Wheat Belly (Revised and Expanded Edition)

by William Davis

  A common cause of peripheral neuropathy is diabetes. High blood sugars occurring repeatedly over several years damage the nerves in the legs, causing reduced sensation (thus allowing a diabetic to step on a thumbtack without knowing it), diminished control over blood pressure and heart rate, and sluggish emptying of the stomach (diabetic gastroparesis), among other manifestations of a nervous system gone haywire.

  DANCE THE WHEAT AWAY

  When I first met Meredith, she was sobbing. She’d come to me because of a minor heart question (an EKG variant that proved benign).

  “Everything hurts! My feet especially,” she said. “They’ve treated me with all kinds of drugs. I hate them because I’ve had lots of side effects. The one I just started two months ago makes me so hungry that I can’t stop eating. I’ve gained fifteen pounds!”

  Meredith described how, in her work as a schoolteacher, she was barely able to stand in front of her class any longer because of the pain in her feet. More recently, she had also started to doubt her ability to walk, since she was also beginning to feel unsteady and uncoordinated. Just getting dressed in the morning was taking longer and longer due to both the pain as well as the increasing clumsiness that impaired such simple activities as putting on a pair of pants. Although only fifty-six years old, she was forced to use a cane.

  I asked her if her neurologist had any explanations for her disability. “None. They all say there’s no good reason. I’ve just got to live with it. They can give me medicines to help with the pain, but it’s probably going to get worse.” That’s when she broke down and started crying again.

  I suspected there was a wheat issue just by looking at Meredith. Beyond the obvious difficulty she had walking into the room, her face was puffy and red. She described her struggles with acid reflux and the abdominal cramping and bloating diagnosed as irritable bowel syndrome. She was about 60 pounds overweight and had a modest quantity of edema (water retention) in her calves and ankles, all signature wheat-consuming signs.

  So I asked Meredith to venture down the wheat-free path. By this time, she was so desperate for any helpful advice that she agreed to try. I also took the gamble of scheduling her for a stress test that would require her to walk at a moderate speed up an incline on a treadmill.

  Meredith returned two weeks later. I asked her if she thought she could manage the treadmill. “No problem! I stopped all wheat immediately after I talked to you. It took about a week, but the pain started to go away. Right now I have about ninety percent less pain than I had a couple of weeks ago. I’d say it’s nearly gone. I’ve already stopped one of the medicines for the pain and I think I’ll stop the other later this week.” She also clearly no longer needed her cane.

  She related how her acid reflux and irritable bowel symptoms had also disappeared completely. And she’d lost 9 pounds in the two-week period.

  Meredith tackled the treadmill without difficulty, handily managing the 3.6-miles-per-hour, 14 percent grade.

  A similar degree of nervous system chaos occurs with wheat exposure without diabetes. The average age of onset of gluten-induced peripheral neuropathy is fifty-five. As with cerebellar ataxia, the majority of sufferers do not have celiac disease.11

  Unlike cerebellar Purkinje cells’ inability to regenerate, peripheral nerves have limited capacity to undergo repair once the offending wheat and gluten are removed, with the majority of people experiencing at least partial reversal of their neuropathy. In one study of thirty-five people with peripheral neuropathy who were positive for the anti-gliadin antibody, the twenty-five participants on a wheat- and gluten-free diet improved over one year, while the ten control participants who did not remove wheat and gluten deteriorated.12 Formal studies of nerve conduction were also performed, demonstrating improved nerve conduction in the wheat- and gluten-free group, and deterioration in the wheat- and gluten-consuming group.

  Because the human nervous system is a complex web of nerve cells and networks, peripheral neuropathy triggered by wheat gluten exposure can show itself in a variety of ways, depending on what collection of nerves are affected. Loss of sensation to both legs along with poor leg muscle control is the most common, called sensorimotor axonal peripheral neuropathy. Less commonly, only one side of the body may be affected (asymmetrical neuropathy); or the autonomic nervous system, the part of the nervous system responsible for automatic functions such as blood pressure, heart rate, and bowel and bladder control, can be affected.13 If the autonomic nervous system is affected, such phenomena as losing consciousness or becoming light-headed while standing up due to poor blood pressure control, inability to empty the bladder or bowels, and inappropriately rapid heart rate while doing nothing can result.

