Wheat Belly (Revised and Expanded Edition)
Page 19
If carbohydrates such as wheat trigger the entire domino effect of VLDL/triglycerides/small LDL particles, then reducing carbohydrates should do the opposite, particularly reducing the most dominant dietary carbohydrate: wheat.
IF THY RIGHT EYE OFFEND THEE…
And if thy right eye offend thee, pluck it out, and cast it from thee: for it is profitable for thee that one of thy members should perish, and not that thy whole body should be cast into hell.
—MATTHEW 5:29
Dr. Ronald Krauss and his colleagues at the University of California–Berkeley were pioneers in drawing the connection between carbohydrate intake and small LDL particles.24 In a series of elegant studies, they demonstrated that, as carbohydrates as a percentage of diet increased from 20 to 65 percent and fat content decreased, there was an explosion of small LDL particles. Even people who start with zero small LDL particles can be forced to develop them by increasing the carbohydrate content of their diet. Conversely, people with plenty of small LDL particles will show marked reductions or elimination with reduction in carbohydrates and an increase in fat intake over just several weeks.
DID YOU SAY “STATIN DRUG”?
Chuck came to me because he had heard that it was possible to reduce cholesterol without drugs.
Although it had been wrongly labeled “high cholesterol,” what Chuck really had, as uncovered by lipoprotein testing, was a great excess of small LDL particles. Measured by one technique (NMR), he showed 2,440 nmol/L small LDL particles. (Little to none is desirable.) This gave Chuck the appearance of a high LDL cholesterol of 190 mg/dl, along with a low HDL cholesterol of 39 mg/dl and high triglycerides of 173 mg/dl.
Three months into his wheat-free experience (he replaced wheat calories with real foods such as raw nuts, eggs, cheese, vegetables, fatty meats, bacon, avocados, and olive and coconut oils), Chuck’s small LDL was reduced to 320 nmol/L, an 87 percent reduction. This was reflected on the surface by an LDL cholesterol of 123 mg/dl, an increase in HDL to 45 mg/dl, a drop in triglycerides to 45 mg/dl, and 14 pounds of weight lost from his belly.
Yes, indeed: Marked and rapid reduction of “cholesterol” by putting a diet contrary to conventional advice to work. And these were just Chuck’s preliminary values. Over a longer time period, extravagantly better values developed—no statin drug in sight.
The misinterpretations, misrepresentations, and exaggerations surrounding the idea that statin drugs reduce cardiovascular risk only begin with absurd dietary advice and imprecise and outdated testing methods. There are other issues in this pharmaceutical house of cards. Take the fact that the statin drug industry paid for the majority of statin drug clinical trials, which is no different from R. J. Reynolds telling us that, according to their studies, cigarette smoking is not associated with heart disease or lung cancer. Wild statistical manipulations that convert a questionable 1 percent reduction in heart attack to a marketing claim of 36 percent reduction in heart attack are also in operation. This originates with a statistical sleight of hand called “relative risk,” in which a 2 percent risk for heart attack reduced to 1 percent is billed as a 50 percent reduction in risk, even though it really means that, at best, two people out of a hundred who might have a heart attack is reduced to one person. Imagine that your stockbroker was guilty of the same and told you that he could return 36 percent per year on your money. At year’s end, you’d find yourself only 1 percent richer—and you’d be on the phone with the SEC, mad as heck. But have a prescription for a statin drug handed to you because the doctor drank the Big Pharma–flavored Kool-Aid, fooled into believing that “reducing cholesterol” with a statin drug dramatically reduces heart attack risk but really doesn’t, and a call to the AMA or state medical society won’t get you anywhere.
Focusing on cutting fat, reducing cholesterol, and taking statin drugs is just a fancy shell game. Rather than play the game with your doctor and Big Pharma, take steps to reduce the real factors that lower cardiovascular risk, such as reduction or elimination of small LDL particles, excessive VLDL, and inflammation—all of which occur when you say good-bye to wheat and related grains.
