Wheat Belly (Revised and Expanded Edition)

by William Davis

  In daily life, the pH of the body is locked at 7.4, thanks to the elaborate control systems in place. By-products of metabolism, such as lactic acid, are acids. Acids drive pH down, triggering a panic mode response from the body to compensate. The body responds by drawing from any alkaline store available, from bicarbonate in the bloodstream to calcium carbonate and calcium phosphate in the bones. Because maintaining a normal pH is so crucial, the body will sacrifice bone health to keep pH stable. In the great triage system that is your body, your bones will be turned into mush before pH is allowed to veer off course. When a happy pH balance is struck, bones will be happy, joints will be happy.

  While pH extremes in either direction are dangerous, the body is happier with a slight alkaline bias. This is subtle and not reflected in blood pH, but it is evident by such methods as measuring acid and alkaline products in the urine.

  Acids that stress the body’s pH can also come through diet. There are obvious dietary sources of acid such as carbonated sodas that contain carbonic acid. Some sodas, such as Coca-Cola, also contain phosphoric acid. The extreme acid loads of carbonated sodas stretch your body’s acid-neutralizing capacity to its limits. The constant draw on calcium from bones, for instance, is associated with fivefold increased fractures in high school girls who consume the most carbonated colas.1

  But certain foods can be not-so-obvious sources of acids in this tightly controlled pH environment. Regardless of source, the body must “buffer” the acid challenge. The composition of the diet can determine whether the net effect is an acid or alkaline challenge.

  Proteins from animal products are meant to be the main acid-generating challenge in the human diet. Meats such as chicken, pork roast, and Arby’s roast beef sandwiches are therefore sources of acid in the average American diet. Acids yielded by meats, such as uric acid and sulfuric acid (the same as in your car’s battery and acid rain), need to be buffered by the body. The fermented product of bovine mammary glands (cheese!) is another highly acidic group of foods, particularly reduced-fat, high-protein cheeses. Any food derived from animal sources, in short, generates an acid challenge, whether fresh, fermented, rare, well done, with or without special sauce.2

  However, animal products may not be as harmful to pH balance as they first appear. Recent research suggests that protein-rich meats have other effects that partially negate the acid load. Animal protein exerts a bone-strengthening effect through stimulation of the hormone insulin-like growth factor (IGF-1), which triggers bone growth and mineralization. (“Insulin-like” refers to its similarity in structure to insulin, not similarity in effect.) The net effect of proteins from animal sources, despite their acid-generating properties, is that of increased bone health. Children, adolescents, and the elderly, for instance, who increase protein intake from meat show increased bone calcium content and improved measures of bone strength.3

  Vegetables and fruits, on the other hand, are the dominant alkaline foods in the diet. Virtually everything in your produce department will drive pH in the alkaline direction. From kale to kohlrabi, generous consumption of vegetables and fruits serves to neutralize the acidic burden from animal products.

  BONE BREAKER

  Hunter-gatherer diets of organs, meats, vegetables, and fruits, along with relatively neutral nuts and roots, yield a net alkaline effect.4 Of course, the struggle for the hunter-gatherer wasn’t pH regulation, but dodging the arrows of an invading conqueror or the ravages of gangrene. So perhaps acid-base regulation did not play a major role in the longevity of primitive people. Nonetheless, the nutritional habits of our ancestors set the biochemical stage for modern human adaptation to diet.

  Around ten thousand years ago, the formerly alkaline human diet pH balance shifted to the acid side with the introduction of grains, especially the most dominant of grains, wheat. The modern human diet of plentiful “healthy whole grains” but lacking in vegetables and fruit is highly acid-charged, inducing a condition called acidosis. Over years, acidosis takes its toll on your bones.

  Like the Federal Reserve, bones from skull to coccyx serve as a repository, not of money but of calcium salts. Calcium, identical to that in rocks and mollusk shells, keeps bones rigid and strong. Calcium salts in bone are in dynamic balance with blood and tissues and provide a ready source of alkalinizing material to counter an acid challenge. But, like money, the supply is not infinite.

