The celiac community offers several resources to help the celiac sufferer succeed. The Celiac Society (www.celiacsociety.com) provides a listing and search feature for gluten-free foods, restaurants, and manufacturers. The Celiac Disease Foundation (www.celiac.org) is a good resource for emerging science. One danger: Some celiac disease organizations obtain revenue from promotion of gluten-free products, a potential diet hazard that, while gluten-free, can act as “junk carbohydrates.” Nonetheless, many of the resources and information provided by these organizations can be helpful. The National Celiac Association (www.nationalceliac.org), the most grassroots effort, is the least commercial. It organizes an annual national meeting for those interested in celiac research and resources.
Following a gluten-free diet, by the way, as the sole strategy to manage celiac disease and its related conditions, as advocated by the majority of gastroenterologists and dietitians, is woefully inadequate, an issue we shall discuss later. It is very common for people with celiac disease to experience partial improvement with diet, then further improvements or total relief by adding several more strategies.
CELIAC DISEASE “LITE”
While celiac disease affects only 1 percent of the population, two common intestinal conditions affect many more people: irritable bowel syndrome (IBS) and acid reflux (also called reflux esophagitis when esophageal inflammation is documented). Both may represent lesser forms of celiac disease, what I call celiac disease “lite.”
IBS is a poorly understood condition, despite its frequent occurrence (although IBS is looking more and more like a manifestation of a form of disrupted bowel flora called small intestinal bacterial overgrowth that we shall address later in the book). Consisting of cramping, abdominal pain, and diarrhea or loose stools alternating with constipation, it affects between 5 and 20 percent of the population, depending on definition.41 Think of IBS as a confused intestinal tract, following a disordered script that complicates your schedule. Repeated endoscopies and colonoscopies are typically performed. Because no visible pathology is identified in IBS sufferers, it is not uncommon for the condition to be dismissed as your imagination or treated with antidepressants.
Acid reflux occurs when stomach acid is permitted to climb back up the esophagus due to a lax gastroesophageal sphincter, the circular valve meant to confine acid to the stomach. Because the esophagus is not equipped to tolerate acidic stomach contents, acid in the esophagus does the same thing that acid would do to your car’s paint job: It dissolves it. Acid reflux is often experienced as common heartburn, accompanied by a bitter taste in the back of the mouth.
There are two general categories of each of these conditions: IBS and acid reflux with positive markers for celiac disease, and IBS and acid reflux without positive markers for celiac disease. People with IBS have a 4 percent likelihood of testing positive for one or more celiac markers.42 People with acid reflux have a 10 percent chance of having positive celiac markers.43
Conversely, 55 percent of celiac sufferers have IBS-like symptoms and between 7 and 19 percent have acid reflux.44, 45, 46 Interestingly, 75 percent of celiac sufferers obtain relief from acid reflux with wheat removal, while non-celiac people who do not eliminate wheat nearly always relapse after a course of acid-suppressing medication.47, 48 Could it be the wheat?
Eliminate wheat, acid reflux improves, symptoms of IBS improve. I have personally witnessed complete or partial relief from symptoms of IBS and acid reflux with gluten removal from the diet many thousands of times, whether or not celiac markers are abnormal.
LET CELIAC DISEASE SET YOU FREE
Celiac disease is a permanent condition. Even if gluten is eliminated for many years, celiac disease or other forms of immune-mediated gluten intolerance come rushing back on re-exposure.
Because susceptibility to celiac disease is, at least partly, genetically determined, it doesn’t dissipate with healthy diet, exercise, weight loss, nutritional supplements, drugs, daily enemas, healing stones, or apologies to your mother-in-law. It stays with you as long as you are human and are unable to trade genes with another organism. In other words, you have celiac disease for a lifetime.
It means that even occasional casual exposure to gluten has health consequences to the celiac disease sufferer or the gluten-sensitive individual, even if immediate symptoms such as diarrhea are not provoked.
