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HarperThorsons

An imprint of HarperCollinsPublishers 1 London Bridge Street London SE1 9GF

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First published in the USA by Rodale Inc. 2011

First published in the UK by HarperThorsons 2014

This edition 2015

© 2011, 2014 by William Davis, MD

William Davis asserts his moral right to be identified as the author of this work.

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Source ISBN: 9780007568130

Ebook Edition © FEBRUARY 2015 ISBN: 9780007568147

Version: 2015-02-03

For Dawn, Bill, Lauren and Jacob, my companions on this wheat-free journey

In order to protect the privacy of patients, some names and personal details have been changed.

CONTENTS

Cover

Title Page

Copyright

Dedication

Foreword

Introduction

PART ONE WHEAT: THE UNHEALTHY WHOLE GRAIN

Chapter 1 What Belly?

Chapter 2 Not Your Gran’s Muffins: The Creation of Modern Wheat

Chapter 3 Wheat Deconstructed

PART TWO WHEAT AND ITS HEAD-TO-TOE DESTRUCTION OF HEALTH

Chapter 4 Hey, Man, Wanna Buy Some Exorphins? The Addictive Properties of Wheat

Chapter 5 Your Wheat Belly Is Showing: The Wheat/Obesity Connection

Chapter 6 Hello, Intestine. It’s Me, Wheat. Wheat and Coeliac Disease

Chapter 7 Diabetes Nation: Wheat and Insulin Resistance

Chapter 8 Dropping Acid: Wheat as the Great pH Disrupter

Chapter 9 Cataracts, Wrinkles and Dowager’s Humps: Wheat and the Ageing Process

Chapter 10 My Particles Are Bigger Than Yours: Wheat and Heart Disease

Chapter 11 It’s All in Your Head: Wheat and the Brain

Chapter 12 Bagel Face: Wheat’s Destructive Effect on the Skin

PART THREE SAY GOODBYE TO WHEAT

Chapter 13 Goodbye, Wheat: Create a Healthy, Delicious, Wheat-Free Life

Epilogue

Appendix A Looking for Wheat in All the Wrong Places

Appendix B Healthy Wheat Belly-Shrinking Recipes

List of Searchable Terms

Acknowledgements

References

About the Publisher

FOREWORD TO THE PAPERBACK EDITION

WHEAT BELLY IS not what it used to be.

In the three years since the original Wheat Belly was published in the US, something astounding and wonderful has happened. What began as an experience in helping people reduce blood sugars, tame inflammation and regain control over appetite has evolved into a nationwide experience of lives transformed on an unprecedented scale. The few thousand people who understood this message in 2011 has now ballooned to the millions, and they are experiencing effortless weight loss and turnarounds in health across a whole spectrum of conditions.

Within weeks of its initial release, I was flooded with stories from people who, for the first time in years, finally understood why they had struggled with health, weight, appetite and pain – despite doing everything ‘right’. A man named Lucas sent a comment saying that he had tried with little success to get rid of his belly despite what he thought was a healthy diet and active lifestyle. ‘I’ve tried raw, vegan, low-carb, low-fat – and none of them had much effect and all left me with food cravings that never went away. In the month since I started Wheat Belly, I’ve lost 12 pounds,’ said Lucas. ‘The most remarkable thing for me, though – and I wasn’t really expecting it – is that after the first week of being completely grainfree, I have not had a single headache of any kind, and I have been a migraine sufferer since my teens.’

Another comment came from Cindy, a woman whose obsession with food was controlling her life. ‘I was in constant turmoil over eating; I couldn’t understand how the educated, intelligent, strongwilled person I believed myself to be could become totally defeated by food. I was completely exhausted by my preoccupation with eating, not eating, dieting, binging, crying, hating myself, dieting again, binging and hating myself more. I was at the end of my rope,’ she said. Then she found Wheat Belly and her life changed. ‘After cutting out the wheat, I could barely believe the feeling of calm that descended upon my life. The weight dropped off, my depression lifted and I too experienced all of the amazing things everyone else had reported. I now love my food, but I rarely think about it anymore.’

Multiply those wonderful stories by several thousand and you get a sense of what unfolded in just the first several months of Wheat Belly’s publication.

When the original Wheat Belly hit the bookstores, I already knew that this message had the potential to change lives, achieve astounding quantities of weight loss, and turn around conditions such as depression, eating disorders, migraine headaches, irritable bowel syndrome, diabetes, high cholesterol, skin rashes, joint pain, heart disease, fatty liver and hundreds of other conditions. I knew this because I’d already witnessed such transformations in thousands of people in my cardiology practice and online discussions, backed up by a surprising wealth of science already available. What I did not anticipate was the tidal wave of people embracing this message. I credit that to the phenomenon of social media and the awesome potential of shared experiences.

When people tell their stories on Facebook or Twitter, for instance, detailing their 56-pound weight loss over 6 months, relief from the disfigurement and pain of rheumatoid arthritis, and transitioning from barely being able to rise from a chair to running their first half-marathon, well … that makes for the kind of conversation that changes the world. It’s the same process that led to the overturn of despotic governments and the same process that can now make the difference between someone winning and losing a presidential election. We’ve now applied this miraculous, 21st-century formula to nutrition.

If you peel back the layers of the nutritional advice given to Americans by ‘official’ agencies through the U.S. Dietary Guidelines for Americans, the USDA Food Pyramid or MyPlate, and the legions of dietitians and other providers of conventional dietary advice, we find the agendas of agribusiness, Big Food and other parties who stand to profit from such advice. We do not find objective, unbiased science, interpreted by the rules of logic.

We also find that the darling of all nutritional advice, the proposed centrepiece of every meal, the widest parts of the pyramid and plate – wheat – is something different today than it was 40 years ago. Just one look at a modern stalk of wheat and you will immediately know: this is not the wheat I remember, not the wheat I’ve seen in pictures, certainly not the wheat I saw as a kid. It’s been changed. That fundamental insight – that many of our foods have been changed by the efforts of agribusiness and genetics, whether the methods were ‘genetic modification’ (using gene splicing techniques, as used to create genetically modified corn) or repetitive hybridization and mutagenesis (the purposeful induction of mutations using chemicals, gamma rays and x-rays, used to create new strains of wheat) – is a growing reality in the 21st-century. Contrary to the claim of geneticists and agribusiness, the full implications of the changes introduced into such crops are not known, but are showing themselves in a variety of ways in the humans who consume them.

Some people, understandably wary of a notion as revolutionary and potentially disruptive as doing away with all things wheat, have asked: ‘Is this elimination based solely on anecdote, or is there clinical data to back it up?’ When I first set out to understand why the removal of wheat might result in such extravagant health and weight changes, I talked to agricultural geneticists, studied their experimental data and probed the data generated by physicians to study conditions such as coeliac disease. What I found was that an astounding amount of science had already been collected that showed us the following: 1) Modern wheat has undergone change in several crucial components, such as the gliadin protein and others; 2) These changes have been associated with various effects in humans, such as intestinal inflammation outside of coeliac disease and an astounding array of mind effects; 3) Direct connections between wheat consumption and conditions such as diabetes, both type 1 and type 2, had been conclusively made … but virtually nobody had collected the data into one place nor dared question conventional advice that advocates essentially unrestrained consumption of the new modern strains of wheat.

Alongside my efforts to explore and understand the changes introduced into modern wheat were my efforts to help people rid themselves of this component of diet. One of the experiences I observed was the 38-year-old schoolteacher (whose story I tell in more detail in this book) who, on the eve of her colon-removal surgery, experienced complete relief from her ulcerative colitis, so dramatically improved that she was able to stop her medications as well as not have her colon removed. After twelve years of failed response to drugs, constant abdominal pain, diarrhoea and intermittent intestinal hemorrhage, she was now essentially cured with removal of all wheat from her diet. That experience spurred me on to share this collection of insights, or else people might undergo such awful things as colon removal or worse, never understanding that wheat is what lies at the root of the entire problem.

Thus was born Wheat Belly. And the nutritional world has never been the same.

INTRODUCTION

FLIP THROUGH YOUR parents’ or grandparents’ family albums and you’re likely to be struck by how thin everyone looks. The women probably wore size-eight dresses and the men sported 32-inch waists. Overweight was something measured only by a few pounds; obesity rare. Overweight children? Almost never. Any 42-inch waists? Not here. Fourteen-stone teenagers? Certainly not.

Why were the typical mums of the fifties and sixties, the stay-at-home housewives, as well as other people of that era, so much skinnier than the modern people we see at the beach, on the high street or in our own mirrors? While women of that era typically weighed in at 7½ to 8 stone, men at 11 or 12 stone, today we carry 4, 5, even 14 stone more.

The women of that world didn’t exercise much at all. (It was considered unseemly, after all, like having impure thoughts at church.) How many times did you see your mum put on her trainers to go out for a three-mile run? Exercise for my mother was hoovering the stairs. Nowadays I go outdoors on any nice day and see dozens of women jogging, riding their bicycles, power walking – things we’d virtually never see 40 or 50 years ago. And yet, we’re getting fatter and fatter every year.

My wife is a triathlete and triathlon instructor, so I observe a few of these extreme exercise events every year. Triathletes train intensively for months to years before a race to complete a 1- to 2½-mile open-water swim, a 56- to 112-mile bike ride, and finish with a 13- to 26-mile run. Just completing a race is a feat in itself, since the event requires up to several thousand calories and spectacular endurance. The majority of triathletes adhere to fairly healthy eating habits.

Then why are a third of these dedicated men and women athletes overweight? I give them even greater credit for having to cart around the extra 1½, 2 or 3½ stone. But, given their extreme level of sustained activity and demanding training schedule, how can they still be overweight?

If we follow conventional logic, overweight triathletes need to exercise more or eat less to lose weight. I believe that is a downright ridiculous notion. I am going to argue that the problem with the diet and health of most Americans is not fat, not sugar, not the rise of the Internet and the demise of the agrarian lifestyle. It’s wheat – or what we are being sold that is called ‘wheat’.