  While we spend our first eighteen or so years growing and building bone, we spend the rest of our lives tearing it back down, a process regulated in part by body pH. The chronic mild metabolic acidosis engendered by our diet worsens as we age, starting in our teens and continuing through the eighth decade.5, 6 The acidic pH pulls calcium carbonate and calcium phosphate from bone to maintain the body pH of 7.4. The acidic environment also stimulates bone-resorbing cells within bones, known as osteoclasts, to work harder and faster to dissolve bone tissue to release the precious calcium.

  The problem comes when you habitually ingest acids in the diet, then draw on calcium stores over and over and over again to neutralize these acids. Though bones have a lot of stored calcium, the supply is not inexhaustible. Bones will eventually become demineralized—i.e., depleted of calcium. That’s when osteopenia (mild demineralization) and osteoporosis (severe demineralization), frailty, and fractures develop.7 (Osteoporosis and frailty usually go hand in hand, since bone density and muscle mass parallel each other.) Incidentally, taking calcium supplements is no more effective at reversing bone loss than randomly tossing bags of cement and bricks into your backyard is at building a new patio.

  An excessively acidified diet will eventually show itself as bone fractures. An impressive analysis of the worldwide incidence of hip fracture demonstrates a striking relationship: The higher the ratio of protein intake from vegetables to the protein intake from animal products, the fewer hip fractures occur.8 The magnitude of difference was substantial: While a vegetable-to-animal-protein intake ratio of 1:1 or less was associated with as many as 200 hip fractures per 100,000 population, a vegetable-to-animal-protein intake ratio of between 2:1 and 5:1 was associated with fewer than 10 hip fractures per 100,000 population—a reduction of more than 95 percent. (At the highest intakes of vegetable protein, the incidence of hip fracture practically vanished.)

  The fractures that result from osteoporosis are not just tumbling down the stairs kinds of fractures. They can also be vertebral fractures from a simple sneeze, a hip fracture from misjudging the sidewalk curb, a forearm fracture from pushing a rolling pin.

  Modern eating patterns therefore create a chronic acidosis that in turn leads us to osteoporosis, bone fragility, and fractures. At age fifty, 53.2 percent of women can expect to experience a fracture in their future, as can 20.7 percent of men.9 Contrast this with a fifty-year-old woman’s risk for breast cancer of 10 percent and risk for endometrial cancer of 2.6 percent.10

  Until recently, osteoporosis was thought to be largely a condition peculiar to postmenopausal females who have lost the bone-preserving effects of estrogen. It is now understood that the decline in bone density begins years before menopause. In the 9,400-participant Canadian Multicentre Osteoporosis Study, females began to show declining bone density in the hip, vertebra, and femur at age twenty-five, with a precipitous decline resulting in accelerated loss at age forty; men show a less marked decline starting at age forty.11 Both men and women showed another phase of accelerated bone loss at age seventy and onward. By age eighty, 97 percent of females have osteoporosis.12

  So even youth does not ensure protection from bone loss. In fact, loss of bone strength is the rule over time, partly due to the chronic low-grade acidosis we create with diet.

  WHAT DO ACID RAIN, CAR BATTERIES, AND WHEAT HAVE IN COMMON?

  Unlike all other foods derived from plants, grains generate acidic by-products, the only plant products to do so. Because wheat is, by a long stretch, the foremost grain in most Americans’ diet, it contributes
substantially to the acid burden of a meat-containing diet.

  Wheat is among the most potent sources of sulfuric acid, yielding more sulfuric acid per gram than any meat.13 (Wheat is surpassed only by oats in quantity of sulfuric acid produced.) Sulfuric acid is dangerous stuff. Put it on your hand and it will cause a severe burn. Get it in your eyes and you can go blind. (Go take a look at the warnings prominently displayed on your car battery.) The sulfuric acid in acid rain erodes stone monuments, kills trees and plants, and disrupts the reproductive behavior of aquatic animals. The sulfuric acid produced by wheat consumption is undoubtedly dilute. But even in teensy-weensy quantities in dilute form, it is an overwhelmingly potent acid that rapidly overcomes the neutralizing effects of alkaline bases.

