MAN WALKS AFTER ELIMINATING WHEAT
Jason was a twenty-six-year-old software programmer: smart, lightning-quick to catch onto an idea. He came to my office with his young wife because he wanted help just to get “healthy.”
When he told me that he had undergone repair of a complex congenital heart defect as an infant, I promptly interrupted him. “Whoa, Jason. I think you may have the wrong guy. That’s not my area of expertise.”
“Yes, I know. I just need your help to get healthier. They tell me I might need a heart transplant. I’m always breathless and I’ve had to be admitted to the hospital to treat heart failure. I’d like to see if there’s anything you can do to either avoid having a heart transplant or, if I have to have it, help me be healthier afterward.”
I thought that was reasonable and gestured for Jason to get on the exam table. “Okay. I get it. Let me take a listen.”
Jason got up from the chair slowly, visibly wincing, and inched his way onto the table, clearly in pain.
“What’s wrong?” I asked.
Jason took his seat on the exam table and sighed. “Everything hurts. All my joints hurt. I can barely walk. At times, I can barely get out of bed.”
“Have you been seen by any rheumatologists?” I asked.
“Yes. Three. None of them could figure out what was wrong, so they just prescribed anti-inflammatories and pain medicines.”
“Have you considered dietary modification?” I asked him. “I’ve seen a lot of people get relief by eliminating all wheat from their diet.”
“Wheat? You mean like bread and pasta?” Jason asked, confused.
“Yes, wheat: white bread, whole wheat bread, multi-grain bread, bagels, muffins, pretzels, crackers, breakfast cereals, pasta, noodles, pancakes, and waffles. Even though it sounds like that’s a lot of what you eat, trust me, there’s plenty of things left to eat.” I gave him a handout detailing how to navigate the wheat-free diet.
“Give it a try: Eliminate all wheat for just four weeks. If you feel better, you’ll have your answer. If you feel nothing, then perhaps this is not the answer for you.”
Jason returned to my office three months later. What struck me was that he sauntered easily into the room without a hint of joint pain.
The improvements he’d experienced had been profound and nearly immediate. “After five days, I couldn’t believe it: I had no pain whatsoever. I didn’t believe it could be true—it had to be a coincidence. So I had a sandwich. Within five minutes, about eighty percent of the pain came back. Now I’ve learned my lesson.”
What impressed me further was that, when I first examined him, Jason had indeed been in mild heart failure. On this visit, he no longer showed any evidence of heart failure. Along with relief from the joint pain, he also told me that his breathing had improved to the point where he could jog short distances and even play a low-key game of basketball, things he had not done in years. We’ve then begun to back down on the medications he’d been taking for heart failure.
Obviously, I am a big believer in a wheat-free life. But when you witness life-changing experiences such as Jason’s, it still gives me goose bumps to know that such a simple solution existed for health problems that had essentially crippled a young man.
That baguette may look innocent, but it’s a lot harder on the joints than you think.
THE BELLY JOINT’S CONNECTED TO THE HIP JOINT
As with weight loss and the brain, people with celiac disease can teach us some lessons about wheat’s effects on bones and joints.
Osteopenia and osteoporosis are common in people with celiac disease and can be present whether or not there are intestinal symptoms, affecting up to 70 percent of people with celiac antibodies.27, 28 Because osteoporosis is so common among celiac sufferers, some investigators have argued that anyone with osteoporosis should be screened for celiac disease. A Washington University Bone Clinic study found undiagnosed celiac disease in 3.4 percent of participants with osteoporosis, compared to 0.2 percent without osteoporosis.29 Elimination of gluten from osteoporotic celiac participants promptly improved measures of bone density—without use of osteoporosis drugs.
The reasons for the low bone density include impaired absorption of nutrients, especially vitamin D and calcium, and increased inflammation that triggers release of bone-demineralizing cytokines, such as interleukins.30 Eliminating wheat from the diet both reduced the inflammation and allowed better absorption of nutrients.