All is not lost if you have celiac disease. Food can be every bit as enjoyable without wheat, even more so. One of the essential but unappreciated phenomena accompanying wheat and gluten elimination, celiac or otherwise: You appreciate food more. You eat foods because you require sustenance and you enjoy their taste and texture more than your grain-consuming days because your taste perception is heightened once gastrointestinal healing occurs. You are also not driven by hidden uncontrollable impulses of the sort triggered by wheat.
If you were to learn that, say, cucumber consumption yielded a severely debilitating or fatal disease in 1 percent of people, accompanied by sky-high potential for cancer if undiagnosed, wouldn’t you question the consumption of cucumbers in everybody, not just the unfortunate 1 percent?
Don’t think of celiac disease as a burden. Think of it as liberation.
We’ve talked about celiac disease and the various forms of gluten-sensitive health consequences. Let’s now talk about all the ways that wheat and its friends wreak other forms of gastrointestinal havoc on these humans foolish enough to consume the seeds of grasses.
CHAPTER 7
SWALLOW: IT CAN’T BE ALL THAT BAD…OR CAN IT?
YOU ARE AN upright, two-legged, nearly hairless creature, navigating the world, a twenty-first-century version of mammals who, not all that long ago (anthropologically speaking), lived in clans of a couple dozen related mammals, wore the skins of animals you butchered, were wary of any wandering newcomer, and killed and foraged for food. You and your group kept on the move, searching for new hunting grounds, fresh animals to kill, new earth to dig for roots, new places to soil with urine and feces.
It’s not the most flattering image, but that is the picture of life that emerges before polyester, supermarkets, and sensitivity about naked body parts emerged. But eat grass? I don’t think so. Conceive of ways to isolate each teensy-weensy seed, one at a time, hoping to collect the thousands necessary to fill a bowl? Surely gathering shellfish or trapping an animal, roasting it over a fire, then licking your lips after satiating yourself by consuming its organs and flesh was preferable to the desperate consumption of seeds of grass.
The health consequences of dietary-habits-gone-wrong are profound and wide—with the stomach, small intestine, and large intestine the unwitting victims of this fatal mistake, ground zero in the battle between grasses and humans. There’s nothing intrinsically wrong with the grasses of the earth: They are beautiful, waving in the wind, providing nutrition to grass-eating species—but not to creatures like us. Every creature adheres to a dietary script written into its genetic code acquired over millions of years. Venture outside this scheme and peculiar things happen, just as a goose who eats the remnant of a tossed-off Quarter Pounder, or a lion forced to eat only kale and spinach, discovers.
The gastrointestinal (GI) tract, much like skin, is the interface between the world around us and our internal organs. While skin negotiates our contact with air, water, and the world around us, the GI tract moderates our contact with the objects we put in our mouths and swallow. The things you ingest, whether a bite of rib-eye steak or onion, must interact with the lining of the GI tract. That interaction can be healthy and physiologic, yielding nutrients to build eye, heart, brain, and bone cells. Or it can be damaging, inflaming the intestinal lining, creating abnormal permeability, and allowing foreign invaders to penetrate into the bloodstream, lymph nodes, and organs, with long-term consequences that show as joint swelling of rheumatoid arthritis or the red, itchy rash of eczema.
In the minds of most doctors, you either have celi
ac disease or you do not. In that line of reasoning, if you do not have celiac disease, go ahead and enjoy your bear claw or French roll and it all fits into your life of moderation. But this overlooks a crucial issue: There are so many more harmful components in seeds of grasses than gluten. Not recognizing this can literally be fatal, or at least generate skin rashes, a fatty liver, anemia, or autoimmune diseases debilitating enough to require plenty of antacids, anti-diarrheal and anti-inflammatory drugs, cholesterol drugs, and lots of medical expenses to find out what is wrong with you. But there’s nothing wrong with you; there is something wrong with the recommendation to consume something that made its way into the human diet in desperation, now mistakenly and fatally celebrated by all who dispense dietary advice.
The range of destructive gastrointestinal effects wrought by grain consumption is so far reaching that, by the end of this chapter and, certainly, by the end of this book, you will come to understand something that has become clearer and clearer, the farther we venture down this grain-free life: The wide-ranging and myriad chronic health conditions that afflict humans can, to a breathtaking degree, be blamed on consumption of wheat and closely related grasses. When we remove this collection of things called “healthy whole grains,” we regain health in ways that, even today, continue to astound all of us engaged in this adventure.