  Regardless of how it is expressed, peripheral neuropathy is progressive and will get worse and worse unless all wheat and gluten are removed.

  WHOLE GRAIN BRAIN

  I think that we can all agree: “Higher” brain functions, such as thinking, learning, and memory, should be off-limits to intruders. Our minds are deeply personal, representing the summation of everything that is you and your experiences. Who wants nosy neighbors or marketing pitchmen to gain access to the private domain of the mind? While the notion of telepathy is fascinating to think about, it’s also really creepy to think that someone could read your thoughts.

  For wheat, nothing is sacred. Not your cerebellum, not your cerebral cortex. While it can’t read your mind, it sure can influence what goes on inside it.

  The effect of wheat on the brain is more than just influence over mood, energy, and sleep. Actual brain damage is possible, as seen in cerebellar ataxia. But the cerebral cortex, the center of memory and higher thinking, the storehouse of you and your unique personality and memories, the brain’s “gray matter,” can also be pulled into the immune battle with wheat, resulting in encephalopathy, or brain disease.

  Gluten encephalopathy shows itself as migraine headaches and strokelike symptoms, such as loss of control over one arm or leg, difficulty speaking, or visual difficulties.14, 15 On an MRI of the brain, there is characteristic evidence of damage surrounding blood vessels in cerebral tissue. Gluten encephalopathy will also show many of the same balance and coordination symptoms as those that occur with cerebellar ataxia.

  In one particularly disturbing Mayo Clinic study of thirteen patients with the recent diagnosis of celiac disease, dementia was also diagnosed. Of those thirteen, frontal lobe biopsy (yes, brain biopsy) or post-mortem examination of the brain failed to identify any other pathology beyond that associated with wheat gluten exposure.16 Prior to biopsy or death, the most common symptoms were memory loss, inability to perform simple arithmetic, confusion, and change in personality. Of the thirteen, nine died due to progressive impairment of brain function. Yes: fatal dementia from wheat.

  In what percentage of dementia sufferers can their deteriorating mind and memory be blamed on wheat? This question has not yet been satisfactorily answered. However, one British research group that has actively investigated this question has, to date, diagnosed sixty-one cases of encephalopathy, including dementia, due to wheat gluten.17

  There is growing evidence that, in many people with so-called non-celiac gluten sensitivity, increased intestinal permeability, inflammation, and disruptions of bowel flora, or dysbiosis, can likewise lead to cognitive decline and dementia.18 Wheat is therefore associated with dementia and brain dysfunction, triggering an immune response, inflammation, and dysbiosis that infiltrates memory and mind.

  Gluten sensitivity can also show itself as seizures. The seizures that arise in response to wheat tend to occur in young people, often teenagers. The seizures are typically of the temporal lobe variety (i.e., originating in the temporal lobe of the brain), just beneath the ears. People with temporal lobe seizures experience hallucinations of smell and taste, odd and inappropriate emotional feelings such as overwhelming fear without real cause, and repetitive behaviors such
as lip smacking or hand movements. A peculiar syndrome of temporal lobe seizures unresponsive to seizure medications and triggered by calcium deposition in a part of the temporal lobe called the hippocampus (responsible for forming new memories) has been associated with positive anti-gliadin antibodies and HLA markers without intestinal disease.19

  Of celiac sufferers, from 1 to 5.5 percent can be expected to be diagnosed with seizures.20, 21 Temporal lobe seizures triggered by wheat gluten are improved after gluten elimination.22, 23 One study demonstrated that epileptics who experience the much more serious generalized (grand mal) seizures were twice as likely (19.6 percent compared to 10.6 percent) to have gluten sensitivity in the form of increased levels of anti-gliadin antibodies without celiac disease.24

  Wheat intersects with Alzheimer’s and other forms of dementia in yet another way: type 3 diabetes. The concept of type 3 diabetes, i.e., the inability to respond to insulin in the brain, emerged in 2005 and has gained steam to explain the explosion in dementia that has developed over the past two decades.25 This means that any factor that increases insulin resistance in muscle, liver, and other organs also does so within the brain. Quick: Name the food that raises blood sugar and insulin the most, thereby cultivating insulin resistance as a body-wide process and accelerating glycation. Yup: Once again, wheat is looking like a major player via its uncommonly digestible, blood sugar–raising, insulin resistance–creating potential of amylopectin A. Throw into the mix the glycation process that occurs every time your blood sugar rises above its normal fasting levels that we discussed in chapter 8 and the AGEs recovered in beta-amyloid plaques in the brains of Alzheimer’s sufferers, and we have the formula that accounts for an awful lot of disrupted brain health.