The severity of bone weakening effects are highlighted by horror stories such as the woman who suffered ten fractures of the spine and extremities over twenty-one years, starting at age fifty-seven, all occurring spontaneously. Eventually crippled, she was finally diagnosed with celiac disease.31 Compared to people without celiac disease, celiac sufferers have a threefold increased risk for fractures.32
The thorny issue of gliadin antibody-positive individuals without intestinal symptoms applies to osteoporosis as well. In one study, 12 percent of people with osteoporosis tested positive for the gliadin antibody but didn’t show any symptoms or signs of celiac disease.33
Wheat can show itself through inflammatory bone conditions outside of osteoporosis and fractures. Rheumatoid arthritis, a disabling and painful autoimmune arthritis that can leave the sufferer with disfigured hand joints, knees, hips, elbows, and shoulders, can also be blamed on wheat sensitivity. A study of participants with rheumatoid arthritis, none of whom had celiac disease, placed on a vegetarian, gluten-free diet demonstrated improved signs of arthritis in 40 percent of participants, as well as reduced gliadin antibody levels.34 And recall that we now know that the gliadin protein of wheat and related proteins of other grains are the initiating cause of increased intestinal permeability, the first step triggered after consuming cupcakes and cinnamon rolls in causing autoimmune diseases.
In my experience, arthritis unaccompanied by celiac antibodies frequently improves with wheat elimination. Some of the most dramatic health turnarounds I’ve ever witnessed have been in obtaining relief from incapacitating joint pain. Because conventional celiac antibodies fail to identify most of these people, this has been difficult to quantify and verify, beyond the subjective improvement people experience. But this may hint at phenomena that hold the greatest promise of arthritis relief for the largest number of people.
Does the outsize risk for osteoporosis and inflammatory joint disease in people with celiac represent an exaggeration of the situation in wheat-consuming people without celiac disease or antibodies to gluten? My belief is that yes, wheat exerts direct and indirect bone- and joint-destructive effects in any wheat-consuming human, just expressed more vigorously in celiac- or gluten antibody–positive people.
What if, rather than a total hip or knee replacement at age sixty-two, you opted for total wheat replacement instead?
The broader health effects of disrupted acid-base balance are only starting to be appreciated. Anyone who has taken a basic chemistry class understands that pH is a powerful factor in determining how chemical reactions proceed. A small shift in pH can have profound influence on the balance of a reaction. The same holds true in the human body.
“Healthy whole grains” such as wheat are the cause for much of the acid-heavy nature of the modern diet. Beyond bone health, emerging experiences suggest that crafting a diet that favors alkaline foods has the potential to reduce age-related muscle wasting, kidney stones, salt-sensitive hypertension, infertility, and kidney disease.
Remove wheat and experience reduced joint inflammation, reduced urinary calcium loss, and fewer blood sugar “highs” that glycate cartilage, and shift the pH balance to alkaline. It sure beats taking Vioxx.
PART THREE
SAY GOOD-BYE TO WHEAT
CHAPTER 14
GOOD-BYE, WHEAT: CREATE A HEALTHY, DELICIOUS, WHEAT-FREE LIFE
HERE’S WHERE WE get down to the real, practic
al nitty-gritty: Like trying to rid your bathing suit of sand, it can be tough to remove this ubiquitous food from eating habits, this thing that seems to cling to every nook, crack, and cranny of American diets.
People sometimes panic when they realize how much of a transformation they will need to make in the contents of their cupboards and refrigerators, in their well-worn habits of shopping, cooking, and eating. “There’s nothing left to eat! I’ll starve!” Many also recognize that more than two hours without a wheat product triggers insatiable cravings and the anxiety of withdrawal. When you see Bob and Jillian patiently hold the hands of The Biggest Loser contestants sobbing over the agony of losing only 3 pounds over a week, you have an idea of what wheat elimination can be like for some people.
Trust me, it’s worth it. If you’ve gotten this far, I assume that you are at least contemplating a divorce from this unfaithful and abusive partner. My advice: Show no mercy. Don’t dwell on the good times from twenty years ago, when angel food cake and cream puffs provided consolation after you were fired from your job, or the beautiful seven-layer cake you had at your wedding. Think of the health beatings you’ve taken, the emotional kicks in the stomach you’ve endured, regardless of the times he begged you to take him back because he has really changed.
