the business of telling Americans what to eat. Accordingly, while obesity grew gradually from , the real upward acceleration of obesity started in the mid-eighties.
Studies conducted during the eighties and since have shown that, when processed white flour products are replaced with whole grain flour products, there is a reduction in colon cancer, heart disease, and diabetes. That is indeed true and indisputable. According to accepted dietary wisdom, if something that is bad for you white flour is replaced by something less bad whole wheat , then lots of that less-bad thing must be great for you.
By that logic, if high-tar cigarettes are bad for you and low-tar cigarettes are less bad, then lots of low-tar cigarettes should be good for you. An imperfect analogy, perhaps, but it illustrates the flawed rationale used to justify the proliferation of grains in our diet. Throw into the mix the fact that wheat has undergone extensive agricultural genetics-engineered changes, and you have devised the formula for creating a nation of fat people.
We drink too much sugary soda and eat too much fast food and junk snacks. Many follow the guidelines set by the USDA food pyramid six to eleven servings of grain per day, of which four or more should be whole grain , the American Heart Association, the American Dietetic Association, or the American Diabetes Association.
The cornerstone of all these nutritional directives? Based on epidemiologic observations that suggested that higher dietary fat intakes are associated with higher cholesterol levels and risk for heart disease, Americans were advised to reduce total and saturated fat intake.
Grain- based foods came to replace the calorie gap left by reduced fat consumption. The whole-grain-is- better-than-white argument further fueled the transition. The low-fat, more-grain message also proved enormously profitable for the processed food industry. It triggered an explosion of processed food products, most requiring just a few pennies worth of basic materials. Wheat flour, cornstarch, high- fructose corn syrup, sucrose, and food coloring are now the main ingredients of products that fill the interior aisles of any modern supermarket.
Whole ingredients such as vegetables, meats, and dairy tend to be at the perimeter of these same stores. Revenues for Big Food companies swelled. J ust as the tobacco industry created and sustained its market with the addictive property of cigarettes, so does wheat in the diet make for a helpless, hungry consumer.
From the perspective of the seller of food products, wheat is a perfect processed food ingredient: The more you eat, the more you want. The extremes of blood sugar and insulin are responsible for growth of fat specifically in the visceral organs. Experienced over and over again, visceral fat accumulates, creating a fat liver, two fat kidneys, a fat pancreas, fat large and small intestines, as well as its familiar surface manifestation, a wheat belly. Not fat deposition in the arms, buttocks, or thighs, but the saggy ridge encircling the abdomen created by bulging fatty internal organs.
Exactly why disordered glucose- insulin metabolism preferentially causes visceral fat accumulation in the abdomen and not your left shoulder or the top of your head is a question that continues to stump medical science. Buttock or thigh fat is precisely that: You sit on it, you squeeze it into your jeans, you lament the cellulite dimples it creates.
It represents excess calories over caloric expenditure. While wheat consumption adds to buttock and thigh fat, the fat in these regions is comparatively quiescent, metabolically speaking. Visceral fat is different. Visceral fat filling and encircling the abdomen of the wheat belly sort is a unique, twenty-four-hour-a-day, seven-day-a-week metabolic factory. And what it produces is inflammatory signals and abnormal cytokines, or cell-to- cell hormone signal molecules, such as leptin, resistin, and tumor necrosis factor.
All body fat is capable of producing another cytokine, adiponectin, a protective molecule that reduces risk for heart disease, diabetes, and hypertension.
However, as visceral fat increases, its capacity to produce protective adiponectin diminishes for reasons unclear.
In other words, in the human body, all fat is not equal. Wheat belly fat is a special fat. It is not just a passive repository for excess pizza calories; it is, in effect, an endocrine gland much like your thyroid gland or pancreas, albeit a very large and active endocrine gland.
The essential phenomenon that sets the growth of the wheat belly in motion is high blood sugar glucose. High blood sugar, in turn, provokes high blood insulin. Insulin is released by the pancreas in response to the blood sugar: Nondiabetics can easily experience the high blood sugars required to cultivate their very own wheat belly, particularly because foods made from wheat so readily convert to sugar. When visceral fat accumulates, the flood of inflammatory signals it produces causes tissues such as muscle and liver to respond less to insulin.