You will see that what we are eating, cleverly disguised as a bran muffin or onion ciabatta, is not really wheat at all but the transformed product of genetic research conducted during the latter half of the twentieth century. Modern wheat is no more real wheat than a chimpanzee is an approximation of a human. While our hairy primate relatives share 99 per cent of all genes found in humans, with longer arms, full body hair and lesser capacity to win at Quiz Night at the pub, I trust you can readily tell the difference that that 1 per cent makes. Compared to its ancestor of only forty years ago, modern wheat isn’t even that close.

I believe that the increased consumption of grains – or more accurately, the increased consumption of this genetically altered thing called modern wheat – explains the contrast between slender, sedentary people of the fifties and overweight twenty-first-century people, triathletes included.

I recognise that declaring wheat a malicious food is like declaring that Ronald Reagan was a Communist. It may seem absurd, even against nature, to demote an iconic dietary staple to the status of public health hazard. But I will make the case that the world’s most popular grain is also the world’s most destructive dietary ingredient.

Documented peculiar effects of wheat on humans include appetite stimulation, exposure to brain-active exorphins (the counterpart of internally derived endorphins), exaggerated blood sugar surges that trigger cycles of satiety alternating with heightened appetite, the process of glycation that underlies disease and ageing, inflammatory and pH effects that erode cartilage and damage bone, and activation of disordered immune responses. A complex range of diseases results from consumption of wheat, from coeliac disease – the devastating intestinal disease that develops from exposure to wheat gluten – to an assortment of neurological disorders, diabetes, heart disease, arthritis, curious rashes and the paralysing delusions of schizophrenia.

If this thing called wheat is such a problem, then removing it should yield outsize and unexpected benefits. Indeed, that is the case. As a cardiologist who sees and treats thousands of patients at risk for heart disease, diabetes and the myriad destructive effects of obesity, I have personally observed protuberant, flop-over-the-belt belly fat vanish when my patients eliminated wheat from their diets, with typical weight loss totalling 1½, 2 or 3½ stone just within the first few months. Rapid and effortless weight loss is usually followed by health benefits that continue to amaze me even today after having witnessed this phenomenon thousands of times.

I’ve seen dramatic turnarounds in health, such as the thirty-eight-year-old woman with ulcerative colitis facing colon removal who was cured with wheat elimination – colon intact. Or the twenty-six-year-old man, incapacitated and barely able to walk because of joint pain, who experienced complete relief and walked and ran freely again after taking wheat off the menu.

Extraordinary as these results may sound, there is ample scientific research to implicate wheat as the root cause of these conditions – and to indicate that removal of wheat can reduce or relieve symptoms entirely. You will see that we have unwittingly traded convenience, abundance and low cost for health, with wheat bellies, bulging thighs and double chins to prove it. Many of the arguments I make in the chapters that follow have been proven in scientific studies that are available for one and all to review. Incredibly, many of the lessons I’ve learnt were demonstrated in clinical studies decades ago, but somehow never percolated to the surface of medical or public consciousness. I’ve simply put two and two together to come up with some conclusions that you may find startling.

IT’S NOT YOUR FAULT

In the film Good Will Hunting, Matt Damon’s character, possessing uncommon genius but harbouring demons of past abuse, breaks down in sobs when psychologist Sean Maguire (Robin Williams) repeats ‘It’s not your fault’ over and over again.

Likewise, too many of us, stricken with an unsightly wheat belly, blame ourselves: too many calories, too little exercise, too little restraint. But it’s more accurate to say that the advice we’ve been given to eat more ‘healthy whole grains’ has deprived us of control over appetites and impulses, making us fat and unhealthy despite our best efforts and good intentions.

I liken the widely accepted advice to eat healthy whole grains to telling an alcoholic that, if a drink or two won’t hurt, nine or ten may be even better. Taking this advice has disastrous repercussions on health.

It’s not your fault.

If you find yourself carrying around a protuberant, uncomfortable wheat belly; unsuccessfully trying to squeeze into last year’s jeans; reassuring your doctor that, no, you haven’t been eating badly, but you’re still overweight and pre-diabetic with high blood pressure and cholesterol; or desperately trying to conceal a pair of humiliating man breasts, consider saying goodbye to wheat.

Eliminate the wheat, eliminate the problem.

What have you got to lose except your wheat belly, your man breasts or your bagel butt?

CHAPTER 1

WHAT BELLY?

The scientific physician welcomes the establishment of a standard loaf of bread made according to the best scientific evidence. . . . Such a product can be included in diets both for the sick and for the well with a clear understanding of the effect that it may have on digestion and growth.

Morris Fishbein, MD,

editor, Journal of the American Medical Association, 1932

IN CENTURIES PAST, a prominent belly was the domain of the privileged, a mark of wealth and success, a symbol of not having to clean your own stables or plough your own field. In this century, you don’t have to plough your own field. Today, obesity has been democratised: everybody can have a big belly. Your dad called his rudimentary mid-twentieth-century equivalent a beer belly. But what are mums, kids and half of your friends and neighbours who don’t drink beer doing with a beer belly?

I call it wheat belly, though I could have just as easily called this condition pretzel brain or bagel bowel or biscuit face since there’s not an organ system unaffected by wheat. But wheat’s impact on the waistline is its most visible and defining characteristic, an outward expression of the grotesque distortions humans experience with consumption of this grain.

A wheat belly represents the accumulation of fat that results from years of consuming foods that trigger insulin, the hormone of fat storage. While some people store fat in their buttocks and thighs, most people collect ungainly fat around the middle. This ‘central’ or ‘visceral’ fat is unique. Unlike fat in other body areas, it provokes inflammatory phenomena, distorts insulin responses and issues abnormal metabolic signals to the rest of the body. In the unwitting wheat-bellied male, visceral fat also produces oestrogen, creating ‘man breasts’.

The consequences of wheat consumption, however, are not just manifested on the body’s surface; wheat can also reach deep down into virtually every organ of the body, from the intestines, liver, heart and thyroid gland all the way up to the brain. In fact, there’s hardly an organ that is not affected by wheat in some potentially damaging way.

PANTING AND SWEATING IN THE HEARTLAND

I practise preventive cardiology in Milwaukee. Like many other midwestern cities, Milwaukee is a good place to live and raise a family. City services work pretty well, the libraries are first-rate, my kids go to high-quality state schools and the population is just large enough to enjoy big-city culture, such as an excellent symphony and art museum. The people living here are a fairly friendly bunch. But . . . they’re fat.

I don’t mean a little bit fat. I mean really, really fat. I mean panting-and-sweating-after-one-flight-of-stairs fat. I mean 17-stone 18-year-old women, 4x4s tipped sharply to the driver’s side, double-wide wheelchairs, hospital equipment unable to accommodate patients who tip the scales at 25 stone or more. (Not only can’t they fit into the CT scanner or other imaging device, you wouldn’t be able to see anything even if they could. It’s like trying to determine whether the image in the murky ocean water is a flounder or a shark.)

Once upon a time, an individual weighing 17 stone or more was a rarity; today it’s a common sight among the men and women walking the streets, as humdrum as selling jeans at Gap. Retired people are overweight or obese, as are middle-aged adults, young adults, teenagers, even children. White-collar workers are fat, blue-collar workers are fat. The sedentary are fat and so are athletes. White people are fat, black people are fat, Hispanics are fat, Asians are fat. Carnivores are fat, vegetarians are fat. Americans are plagued by obesity on a scale never before seen in the human experience. No demographic has escaped the weight gain crisis.

Ask the USDA or the Surgeon General’s office and they will tell you that Americans are fat because they drink too many fizzy drinks, eat too many crisps, drink too much beer, and don’t exercise enough. And those things may indeed be true. But that’s hardly the whole story.

Many overweight people, in fact, are quite health conscious. Ask anyone tipping the scales over 17 stone: What do you think happened to allow such incredible weight gain? You may be surprised at how many do not say ‘I drink Big Gulps, eat Pop Tarts and watch TV all day.’ Most will say something like ‘I don’t get it. I exercise five days a week. I’ve cut my fat and increased my healthy whole grains. Yet I can’t seem to stop gaining weight!’

HOW DID WE GET HERE?

The national trend to reduce fat and cholesterol intake and increase carbohydrate calories has created a peculiar situation in which products made from wheat have not just increased their presence in our diets; they have come to dominate our diets. For most Americans, every single meal and snack contains foods made with wheat flour. It might be the main course, it might be the side dish, it might be the dessert – and it’s probably all of them.

Wheat has become the national icon of health: ‘Eat more healthy whole grains’, we’re told, and the food industry happily jumped on board, creating ‘heart healthy’ versions of all our favourite wheat products chock-full of whole grains.

The sad truth is that the proliferation of wheat products in the American diet parallels the expansion of our waists. Advice to cut fat and cholesterol intake and replace the calories with whole grains that was issued by the National Heart, Lung, and Blood Institute through its National Cholesterol Education Program in 1985 coincides precisely with the start of a sharp upwards climb in body weight for men and women. Ironically, 1985 also marks the year when the Centers for Disease Control and Prevention (CDC) began tracking body-weight statistics, tidily documenting the explosion in obesity and diabetes that began that very year.

Of all the grains in the human diet, why only pick on wheat? Because wheat, by a considerable margin, is the dominant source of gluten protein in the human diet. Unless they’re Euell Gibbons (Texas-born champion of natural diets in the 1960s), most people don’t eat much rye, barley, spelt, triticale, bulgur, kamut or other less common gluten sources; wheat consumption overshadows consumption of other gluten-containing grains by more than a hundred to one. Wheat also has unique attributes those other grains do not, attributes that make it especially destructive to our health, which I will cover in later chapters. But I focus on wheat because, in the vast majority of American diets, gluten exposure can be used interchangeably with wheat exposure. For that reason, I often use wheat to signify all gluten-containing grains.

