"Wheat Belly" - A Summary
The following is a summary of the book “Wheat Belly” written by William Davis, M.D. that describes how wheat and its gluten proteins are contributors to disease.
At the heart of the matter is how wheat consumption induces the accumulation of abdominal fat (wheat belly) through transient but rapid elevations of blood sugar, which stimulates insulin, the fat storage hormone. The accumulation of abdominal fat results in what is called visceral adipose tissue (VAT). VAT becomes an active endocrine organ pumping out inflammatory mediators and hormones like estrogen. This is why you see obese men with excessive VAT develop “man breasts.” As the VAT increases, the more resistant you become to your own insulin, requiring higher and higher levels of insulin to be released in an attempt to manage elevations in blood sugar. In many individuals, this process eventually results in diabetes due to insulin resistance, and subsequently the loss of the pancreas’s ability to produce insulin.
Whole wheat bread has a higher glycemic index than table sugar (72 versus 59). The higher the glycemic index of a food type, the more easily it produces a rise in blood sugar. The glycemic index of a Snickers bar is 41 – much lower than whole wheat. Of the complex carbohydrate form of wheat, 75% is of glucose branching chain units called amylopectin A, the most digestible form of amylopectins. Amylopectin A’s easy digestion is what causes the rapid rise in blood sugar.
Wheat strains have been hybridized and cross-bread to make wheat resistant to environmental conditions such as drought and pathogens. Such changes to wheat have resulted in drastic changes in its genetic code. Even small changes in the protein structure of wheat can cause an abnormal immune response in many individuals. Glutens are the proteins in wheat, and hybridization causes a structural change to these proteins. In one hybridization experiment, fourteen new gluten proteins were identified in the offspring of wheat that were not present in the parents. When compared to century-old strains of wheat, modern wheat strains exhibit a higher amount of genes for gluten proteins that are associated with celiac disease.
Celiac disease is an autoimmune condition in which gluten triggers an immune response resulting in the body attacking the lining of the small intestine. celiac disease results in a myriad of systemic problems associated with malabsorption, secondary vitamin deficiencies, and other autoimmune conditions. Only certain individuals are prone to develop celiac disease based on a genetic predisposition. While celiac disease is the worst form of gluten sensitivity, it is only the tip of the iceberg as many other individuals without celiac disease have gluten sensitivity resulting in a wide variety of systemic signs and symptoms.
It is not just the gluten protein in wheat that is a problem for many individuals. For some, it is the rapid rise in blood sugar, and subsequent stimulation of insulin induced VAT that causes wheat belly. For other groups of individuals, it is an immune response to the non-gluten components of wheat that cause allergy type symptoms. One specific condition is called wheat-dependent exercise-induced anaphylaxis (WDEIA) in which exercise in combination with wheat consumption causes rashes, asthma, or anaphylaxis (allergic shock). And for some, it is all of the above that causes systemic illness resulting from a combination of abnormal blood sugar and insulin responses, elevations in estrogen, elevations in inflammatory mediators, and the development of autoimmune conditions.
In Dr. Davis’s experience, 30 percent of people who eliminate wheat from their diet experience withdrawal symptoms. This is not surprising since several experiments documented in his book showed how wheat adversely affects certain people with schizophrenia. A study on rats by the National Institute for Health gives us clues as to how wheat, specifically gluten, impacts brain chemistry. In this study, gluten was degraded into polypeptides using a mix of pepsin (stomach enzyme) and hydrochloric acid (stomach acid). The dominant polypeptides were isolated and administered to lab rats, and found to cross the blood-brain barrier that separates the bloodstream from the brain. Once these wheat polypeptides gained entry to the brain, they were found to bind with the brain’s morphine receptors. The researchers named this dominant polypeptide “gluteomorphin,” or morphine-like compound from gluten. What is even more compelling is that the brain effect of gluteomorphin is blocked by the administration of the drug naltrexone, the same drug given to heroin addicts to block heroin’s effect. So in summary, digestion of wheat produces morphine-like compounds that bind to the brain’s opiate receptors inducing a mild euphoria. When wheat is eliminated from the diet, some people go through a short withdrawal period. This would explain why wheat acts as an appetite stimulant and why some people experience cravings.
Another impact wheat has on brain function is even more devastating. Cerebellar ataxia is a condition in which people lose their ability to coordinate their movements. Up to 22.5 percent of people with celiac disease have nervous system involvement, and for people with unexplained ataxia, up to 50 percent have elevated markers in their blood for gluten. Antigliadin antibodies, triggered by gluten exposure bind to cells in the cerebellum and cause significant neurologic dysfunction. Gluten exposure in a subset of individuals also causes peripheral neuropathy, similar to the nerve damage diabetics may incur. In one study of thirty-five people with peripheral neuropathy who had elevated antigliadin antibodies, twenty-five of them who went on a wheat/gluten free diet improved over one year, while the ten people who did not eliminate wheat/gluten continued to deteriorate. Some individuals develop a gluten encephalopathy with wide-spread brain damage as evidenced by MRI studies. Gluten sensitivity has been clinically associated with dementia and seizures. It is clear that wheat has negative impacts on the nervous system in certain individuals, some of which are related to gluten, and some which are related to the production of the morphine-like compounds created by wheat.
