Wheat Belly (Revised and Expanded Edition)

by William Davis

  The phytates in just two ounces of grain flour are sufficient to nearly completely block intestinal zinc absorption.10 Zinc deficiency correlates with grain consumption: the more consumed, the more likely zinc deficiency develops. Given modern grain-consuming habits, as many as 35 to 45 percent of older adults are zinc deficient. As wheat and related grains become increasingly dominant worldwide dietary staples, zinc deficiency now afflicts an estimated two billion people.11

  Because zinc is a mineral essential for hundreds of body processes, deficiency manifests as phenomena as varied as skin rashes, diarrhea, and hair loss. Because nearly all dietary zinc is provided by animal products and virtually none is from plants, vegans and vegetarians are especially prone to zinc deficiency.12 Combine the poor zinc content of plant products and impaired absorption posed by grain phytates, and vegans and vegetarians who consume grains not uncommonly develop difficulties mounting normal immune responses; in addition, fertility and reproduction are adversely impacted, children and adolescents experience impaired growth, and neurological maturation is impaired. The ever-resourceful grain industry has responded, not unexpectedly, by increasing zinc content in grains, including use of fertilizers supplemented with zinc. Or you could simply remove grains from the diet to allow normal, natural zinc absorption.

  Likewise, magnesium and calcium absorption are also blocked by phytates. We are all deficient in magnesium to begin with because we rely on water filtration that removes all magnesium, and the magnesium content of modern vegetables and fruit is reduced. When we eat foods that provide magnesium, 60 percent is blocked from absorption if phytate-containing foods are present, causing human magnesium status to go from bad to worse.13 Calcium metabolism is disrupted by wheat and related grains. Not only do phytates bind calcium in the intestines and make them unavailable, but the gliadin protein also causes marked loss of calcium through urination—absorption is reduced and the little calcium you do absorb is tossed away.14 Lack of magnesium and calcium introduces the potential for many health problems, from heart rhythm issues, to migraine headaches, to bone thinning.

  Can this get any worse? Yes, indeed: Let’s now talk about the effects of gliadin in people without celiac disease.

  YOU ARE THE 99 PERCENT

  Dr. Alessio Fasano’s research while at the University of Maryland demonstrated that the gliadin protein initiates a process that leads to increased intestinal permeability, opening the “tight junctions” between intestinal cells that serve as a barrier to the foreign compounds in transit through your intestines. Once opened, all manner of unwanted things get into the body: wheat germ agglutinin, bacterial breakdown products such as lipopolysaccharide that are highly inflammatory, even gliadin itself. While this process occurs in individuals with celiac disease, it also occurs in the other 99 percent—nobody escapes it.15

  While the intensity of the effect is variable, everyone is subject to this effect to one degree or another. Given their structural similarities, the gliadin-like proteins of other grains exert similar effects.16, 17 This process is the trigger for type 1 diabetes, rheumatoid arthritis, and other autoimmune conditions—a revolutionary finding (and one that escapes the understanding of most doctors who prescribe drugs like Humira or Enbrel, a thousands-of-dollars-per-month example of ignorance of dietary issues).18 You therefore do not need to suffer from celiac disease to have a life-changing, even crippling, response to the seeds of grasses.

  It gets worse. Proteins from food or bacteria that partially resemble human proteins also get through, a process that can result in misguided triggering of an immune response. In a peculiar twist, the gliadin protein resembles portions of transglutaminase proteins present, for instance, in the intestinal lining, brain, joints, skin, liver, and other human organs. Antibodies generated against gliadin therefore also attack organs containing transglutaminase, resulting in autoimmune brain injury, joint inflammation, skin rashes, autoimmune hepatitis, etc.19 This is an example of “molecular mimicry” that fools the immune system into attacking its own organs, all due to the trickery of gliadin.