  Grains such as wheat account for 38 percent of the average American’s acid load, more than enough to tip the balance into the acid range. Even in a diet limited to 35 percent of calories from animal products, adding wheat shifts the diet from net alkaline to strongly net acid.14

  One way to gauge acid-induced extraction of calcium from bone is to measure urinary calcium loss. A University of Toronto study examined the effect of increasing gluten consumption from bread on the level of calcium lost in the urine. Increased gluten intake increased urinary calcium loss by an incredible 63 percent, along with increased markers of bone resorption, i.e., blood markers for bone weakening that lead to bone diseases such as osteoporosis.15

  So what happens when you consume a substantial quantity of meat products but fail to counterbalance the acid load with plentiful alkaline plant products such as spinach, cabbage, and green peppers? An acid-heavy situation results. What happens if acids from meat consumption are not counterbalanced by alkaline plants and the pH scales are tipped even more to the acidic side by grain products such as wheat, as happens with a burger in a bun without an accompanying big salad? That’s when it gets ugly. Diet is then shifted sharply to that of an acid-rich situation.

  The result: a chronic acid burden that eats away at bone health.

  WHEAT, TOUPÉE, AND A CONVERTIBLE

  Remember Ötzi? He was the Tyrolean Iceman found buried and mummified in the glaciers of the Italian Alps, preserved since his death more than 5,000 years ago, circa 3300 BC. While the remains of unleavened einkorn bread were discovered in Ötzi’s gastrointestinal tract, most of the digestive contents were meats and plants. Ötzi lived and died 4,700 years after humans began incorporating grains such as cold-tolerant einkorn into their diet, but wheat remained a relatively minor portion of the diet in his mountain-dwelling culture. Ötzi was primarily a hunter-gatherer most of the year. In fact, he was likely hunting with his bow and arrow when he met his violent end at the hand of another hunter-gatherer.

  The meat-rich diet of hunter-gatherer humans such as Ötzi provided a substantial acid load. Ötzi’s greater consumption of meat than most modern humans (35 to 55 percent of calories from animal products) therefore yielded more sulfuric and other organic acids.

  Despite the relatively high consumption of animal products, the abundant non-grain plants in the diets of hunter-gatherers yielded generous amounts of alkalinizing potassium salts, such as potassium citrate and potassium acetate, that counterbalanced the acidic load. The alkalinity of primitive diets has been estimated to be six- to ninefold greater than that of modern diets due to the high plant content.16 This resulted in alkaline urine pH as high as 7.5 to 9.0, compared to the typical modern acidic range of 4.4 to 7.0.17

  Wheat and other grains enter the picture, however, and shift the balance back to acid, accompanied by calcium loss from bone. Ötzi’s relatively modest consumption of einkorn wheat likely meant that his diet remained net alkaline most of the year. In contrast, in our modern world of plenty, with unlimited supplies of cheap wheat-containing foods on every corner and table, the acidic load tips the scales heavily toward net acid.

  If wheat and other grains are responsible for tipping the pH balance toward acid, what happens if you do nothing more than remove wheat from the modern diet and replace the lost calories with other plant foods such as vegetables, fruits, beans, and nuts? The balance shifts back into the alkaline range, mimicking the hunter-gatherer pH experience.18

  Wheat is therefore the great disrupter. Wheat shifts a diet that had hopes of being net alkaline to net acid, causing a constant draw of calcium out of the bone. Throw in the increase in urinary calcium loss associated with wheat consumption, as well as the common deficiency of the master control nutrients of bone health, vitamins D and K2, and your poor femur or pelvis doesn’t stand a chance.

  The conventional solution to the “healthy whole grain” acid diet and its osteoporosis-promoting effects are prescription drugs such as Fosamax and Boniva, agents that claim to reduce the risk for osteoporotic fractures, especially of the hip. The market for osteoporosis drugs has already topped $11 billion a year, serious money even by the jaded standards of the pharmaceutical industry.

  Once again, wheat enters the picture, adding its peculiar health-disrupting effects, embraced by the USDA and providing new and bountiful revenue opportunities for Big Pharma.

  TWO WHEAT HIPS TO MATCH YOUR WHEAT BELLY

  Ever notice how people with a wheat belly almost invariably also have arthritis of one or more joints? If you haven’t, take notice of how many times someone who carts around the characteristic front loader also limps or winces with hip, knee, or back pain.