This so-called insulin resistance means that the pancreas must produce greater and greater quantities of insulin to metabolize the sugars. Eventually, a vicious circle of increased insulin resistance, increased insulin production, increased deposition of visceral fat, increased insulin resistance, etc. Nutritionists established the fact that wheat increases blood sugar more profoundly than table sugar thirty years ago. By this measure, whole wheat bread has a GI of 72, while plain table sugar has a GI of 59 though some labs have gotten results as high as In contrast, kidney beans have a GI of 51, grapefruit comes in at 25, while noncarbohydrate foods such as salmon and walnuts have GIs of essentially zero: Eating these foods has no effect on blood sugar.
In fact, with few exceptions, few foods have as high a GI as foods made from wheat. Outside of dried sugar-rich fruits such as dates and figs, the only other foods that have GIs as high as wheat products are dried, pulverized starches such as cornstarch, rice starch, potato starch, and tapioca starch. More on this later. Because wheat carbohydrate, the uniquely digestible amylopectin A, causes a greater spike in blood sugar than virtually any other food—more than a candy bar, table sugar, or ice cream—it also triggers greater insulin release.
More amylopectin A means higher blood sugar, higher insulin, more visceral fat deposition … bigger wheat belly. Throw in the inevitable drop in blood sugar hypoglycemia that is the natural aftermath of high insulin levels and you see why irresistible hunger so often results, as the body tries to protect you from the dangers of low blood sugar.
You scramble for something to eat to increase blood sugar, and the cycle is set in motion again, repeating every two hours. In addition to producing inflammatory hormones such as leptin, visceral fat is also a factory for estrogen production in both sexes, the very same estrogen that confers female characteristics on girls beginning at puberty, such as widening of the hips and growth of the breasts. Until menopause, adult females have high levels of estrogen.
Surplus estrogen, however, produced by visceral fat adds considerably to breast cancer risk, since estrogen at high levels stimulates breast tissue. Breast cancer risk in postmenopausal women with the visceral fat of a wheat belly is double that of slender, non-wheat-belly-bearing postmenopausal females. If we simply connect the dots, a marked reduction in risk would be predicted. Males, having only a tiny fraction of the estrogen of females, are sensitive to anything that increases estrogen.
The bigger the wheat belly in males, the more estrogen that is produced by visceral fat tissue. Enlarged breasts on a male are therefore not just the embarrassing body feature that your annoying nephew snickers at, but B-cup evidence that estrogen and prolactin levels are increased due to the inflammatory and hormonal factory hanging around your waist.
An entire industry is growing to help men embarrassed by their enlarged breasts. Male breast reduction surgery is booming, growing nationwide at double-digit rates. Increased estrogen, breast cancer, man boobs … all from the bag of bagels shared at the office. Celiac sufferers are counseled to remove wheat products from their diet, lest all manner of nasty complications of their disease develop.
What can their experience teach us about the effects of wheat elimination? In fact, there are unclaimed gems of important weight loss lessons to be gleaned from clinical studies of people with celiac disease who remove wheat gluten-containing foods.
The lack of appreciation of celiac disease among physicians, coupled with its many unusual presentations for example, fatigue or migraine headaches without intestinal symptoms , means an average delay of eleven years from symptom onset to diagnosis. This is especially true for children with celiac disease, who are often both underweight and underdeveloped for their age. A Columbia University study of people with celiac disease enrolled 64 participants Years of poor nutrient and calorie absorption, worsened by frequent diarrhea, leave many celiac sufferers underweight, malnourished, and struggling just to maintain weight.
Elimination of wheat gluten removes the offensive agent that destroys the intestinal lining. Once the intestinal lining regenerates, better absorption of vitamins, minerals, and calories becomes possible, and weight begins to increase due to improved nutrition.
Such studies document the weight gain with wheat removal experienced by underweight, malnourished celiac sufferers. For this reason, celiac disease has traditionally been regarded as a plague of children and emaciated adults.
However, celiac experts have observed that, over the past thirty to forty years, newly diagnosed patients with celiac disease are more and more often overweight or obese.