Forget it. It won’t happen. There is no rehabilitation, only elimination. Spare yourself the divorce court theatrics: Declare yourself free of wheat, don’t ask for alimony or child support, don’t look back or reminisce about the good times. Just run.
BRACE YOURSELF FOR HEALTH
Forget everything you’ve learned about “healthy whole grains.” For years we’ve been told they should dominate our diet. This line of thinking says that a diet filled with “healthy whole grains” will make you vibrant, popular, good-looking, sexy, and successful. You will also enjoy healthy cholesterol levels and regular bowel movements. Neglect intake of whole grains and you will be unhealthy, malnourished, constipated, and succumb to heart disease or cancer. You’ll be tossed out of the country club, barred from your bowling league, ostracized from society, and condemned to a life of Preparation H and crippling disease.
Instead, remember that the need for “healthy whole grains” is pure fiction. Grains such as wheat are no more a necessary part of the human diet than personal injury attorneys are to your backyard pool party.
Let me describe a typical person with wheat deficiency: slender, flat tummy, low triglycerides, high HDL (“good”) cholesterol, normal blood sugar, normal blood pressure, high energy, good sleep, clear-headed, normal bowel function. Heart disease, type 2 diabetes, obesity, ulcerative colitis, Crohn’s disease, skin rashes, and autoimmune diseases are a rarity.
In other words, the sign that you have the “wheat deficiency syndrome” is that you’re normal, slender, and healthy.
Contrary to popular wisdom, including that of your friendly neighborhood dietitian, there is no deficiency that develops from elimination of wheat—provided the lost calories are replaced with the right foods.
If the gap left by wheat is filled with vegetables, nuts, meats, eggs, avocados, olives, cheese—i.e., real food—then not only will you not develop a dietary deficiency, but you will also enjoy better health, more energy, better sleep, weight loss, and reversal of all the abnormal phenomena we’ve discussed. If you fill the gap left by excising wheat products with corn chips, energy bars, and fruit drinks, then, yes, you will simply have replaced one undesirable group of foods with another undesirable group; you’ve achieved little. And you may indeed become deficient in several important nutrients, as well as continue in the unique American shared experience of getting fat, becoming diabetic, and increasing your reliance on the blundering healthcare system.
So removing wheat is the first step. Finding suitable replacements to fill the smaller—remember, wheat-free people naturally and unconsciously consume 400 fewer calories or more per day—calorie gap is the second step. Because I use the term “wheat” to represent all related grains, it also means removing rye, barley, emmer, einkorn, spelt, bulgur, triticale, oats, millet, sorghum, and rice, given the many ways these grains overlap in effects.
In its simplest form, a diet in which you eliminate wheat but allow all other foods to expand proportionally to fill the gap, while not perfect, is still a far cry better than the same diet that includes wheat. In other words, remove wheat and just eat a little more of the foods remaining in your diet: Eat a larger portion of baked chicken, green beans, scrambled eggs, Cobb salad, etc. You will still realize the benefits discussed here. However, I’d be guilty of oversimplifying if I suggested that all it takes is removing wheat and related grains. If ideal health is your goal, then it does indeed matter what foods you choose to fill the gap left by eliminating wheat.
Should you choose to go further than just removing wheat, you must replace lost wheat calories with real food. I distinguish real food from highly processed, herbicided, genetically modified, ready-to-eat, high-fructose corn syrup–filled, just-add-water food products, the ones packaged with cartoon characters, sports figures, and other clever marketing ploys.
This is a battle that needs to be fought on all fronts, since there are incredible societal pressures to not eat real food. Turn on the TV and you won’t see ads for cucumbers, artisanal cheeses, or eggs from locally raised chickens roaming a pasture. You will be inundated with ads for potato chips, frozen dinners, soft drinks, and the rest of the cheap-ingredient, high-markup world of processed foods, along with the direct-to-consumer ads for the drugs to “treat” the consequences of consuming these foods.