Dr. Davis goes on to discuss how grains, especially wheat, contribute to excessive acidity in the body. Wheat is one of the most prolific producers of sulfuric acid in the body, only surpassed by oats. The body has mechanisms in place to keep the blood pH carefully balanced, but at the expense of bone loss. So for osteoporosis prevention and management, avoidance of grains, especially wheat, is crucial. Meat consumption also produces acidity, but protein-rich meats have other effects that partially negate the acid load. Animal protein has a bone-strengthening effect through stimulation of the hormone insulin-like growth factor, which supports bone growth and mineralization. The key to supporting a healthy more alkaline body pH is through consumption of vegetables and fruits to neutralize the acid burden from animal proteins, and avoidance of grains.
Wheat increases VAT (belly fat) and overall body weight contributing to degenerative arthritis in weight bearing joints. In addition, wheat through excessive elevations in blood sugar, contributes to a process called glycation. Glycation causes an irreversible modification of proteins in the bloodstream and body tissues, including joints. Cartilage in joints is especially susceptible to glycation as they are long-lived and not capable of reproducing themselves. Once damaged by glycation, the cartilage in joints becomes stiff and brittle, and don’t recover. Another interesting link to bone disease is that people with celiac disease have a much higher risk for osteoporosis, and elimination of gluten can increase bone mineral density. Bone loss in celiac disease is due to impaired absorption of calcium and vitamin D, along with the production of inflammatory mediators that induce bone demineralization. Even in patients without celiac disease, wheat can contribute to the progression of rheumatoid arthritis, an inflammatory arthritis. In one study, 40 percent participants with rheumatoid arthritis who were placed on a gluten free diet demonstrated improvement in signs of arthritis. Dr. Davis’s suspicion is that wheat exerts direct and indirect bone and joint destructive effects in many individuals, but more so in celiac patients, and those with elevated antibodies to gluten.
Some people with celiac disease develop a condition known as dermatitis herpetiformis (DH), a herpes-like skin rash directly related to an immune response induced by gluten. Most celiac disease patients who develop DH don’t have intestinal symptoms but still show intestinal inflammation on biopsies. Wheat gluten-related skin conditions include acne, oral ulcers, cutaneous vasculitis, acanthosis nigrans, erythema nodosum, psoriasis, vitiligo, Behcet’s disease, dermatomyositis, icthyosiform dermatosis, pyoderma gangrenosum, and alopecia areata.
For some individuals, elimination of wheat from their diet is one of the best anti-aging techniques they can do. This is because the excessive elevation of blood sugar associated with wheat consumption creates advanced glycation end products (AGE). AGEs are end products of metabolism that are associated with the ageing process in all of the body’s tissues. The higher the blood sugar, the more AGEs will accumulate and the faster the decay of aging will occur. AGEs are what contribute to the complication of diabetes – kidney disease, nerve damage, retina damage, and cardiovascular disease. The more rapid and efficient digestion of wheat amylopectin A means higher blood sugars over the following two hours after wheat ingestion, which in turns means more production of AGE products.
When it comes to cholesterol, size matters. Small LDL cholesterol particles are much more dangerous than large LDL cholesterol particles as far as their ability to cause cardiovascular disease. Very low-density lipoproteins, or VLDL are the parents of LDL particles, and diet determines what proportion will be big LDL versus small LDL. VLDL particles are rich with triglycerides, and depending on diet, more or less VLDL particles are produced by the liver. In a standard cholesterol panel, excessive VLDL will be reflected by higher levels of triglycerides. Through a series of events, VLDL particles exchange triglycerides with LDL particles for cholesterol, and then lose triglycerides resulting in smaller LDL particles. An elevation of triglycerides after a meal triggers an even greater formation of small LDL particles (the dangerous ones). Any foods that increase triglycerides and VLDL particles for several hours after eating will also increase the formation of small LDL. As it turns out, carbohydrates are the main cause of dietary induced elevations of triglycerides and VLDL just after eating. And as we know, wheat is the chief of carbohydrates. Wheat and other carbohydrates stimulate insulin, which in turn stimulates fatty acid production by the liver flooding the bloodstream with triglycerides. Depending on your genetic predisposition, this can result in sustained elevations of triglycerides, which are then packaged into VLDL particles, the precursors of small LDL particles. Carbohydrate intake and not fat intake is what stimulates triglyceride production. Carbohydrates are what stimulate insulin to cause fat deposition. When deposited in the liver, you get a fatty liver, a condition that can eventually result in cirrhosis.
Why pick on wheat? Wheat is a carbohydrate that dominates the standard American diet (SAD), and is an efficient stimulator of blood sugar elevation, triglyceride elevation, insulin production, fat deposition, and devastating immune responses. So the idea that eating whole grains is healthy is clearly not meant for everyone. If your doctor can’t tell you why you have certain conditions, try eliminating wheat from your diet for three months, and see if your condition improves. In most instances, that is clearly a safer approach than trying a different medication.
“Wheat Belly” by William Davis, M.D. is a well-written New York Times bestselling book that describes how wheat has been changed through hybridization, and how it negatively impacts the health of millions of people world-wide. It is an eye-opener. To order the book to read a more detailed description with scientific citations of the studies cited, click on the link below:
Keith R. Holden, M.D.