Dr. Volek and his colleagues, while at the University of Connecticut, have also published a number of studies demonstrating the lipoprotein effects of reduced carbohydrates. In one such study, carbohydrates, including wheat flour products, sugared soft drinks, foods made of cornstarch or cornmeal, potatoes, and rice, were eliminated, reducing carbohydrates to 10 percent of total calories. Subjects were instructed to consume unlimited beef, poultry, fish, eggs, cheese, nuts, and seeds, and low-carbohydrate vegetables and salad dressings. Over twelve weeks, small LDL particles were reduced by 26 percent.25 (The quantity of small LDL particles drops even more precipitously over longer time periods. This is because weight loss mobilizes triglycerides from fat cells that enter the bloodstream, temporarily “propping up” the quantity of small LDL during active weight loss. Once weight loss plateaus, small LDL particles plummet even further.)
From the standpoint of small LDL particles, it is nearly impossible to tease out the effects of wheat versus other carbohydrates, such as candy, soft drinks, and chips, since all of these foods trigger small LDL formation. We can safely predict however that foods that increase blood sugar the most also trigger insulin the most, followed by the most vigorous stimulation of de novo lipogenesis in the liver and greater visceral fat deposition, followed by increased VLDL/triglycerides and small LDL. Wheat, of course, fits that description perfectly, triggering greater spikes in blood sugar than nearly all other foods.
Accordingly, reduction or elimination of wheat yields unexpectedly vigorous reductions in small LDL, provided the lost calories are replaced with those from vegetables, fats, and proteins.
CAN “HEART HEALTHY” CAUSE HEART DISEASE?
Who doesn’t love a Mission Impossible double agent story, where the trusted companion or lover suddenly double-crosses the secret agent, having worked for the enemy all along?
How about the nefarious side of wheat? It’s a food that has been painted as your savior in the battle against heart disease, yet the most current research shows it is anything but. (Angelina Jolie made a movie about multiple layers of espionage and betrayal called Salt. How about a similar movie starring Russell Crowe called Wheat, about a middle-aged businessman who thinks he’s eating healthy foods, only to find out…? Okay, maybe not.)
Wheat Belly Success Story: Niki
“It has been a year since I have embarked on the adventure of taking my health into my own hands. Doctors were telling me some people are just genetically disposed to certain weight issues and inflammation. And tests were done with no results that would satisfy me. I decided to look up Wheat Belly. I ordered the book right away. I got to reading and was blown away! I started right away and loved the results.
“A month and a half later my family and I relocated to another state. The transition was stressful and hard and, though I tried to remain compliant, I did fall off the wagon at times. But I’d see the negative results from that and put an end to it.
“I was suffering horrible swelling in my legs, feet, and ankles—and it was painful. I was embarrassed to wear shorts ever. No matter what I did, I couldn’t get the weight off of me. I was suffering from severe depression, anxiety, and embarrassment. I went to work each day and I would come home, sit down on the couch, and not move until bedtime. I had little to no energy. I was suffering with Plantar fasciitis. I hated taking pictures with my family. I never wanted to look at new clothes, knowing I was at my highest weight ever and thinking I may have to settle on the fact I was going to spend the rest of my life that way.
“Allergies, sinus issues that I had constantly, have diminished. I have so much energy to enjoy each day and I am not chained to a couch because of depression, anxiety, and embarrassment. I started at 224 pounds. Now, twelve months later, I’m 178 pounds.
“I am even mo
re excited that only the people around me in our new home state have seen this transformation. I haven’t seen my closest friends or family since before I started this and I haven’t told them either! Next month, I’m going to visit them and cannot wait to show them all what Wheat Belly and this support group has done for me—and my health and weight!
While Wonder Bread claims to “build strong bodies 12 ways,” the many “heart healthy” varieties of bread and other wheat products come in a range of disguises. But whether stone-ground, sprouted grain, or sourdough, organic, “fair trade,” “handcrafted,” or “home-baked,” it’s still wheat. It is still a combination of gluten proteins, glutenins, wheat germ agglutinin, phytates, and amylopectin, triggering wheat’s unique panel of inflammatory effects, neurologically active exorphins, excessive insulin and glucose levels, mineral deficiencies, and plentiful VLDL and small LDL particles.