Wheat Belly Success Story: Keoni
“I have a huge list of health issues and ailments that are completely gone or mostly gone.
“These conditions were:
1. Plantar fasciitis
2. Stuffy sinuses while lying down that required some type of sinus medication every night
3. Sleep apnea
4. Benign lump under my right tricep, now 90 percent dissolved
5. Skin tags disappeared
6. Strange small scabs on the back of my head disappeared along with other skin irritations
7. No longer obese
8. Less brain fog and improved mental clarity
9. Persistent mucus and phlegm are gone
10. Intermittent coughing and scratchy throat gone
11. Shortness of breath has disappeared
12. Joint pain everywhere is completely gone
13. High blood sugar levels are gone
14. No longer tired in the middle of the day
15. No more headaches
16. One of the things that really worried me, which no doctor could ever figure out, is whenever I exerted myself strenuously I got sharp pains and pressure behind my eyes and in the top of my head; that has reduced by 70 to 80 percent
17. Inflammation throughout my body has disappeared
18. Twenty years of chronic muscle spasms around my neck and shoulders, along with pain, are gone
19. Cuts and scrapes heal much faster
20. Enormous reduction in anxiety and stress
21. Increased libido
“Looking back, it is a shocking realization that it probably took twenty-five or thirty years to create all the problems I once had and then, in a very short time, those problems were dramatically reduced or completely disappeared.
“When you’re first starting out it can be difficult and challenging because of all the new things you’re learning, but you will start to see changes and after a couple of hurdles and mud puddles you will come out on the other side to meet ‘The Real You!’
“In the photo on the left, I weighed 220 pounds when I started this fourteen months ago. The after photo was taken just now at 160 pounds.”
Let’s discuss what happens when Homo sapiens, unadapted to consuming the seeds of grasses, try to imitate a goat or horse and make them a dietary staple.
CAN YOU STOMACH WHEAT AND GRAINS?
Kids swallow all kinds of things, from marbles to coins. But you know better, right?
Once seeds of grasses are swallowed, they wreak an astonishing array of digestive havoc. People can struggle for years, dealing with bloating, abdominal pain, diarrhea, emergency room visits, repeated endoscopies resulting in no cause identified or in a prescription for one of doctors’ common favorites: acid suppressing medications, laxatives, or antibiotics. Bowel urgency that keeps people from traveling or leaving their homes, dashing to bathrooms with barely a warning, is a particularly common complaint of the grain consumer. Constipation is another common result for which the conventional solution, ironically, is more fiber from grains—or one or more $300-per-month prescriptions to force it out of you. Some of the worst constipation imaginable, called “obstipation,” an obstinate intestinal situation in which bowel movements occur every several weeks and for which fiber and laxatives are ineffective, leaves frequent enemas as your only conventional solution. The range and frequency of bowel disruption by grains is all the more astounding when we are told just how much they are supposed to be good for gastrointestinal health—if you would just shut up and eat your bran cereal.
Wheat and related grains are not only not good for gastrointestinal health, but potently toxic when consumed chronically. Diarrhea, constipation, obstipation, malabsorption, and inflammatory bowel disease should come as no surprise when you recognize the collection of toxins contained in seeds of grasses. For us non-ruminants without four-compartment stomachs or spiral colons that harbor cellulose-consuming microorganisms, wheat is an alphabet soup of gastrointestinal toxins. Let’s catalog some of the most important.
Remember wheat germ agglutinin (WGA), the protein enriched by wheat breeders to enhance pest resistance? By itself, WGA is a potent toxin, exerting both direct and indirect toxic GI effects. As we’ve discussed, direct contact of WGA with the intestinal lining results in denuding, i.e, exposing tissue beneath the lining, much like scraping your knee, which exposes underlying red, bleeding tissue. But it goes further than that.