One such recent ten-year tabulation of newly diagnosed celiac patients showed that 39 percent started overweight BMI 25 to If we focus only on overweight people who are not severely malnourished at time of diagnosis, celiac sufferers actually lose a substantial quantity of weight when they eliminate wheat gluten. Similar observations have been made in children. Kids with celiac disease who eliminate wheat gluten gain muscle and resume normal growth, but also have less fat mass compared to kids without celiac disease.
Another study showed that 50 percent of obese children with celiac disease approached normal BMI with wheat gluten elimination. These were not purposeful weight loss programs, just wheat and gluten elimination. No calorie counting was involved, nor portion control, exercise, or any other means of losing weight … just losing the wheat. There are no prescriptions for carbohydrate or fat content, just removal of wheat gluten.
As we will discuss later, if you have a goal of weight loss, it will be important not to substitute one weight-increasing food, wheat, with yet another collection of weight-increasing foods, gluten-free items. In many gluten-free programs, gluten-free foods are actually encouraged. Despite this flawed diet prescription, the fact remains: Overweight celiac sufferers experience marked weight loss with elimination of wheat gluten. Interestingly, these patients have substantially lower caloric intake once on a gluten-free diet, compared to people not on a gluten-free diet, even though other foods are not restricted.
Calorie intake measured 14 percent less per day on gluten-free diets. Guess what that does to weight? In other words, the investigators proved the value of a wheat-free diet that reduces appetite and requires calorie replacement with real food without intending to or, indeed, even realizing they had done so. A recent thorough review of celiac disease, for instance, written by two highly regarded celiac disease experts, makes no mention of weight loss with gluten elimination.
Investigators in these studies also tend to dismiss the weight loss that results from wheat-free, gluten- free diets as due to the lack of food variety with wheat elimination, rather than wheat elimination itself.
As you will see later, there is no lack of variety with elimination of wheat; there is plenty of great food remaining in a wheat-free lifestyle.
It might be the lack of exorphins, reduction of the insulin-glucose cycle that triggers hunger, or some other factor, but elimination of wheat reduces total daily calorie intake by to calories— with no further restrictions on calories, fats, carbohydrates, or portion sizes.
No smaller plates, prolonged chewing, or frequent small meals. J ust banishing wheat from your table. I know: Eliminate wheat in all its myriad forms and pounds melt away, often as much as a pound a day. But the initial pace of weight loss can be shocking, equaling what you might achieve with an outright fast.
I find this phenomenon fascinating: Why would elimination of wheat yield weight loss as rapid as starvation? I suspect it is a combination of halting the glucose-insulin-fat-deposition cycle and the natural reduction in calorie intake that results. But I have seen it happen time and time again in my practice. Wheat elimination is often part of low-carbohydrate diets. Clinical studies are accumulating that demonstrate the weight loss advantages of low-carb diets. Cut carbs and, by necessity, you cut wheat.
Because wheat dominates the diets of most modern adults, removing wheat removes the biggest problem source. Sugar and other carbohydrates do indeed count, too. In other words, if you eliminate wheat but drink sugary sodas and eat candy bars and corn chips every day, you will negate most of the weight loss benefit of eliminating wheat.
Wheat elimination is a vastly underappreciated strategy for rapid and profound weight loss, particularly from visceral fat. Eliminate wheat and weight drops rapidly, effortlessly, often as much as fifty, sixty, a hundred or more pounds over a year, depending on the degree of excess weight to start. J ust among the last thirty patients who eliminated wheat in my clinic, the average weight loss was The amazing thing about wheat elimination is that removing this food that triggers appetite and addictive behavior forges a brand-new relationship with food: You will find yourself barely interested in lunch at noon, easily bypassing the bakery counter at the grocery store, turning down the donuts in the office breakroom without a blink.
You will divorce yourself from the helpless, wheat-driven desire for more and more and more. It makes perfect sense: If you eliminate foods that trigger exaggerated blood sugar and insulin responses, you eliminate the cycle of hunger and momentary satiety, you eliminate the dietary source of addictive exorphins, you are more satisfied with less.
Excess weight dissolves and you revert back to physiologically appropriate weight.
You lose the peculiar and unsightly ring around your abdomen: Kiss your wheat belly good-bye. At 5 feet 10, his pounds included a considerable wheat belly flowing over his belt. I somehow got through to him, despite his seemingly indifferent demeanor. Six months later, Geno came back to my office.