  The implications of Dr. Fasano’s work are huge. It means that the abnormally increased intestinal permeability induced by gliadin is the first step leading to autoimmunity in those with genetic susceptibility. In other words, if you have genetic susceptibility to rheumatoid arthritis (human leukocyte antigen [HLA] genes for HLA-DRB1, HLA-DPB1, or HLA-B), joint swelling, inflammation, and disfigurement may never show unless the process is initiated by grain proteins. Or if you have genetic susceptibility to multiple sclerosis (HLA-DRB1*15 and others), fatigue, numbness, incoordination, and bladder/bowel dysfunction never appear unless grain proteins initiate increased intestinal permeability that allows the genetic susceptibility to manifest. You are not genetically flawed; you’ve been eating something that should never have made it past your lips, and that is now responsible for all manner of disrupted, disordered, and destructive immune phenomena.

  Recall that wheat also contains a collection of potential allergens, such as α-amylase inhibitors, the various forms of gliadin proteins, and thioredoxins. While these most commonly cause asthma and skin rashes, they can also be responsible for a variety of gastrointestinal issues, especially abdominal pain, bloating, and diarrhea.20

  So what was that they were saying again about “healthy whole grains”?

  THIRTY-FOOT BATTLEGROUND

  If you could bring wheat up on charges of assault and battery, you could put it away for life, given the beating the thirty feet of your GI tract has had to endure.

  In the battle between wheat and your GI tract, you don’t stand a chance. If you exercise, don’t smoke or drink too much, follow advice to reduce fat, and eat healthy whole grains, yet ended up with a collection of gastrointestinal struggles, you now know why health and life did not turn out the way they promised. Put aside the superficial science and marketing about B vitamins, fiber, and healthy breakfasts, and you will find that you have been consuming a collection of toxic foods that leave your gallbladder, pancreas, and intestines in tears. Like a marriage gone sour, all the smiles, promises, and kisses are long gone, leaving you tired, overweight, medicated, hoping the doctor might have some answers, only to return home to your smug abuser.

  Let’s catalog the gastrointestinal effects of consuming the seeds of grasses:

  Acid reflux, reflux esophagitis—Millions of people are plagued by the discomfort of acid reflux and esophageal inflammation and prescribed acid suppressing medications such as Prilosec, Prevacid, and Protonix, taken every day for years. More than one billion people—one out of every seven people on the planet—have been prescribed these drugs since their appearance on the market thirty-five years ago.

  Though such drugs are generally regarded by doctors as benign, they are not. They have been associated with deficiencies of vitamin B12 and magnesium; impaired calcium absorption, osteoporosis, increased risk of bone fracture risk, and increased risk of pneumonia.21 They have been associated with changes in bowel flora and increased potential for infection with Clostridium difficile, which is often difficult to treat and life-threatening (spawning efforts such as fecal transplant).22 Dysbiosis (disrupted bowel flora) provoked by such drugs is believed to explain, for instance, the deterioration of multiple sclerosis that often develops with their use.23 Say good-bye to the seeds of grasses and most people experience relief from acid reflux and esophagitis within days of doing so.

  Bowel urgency, diarrhea—Millions of people struggle to manage explosive bowel urgency, which provides just seconds of warning and fills the lives of its sufferers with anxiety when they are in social situations, traveling, or just going to the grocery store. Ironically, wheat and grains are commonly painted as good for bowel health because of their fiber, which is thought to be necessary to maintain regular bowel habits and cholesterol. Of course, the real story is that components of wheat create feelings of urgency, often labeled irritable bowel syndrome (IBS). B
owel urgency is your body’s way of telling you that it is trying to get rid of an irritating toxin. Just as you would listen to the advice of a counselor who tells you to exit an abusive relationship, it is wise to heed the wisdom of your bowels when they tell you to stop the grains.

  IBS is also proving to be more celiac disease–like than previously suspected, in that it is associated with increased intestinal permeability and a high likelihood of dysbiosis, including a severe form called small intestinal bacterial overgrowth (SIBO), in which microorganisms, normally confined to the colon, ascend up the twenty-some feet of small intestine, all the way up to the stomach, a full-length infection that is highly inflammatory and poses numerous implications for health.24, 25 IBS and/or “gluten sensitivity” are therefore not as benign as previously advertised, given the potential that increased intestinal permeability has for issues such as the initiation of autoimmune processes.