The health impact of Triticum aestivum, common bread wheat, and its genetic brethren ranges far and wide, with curious effects from mouth to anus, brain to pancreas, Appalachian housewife to Wall Street arbitrageur.

If it sounds crazy, bear with me. I make these claims with a clear, wheat-free conscience.

NUTRI-GROAN

Like most children of my generation, born in the middle of the twentieth century and reared on Wonder Bread and Devil Dogs, I have a long and close personal relationship with wheat. My sisters and I were veritable connoisseurs of sugary breakfast cereals, making our own individual blends of Trix, Lucky Charms and Froot Loops and eagerly drinking the sweet, pastel-hued milk that remained at the bottom of the bowl. The Great American Processed Food Experience didn’t end at breakfast, of course. For school lunch my mum usually packed peanut butter or bologna sandwiches, the prelude to cellophane-wrapped Ho Hos and Scooter Pies. Sometimes she would throw in a few Oreos or Vienna Fingers, too. For supper, we loved the TV dinners that came packaged in their own foil plates, allowing us to consume our battered chicken, corn muffin, and apple brown betty in front of the TV.

My first year of college, armed with an all-you-can-eat dining room ticket, I gorged on waffles and pancakes for breakfast, fettuccine Alfredo for lunch, pasta with Italian bread for dinner. Poppy seed muffin or angel food cake for dessert? You bet! Not only did I gain a hefty spare tire around the middle at the age of nineteen, I felt exhausted all the time. For the next twenty years, I battled this effect, drinking gallons of coffee, struggling to shake off the pervasive stupor that persisted no matter how many hours I slept each night.

Yet none of this really registered until I caught sight of a photo my wife snapped of me while on holiday with our kids, then ages ten, eight, and four, on Marco Island, Florida. It was 1999.

In the picture, I was fast asleep on the sand, my flabby abdomen splayed to either side, my second chin resting on my crossed flabby arms.

That’s when it really hit me: I didn’t just have a few extra pounds to lose, I had a good thirty pounds of accumulated weight around my middle. What must my patients be thinking when I counselled them on diet? I was no better than the doctors of the sixties puffing on Marlboros while advising their patients to live healthier lives.

Why did I have those extra pounds under my belt? After all, I jogged three to five miles every day, ate a sensible, balanced diet that didn’t include excessive quantities of meats or fats, avoided junk foods and snacks, and instead concentrated on getting plenty of healthy whole grains. What was going on here?

Sure, I had my suspicions. I couldn’t help but notice that on the days when I’d eat toast, waffles or bagels for breakfast, I’d stumble through several hours of sleepiness and lethargy. But eat a three-egg omelette with cheese, feel fine. Some basic laboratory work, though, really stopped me in my tracks. Triglycerides: 350 mg/dl; HDL (‘good’) cholesterol: 27 mg/dl. And I was diabetic, with a fasting blood sugar of 161 mg/dl. Jogging nearly every day but I was overweight and diabetic? Something had to be fundamentally wrong with my diet. Of all the changes I had made in my diet in the name of health, boosting my intake of healthy whole grains had been the most significant. Could it be that the grains were actually making me fatter?

That moment of flabby realisation began the start of a journey, following the trail of crumbs back from being overweight and all the health problems that came with it. But it was when I observed even greater effects on a larger scale beyond my own personal experience that I became convinced that there really was something interesting going on.

LESSONS FROM A WHEAT-FREE EXPERIMENT

An interesting fact: whole-wheat bread (glycaemic index 72) increases blood sugar as much as or more than table sugar, or sucrose (glycaemic index 59). (Glucose increases blood sugar to 100, hence a glycaemic index of 100. The extent to which a particular food increases blood sugar relative to glucose determines that food’s glycaemic index.) So when I was devising a strategy to help my overweight, diabetes-prone patients reduce blood sugar most efficiently, it made sense to me that the quickest and simplest way to get results would be to eliminate the foods that caused their blood sugar to rise most profoundly: in other words, not sugar, but wheat. I provided a simple handout detailing how to replace wheat-based foods with other low-glycaemic whole foods to create a healthy diet.

After three months, my patients returned to have more blood work done. As I had anticipated, with only rare exceptions, blood sugar (glucose) had indeed often dropped from diabetic range (126 mg/dl or greater) to normal. Yes, diabetics became nondiabetics. That’s right: diabetes in many cases can be cured – not simply managed – by removal of carbohydrates, especially wheat, from the diet. Many of my patients had also lost twenty, thirty, even forty pounds.

But it’s what I didn’t expect that astounded me.

They reported that symptoms of acid reflux disappeared and the cyclic cramping and diarrhoea of irritable bowel syndrome were gone. Their energy improved, they had greater focus, sleep was deeper. Rashes disappeared, even rashes that had been present for many years. Their rheumatoid arthritis pain improved or disappeared, enabling them to cut back, even eliminate, the nasty medications used to treat it. Asthma symptoms improved or resolved completely, allowing many to throw away their inhalers. Athletes reported more consistent performance.

Thinner. More energetic. Clearer thinking. Better bowel, joint and lung health. Time and time again. Surely these results were reason enough to forgo wheat.

What convinced me further were the many instances in which people removed wheat, then permitted themselves a wheat indulgence: a couple of pretzels, a canapé at a cocktail party. Within minutes, many would experience diarrhoea, joint swelling and pain, or wheezing. On again, off again, the phenomenon would repeat itself.

What started out as a simple experiment in reducing blood sugars exploded into an insight into multiple health conditions and weight loss that continues to amaze me even today.

A RADICAL WHEAT-ECTOMY

For many, the idea of removing wheat from the diet is, at least psychologically, as painful as the thought of having root-canal treatment without anaesthesia. For some, the process can indeed have uncomfortable side effects akin to withdrawal from cigarettes or alcohol. But this procedure must be performed to permit the patient to recover.

Wheat Belly explores the proposition that the health problems of Americans, from fatigue to arthritis to gastrointestinal distress to obesity, originate with the innocent-looking bran muffin or cinnamon raisin bagel you down with your coffee every morning.

The good news: there is a cure for this condition called wheat belly – or, if you prefer, pretzel brain, bagel bowel or biscuit face.

The bottom line: elimination of this food, part of human culture for more centuries than Larry King was on the air, will make you sleeker, smarter, faster and happier. Weight loss, in particular, can proceed at a pace you didn’t think possible. And you can selectively lose the most visible, insulin-opposing, diabetes-creating, inflammation-producing, embarrassment-causing fat: belly fat. It is a process accomplished with virtually no hunger or deprivation, with a wide spectrum of health benefits.

So why eliminate wheat rather than, say, sugar, or all grains in general? The next chapter will explain why wheat is unique among modern grains in its ability to convert quickly to blood sugar. In addition, it has a poorly understood and understudied genetic makeup and addictive properties that actually cause us to overeat even more; has been linked to literally dozens of debilitating ailments beyond those associated with overweight; and has infiltrated almost every aspect of our diet. Sure, cutting out refined sugar is probably a good idea, as it provides little or no nutritional benefit and will also impact your blood sugar in a negative way. But for the most bang for your buck, eliminating wheat is the easiest and most effective step you can take to safeguard your health and trim your waistline.

CHAPTER 2

NOT YOUR GRAN’S MUFFINS: THE CREATION OF MODERN WHEAT

He is as good as good bread.

Miguel de Cervantes,

Don Quixote

WHEAT, MORE THAN any other foodstuff (including sugar, fat and salt), is woven into the fabric of the Western food experience, a trend that began even before 1950s US TV show Ozzie met Harriet. It has become such a ubiquitous part of our diet in so many ways that it seems essential to our lifestyle. What would a fry-up be without toast, lunch without sarnies, bacon butty without bread, picnics without hot-dog buns, dip without crackers, hummus without pitta, coffee without a croissant, apple pie without the pastry?

IF IT’S TUESDAY, IT MUST BE WHEAT

I once measured the length of the bread aisle at my local supermarket: sixty-eight feet.

That’s sixty-eight feet of white bread, whole-wheat bread, multi-grain bread, seven-grain bread, rye bread, pumpernickel bread, sourdough bread, Italian bread, French bread, bread sticks, white bagels, raisin bagels, cheese bagels, garlic bagels, oat bread, flax bread, pitta bread, dinner rolls, Kaiser rolls, poppy seed rolls, hamburger buns, and fourteen varieties of hot dog buns. That’s not even counting the bakery and the additional forty feet of shelves packed with a variety of ‘artisanal’ wheat products.

And then there’s the snack aisle with forty-something brands of crackers and twenty-seven brands of pretzels. The baking aisle has bread crumbs and croutons. The dairy case has dozens of those tubes you crack open to bake rolls, Danish pastries and croissants.

Breakfast cereals fill a world unto themselves, usually enjoying a monopoly over an entire supermarket aisle, top to bottom shelf.

There’s much of an aisle devoted to boxes and bags of pasta and noodles: spaghetti, lasagna, penne, elbows, shells, whole-wheat pasta, green spinach pasta, orange tomato pasta, egg noodles, tiny-grained couscous to seven-inch-wide lasagne sheets.

How about frozen foods? The freezer has hundreds of noodle, pasta and wheat-containing side dishes to accompany the meat loaf and roast beef au jus.

In fact, apart from the detergent and soap aisle, there’s barely a shelf that doesn’t contain wheat products. Can you blame Americans if they’ve allowed wheat to dominate their diets? After all, it’s in practically everything.

Wheat as a crop has succeeded on an unprecedented scale, exceeded only by corn in acreage of farmland planted. It is, by a long stretch, among the most consumed grains on earth, constituting 20 per cent of all calories consumed.