Alert, attentive, and smiling, Geno told me that his life had changed. He had not only lost an incredible sixty- four pounds and fourteen inches off his waist in those six months, he had regained the energy of his youth, again wanting to socialize with friends and travel with his wife, walking and biking outdoors, sleeping more deeply, along with a newly rediscovered optimism.
And he had laboratory values that matched: Another six months later, Geno had lost forty more pounds, now tipping the scale at —a total of pounds lost in one year. Gluten is the main protein of wheat, and as I have explained, it is responsible for some, though not all, of the adverse effects of wheat consumption.
Gluten is the culprit underlying inflammatory damage to the intestinal tract in celiac disease. People with celiac disease must meticulously avoid food containing gluten.
This means the elimination of wheat, as well as gluten-containing grains such as barley, rye, spelt, triticale, kamut, and perhaps oats.
An entire industry has developed to meet their gluten-free desires, from gluten-free bread to gluten-free cakes and desserts. However, many gluten-free foods are made by replacing wheat flour with cornstarch, rice starch, potato starch, or tapioca starch starch extracted from the root of the cassava plant. This is especially hazardous for anybody looking to drop twenty, thirty, or more pounds, since gluten-free foods, though they do not trigger the immune or neurological response of wheat gluten, still trigger the glucose- insulin response that causes you to gain weight.
Wheat products increase blood sugar and insulin more than most other foods. But remember: Foods made with cornstarch, rice starch, potato starch, and tapioca starch are among the few foods that increase blood sugar even more than wheat products. So gluten-free foods are not problem-free. Gluten-free foods are the likely explanation for the overweight celiac sufferers who eliminate wheat and fail to lose weight. In my view, there is no role for gluten-free foods beyond the occasional indulgence, since the metabolic effect of these foods is little different from eating a bowl of jelly beans.
Thus, wheat elimination is not just about eliminating gluten. Eliminating wheat means eliminating the amylopectin A of wheat, the form of complex carbohydrate that actually increases blood sugar higher than table sugar and candy bars. And avoid gluten-free foods if you are gluten-free. Later in the book, I will discuss the ins and outs of wheat removal, how to navigate everything from choosing healthy replacement foods to wheat withdrawal. I provide a view from the trenches, having witnessed thousands of people do it successfully.
Even if you do not suffer from this devastating disease, understanding its causes and cures provides a useful framework for thinking about wheat and its role in the human diet.
Beyond teaching us lessons about weight loss, celiac disease can provide other useful health insights to those of us without this condition. There it is, doing its job every day, pushing along the partially digested remains of your last meal through twenty-some feet of small intestine, four feet of large intestine, eventually yielding the stuff that dominates the conversations of most retired people.
It never stops for a rest but just does its thing, never asking for a raise or health care benefits. Deviled eggs, roast chicken, or spinach salad are all transformed into the familiar product of digestion, the bilirubin-tinted, semisolid waste that, in our modern society, you just flush away, no questions asked. Enter an intruder that can disrupt the entire happy system: After Homo sapiens and our immediate predecessors spent millions of years eating from the limited menu of hunting and gathering, wheat entered the human diet, a practice that developed only during the past ten thousand years.
This relatively brief time— generations—was insufficient to allow all humans to make the adaptation to this unique plant. The most dramatic evidence of failed adaptation to wheat is celiac disease, the disruption of small intestinal health by wheat gluten. There are other examples of failed adaptation to foods, such as lactose intolerance, but celiac disease stands alone in the severity of the response and its incredibly varied expression.
Wheat Belly is not a book about celiac disease. But it is impossible to talk about the effects of wheat on health without talking about celiac disease. Celiac disease is the prototype for wheat intolerance, a standard against which we compare all other forms of wheat intolerance.
Celiac disease is also on the rise, increasing fourfold over the past fifty years, a fact that, I believe, reflects the changes that wheat itself has undergone. Not having celiac disease at age twenty-five does not mean you cannot develop it at age forty-five, and it is increasingly showing itself in a variety of new ways besides disruption of intestinal function. Flowery descriptions of the characteristic diarrheal struggles of celiac sufferers started with the ancient Greek physician Aretaeus in AD , who advised celiac patients to fast.