  Dysbiosis—Grains disrupt bowel flora, allowing unhealthy species of bacteria to proliferate, while suppressing healthy species, with effects beyond that of IBS. In its most severe form, SIBO, IBS is experienced as nausea, abdominal pain, diarrhea, fatigue and low energy, joint inflammation, skin rashes such as eczema and psoriasis, diffuse muscle pain (often labeled “fibromyalgia”), nutrient deficiencies, anxiety, depression, and autoimmune diseases. Most gastroenterologists will, incredibly, declare people with this condition to be “fine” because there is no observable ulcer and cancer is not detected by endoscopy, then prescribe—this happens every day—an acid-suppressing medication and plenty of fiber along with an anti-diarrheal drug.

  Gallbladder disease, lack of pancreatic enzymes—Wheat germ agglutinin (WGA) is a potent binder of glycoproteins (proteins with a sugar molecule attached). By yet another odd collision between humans and wheat, cholecystokinin (CCK) receptors in the gallbladder and pancreas are glycoproteins, the kind of protein that WGA loves to bind.26, 27 WGA blocks the CCK signal received by the gallbladder to release bile and the pancreas to release digestive enzymes. The result: inefficient, incomplete digestion. Undigested food ferments and decays in the presence of bacteria, effects that are experienced as bloating, gas, and changes in stool character such as lighter color or floating (due to undigested oils and fats). Over time, dysbiosis worsens, as rotting food encourages growth of putrefactive bacteria and SIBO often results. To top it all off, failed release of bile by the gallbladder leads to bile stasis that allows formation of gallstones.

  Worsening of inflammatory bowel diseases—Ulcerative colitis and Crohn’s disease can be activated by toxins in wheat, further complicated by dysbiosis, worsening the diarrhea, bleeding, impaired nutrient absorption, pain, and long-term risk for colon cancer in ulcerative colitis, and the small intestinal lymphoma and fistulas (abnormal connections, e.g, bowel and bladder, a very serious complication) in Crohn’s disease.

  Constipation—Put food in your mouth and the remains should exit without invitation, preferably today, certainly no later than tomorrow. People living primitive lives without grains, sugars, and soft drinks enjoy such predictable bowel behavior: Eat some fish, alpaca, mushrooms, or mongongo nuts for breakfast, out it all comes that afternoon or evening, as large, steamy fecal matter, filled with undigested remains and prolific quantities of bacteria—no straining, laxatives, or stack of magazines required. Live a modern life and have breakfast cereal, even bran cereal, instead, and you’ll be lucky to pass it out by tomorrow or the next day, maybe even next week—and often in hard, painful bits and pieces. The combined effects of impaired CCK signaling, reduced bile release, insufficient pancreatic enzymes, and dysbiosis disrupt the orderly passage of digested foods.

  The conventional response to constipation from wheat and grains is to include more fiber, especially cellulose—essentially wood fiber—from grains. This strategy does indeed work for some, as indigestible cellulose fibers yield bulk that people mistake for healthy bowel movements, never mind all the other disruptions of digestion.

  As banal, uninspiring, and ordinary as it is, constipation contains a world of important lessons to teach us about our relationship with seeds of grasses. Slowed passage of putrefied stool has been linked to increased cancer risk, especially of the rectum.28 Over time, constipation and its accompanying added work of evacuation lead to hemorrhoids, anal fissures, prolapse of the uterus, vagina, and rectum, and even bowel obstruction, a surgical emergency. Once again, the healthcare system, with its enthusiasm for costly procedures, has solutions. Yes, there is order and justice in the digestive world, but you won’t find it in that box of fiber-rich cereal.

  IF IT QUACKS LIKE A DUCK…

  Defenders of grains would have us believe that the only problem with consuming the seeds of grasses is that it can cause celiac disease. More recently, this notion has crumbled as consensus grows pointing out that there is another form of intolerance to these same proteins labeled “non-celiac gluten sensitivity” (NCGS), with many of the same symptoms experienced by celiac sufferers.