  Osteoarthritis is the most common form of arthritis in the world, more common than rheumatoid arthritis, gout, or any other variety. Painful “bone-on-bone” loss of cartilage resulted in knee and hip replacements in 310,000 Americans in 2010 alone.19

  This is no small problem. It is estimated that as many as ninety-one million people, or one in 3.5 Americans, have been diagnosed with osteoarthritis by their physicians.20 Many more hobble around without formal diagnosis.

  Conventional thought for years was that common arthritis of the hips and knees was the simple result of excessive wear and tear, like too many miles on your tires. A 110-pound woman: knees and hips likely to last a lifetime. A 220-pound woman: knees and hips take a beating and wear out. Excess weight in any part of the body—bottom, belly, chest, legs, arms—provides a mechanical stress to joints.

  It has proven to be more complicated than that. The same inflammation that issues from the visceral fat of the wheat belly and results in diabetes, heart disease, cancer, and Alzheimer’s dementia also yields inflammation of joints. Inflammation-mediating hormones, such as tumor necrosis factor-alpha, interleukins, and leptin, have been shown to inflame and erode joint tissue.21 Leptin, in particular, has demonstrated direct joint destructive effects: The greater the degree of overweight (i.e., higher BMI), the higher the quantity of leptin within joint fluid, and the greater the severity of cartilage and joint damage.22 The level of leptin in joints precisely mirrors the level in blood.

  The risk of arthritis is therefore even greater for someone with visceral fat of the wheat belly variety, as evidenced by the threefold greater likelihood of knee and hip replacements in people with larger waist circumferences.23 It also explains why joints that don’t bear the added weight of obesity, such as those in the hands and fingers, also develop arthritis, all part of the body-wide inflammation that develops in wheat-consumers.

  Losing weight, and thereby visceral fat, improves arthritis more than can be expected from just the decreased weight load.24 In one study of obese participants with osteoarthritis, there was 10 percent improvement in symptoms and joint function with each 1 percent reduction in body fat.25

  The prevalence of arthritis, the common images of people rubbing their painful hands and knees or people carted through stores and airports in wheelchairs, leads you to believe that arthritis is an unavoidable accompaniment of aging, as inevitable as death, taxes, and hemorrhoids. Not true. Joints do indeed have the potential to serve us for the eight or so decades of our life…until we
ruin them with repeated insults, such as excessive acidity and inflammatory molecules like leptin originating from visceral fat cells.

  Another phenomenon that adds to the wheat-induced pounding that joints sustain over the years: glycation. You’ll recall that, more than nearly all other foods, wheat products increase blood sugar, i.e., blood glucose. The more wheat products you consume, the higher and more frequently blood glucose increases, the more glycation occurs. Glycation represents an irreversible modification of proteins in the bloodstream and in body tissues, including joints such as the knees, hips, wrists, and fingers.

  The cartilage in joints is uniquely susceptible to glycation, since cartilage cells are extremely long-lived and incapable of reproducing. Once damaged, they do not recover. The very same cartilage cells residing in your knee at age twenty-five will (we hope) be there when you are eighty; therefore, these cells are susceptible to all the biochemical ups and downs of life, including blood sugar adventures. If cartilage proteins, such as collagen and aggrecan, become glycated, they become abnormally stiff. The damage of glycation is cumulative, making cartilage brittle and unyielding, eventually crumbling.26 Joint inflammation, pain, and destruction, the hallmarks of arthritis, result. At its extremes, cartilage is worn through completely, yielding the bone-on-bone arthritis that so commonly leads to around-the-clock pain and surgical joint replacement.

  High blood sugars that encourage growth of a wheat belly, coupled with inflammatory activity in visceral fat cells and glycation of cartilage, lead to destruction of bone and cartilage tissue in joints. Over the years, it results in the familiar pain and swelling of the hips, knees, and hands. Conventional answers include anti-inflammatory drugs, prosthetic joints, and a cane or walker, but, if begun early enough in life, you have the power of saying no to pancakes and ciabattas to keep your joints in youthful shape.