A great deal of money is spent pushing the products you need to avoid. Kellogg’s, known to the public for its breakfast cereals (about $5 billion in breakfast cereal sales in 2017), is also behind Yoplait yogurt, Häagen-Dazs ice cream, Lärabar health bars, Keebler graham crackers, Famous Amos chocolate chip cookies, and Cheez-It crackers, as well as Cheerios and Apple Jacks. These foods fill the supermarket, are highlighted at aisle end caps, strategically placed at eye level on shelves, and dominate daytime and nighttime TV. They comprise the bulk of ads in magazines. And Kellogg’s is just one food company among many. Big Food also pays for much of the “research” conducted by dietitians and nutrition scientists, they endow faculty positions at universities and colleges, and they influence the content of media. In short, they are everywhere.
And they are extremely effective. The great majority of Americans have fallen for their marketing hook, line, and sinker. It’s made even more difficult to ignore when the American Heart Association and other health organizations endorse their products. (The American Heart Association’s heart-check mark stamp of approval, for instance, has been bestowed on more than eight hundred foods, including Honey Nut Cheerios and, until recently, Cocoa Puffs.)
And here you are trying to ignore them, tune them out, and march to your own drummer.
One thing is clear: There is no nutritional deficiency that develops when you stop consuming wheat and other processed foods. Furthermore, you will simultaneously experience reduced exposure to sucrose, high-fructose corn syrup, artificial food colorings and flavors, cornstarch, herbicides such as glyphosate, and the list of unpronounceables on the product label. Again, there is no nutritional deficiency from any of this. But this hasn’t stopped the food industry and its friends at the USDA, the American Heart Association, the Academy of Nutrition and Dietetics, and the American Diabetes Association from suggesting that these foods are somehow necessary for health and that doing without them is unhealthy and leads to nutritional deficiencies. Nonsense. Absolute, unadulterated, 180-proof, whole grain nonsense.
Some people, for instance, are concerned that they will not consume sufficient fiber if they eliminate wheat. Ironically, if you replace wheat calories with those from vegetables and raw nuts, fiber intake goes up. If two slices of whole wheat bread containing 138 calories are replaced by a calorically equivalent handful of raw nuts such a
s almonds or walnuts (approximately 24 nuts), you will match or exceed the 3.9 grams of fiber from the bread. Likewise, a calorie-equivalent salad of mixed greens, carrots, and peppers will match or exceed the amount of fiber in the bread. This is, after all, how primitive hunter-gatherer cultures—the cultures that first taught us about the importance of dietary fiber—obtained their fiber: through plentiful consumption of plant foods, not bran cereals or other processed fiber sources. And fiber from sources such as garlic, onions, dandelion greens, and legumes is the prebiotic variety, i.e., fibers that nourish bowel flora in the colon, the truly essential form of fiber for health, not inert cellulose fiber—“bulk”—of grains that you pass into the toilet. Fiber intake is therefore not a concern if wheat elimination is paired with increased consumption of healthy foods.
The dietary community assumes that you live on taco chips, jelly beans, and Coca-Cola and you therefore require foods “fortified” with various vitamins. However, those assumptions fall apart if you don’t exist on what you can obtain from the local convenience store but consume real foods instead. B vitamins, such as B6, B12, folic acid, and thiamine, are added to baked, processed wheat products; dietitians therefore warn us that forgoing these products will yield vitamin B deficiencies. Also untrue. B vitamins are present in more than ample quantities in meats, vegetables, legumes, and nuts. While bread and other wheat products are required by law to have added folic acid, you’ll exceed the folic acid content of wheat products several times over just by eating a handful of sunflower seeds or asparagus. A ¼ cup of spinach or four asparagus spears, for instance, matches the quantity of folic acid in most breakfast cereals. (Also, the folates of natural sources are superior to the synthetic folic acid in fortified processed foods.) Nuts and green vegetables are exceptionally rich sources of folate and represent the way that humans were meant to obtain it. (Women who are pregnant or breastfeeding may still benefit from folate supplementation to meet their increased needs in order to prevent neural tube defects.) Likewise, vitamin B6 and thiamine are obtained in much greater amounts from four ounces of chicken or pork, an avocado, or ¼ cup of ground flaxseed than from an equivalent weight of wheat products.
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