No lack of theories issued over the ensuing centuries to try to explain why celiac sufferers had intractable diarrhea, cramping, and malnutrition. It led to useless treatments such as castor oil, frequent enemas, and eating bread only if toasted. There were even treatments that enjoyed some degree of success, including Dr.
Willem-Karel Dicke. During food shortages toward the end of World War II, bread became scarce and Dicke witnessed improvements of celiac symptoms in children, only to witness deterioration when Swedish relief planes dropped bread into the Netherlands. Gluten elimination yielded dramatic cures, major improvements over the banana and mussel regimens. About 1 percent of the population is unable to tolerate wheat gluten, even in small quantities. Feed gluten to these people, and the lining of the small intestine, the delicate barrier separating incipient fecal matter from the rest of you, breaks down.
It leads to cramping, diarrhea, and yellow-colored stools that float in the toilet bowl because of undigested fats. If this is allowed to progress over years, the celiac sufferer becomes unable to absorb nutrients, loses weight, and develops nutritional deficiencies, such as deficiencies of protein, fatty acids, and vitamins B 12 , D, E, K, folate, iron, and zinc. Antibodies against wheat gliadin, one of the components of gluten, can be found in the blood.
It also causes the body to generate antibodies against components of the disrupted intestinal lining itself, such as transglutaminase and endomysium, two proteins of intestinal muscle that also provide the basis for the two other antibody tests for diagnosis of celiac, transglutaminase and endomysium antibodies.
As the means to diagnose the disease have improved, the number of people with it has expanded to 1 per Immediate relatives of people with celiac disease have a 4. Those with suggestive intestinal symptoms have as high as 17 percent likelihood. Nonetheless, celiac disease is a well-kept secret.
In the United States, 1 in equates to just over two million people who have celiac disease, yet less than 10 percent of them know it. While 50 percent will experience the classic cramping, diarrhea, and weight loss over time, the other half show anemia, migraine headaches, arthritis, neurological symptoms, infertility, short stature in children , depression, chronic fatigue, or a variety of other symptoms and disorders that, at first glance, seem to have nothing to do with celiac disease.
The ways that celiac disease shows itself are also changing. More recently, children are more likely to be diagnosed because of anemia, chronic abdominal pain, or with no symptoms at all, and not until age eight or older.
The most popular theory currently: More mothers are breastfeeding.
Yeah, I laughed, too. Much of the changing face of celiac disease can certainly be attributed to earlier diagnosis aided by the widely available antibody blood tests. But there also seems to be a fundamental change in the disease. Could the changing face of celiac disease be due to a change in wheat itself? Norman Borlaug, to roll over in his grave, but there is data suggesting that something in wheat itself indeed changed sometime during the past fifty years.
A fascinating study performed at the Mayo Clinic provides a unique snapshot of celiac incidence in US residents from half a century ago, the closest we will come to having a time machine to answer our question.
The researchers acquired blood samples drawn fifty years ago for a streptococcal infection study, and kept frozen since. After establishing the reliability of the long-frozen samples, they tested them for celiac markers transglutaminase and endomysium antibodies and compared results to samples from two modern groups. A second modern control group consisted of 7, men of similar age mean age 37 years at the time of the blood draw of the Air Force recruits.
It suggests that the incidence of celiac increased fourfold since in men as they age, and has increased fourfold in modern young men. The incidence is likely to be even higher in females, since women outnumber men in celiac disease, but all the recruits enrolled in the original study were male.
Recruits with positive celiac markers were also four times more likely to die, usually from cancer, over the fifty years since providing blood samples.
I asked Dr. J oseph Murray, lead researcher in the study, if he expected to find the marked increase in the incidence of celiac disease. While that was partly true, the data taught me otherwise: It really is increasing. Other studies showing that celiac disease occurs for the first time in elderly patients back up the imputation that something is affecting the population at any age, not just infant feeding patterns.
Some 7, male and female Finns over age 30 provided blood samples for celiac markers from to Twenty years later, in , another 6, male and female Finns, also over 30, provided blood samples. Measuring transglutaminase and endomysial antibody levels in both groups, the frequency of abnormal celiac markers increased from 1. Antigliadin antibodies. The short-lived IgA antibody and the longer-lived IgG antigliadin antibodies are often used to screen people for celiac.