Don’t be misled by other health claims attached to wheat products. It may be “vitamin-enriched” with synthetic B vitamins, but it’s still wheat. It might be organic (and thereby free of herbicides like glyphosate), stone-ground, whole grain bread with added omega-3 from flax oil, but it’s still wheat. It might help you have regular bowel movements and emerge from the ladies’ room with a satisfied smile, but it’s still wheat. It could be taken as the sacrament and blessed by the pope, but—holy or not—it’s still wheat.
I think you’re probably getting the idea. I hammer this point home because it exposes a common ploy used by the food industry: Add “heart healthy” ingredient(s) to a food and call it a “heart healthy” muffin, cracker, or bread. Fiber, for instance, does indeed have modest health benefits. So does the linolenic acid of flaxseed and flaxseed oil. But no “heart healthy” ingredient will erase the adverse health effects of the wheat. “Heart healthy” bread packed with fiber and omega-3 fats will still trigger high blood sugar, glycation, visceral fat deposition, fatty liver, VLDL, small LDL particles, exorphin release, mineral deficiencies, and inflammatory responses.
IF YOU CAN’T STAND THE WHEAT, GET OUT OF THE KITCHEN
Foods that increase blood glucose to a greater degree therefore trigger VLDL production by the liver. Greater VLDL availability favors formation of small LDL particles that linger for longer periods of time in the bloodstream. High blood glucose encourages glycation of LDL particles, particularly those that are already oxidized.
LDL particle longevity, oxidation, glycation…it all adds up to heightened potential to trigger the formation and growth of atherosclerotic plaque in arteries, increasing the potential for a heart attack. Who’s the head honcho, the top dog, the master at creating VLDL, small LDL, and glycation? Wheat, of course.
There’s a silver lining to this dark wheat cloud: If wheat consumption causes marked increase in small LDL and all its associated phenomena, then elimination of wheat should reverse it. Indeed, that is what happens.
Dramatic reductions in small LDL particles—along with dramatic reductions in VLDL particles, triglycerides, blood sugar, fatty liver, etc.—can be accomplished by eliminating wheat products, provided your diet is otherwise healthy and you don’t replace lost wheat calories with other foods that contain sugar or readily convert to sugar on consumption.
CHAPTER 11
IT’S ALL IN YOUR HEAD: WHEAT AND THE BRAIN
OKAY. SO WHEAT messes with your bowels, amps up your appetite, and makes you the brunt of beer belly jokes. But is it really that bad?
Wheat’s effects reach the brain in the form of opiate-like peptides. But the polypeptide exorphins responsible for these effects come and go, dissipating over time. Exorphins cause your brain to instruct you to eat more food, increase caloric consumption, desperately scratch at the stale crackers at the bottom of the box when there’s nothing else left, and provoke an effect many call “mind fog,” an inability to focus full, undivided attention.
These effects are reversible. Stop eating wheat, the effects go away over several days, the brain recovers, and you’re again ready to help your teenager tackle quadratic equations.
But wheat’s effects on the brain don’t end there. Among the most disturbing of wheat’s effects are those exerted on brain tissue itself—not “just” on thoughts and behavior, but on the cerebrum, cerebellum, and other nervous system structures, with consequences ranging from incoordination to incontinence, from seizures to dementia. And, unlike addictive phenomena, these effects are not entirely reversible.
WATCH WHERE YOU STEP: WHEAT AND CEREBELLAR HEALTH
Imagine I was to blindfold you and set you loose in an unfamiliar room full of odd angles, nooks and crannies, and randomly placed objects. Within a few steps you’re likely to find yourself face-first in the shoe rack. Such are the struggles of someone with a condition known as cerebellar ataxia. But these people struggle with eyes wide open.