  It’s a sobering idea that a BLT sandwich or oatmeal cookies have the capacity to reach into the human brain and cause changes in thought, behavior, and structure, occasionally to the point of provoking dementia and seizures. The research into the relationship of wheat and brain disease is still preliminary, with many unanswered questions remaining, but what we do know is deeply troubling. I shudder to think what we might find next.

  GRAY MATTERS

  Gluten is the component of wheat confidently linked with triggering destructive immune reactions in the brain and nervous system, whether expressed as cerebellar ataxia, peripheral neuropathy, seizures, or dementia. However, many health effects of wheat have nothing to do with gluten. The addictive properties of wheat, for instance, expressed as overwhelming temptation and food obsessions, are not directly due to gluten, but to exorphins, the breakdown product of gliadin within gluten. While the component of wheat responsible for behavioral distortions in people with schizophrenia and children with autism and ADHD has not been identified, it is likely that these phenomena are also due to wheat exorphins and not a gluten-triggered immune response. Unlike gluten sensitivity, which can usually be diagnosed with antibody tests, there is at present no marker that can be measured to assess exorphin effects.

  Non-gluten effects can add to gluten effects. The psychological influence of wheat exorphins on appetite and impulse, or glucose-insulin-glycation effects, and perhaps other effects of wheat that have yet to be described, can occur independently or in combination with immune effects. Someone suffering with undiagnosed intestinal celiac disease can have odd cravings for the foods that damage their small intestine, but also show diabetic blood sugars with wheat consumption, along with wide mood swings, fragmented memory, and disfiguring skin rashes. Someone else without celiac disease can accumulate visceral fat and show neurological impairment from wheat, worsened by brain insulin resistance and accumulation of glycation-associated brain tissue debris, while also struggling with irritable bowel symptoms and seborrhea. Others may become helplessly tired, overweight, edematous, and diabetic, yet suffer neither intestinal nor nervous system effects of wheat gluten. The tangle of health consequences of wheat consumption is truly impressive.

  The tremendously varying way the neurological effects of wheat can be experienced complicates making the “diagnosis.” Potential immune effects can be gauged with antibody blood tests. But non-immune effects are not revealed by any blood test and are therefore more difficult to identify and quantify.

  The world of the “wheat brain” has just started yielding to the light of day. The brighter the light shines, the uglier the situation gets. But, as bad as the effects of wheat on the human brain and nervous system can be, you have the solution in your hands.

  CHAPTER 12

  BAGEL FACE: WHEAT’S DESTRUCTIVE EFFECT ON SKIN

  IF WHEAT CAN grasp hold of organs such as the brain, intestines, arteries, and bones, can it also affect the largest organ of the body, the skin?

  Indeed it can. And it can display its peculiar effects in more ways than Krispy Kreme has donuts.

  Despite its outwardly quiet facade, skin is an active organ, a hotbed of physiologic activity, a waterproof barrier fending off the attacks of billions of foreign organisms while hosting those that are friendly, regulating body temperature through sweat, enduring bumps and scrapes every day, regenerating itself to repel the constant barrage. Skin is the physical barrier separating you from the rest of the world. Each person’s skin provides a home to ten trillion bacteria, most of which assume residence in quiet symbiosis with their mammalian host.

  Any dermatologist can tell you that skin is the outward reflection of internal body processes. A simple blush demonstrates this fact: the acute and intense facial vasodilatation (capillary dilation) that results when you realize the guy you flipped off in traffic was your boss. But the skin reflects more than our emotional states. It can also display evidence of internal physical processes.

  Wheat can exert age-advancing skin effects, such as wrinkles and lost elasticity, through the formation of advanced glycation end products. But wheat has plenty more to say about your skin’s health than just making you age faster.