And wheat has been an undeniable financial success. How many other ways can a manufacturer transform five pence worth of raw material into £2.50 worth of glitzy, consumer-friendly product, topped off with endorsements from the American Heart Association? In most cases, the cost of marketing these products exceeds the cost of the ingredients themselves.

Foods made partly or entirely of wheat for breakfast, lunch, dinner and snacks have become the rule. Indeed, such a regimen would make the USDA, the Whole Grains Council, the Whole wheat Council, the American Dietetic Association, the American Diabetes Association and the American Heart Association happy, knowing that their message to eat more ‘healthy whole grains’ has gained a wide and eager following.

So why has this seemingly benign plant that sustained generations of humans suddenly turned on us? For one thing, it is not the same grain our forebears ground into their daily bread. Wheat naturally evolved to only a modest degree over the centuries, but it has changed dramatically in the past fifty years under the influence of agricultural scientists. Wheat strains have been hybridised, crossbred and introgressed to make the wheat plant resistant to environmental conditions, such as drought, or pathogens, such as fungi. But most of all, genetic changes have been induced to increase yield per acre. The average yield on a modern North American farm is more than tenfold greater than farms of a century ago. Such enormous strides in yield have required drastic changes in genetic code, including reducing the proud ‘amber waves of grain’ of yesteryear to the rigid, eighteen-inch-tall high-production ‘dwarf’ wheat of today. Such fundamental genetic changes, as you will see, have come at a price.

Even in the few decades since our American grandmothers survived Prohibition and danced the Big Apple, wheat has undergone countless transformations. As the science of genetics has progressed over the past fifty years, permitting human intervention at a much more rapid rate than nature’s slow, year-by-year breeding influence, the pace of change has increased exponentially. The genetic backbone of your high-tech poppy-seed muffin has achieved its current condition by a process of evolutionary acceleration that makes us look like Homo habilis trapped somewhere in the early Pleistocene.

FROM NATUFIAN PORRIDGE TO DOUGHNUT HOLES

‘Give us this day our daily bread.’

It’s in the Bible. In Deuteronomy, Moses describes the Promised Land as ‘a land of wheat and barley and vineyards’. Bread is central to religious ritual. Jews celebrate Passover with unleavened matzo to commemorate the flight of the Israelites from Egypt. Christians consume wafers representing the body of Christ. Muslims regard unleavened naan as sacred, insisting it be stored upright and never thrown away in public. In the Bible, bread is a metaphor for bountiful harvest, a time of plenty, freedom from starvation, even a source of salvation.

Don’t we break bread with friends and family? Isn’t something new and wonderful ‘the best thing since sliced bread’? ‘Taking the bread out of someone’s mouth’ is to deprive that person of a fundamental necessity. Bread is a nearly universal diet staple: chapati in India, tsoureki in Greece, pitta in the Middle East, aebleskiver in Denmark, naan bya for breakfast in Burma, glazed doughnuts any old time in the United States.

The notion that a foodstuff so fundamental, so deeply ingrained in the human experience, can be bad for us is, well, unsettling and counter to long-held cultural views of wheat and bread. But today’s bread bears little resemblance to the loaves that emerged from our forebears’ ovens. Just as a modern Napa Cabernet Sauvignon is a far cry from the crude ferment of fourth-century BC Georgian winemakers who buried wine urns in underground mounds, so has wheat changed. Bread and other foods made of wheat have sustained humans for centuries, but the wheat of our ancestors is not the same as modern commercial wheat that reaches your breakfast, lunch and dinner table. From the original strains of wild grass harvested by early humans, wheat has exploded to more than 25,000 varieties, virtually all of them the result of human intervention.

In the waning days of the Pleistocene, around 8500 BC, millennia before any Christian, Jew or Muslim walked the earth, before the Egyptian, Greek and Roman empires, the Natufians led a semi-nomadic life roaming the Fertile Crescent (now Syria, Jordan, Lebanon, Israel and Iraq), supplementing their hunting and gathering by harvesting indigenous plants. They harvested the ancestor of modern wheat, einkorn, from fields that flourished wildly in open plains. Meals of gazelle, boar, fowl and ibex were rounded out with dishes of wild-growing grain and fruit. Relics like those excavated at the Tell Abu Hureyra settlement in what is now central Syria suggest skilled use of tools such as sickles and mortars to harvest and grind grains, as well as storage pits for stockpiling harvested food. Remains of harvested wheat have been found at archaeological digs in Tell Aswad, Jericho, Nahal Hemar, Navali Cori and other locales. Wheat was ground by hand, then eaten as porridge. The modern concept of bread leavened by yeast would not come along for several thousand years.

Natufians harvested wild einkorn wheat and may have purposefully stored seeds to sow in areas of their own choosing the next season. Einkorn wheat eventually became an essential component of the Natufian diet, reducing the need for hunting and gathering. The shift from harvesting wild grain to cultivating it was a fundamental change that shaped their subsequent migratory behaviour, as well as the development of tools, language and culture. It marked the beginning of agriculture, a lifestyle that required long-term commitment to more or less permanent settlement, a turning point in the course of human civilisation. Growing grains and other foods yielded a surplus of food that allowed for occupational specialisation, government and all the elaborate trappings of culture (while, in contrast, the absence of agriculture arrested cultural development at something resembling Neolithic life).

Over most of the ten thousand years that wheat has occupied a prominent place in the caves, huts and adobes and on the tables of humans, what started out as harvested einkorn, then emmer, followed by cultivated Triticum aestivum, changed gradually and only in small fits and starts. The wheat of the seventeenth century was the wheat of the eighteenth century, which in turn was much the same as the wheat of the nineteenth century and the first half of the twentieth century. Riding your oxcart through the countryside during any of these centuries, you’d see fields of four-foot tall ‘amber waves of grain’ swaying in the breeze. Crude human wheat breeding efforts yielded hit-and-miss, year-over-year incremental modifications, some successful, most not, and even a discerning eye would be hard pressed to tell the difference between the wheat of early twentieth-century farming from its many centuries of predecessors.

During the nineteenth and early twentieth centuries, as in many preceding centuries, wheat changed little. The Pillsbury’s Best XXXX flour my grandmother used to make her famous sour cream muffins in 1940 was little different from the flour of her great-grandmother sixty years earlier or, for that matter, from that of a relative two centuries before that. Grinding of wheat had become more mechanised in the twentieth century, yielding finer flour on a larger scale, but the basic composition of the flour remained much the same.

That all ended in the latter part of the twentieth century, when an upheaval in hybridisation methods transformed this grain. What now passes for wheat has changed, not through the forces of drought or disease or a Darwinian scramble for survival, but through human intervention. As a result, wheat has undergone a more drastic transformation than Joan Rivers, stretched, sewed, cut, and stitched back together to yield something entirely unique, nearly unrecognisable when compared to the original and yet still called by the same name: wheat.

Modern commercial wheat production has been intent on delivering features such as increased yield, decreased production costs and large-scale production of a consistent commodity. All the while, virtually no questions have been asked about whether these features are compatible with human health. I submit that, somewhere along the way during wheat’s history, perhaps five thousand years ago but more likely fifty years ago, wheat changed.

The result: a loaf of bread, biscuit, or pancake of today is different than its counterpart of a thousand years ago, different even from what our grandmothers made. They might look the same, even taste much the same, but there are biochemical differences. Small changes in wheat protein structure can spell the difference between a devastating immune response to wheat protein versus no immune response at all.

WHEAT BEFORE GENETICISTS GOT HOLD OF IT

Wheat is uniquely adaptable to environmental conditions, growing in Jericho, 850 feet below sea level, to Himalayan mountainous regions 10,000 feet above sea level. Its latitudinal range is also wide, ranging from as far north as Norway, 65° north latitude, to Argentina, 45° south latitude. Wheat occupies sixty million acres of farmland in the United States, an area equal to the state of Ohio. Worldwide, wheat is grown on an area ten times that figure, or twice the total acreage of Western Europe.

The first wild, then cultivated, wheat was einkorn, the great-granddaddy of all subsequent wheat. Einkorn has the simplest genetic code of all wheat, containing only fourteen chromosomes. Circa 3300 BC, hardy, cold-tolerant einkorn wheat was a popular grain in Europe. This was the age of the Tyrolean Iceman, fondly known as Ötzi. Examination of the intestinal contents of this naturally mummified Late Neolithic hunter, killed by attackers and left to freeze in the mountain glaciers of the Austrian/Italian Alps, revealed the partially digested remains of einkorn wheat consumed as unleavened flatbread, along with remains of plants, deer and ibex meat.¹

Shortly after the cultivation of the first einkorn plant, the emmer variety of wheat, the natural offspring of parents einkorn and an unrelated wild grass, Aegilops speltoides or goatgrass, made its appearance in the Middle East.² Goatgrass added its genetic code to that of einkorn, resulting in the more complex twenty-eight-chromosome emmer wheat. Plants such as wheat have the ability to retain the sum of the genes of their forebears. Imagine that, when your parents mated to create you, rather than mixing chromosomes and coming up with forty-six chromosomes to create their offspring, they combined forty-six chromosomes from Mum with forty-six chromosomes from Dad, totalling ninety-two chromosomes in you. This, of course, doesn’t happen in higher species. Such additive accumulation of chromosomes in plants is called polyploidy.

Einkorn and its evolutionary successor emmer wheat remained popular for several thousand years, sufficient to earn their place as food staples and religious icons, despite their relatively poor yield and less desirable baking characteristics compared to modern wheat. (These denser, cruder flours would have yielded lousy ciabattas or bear claws.) Emmer wheat is probably what Moses referred to in his pronouncements, as well as the kussemeth mentioned in the Bible, and the variety that persisted up until the dawn of the Roman Empire.

Sumerians, credited with developing the first written language, left us tens of thousands of cuneiform tablets. Pictographic characters scrawled on several tablets, dated to 3000 BC, describe recipes for breads and pastries, all made by taking pestle and mortar or a hand-pushed grinding wheel to emmer wheat. Sand was often added to the mixture to hasten the laborious grinding process, leaving bread-eating Sumerians with sand-chipped teeth.