These are the people you often see using canes and walkers, or stumbling over a crack in the sidewalk that results in a fractured leg or hip. Something has impaired their ability to navigate the world, causing them to lose control over balance and coordination, functions centered in a region of the brain called the cerebellum.
The majority of people with cerebellar ataxia consult with a neurologist, often to have their condition deemed idiopathic, without known cause. No treatment is prescribed, nor has a treatment been developed. The neurologist simply suggests a walker, advises removing potential stumbling hazards in the home, and discusses adult diapers for the urinary incontinence that will eventually develop. Cerebellar ataxia is progressive, getting worse with each passing year until the sufferer is unable to comb his hair, brush his teeth, or go to the bathroom alone. Even the most basic self-care activities will eventually need to be performed with assistance. At this point, the end is near, as such extreme debilitation hastens complications such as pneumonia and infected bedsores.
Between 10 and 22.5 percent of people with celiac disease have nervous system involvement, but cerebellar ataxia can occur independent of celiac disease.1, 2 Of people with unexplained ataxia—i.e., no cause can be identified—abnormal blood markers for gluten are measured in 50 percent of the afflicted.3
Problem: The majority of people with ataxia triggered by wheat gluten have no signs or symptoms of intestinal disease, no celiac-like warnings to send the signal that a gluten-sensitive process is at work.
While the gluten-brain connection underlying neurological impairment was suspected as long ago as 1966, it was thought to be due to nutritional deficiencies.4 More recently, it has become clear that brain and nervous system involvement result from a direct immune attack on nerve cells. The anti-gliadin antibodies triggered by gluten can bind to Purkinje cells of the brain, cells unique to the cerebellum.5 Purkinje cells do not have the capacity to regenerate: Once damaged, cerebellar Purkinje cells are gone…forever.
In addition to loss of balance and coordination, wheat-induced cerebellar ataxia can show such odd phenomena as, in the arcane language of neurology, nystagmus (lateral involuntary twitching of the eyeballs), myoclonus (involuntary muscle twitching), and chorea (chaotic involuntary jerking motions of the limbs). One study of 104 people with cerebellar ataxia also revealed impaired memory and verbal abilities, suggesting that wheat-induced destruction involves cerebral tissue, the seat of higher thought and memory.6
The typical age of onset of symptoms of wheat-induced cerebellar ataxia is forty-eight to fifty-three. On an MRI of the brain, 60 percent show atrophy of the cerebellum, reflecting irreversible destruction of Purkinje cells.7 Only limited recovery of neurological function occurs with wheat gluten elimination due to the poor capacity of brain tissue to regenerate. Most people simply stop getting worse once the flow of gluten stops.8
The first hurdle in diagnosing ataxia that develops from wheat exposure is to have a physician who even considers the diagnosis in the first place. This can be the toughest hurdle of all, since much of the medical community continues to embr
ace the notion that wheat is good for you. Once considered, however, making the diagnosis is a bit tricky, as a brain biopsy is objectionable to most people, and it therefore takes a well-informed neurologist to make the diagnosis. One marker in particular is proving to be helpful in identifying many, though not all, cases, the anti-transglutaminase-6 (TG6) antibody in addition to the anti-gliadin antibody.9 The diagnosis may rest on a combination of suspicion and positive antibody and HLA DQ markers, along with observation of improvement or stabilization with wheat and gluten elimination.10
The painful reality of cerebellar ataxia is that, in the great majority of cases, you won’t know you have it until you start tripping over your own feet, drifting into walls, or wetting your pants. Once it shows itself, your cerebellum is likely already shrunken and damaged. Halting all wheat and gluten ingestion at this point may not keep you out of the assisted living facility but will keep you alive.
All of this due to the muffins and bagels you so crave.
FROM YOUR HEAD DOWN TO YOUR TOES: WHEAT AND PERIPHERAL NEUROPATHY
While cerebellar ataxia is due to wheat-triggered immune reactions on the brain, a parallel condition, called peripheral neuropathy, occurs in the nerves of the legs, pelvis, and other organs.