  Bloating, diarrhea, abdominal pain, fatigue, and headache are experienced by these people. Biopsy reveals the absence of the transglutaminase or endomysial antibodies and lack of celiac abnormalities, yet they have symptoms reliably triggered by re-exposure to grains. Because of differences in how this condition is defined, anywhere from a few percent to 30 percent of the population is estimated to have NCGS.29 People with NCGS have greater likelihood of antibodies to gliadin; as much as 56 percent show such antibodies, suggesting that an autoimmune process is at work.30 Another fundamental oversight is that NCGS may represent toxic reactions to other components of grains, such as WGA or the dozens of other potential toxins in seeds of grass.

  The beleaguered grain lobby, having endured some tough years as critics of wheat and grain consumption (like the one who wrote this book) have gained traction, have tried to put a positive spin on “non-gluten grains,” such as amaranth, rice, and millet, hoping to deflect growing anti-gluten criticism while preserving their market.

  BOWEL FLORA: WEEDS IN THE GARDEN

  You can view bowel flora like a garden: If you fertilize it properly, provide sufficient water, keep the rabbits away, and avoid herbicides and pesticides that disrupt the natural balance, your garden will yield a healthy bounty of zucchini and tomatoes. If you fail to water or fertilize it properly, or let the kids trample across it, you will likely have little to show, not to mention lots of weeds. Bowel flora operate on similar principles.

  We know that diet plays a crucial role in shaping the composition of bowel flora. Microorganisms in our gastrointestinal tract vary from individual to individual, shift with age and hormonal status, and are modified by exposure to antibiotics, herbicides, pesticides, prescription drugs, stress, and other factors.

  A number of health conditions have been associated with disruptions of bowel flora, such as multiple sclerosis, fibromyalgia, diabetes (both type 1 and type 2), irritable bowel syndrome, gallstones, acid reflux/esophagitis, ulcerative colitis, Crohn’s disease, and food allergies.31 Funny thing: Each and every one of these conditions has also been associated with grain consumption, especially wheat, rye, barley, and corn. SIBO, in particular, is strongly associated with several of these conditions, especially fibromyalgia, irritable bowel syndrome, Crohn’s disease and ulcerative colitis.32 When “normal” people are assessed for SIBO, 35 percent demonstrate evidence for abnormal intestinal infestations, even if no symptoms are present.33 When SIBO is diagnosed, conventional treatment is to prescribe antibiotics, such as rifaximin, that wipes out bowel flora, both good and bad. And it works, though it ignores the question: Why did SIBO develop in the first place? And, of course, wiping out bowel flora does not guarantee that intestines re-populate with healthy bacteria, particularly if the inciting causes of SIBO remain uncorrected.

  One disturbing trend is the increasing incidence of infection by Clostridium difficile, a strain of bacteria capable of inflicting severe damage to the colon, cal
led pseudomembranous colitis, that involves sepsis (entry of bacteria into the bloodstream) and death. Ordinarily, C. difficile quietly inhabits colons of healthy people in low numbers, as it competes with other bacteria for nutrients and is suppressed by factors expressed by other bacterial species. We know that C. difficile can emerge following use of antibiotics that indiscriminately knock off bowel flora, good and bad, obliging even more antibiotics. More recently, C. difficile has proven to be a source of trouble even without a preceding course of antibiotics, occurring “spontaneously.” The reasons to explain why this organism is becoming increasingly aggressive are unclear. Might the distortions introduced into bowel flora by grains, changed by agribusiness, play a role?

  Changes in composition of bacteria develop as quickly as days to weeks after a change in diet.34, 35 Right now, the understanding of bowel flora is incomplete, but is rapidly yielding to study. We shall discuss steps that you can take to re-establish healthy bowel flora later in the book.

  DIETARY TROUBLEMAKER

  If, at the end of this discussion about the gastrointestinal effects of grains, you conclude that, not only are grains not beneficial for bowel health and nutrition, but they are also a dreadful, nasty, trouble-making collection of bowel toxins, you are now empowered with the key to understanding why people are plagued by chronic gastrointestinal complaints, inflammation, rashes, and joint struggles, regardless of how “balanced” the diet, how vigorous the exercise, or how many nutritional supplements they take. You are also on your way to understanding how to solve this enormous health puzzle.