Wheat germ agglutinin blocks the intestinal hormone cholecystokinin (CCK), which signals the gallbladder to release bile and the pancreas to release enzymes, both required to reduce, say, hamburger or broccoli into basic nutrients. Blocking CCK leads to bile stasis, which causes gallstones to form over time, while inadequate quantities of digestive enzymes lead to incomplete digestion of fats, proteins, and carbohydrates. All this results in impaired nutrient absorption and unhealthy alterations in bowel flora. Digestive disruption from wheat can therefore result in gallstones, heartburn, diarrhea, and dysbiosis (disrupted bowel flora), which leads, over time, to conditions such as autoimmune diseases, diverticular disease, and colon cancer. A small amount of wheat germ agglutinin also gains entry into the bloodstream, where it exerts inflammatory effects, can provoke blood clotting (thus it’s name: “agglutinin,” referring to the agglutination of red blood cells), and interferes with hormones such as insulin.1
Then there are phytates. Whole wheat bread and seven-grain muffins do indeed have a respectable profile of B vitamins and fiber. But the nutrients of wheat are accompanied by a storage form of phosphorus called phytates that block absorption of nutrients, resulting in common nutritional deficiencies. Phytates bind minerals with a positive charge, making them unavailable for absorption: iron, zinc, calcium, and magnesium are among the most important. “Healthy whole grains” for breakfast are not the start to a healthy day; they are the start to a day of nutritional deficiencies sufficient to impair health.
Recall that, like WGA, grain breeders have selected strains of wheat for greater phytate content to enhance pest resistance. Whole wheat, for instance, contains 800 mg phytates per 100 grams (approximately 3.5 ounces) of flour. As little as 50 mg phytates reduces iron absorption by 80 to 90 percent, making iron unavailable for absorption regardless of how much is contained in a meal.2 Have some French bread before your filet mignon? Virtually all the iron will be flushed down the toilet.
Iron deficiency became a real problem when early humans first consumed seeds of grasses, an observation evident in porotic hyperostosis and cri
bra orbitalia in bones recovered by anthropologists, deformities that developed due to hyperactive bone marrow compensating for anemia resulting from lack of iron. Because iron deficiency can impair a primitive human’s ability to run, hunt, gather food, and tolerate weather extremes, it exerted evolutionary pressure over the last ten thousand years and led to the appearance of a gene for hemochromatosis, carried by 8 percent of people of northern European descent, to improve iron absorption to partially counteract the iron-impairing effect of grains.3 (It takes a lot more than a single gene mutation, however, to disable the full collection of toxic components in seeds of grasses.)
Because most of us do not carry the hemochromatosis gene, consumption of grains is the most common explanation for iron deficiency anemia after blood loss, a worldwide problem.4, 5 In Egypt, for example, as grain consumption of baladi bread increased, iron deficiency doubled between 2000 and 2005.6 It should come as no surprise that 46 percent of people with celiac disease show decreased iron stores (low ferritin levels) and anemia from iron deficiency.7 People who have Crohn’s disease, malabsorption, and dysbiosis are especially prone to iron deficiency with wheat consumption. Iron deficiency in otherwise normal people is also common. Because most doctors fail to understand this simple fact, patients are subjected not just to prescription iron supplements, but also to iron injections, bone marrow biopsies, and blood transfusions, often for years, while common phytate-induced iron deficiency anemia disappears within two weeks of saying good-bye to wheat.8
Let’s discuss another important mineral blocked by wheat: zinc. Zinc deficiency was thought to be rare until a severe case was diagnosed in Iran in 1958. An underdeveloped adult male, age twenty-two, who had the body of a ten-year-old and whose diet had been dominated by tanok bread, was diagnosed with an enlarged liver and spleen, heart failure, and an appetite for eating dirt. Zinc supplementation reversed his bizarre health problems.9 The bread component responsible for zinc deficiency was not identified, however, until chickens and pigs were diagnosed with zinc deficiency; this was then backtracked to the phytate content of the wheat being fed to them. Zinc deficiency has since proven to be widespread.
Wheat Belly (Revised and Expanded Edition) Page 12