Emmer wheat flourished in ancient Egypt, its cycle of growth suited to the seasonal rise and fall of the Nile. Egyptians are credited with learning how to make bread ‘rise’ by the addition of yeast. When the Jews fled Egypt, in their hurry they failed to take the leavening mixture with them, forcing them to consume unleavened bread made from emmer wheat.

Sometime in the millennia predating biblical times, twenty-eight-chromosome emmer wheat (Triticum turgidum) mated naturally with another grass, Triticum tauschii, yielding primordial forty-two-chromosome Triticum aestivum, genetically closest to what we now call wheat. Because it contains the sum total of the chromosomal content of three unique plants with forty-two chromosomes, it is the most genetically complex. It is therefore the most genetically ‘pliable’, an issue that will serve future genetics researchers well in the millennia to come.

Over time, the higher yielding and more baking-compatible Triticum aestivum species gradually overshadowed its parents einkorn and emmer wheat. For many ensuing centuries, Triticum aestivum wheat changed little. By the mid-eighteenth century, the great Swedish botanist and biological cataloguer, Carolus Linnaeus, father of the Linnean system of the categorisation of species, counted five different varieties falling under the Triticum genus.

Wheat did not evolve naturally in the New World, but was introduced by Christopher Columbus, whose crew first planted a few grains in Puerto Rico in 1493. Spanish explorers accidentally took wheat seeds in a sack of rice to Mexico in 1530, and later introduced it to the American southwest. The namer of Cape Cod and discoverer of Martha’s Vineyard, Bartholomew Gosnold, first took wheat to New England in 1602, followed shortly thereafter by the Pilgrims, who transported wheat with them on the Mayflower.

The Real Wheat

What was the wheat grown ten thousand years ago and harvested by hand from wild fields like? That simple question took me to the Middle East – or more precisely, to a small organic farm in western Massachusetts.

There I found Elisheva Rogosa. Eli is not only a science teacher but an organic farmer, advocate of sustainable agriculture and founder of the Heritage Wheat Conservancy (www.growseed.org), an organisation devoted to preserving ancient food crops and cultivating them using organic principles. After living in the Middle East for ten years and working with the Jordanian, Israeli and Palestinian GenBank project to collect nearly extinct ancient wheat strains, Eli returned to the United States with seeds descended from the original wheat plants of ancient Egypt and Canaan. She has since devoted herself to cultivating the ancient grains that sustained her ancestors.

My first contact with Ms Rogosa began with an exchange of emails that resulted from my request for two pounds (900 grams) of einkorn wheat grain. She couldn’t stop herself from educating me about her unique crop, which was not just any old wheat grain, after all. Eli described the taste of einkorn bread as ‘rich, subtle, with more complex flavour,’ unlike bread made from modern wheat flour, which she claimed tasted like cardboard.

Eli bristles at the suggestion that wheat products might be unhealthy, citing instead the yield-increasing, profit-expanding agricultural practices of the past few decades as the source of adverse health effects of wheat. She views einkorn and emmer as the solution, restoring the original grasses, grown under organic conditions, to replace modern industrial wheat.

And so it went, a gradual expansion of the reach of wheat plants with only modest and gradual evolutionary selection at work.

Today einkorn, emmer, and the original wild and cultivated strains of Triticum aestivum have been replaced by thousands of modern human-bred offspring of Triticum aestivum, as well as Triticum durum (pasta) and Triticum compactum (very fine flours used to make cupcakes and other products). To find einkorn or emmer today, you’d have to look for the limited wild collections or modest human plantings scattered around the Middle East, southern France, and northern Italy. Courtesy of modern human-designed hybridisations, Triticum species of today are hundreds, perhaps thousands, of genes apart from the original einkorn wheat that bred naturally.

Triticum wheat of today is the product of breeding to generate greater yield and characteristics such as disease, drought and heat resistance. In fact, wheat has been modified by humans to such a degree that modern strains are unable to survive in the wild without human support such as nitrate fertilisation and pest control.³ (Imagine this bizarre situation in the world of domesticated animals: an animal able to exist only with human assistance, such as special feed, or else it would die.)

Differences between the wheat of the Natufians and what we call wheat in the twenty-first century would be evident to the naked eye. Original einkorn and emmer wheat were ‘hulled’ forms, in which the seeds clung tightly to the stem. Modern wheats are ‘naked’ forms, in which the seeds depart from the stem more readily, a characteristic that makes threshing (separating the edible grain from the inedible chaff) easier and more efficient, determined by mutations at the Q and Tg (tenacious glume) genes.⁴ But other differences are even more obvious. Modern wheat is much shorter. The romantic notion of tall fields of wheat grain gracefully waving in the wind has been replaced by ‘dwarf’ and ‘semi-dwarf’ varieties that stand barely a foot or two tall, yet another product of breeding experiments to increase yield.

SMALL IS THE NEW BIG

For as long as humans have practised agriculture, farmers have strived to increase yield. Marrying a woman with a dowry of several acres of farmland was, for many centuries, the primary means of increasing crop yield, arrangements often accompanied by several goats and a sack of rice. The twentieth century introduced mechanised farm machinery, which replaced animal power and increased efficiency and yield with less manpower, providing another incremental increase in yield per acre. While production in the United States was usually sufficient to meet demand (with distribution limited more by poverty than by supply), many other nations worldwide were unable to feed their populations, resulting in widespread hunger.

In modern times, humans have tried to increase yield by creating new strains, crossbreeding different wheats and grasses and generating new genetic varieties in the laboratory. Hybridisation efforts involve techniques such as introgression and ‘back-crossing’, in which offspring of plant breeding are mated with their parents or with different strains of wheat or even other grasses. Such efforts, though first formally described by Austrian priest and botanist Gregor Mendel in 1866, did not begin in earnest until the mid-twentieth century, when concepts such as heterozygosity and gene dominance were better understood. Since Mendel’s early efforts, geneticists have developed elaborate techniques to obtain a desired trait, though much trial and error is still required.

Much of the current world supply of purposefully bred wheat is descended from strains developed at the International Maize and Wheat Improvement Center (IMWIC), located east of Mexico City at the foot of the Sierra Madre Oriental mountains. IMWIC began as an agricultural research programme in 1943 through a collaboration of the Rockefeller Foundation and the Mexican government to help Mexico achieve agricultural self-sufficiency. It grew into an impressive worldwide effort to increase the yield of corn, soya and wheat, with the admirable goal of reducing world hunger. Mexico provided an efficient proving ground for plant hybridisation, since the climate allows two growing seasons per year, cutting the time required to hybridise strains by half. By 1980, these efforts had produced thousands of new strains of wheat, the most high-yielding of which have since been adopted worldwide, from Third World countries to modern industrialised nations, including the United States.

One of the practical difficulties solved during IMWIC’s push to increase yield is that, when large quantities of nitrogen-rich fertiliser are applied to wheat fields, the seed head at the top of the plant grows to enormous proportions. The top-heavy seed head, however, buckles the stalk (what agricultural scientists call ‘lodging’). Buckling kills the plant and makes harvesting problematic. University of Minnesota-trained geneticist Norman Borlaug, working at IMWIC, is credited with developing the exceptionally high-yielding dwarf wheat that was shorter and stockier, allowing the plant to maintain erect posture and resist buckling under the large seed head. Tall stalks are also inefficient; short stalks reach maturity more quickly, which means a shorter growing season with less fertiliser required to generate the otherwise useless stalk.

Dr Borlaug’s wheat-hybridising accomplishments earned him the title of ‘Father of the Green Revolution’ in the agricultural community, as well as the Presidential Medal of Freedom, the Congressional Gold Medal, and the Nobel Peace Prize in 1970. On his death in 2009, the Wall Street Journal eulogised him: ‘More than any other single person, Borlaug showed that nature is no match for human ingenuity in setting the real limits to growth.’ Dr Borlaug lived to see his dream come true: his high-yield dwarf wheat did indeed help solve world hunger, with the wheat crop yield in China, for example, increasing eightfold from 1961 to 1999.

Dwarf wheat today has essentially replaced most other strains of wheat in the United States and much of the world thanks to its extraordinary capacity for high yield. According to Allan Fritz, PhD, professor of wheat breeding at Kansas State University, dwarf and semi-dwarf wheat now comprise more than 99 per cent of all wheat grown worldwide.

BAD BREEDING

The peculiar oversight in the flurry of breeding activity, such as that conducted at IMWIC, was that, despite dramatic changes in the genetic make-up of wheat and other crops, no animal or human safety testing was conducted on the new genetic strains that were created. So intent were the efforts to increase yield, so confident were plant geneticists that hybridisation yielded safe products for human consumption, so urgent was the cause of world hunger, that these products of agricultural research were released into the food supply without human safety concerns being part of the equation.

It was simply assumed that, because hybridisation and breeding efforts yielded plants that remained essentially ‘wheat’, new strains would be perfectly well tolerated by the consuming public. Agricultural scientists, in fact, scoff at the idea that hybridisation has the potential to generate hybrids that are unhealthy for humans. After all, hybridisation techniques have been used, albeit in cruder form, in crops, animals, even humans for centuries. Mate two varieties of tomatoes, you still get tomatoes, right? What’s the problem? The question of animal or human safety testing is never raised. With wheat, it was likewise assumed that variations in gluten content and structure, modifications of other enzymes and proteins, qualities that confer susceptibility or resistance to various plant diseases, would all make their way to humans without consequence.