While widely available, they are less likely to make the diagnosis in all people with the disease, failing to diagnose approximately 20 to 50 percent of true celiac sufferers. Gluten damage to the intestinal lining uncovers muscle proteins that trigger antibody formation. Transglutamin-ase is one such protein. The antibody against this protein can be measured in the bloodstream and used to gauge the ongoing autoimmune response. Compared to intestinal biopsy, the transglutaminase antibody test identifies approximately 86 to 89 percent of celiac cases.
Like the transglutaminase antibody test, the endomysium antibody identifies another intestinal tissue protein that triggers an antibody response. Introduced in the mid-nineties, this test is emerging as the most accurate antibody test, identifying more than 90 percent of celiac cases.
So the tests have value only for people currently consuming wheat products or only for those recently having stopped consuming wheat products. Fortunately, there are some other tests available. These are not antibodies, but genetic markers for human leukocyte antigens, or HLA, that, if present, make the bearer more likely to develop celiac disease. More than 90 percent of people who have celiac disease diagnosed by intestinal biopsy have either of these two HLA markers, most commonly the DQ2.
However, this latter group has been shown to experience better health when wheat gluten is eliminated. Rectal challenge. Not a new TV game show, but a test involving the placement of a sample of gluten into the rectum to see whether an inflammatory response is triggered. While quite accurate, the logistical challenges of this four-hour test limit its usefulness. The positive: The diagnosis can be made confidently. An endoscopy and biopsies are required. Most gastroenterologists advise a small intestinal biopsy to confirm the diagnosis if suggestive symptoms, such as chronic cramping and diarrhea, are present and antibody tests suggest celiac disease.
However, some experts have argued and I agree that the increasing reliability of antibody tests, such as the endomysium antibody test, potentially make intestinal biopsy less necessary, perhaps unnecessary. In the occasional situation in which symptoms are highly suggestive of celiac disease but antibody tests are negative, intestinal biopsy might still be considered.
Conventional wisdom holds that, if one or more antibody tests are abnormal but intestinal biopsy is negative for celiac, then gluten elimination is not necessary. I believe this is dead wrong, since many of these so-called gluten-sensitive or latent celiac disease sufferers will either develop celiac disease over time, or will develop some other manifestation of celiac disease, such as neurological impairment or rheumatoid arthritis.
Another perspective: If you are committed to this notion of removing wheat from your diet, along with other sources of gluten such as rye and barley, then testing may be unnecessary. The only time testing is a necessity is when serious symptoms or potential signs of wheat intolerance are present and documentation would be useful to help eliminate the possibility of other causes.
Knowing that you harbor the markers for celiac might also increase your resolve to be meticulously gluten-free. We therefore have good evidence that the apparent increase in celiac disease or at least the immune markers to gluten is not just due to better testing: The disease itself has increased in frequency, fourfold over the past fifty years, doubling in just the past twenty years.
A study from the Netherlands compared thirty-six modern strains of wheat with fifty strains representative of wheat grown up until a century ago.
By looking for the gluten protein structures that trigger celiac, researchers found that celiac-triggering gluten proteins were expressed to higher levels in modern wheat, while non-celiac-triggering proteins were expressed less. And you are more likely to have the disease than your grandparents were. While twenty to fifty years may be a long time in terms of wine or mortgages, it is far too little time for humans to have changed genetically.
Intestines are not meant to be freely permeable. You already know that the human intestinal tract is home to all manner of odd things, many of which you observe during your morning ritual on the toilet. The wondrous transformation of ham sandwich or pep-peroni pizza into the components of your body, the remainder discarded, is truly fascinating.
But the process needs to be tightly regulated, allowing entry of only selected components of ingested foods and liquids into the bloodstream. So what happens if various obnoxious compounds mistakenly gain entry into the bloodstream?
One of the undesirable effects is autoimmunity—i.
Regulating intestinal permeability is therefore a fundamental function of the cells lining the fragile intestinal wall. Recent research has fingered wheat gliadin as a trigger of intestinal release of a protein called zonulin, a regulator of intestinal permeability. When gliadin triggers zonulin release, intestinal tight junctions are disrupted, and unwanted proteins such as gliadin and other wheat protein fractions gain entry to the bloodstream.