  Wheat expresses itself—actually, the body’s reaction to wheat expresses itself—through the skin. Just as digestive by-products of wheat lead to joint inflammation, increased blood sugar, and brain effects, so too can they result in reactions in the skin, effects that range from petty annoyances to life-threatening ulcers and gangrene.

  Skin changes do not generally occur in isolation: If an abnormality due to wheat is expressed on the skin surface, then it usually means that the skin is not the only organ experiencing an unwanted response. Other organs may be involved, from intestines to brain—though you may not be aware of it.

  YO, PIMPLE FACE

  Acne: the common affliction of adolescents and young adults, responsible for more distress than prom night.

  Nineteenth-century doctors called it “stone-pock,” while ancient physicians often made issue of the rash-like appearance minus the itching. The condition has been attributed to everything from emotional struggles, especially those involving shame or guilt, to deviant sexual behavior. Treatments were dreadful, including powerful laxatives and enemas, foul-smelling sulfur baths, and prolonged exposure to X-ray.

  Aren’t teenage years already tough enough?

  As if teenagers need any more reason to feel awkward, acne visits the twelve- to eighteen-year-old set with uncommon frequency. It is, along with the onslaught of bewildering hormonal effects, a nearly universal phenomenon in Western cultures, affecting more than 80 percent of teenagers, up to 95 percent of sixteen- to eighteen-year-olds, sometimes to disfiguring degrees. Adults are not spared, with 50 percent of those over age twenty-five having intermittent bouts.1

  While acne may be nearly universal in American teenagers, it is not a universal phenomenon in all cultures. Some cultures display no acne whatsoever. Cultures as wide ranging as the Kitavan Islanders of Papua New Guinea, the Aché hunter-gatherers of Paraguay, natives of the Purus Valley in Brazil, African Bantus and Zulus, Japanese Okinawans, and Canadian Inuit are curiously spared the nuisance and embarrassment of
acne.

  Are these cultures spared the heartbreak of acne because of unique genetic immunity?

  Evidence suggests that it is not a genetic issue, but one of diet. Cultures that rely only on foods provided by their unique location and climate allow us to observe the effects of foods added or subtracted to the diet. Acne-free populations such as the Kitavans of New Guinea exist on a hunter-gatherer diet of vegetables, fruits, tubers, coconuts, and fish. The Paraguayan Aché hunter-gatherers follow a similar diet and are also spared completely from acne.2 Japanese Okinawans, probably the most long-lived group on planet earth, consumed a diet rich in an incredible array of vegetables, sweet potatoes, soy, pork, and fish until the eighties; acne was virtually unknown among them.3 The traditional Inuit diet, consisting of seal, fish, caribou, and whatever seaweed, berries, and roots they could find, likewise leaves Inuits acne-free. The diets of African Bantus and Zulus differ according to season and terrain, but are rich in indigenous wild plants such as guava, mangoes, and tomatoes, in addition to the fish and wild game they catch; once again, no acne.4

  In other words, cultures without acne consume little to no wheat, sugar, or dairy products. As Western influence introduced processed starches such as wheat and sugars into groups such as the Okinawans, Inuits, and Zulus, acne promptly followed.5, 6, 7 In other words, acne-free cultures had no special genetic protection from acne, but simply followed a diet that lacked the foods that provoke the condition. Introduce wheat, sugar, and dairy products, and Clearasil sales skyrocket.

  Ironically, it was “common knowledge” in the early twentieth century that acne was caused or worsened by eating starchy foods such as pancakes and biscuits. This notion fell out of favor in the eighties after a single wrongheaded study that compared the effects of a chocolate bar versus a “placebo” candy bar. The study concluded that there was no difference in acne observed among the sixty-five participants regardless of which bar they consumed—except that the placebo bar was virtually the same as the chocolate bar in calories and sugar content, just minus the cocoa.8 (Cocoa lovers rejoice: Cocoa does not cause acne. Enjoy your 85 percent cacao dark chocolate.) This didn’t stop the dermatology community, however, from pooh-poohing the relationship of acne and diet for many years, largely based on this single study that was cited repeatedly, reflecting dermatologists’ nutritional sophistication as not even skin deep.