Judging by research findings of agricultural geneticists, such assumptions may be unfounded and just plain wrong. Analyses of proteins expressed by a wheat hybrid compared to its two parent strains have demonstrated that, while approximately 95 per cent of the proteins expressed in the offspring are the same, 5 per cent are unique, found in neither parent.⁵ Wheat gluten proteins, in particular, undergo considerable structural change with hybridisation. In one hybridisation experiment, fourteen new gluten proteins were identified in the offspring that were not present in either parent wheat plant.⁶ Moreover, when compared to century-old strains of wheat, modern strains of Triticum aestivum express a higher quantity of genes for gluten proteins that are associated with coeliac disease.⁷

A Good Grain Gone Bad?

Given the genetic distance that has evolved between modern-day wheat and its evolutionary predecessors, is it possible that ancient grains such as emmer and einkorn can be eaten without the unwanted effects that attach to other wheat products?

I decided to put einkorn to the test, grinding 900 grams of whole grain to flour, which I then used to make bread. I also ground conventional organic whole-wheat flour from seed. I made bread from both the einkorn and conventional flour using only water and yeast with no added sugars or flavourings. The einkorn flour looked much like conventional whole-wheat flour, but once water and yeast were added, differences became evident: the light brown dough was less stretchy, less pliable and stickier than a traditional dough, and lacked the mouldability of conventional wheat flour dough. The dough smelt different, too, more like peanut butter rather than the standard neutral smell of dough. It rose less than modern dough, rising just a little, compared to the doubling in size expected of modern bread. And, as Eli Rogosa claimed, the final bread product did indeed taste different: heavier, nutty, with an astringent aftertaste. I could envision this loaf of crude einkorn bread on the tables of third-century BC Amorites or Mesopotamians.

I have a wheat sensitivity. So, in the interest of science, I conducted my own little experiment: 115 grams of einkorn bread on day one versus 115 grams of modern organic whole-wheat bread on day two. I braced myself for the worst, since in the past my reactions have been rather unpleasant.

Beyond simply observing my physical reaction, I also performed fingerstick blood sugars after eating each type of bread. The differences were striking.

Blood sugar at the start: 84 mg/dl. Blood sugar after consuming einkorn bread: 110 mg/dl. This was more or less the expected response to eating some carbohydrate. Afterwards, though, I felt no perceptible effects – no sleepiness, no nausea, nothing hurt. In short, I felt fine. Whew!

The next day, I repeated the procedure, substituting 115 grams of conventional organic whole-wheat bread. Blood sugar at the start: 84 mg/dl. Blood sugar after consuming conventional bread: 167 mg/dl. Moreover, I soon became nauseated, nearly losing my lunch. The queasy effect persisted for thirty-six hours, accompanied by stomach cramps that started almost immediately and lasted for many hours. Sleep that night was fitful, though filled with vivid dreams. I couldn’t think straight, nor could I understand the research papers I was trying to read the next morning, having to read and reread paragraphs four or five times; I finally gave up. Only a full day and a half later did I start feeling normal again.

I survived my little wheat experiment, but I was impressed with the difference in responses to the ancient wheat and the modern wheat in my whole-wheat bread. Surely something odd was going on here.

My personal experience, of course, does not qualify as a clinical trial. But it raises some questions about the potential differences that span a distance of ten thousand years: ancient wheat that predates the changes introduced by human genetic intervention versus modern wheat.

Multiply these alterations by the tens of thousands of hybridisations to which wheat has been subjected and you have the potential for dramatic shifts in genetically determined traits such as gluten structure. And note that the genetic modifications created by hybridisation for the wheat plants themselves were essentially fatal, since the thousands of new wheat breeds were helpless when left to grow in the wild, relying on human assistance for survival.⁸

The new agriculture of increased wheat yield was initially met with scepticism in the Third World, with objections based mostly on the perennial ‘That’s not how we used to do it’ variety. Dr Borlaug, hero of wheat hybridisation, answered critics of high-yield wheat by blaming explosive world population growth, making high-tech agriculture a ‘necessity’. The marvellously increased yields enjoyed in hunger-plagued India, Pakistan, China, Colombia and other countries quickly quieted naysayers. Yields improved exponentially, turning shortages into surplus and making wheat products cheap and accessible.

Can you blame farmers for preferring high-yield dwarf hybrid strains? After all, many small farmers struggle financially. If they can increase yield-per-acre up to tenfold, with a shorter growing season and easier harvest, why wouldn’t they?

In the future, the science of genetic modification has the potential to change wheat even further. No longer do scientists need to breed strains, cross their fingers and hope for just the right mix of chromosomal exchange. Instead, single genes can be purposefully inserted or removed, and strains bred for disease resistance, pesticide resistance, cold or drought tolerance, or any number of other genetically determined characteristics. In particular, new strains can be genetically tailored to be compatible with specific fertilisers or pesticides. This is a financially rewarding process for big agribusiness, and seed and farm chemical producers such as Cargill, Monsanto and ADM, since specific strains of seed can be patent protected and thereby command a premium and boost sales of the compatible chemical treatments.

Genetic modification is built on the premise that a single gene can be inserted in just the right place without disrupting the genetic expression of other characteristics. While the concept seems sound, it doesn’t always work out that cleanly. In the first decade of genetic modification, no animal or safety testing was required for genetically modified plants, since the practice was considered no different than the assumed-to-be-benign practice of hybridisation. Public pressure has, more recently, caused regulatory agencies, such as the food-regulating branch of the FDA, to require testing prior to a genetically modified product’s release into the market. Critics of genetic modification, however, have cited studies that identify potential problems with genetically modified crops. Test animals fed glyphosate-tolerant soya beans (known as Roundup Ready, these beans are genetically bred to allow the farmer to freely spray the weed killer Roundup without harming the crop) show alterations in liver, pancreatic, intestinal and testicular tissue compared to animals fed conventional soya beans. The difference is believed to be due to unexpected DNA rearrangement near the gene insertion site, yielding altered proteins in food with potential toxic effects.⁹

It took the introduction of gene modification to finally bring the notion of safety testing for genetically altered plants to light. Public outcry has prompted the international agricultural community to develop guidelines, such as the 2003 Codex Alimentarius, a joint effort by the Food and Agricultural Organization of the United Nations and the World Health Organization, to help determine what new genetically modified crops should be subjected to safety testing, what kinds of tests should be conducted and what should be measured.

But no such outcry was raised years earlier as farmers and geneticists carried out tens of thousands of hybridisation experiments. There is no question that unexpected genetic rearrangements that might generate some desirable property, such as greater drought resistance or better dough properties, can be accompanied by changes in proteins that are not evident to the eye, nose or tongue, but little effort has focused on these side effects. Hybridisation efforts continue, breeding new ‘synthetic’ wheat. While hybridisation falls short of the precision of gene modification techniques, it still possesses the potential to inadvertently ‘turn on’ or ‘turn off’ genes unrelated to the intended effect, generating unique characteristics, not all of which are presently identifiable.¹⁰

Thus, the alterations of wheat that could potentially result in undesirable effects on humans are not due to gene insertion or deletion, but are due to the hybridisation experiments that predate genetic modification. As a result, over the past fifty years, thousands of new strains have made it to the human commercial food supply without a single effort at safety testing. This is a development with such enormous implications for human health that I will repeat it: modern wheat, despite all the genetic alterations to modify hundreds, if not thousands, of its genetically determined characteristics, made its way to the worldwide human food supply with nary a question surrounding its suitability for human consumption.

Because hybridisation experiments did not require the documentation of animal or human testing, pinpointing where, when and how the precise hybrids that might have amplified the ill effects of wheat is an impossible task. Nor is it known whether only some or all of the hybrid wheat generated has potential for undesirable human health effects.

The incremental genetic variations introduced with each round of hybridisation can make a world of difference. Take human males and females. While men and women are, at their genetic core, largely the same, the differences clearly make for interesting conversation, not to mention romantic dalliances. The crucial differences between human men and women, a set of differences that originate with just a single chromosome, the diminutive male Y chromosome and its few genes, set the stage for thousands of years of human life and death, Shakespearean drama and the chasm separating Homer from Marge Simpson.

And so it goes with this human-engineered grass we still call ‘wheat’. Genetic differences generated via thousands of human-engineered hybridisations make for substantial variation in composition, appearance and qualities important not just to chefs and food processors, but also potentially to human health.

CHAPTER 3

WHEAT DECONSTRUCTED

WHETHER IT’S A LOAF OF organic high-fibre multigrain bread or a mass-produced biscuit, what exactly are you eating? We all know that the biscuit is just a processed indulgence, but conventional advice tells us that the former is a better health choice, a source of fibre and B vitamins, and rich in ‘complex’ carbohydrates.

Ah, but there’s always another layer to the story. Let’s peer inside the contents of this grain and try to understand why – regardless of shape, colour, fibre content, organic or not – it potentially does odd things to humans.

WHEAT: SUPERCARBOHYDRATE

The transformation of the domesticated wild grass of Neolithic times into the modern brownies, cupcakes or Victoria sponge requires some serious sleight of hand. These modern configurations were not possible with the dough of ancient wheat. An attempt to make a modern jam doughnut with einkorn wheat, for example, would yield a crumbly mess that would not hold its filling, and it would taste, feel and look like, well, a crumbly mess. In addition to hybridising wheat for increased yield, plant geneticists have also sought to generate hybrids that have properties best suited to become, for instance, a chocolate cupcake or a seven-tiered wedding cake.

Modern Triticum aestivum wheat flour is, on average, 70 per cent carbohydrate by weight, with protein and indigestible fibre each comprising 10 to 15 per cent. The small remaining weight of Triticum wheat flour is fat, mostly phospholipids and polyunsaturated fatty acids.¹ (Interestingly, ancient wheat has higher protein content. Emmer wheat, for instance, contains 28 per cent or more protein.²)

Wheat starches are the complex carbohydrates that are the darlings of dietitians. ‘Complex’ means that the carbohydrates in wheat are composed of polymers (repeating chains) of the simple sugar, glucose, unlike simple carbohydrates such as sucrose, which are one- or two-unit sugar structures. (Sucrose is a two-sugar molecule, glucose + fructose.) Conventional wisdom, such as that from your dietitian or the USDA, says we should all reduce our consumption of simple carbohydrates in the form of sweets and fizzy drinks, and increase our consumption of complex carbohydrates.

Of the complex carbohydrate in wheat, 75 per cent is the chain of branching glucose units, amylopectin, and 25 per cent is the linear chain of glucose units, amylose. In the human gastrointestinal tract, both amylopectin and amylose are digested by the salivary and stomach enzyme amylase. Amylopectin is efficiently digested by amylase to glucose, while amylose is much less efficiently digested, some of it making its way to the colon undigested. Thus, the complex carbohydrate amylopectin is rapidly converted to glucose and absorbed into the bloodstream and, because it is most efficiently digested, is mainly responsible for wheat’s blood-sugar-increasing effect.

Other carbohydrate foods also contain amylopectin, but not the same kind of amylopectin as wheat. The branching structure of amylopectin varies depending on its source.³ Amylopectin from legumes, so-called amylopectin C, is the least digestible – hence the schoolkid’s chant, ‘Beans, beans, they’re good for your heart, the more you eat ’em, the more you. . . .’ Undigested amylopectin makes its way to the colon, whereupon the symbiotic bacteria happily dwelling there feast on the undigested starches and generate gases such as nitrogen and hydrogen, making the sugars unavailable for you to digest.

Amylopectin B is the form found in bananas and potatoes and, while more digestible than bean amylopectin C, still resists digestion to some degree. The most digestible form of amylopectin, amylopectin A, is the form found in wheat. Because it is the most digestible, it is the form that most enthusiastically increases blood sugar. This explains why, gram for gram, wheat increases blood sugar to a greater degree than, say, kidney beans or crisps. The amylopectin A of wheat products, complex or no, might be regarded as a supercarbohydrate, a form of highly digestible carbohydrate that is more efficiently converted to blood sugar than nearly all other carbohydrate foods, simple or complex.

This means that not all complex carbohydrates are created equal, with amylopectin A-containing wheat increasing blood sugar more than other complex carbohydrates. But the uniquely digestible amylopectin A of wheat also means that the complex carbohydrate of wheat products, on a gram-for-gram basis, are no better, and are often worse, than even simple carbohydrates such as sucrose.

People are usually shocked when I tell them that whole-wheat bread increases blood sugar to a higher level than sucrose.⁴ Aside from some extra fibre, eating two slices of whole-wheat bread is really little different, and often worse, than drinking a can of a sugar-sweetened fizzy drink or eating a sugary chocolate bar.

This information is not new. A 1981 University of Toronto study launched the concept of the glycaemic index, i.e., the comparative blood sugar effects of carbohydrates: the higher the blood sugar after consuming a specific food compared to glucose, the higher the glycaemic index (GI). The original study showed that the GI of white bread was 69, while the GI of whole-grain bread was 72 and Shredded Wheat cereal was 67, while that of sucrose (table sugar) was 59.⁵ Yes, the GI of whole-grain bread is higher than that of sucrose. Incidentally, the GI of a Mars bar – nougat, chocolate, sugar, caramel and all – is 68. That’s better than whole-grain bread. The GI of a Snickers bar is 41 – far better than whole-grain bread.

In fact, the degree of processing, from a blood sugar standpoint, makes little difference: wheat is wheat, with various forms of processing or lack of processing, simple or complex, high-fibre or low-fibre, all generating similarly high blood sugars. Just as ‘boys will be boys’, amylopectin A will be amylopectin A. In healthy, slender volunteers, two medium-sized slices of whole-wheat bread increase blood sugar by 30 mg/dl (from 93 to 123 mg/dl), no different from white bread.⁶ In people with diabetes, both white and whole-grain bread increase blood sugar 70 to 120 mg/dl over starting levels.⁷

One consistent observation, also made in the original University of Toronto study as well as in subsequent efforts, is that pasta has a lower two-hour GI, with whole-wheat spaghetti showing a GI of 42 compared to white-flour spaghetti’s GI of 50. Pasta stands apart from other wheat products, probably due, in part, to the compression of the wheat flour that occurs during the extruding process, slowing digestion by amylase. (Rolled fresh pasta, such as fettuccine, has similar glycaemic properties to extruded pastas.) Pastas are also usually made from Triticum durum rather than aestivum, putting them genetically closer to emmer. But even the favourable GI rating of pasta is misleading, since it is only a two-hour observation and pasta has the curious ability to generate high blood sugars for periods of four to six hours after consumption, sending blood sugars up by 100 mg/dl for sustained periods in people with diabetes.⁸, ⁹

These irksome facts have not been lost on agricultural and food scientists, who have been trying, via genetic manipulation, to increase the content of so-called resistant starch (starch that does not get fully digested) and reduce the amount of amylopectin. Amylose is the most common resistant starch, comprising as much as 40 to 70 per cent by weight in some purposefully hybridised varieties of wheat.¹⁰

Therefore, wheat products elevate blood sugar levels more than virtually any other carbohydrate, from beans to chocolate bars. This has important implications for body weight, since glucose is unavoidably accompanied by insulin, the hormone that allows entry of glucose into the cells of the body, converting the glucose to fat. The higher the blood glucose after consumption of food, the greater the insulin level, the more fat is deposited. This is why, say, eating a three-egg omelette that triggers no increase in glucose does not add to body fat, while two slices of whole-wheat bread increases blood glucose to high levels, triggering insulin and growth of fat, particularly abdominal or deep visceral fat.

There’s even more to wheat’s curious glucose behaviour. The amylopectin A-induced surge in glucose and insulin following wheat consumption is a 120-minute-long phenomenon that produces the ‘high’ at the glucose peak, followed by the ‘low’ of the inevitable glucose drop. The surge and drop creates a two-hour roller coaster ride of satiety and hunger that repeats itself throughout the day. The glucose ‘low’ is responsible for stomach growling at 9 am, just two hours after a bowl of wheat cereal or an English muffin breakfast, followed by 11 am pre-lunch cravings, as well as the mental fog, fatigue and shakiness of the hypoglycaemic glucose nadir.

Trigger high blood sugars repeatedly and/or over sustained periods, and more fat accumulation results. The consequences of glucose-insulin-fat deposition are especially visible in the abdomen – resulting in, yes, wheat belly. The bigger your wheat belly, the poorer your response to insulin, since the deep visceral fat of the wheat belly is associated with poor responsiveness, or ‘resistance’, to insulin, demanding higher and higher insulin levels, a situation that cultivates diabetes. Moreover, the bigger the wheat belly in males, the more oestrogen is produced by fat tissue, and the larger the breasts. The bigger your wheat belly, the more inflammatory responses that are triggered: heart disease and cancer.

Because of wheat’s morphine-like effect (discussed in the next chapter) and the glucose-insulin cycle that wheat amylopectin A generates, wheat is, in effect, an appetite stimulant. Accordingly, people who eliminate wheat from their diet consume fewer calories, something I will discuss later in the book.

If glucose-insulin-fat provocation from wheat consumption is a major phenomenon underlying weight gain, then elimination of wheat from the diet should reverse the phenomenon. And that is exactly what happens.

For years, wheat-related weight loss has been observed in patients with coeliac disease, who must eliminate all foods containing gluten from their diets to halt an immune response gone awry, which in coeliac patients essentially destroys the small intestine. As it happens, wheat-free, gluten-free diets are also amylopectin A-free.

However, the weight-loss effects of wheat elimination are not immediately clear from clinical studies. Many coeliac sufferers are diagnosed after years of suffering and begin the diet change in a severely malnourished state due to prolonged diarrhoea and impaired nutrient absorption. Underweight, malnourished coeliac sufferers may actually gain weight with wheat removal thanks to improved digestive function.

But if we look only at overweight people who are not severely malnourished at the time of diagnosis who remove wheat from their diet, it becomes clear that this enables them to lose a substantial amount of weight. A Mayo Clinic/University of Iowa study of 215 obese coeliac patients showed 27.5 pounds of weight loss in the first six months of a wheat-free diet.¹¹ In another study, wheat elimination slashed the number of people classified as obese (body mass index, or BMI, 30 or greater) in half within a year.¹² Oddly, investigators performing these studies usually attribute the weight loss of wheat- and gluten-free diets to lack of food variety. (Food variety, incidentally, can still be quite wide and wonderful after wheat is eliminated, as I will discuss.)

Advice to consume more healthy whole grains therefore causes increased consumption of the amylopectin A form of wheat carbohydrate, a form of carbohydrate that, for all practical purposes, is little different, and in some ways worse, than dipping your spoon into the sugar bowl.

GLUTEN: WE HARDLY KNOW YA!

If you were to add water to wheat flour, knead the mixture into dough, then rinse the glob under running water to wash away starches and fibre, you’d be left with a protein mixture called gluten.

Wheat is the principal source of gluten in the diet, both because wheat products have come to dominate and because most Americans do not make a habit of consuming plentiful quantities of barley, rye, bulgur, kamut or triticale, the other sources of gluten. For all practical purposes, therefore, when I discuss gluten, I am primarily referring to wheat.

While wheat is, by weight, mostly carbohydrate as amylopectin A, gluten protein is what makes wheat ‘wheat’. Gluten is the unique component of wheat that makes dough ‘doughy’: stretchable, rollable, spreadable, twistable, baking gymnastics that cannot be achieved with rice flour, corn flour or any other grain. Gluten allows the pizza-maker to roll and toss dough and mould it into the characteristic flattened shape; it allows the dough to stretch and rise when yeast fermentation causes it to fill with air pockets. The distinctive doughy quality of the simple mix of wheat flour and water, properties food scientists call viscoelasticity and cohesiveness, are due to gluten. While wheat is mostly carbohydrate and only 10 to 15 per cent protein, 80 per cent of that protein is gluten. Wheat without gluten would lose the unique qualities that transform dough into bagels, pizza or focaccia.

Here’s a quick lesson in this thing called gluten (a lesson that you might categorise under ‘Know thine enemy’). Glutens are the storage proteins of the wheat plant, a means of storing carbon and nitrogen for germination of the seed to form new wheat plants. Leavening, the ‘rising’ process created by the marriage of wheat with yeast, does not occur without gluten, and is therefore unique to wheat flour.

The term ‘gluten’ encompasses two primary families of proteins, the gliadins and the glutenins. The gliadins, the protein group that most vigorously triggers the immune response in coeliac disease, has three subtypes: α/β-gliadins, Γ-gliadins and Ω-gliadins. Like amylopectin, glutenins are large repeating structures, or polymers, of more basic structures. The strength of dough is due to the large polymeric glutenins, a genetically programmed characteristic purposefully selected by plant breeders.¹³

Gluten from one wheat strain can be quite different in structure from that of another strain. The gluten proteins produced by einkorn wheat, for example, are distinct from the gluten proteins of emmer, which are, in turn, different from the gluten proteins of Triticum aestivum.¹⁴, ¹⁵ Because fourteen-chromosome einkorn, containing the so-called A genome (set of genes), has the smallest chromosomal set, it codes for the fewest number and variety of glutens. Twenty-eight-chromosome emmer, containing the A genome with the added B genome, codes for a larger variety of gluten. Forty-two-chromosome Triticum aestivum, with the A, B and D genomes, has the greatest gluten variety, even before any human manipulation of its breeding. Hybridisation efforts of the past fifty years have generated numerous additional changes in gluten-coding genes in Triticum aestivum, most of them purposeful modifications of the D genome that confer baking and aesthetic characteristics on flour.¹⁶ Indeed, genes located in the D genome are those most frequently pinpointed as the source of the glutens that trigger coeliac disease.¹⁷

It is therefore the D genome of modern Triticum aestivum that, having been the focus of all manner of genetic shenanigans by plant geneticists, has accumulated substantial change in genetically determined characteristics of gluten proteins. It is also potentially the source for many of the odd health phenomena experienced by consuming humans.

IT’S NOT ALL ABOUT GLUTEN

Gluten isn’t the only potential villain lurking in wheat flour.

Beyond gluten, the other 20 per cent or so of nongluten proteins in wheat include albumins, prolamins and globulins, each of which can also vary from strain to strain. In total, there are more than a thousand other proteins that are meant to serve such functions as protecting the grain from pathogens, providing water resistance and providing reproductive functions. There are agglutinins, peroxidases, α-amylases, serpins and acyl CoA oxidases, not to mention five forms of glycerinaldehyde-3-phosphate dehydrogenases. I shouldn’t neglect to mention β-purothionin, puroindolines a and b, and starch synthases. Wheat ain’t just gluten, any more than Southern cooking is just grits.

As if this protein/enzyme smorgasbord weren’t enough, food manufacturers have also turned to fungal enzymes, such as cellulases, glucoamylases, xylanases and β-xylosidases, to enhance leavening and texture in wheat products. Many bakers also add soya flour to their dough to enhance mixing and whiteness, introducing yet another collection of proteins and enzymes.

In coeliac disease, the one conventionally accepted (though much underdiagnosed) example of wheat-related intestinal illness, gluten protein, specifically α-gliadin, provokes an immune response that inflames the small intestine, causing incapacitating abdominal cramps and diarrhoea. Treatment is simple: complete avoidance of anything containing gluten.

Beyond coeliac disease, though, there are allergic or anaphylactic (a severe reaction resulting in shock) reactions to nongluten proteins, including α-amylases, thioredoxin and glycerinaldehyde-3-phosphate dehydrogenase, along with about a dozen others.¹⁸ Exposure in susceptible individuals triggers asthma, rashes (atopic dermatitis and urticaria), and a curious and dangerous condition called wheat-dependent exercise-induced anaphylaxis (WDEIA), in which rash, asthma or anaphylaxis are provoked during exercise. WDEIA is most commonly associated with wheat (it can also occur with shellfish) and has been attributed to various Ω-gliadins and glutenins.

In short, wheat is not just a complex carbohydrate with gluten and bran. Wheat is a complex collection of biochemically unique compounds that vary widely according to genetic code. Just by looking at a poppy seed muffin, for instance, you would be unable to discern the incredible variety of gliadins, other gluten proteins and nongluten proteins contained within it, many of them unique to the modern dwarf wheat that was your muffin’s source. On taking your first bite, you would enjoy the immediate sweetness of the muffin’s amylopectin A as it sends your blood sugar skyward.

Let’s next explore the incredible wide-ranging health effects of your muffin and other wheat-containing foods.

CHAPTER 4

HEY, MAN, WANNA BUY SOME EXORPHINS? THE ADDICTIVE PROPERTIES OF WHEAT

ADDICTION. WITHDRAWAL. DELUSIONS. Hallucinations. I’m not describing mental illness or a scene from One Flew Over the Cuckoo’s Nest. I’m talking about this food you invite into your kitchen, share with friends and dunk in your tea.

I will discuss why wheat is unique among foods for its curious effects on the brain, effects shared with opiate drugs. It explains why some people experience incredible difficulty removing wheat from their diet. It’s not just a matter of inadequate resolve, inconvenience or breaking well-worn habits; it’s about severing a relationship with something that gains hold of your psyche and emotions, not unlike the hold heroin has over the desperate addict.

While you knowingly consume coffee and alcohol to obtain specific mind effects, wheat is something you consume for ‘nutrition’, not for a ‘fix’. Like drinking the Kool-Aid at the Jim Jones revival meeting, you may not even be aware that this thing, endorsed by all ‘official’ agencies, is fiddling with your mind.

People who eliminate wheat from their diet typically report improved mood, fewer mood swings, improved ability to concentrate and deeper sleep within just days to weeks of their last bite of bagel or baked lasagna. These sorts of ‘soft’ subjective experiences on our brains, however, are tough to quantify. They are also subject to the placebo effect – i.e., people just think they’re feeling better. I am, however, impressed with how consistent these observations are, experienced by the majority of people once the initial withdrawal effects of mental fog and fatigue subside. I’ve personally experienced these effects and also witnessed them in thousands of people.

It is easy to underestimate the psychological pull of wheat. Just how dangerous can an innocent bran muffin be, after all?

‘BREAD IS MY CRACK!’

Wheat is a food that is unparalleled for its potential to generate entirely unique effects on the brain and nervous system. There is no doubt: for some people, wheat is addictive. And, in some people, it is addictive to the point of obsession.

Some people with wheat addiction just know they have a wheat addiction. Or perhaps they identify it as an addiction to some wheat-containing food, such as pasta or pizza. They already understand, even before I tell them, that their wheat-food-addiction-of-choice provides a little ‘high’. I still get shivers when a well-dressed, suburban mum desperately confesses to me, ‘Bread is my crack. I just can’t give it up!’

Wheat can dictate food choice, calorie consumption, timing of meals and snacks. It can influence behaviour and mood. It can even come to dominate thoughts. A number of my patients, when presented with the suggestion of removing it from their diets, report obsessing over wheat products to the point of thinking about them, talking about them, salivating over them constantly for weeks. ‘I can’t stop thinking about bread. I dream about bread!’ they tell me, leading some to succumb to a wheat-consuming frenzy and give up within days after starting.

There is, of course, a flip side to addiction. When people divorce themselves from wheat-containing products, 30 per cent experience something that can only be called withdrawal.

I’ve personally witnessed hundreds of people report extreme fatigue, mental fog, irritability, inability to function at work or school, even depression in the first several days to weeks after eliminating wheat. Complete relief is achieved by a bagel or cupcake (or, sadly, more like four bagels, two cupcakes, a bag of pretzels, two muffins and a handful of brownies, followed the next morning by a nasty case of wheat remorse). It’s a vicious circle. Abstain from a substance and a distinctly unpleasant experience ensues; resume it, the unpleasant experience ceases – that sounds a lot like addiction and withdrawal to me.

People who haven’t experienced these effects pooh-pooh it all, thinking it strains credibility to believe that something as pedestrian as wheat can affect the central nervous system much as nicotine or crack cocaine do.

There is a scientifically plausible reason for both the addiction and withdrawal effects. Not only does wheat exert effects on the normal brain, but also on the vulnerable abnormal brain, with results beyond simple addiction and withdrawal. Studying the effects of wheat on the abnormal brain can teach us some lessons on why and how wheat can be associated with such phenomena.

WHEAT AND THE SCHIZOPHRENIC MIND

The first important lessons on the effects wheat has on the brain came through studying its effects on people with schizophrenia.

Schizophrenics lead a difficult life. They struggle to differentiate reality from internal fantasy, often entertaining delusions of persecution, even believing their minds and actions are controlled by external forces. (Remember ‘Son of Sam’ David Berkowitz, the New York City serial killer who stalked his victims on instructions received from his dog? Thankfully, violent behaviour is unusual in schizophrenics, but it illustrates the depth of pathology possible.) Once schizophrenia is diagnosed, there is little hope of leading a normal life of work, family and children. A life of institutionalisation, medications with awful side effects and a constant struggle with dark internal demons lies ahead.

So what are the effects of wheat on the vulnerable schizophrenic mind?

The earliest formal connection of the effects of wheat on the schizophrenic brain began with the work of psychiatrist F. Curtis Dohan, whose observations ranged as far as Europe and New Guinea. Dr Dohan journeyed down this line of investigation because he observed that, during World War II, the men and women of Finland, Norway, Sweden, Canada and the United States required fewer hospitalisations for schizophrenia when food shortages made bread unavailable, only to require an increased number of hospitalisations when wheat consumption resumed after the war was over.¹

Dr Dohan observed a similar pattern in the hunter-gatherer Stone Age culture of New Guinea. Prior to the introduction of Western influence, schizophrenia was virtually unknown, diagnosed in only 2 of 65,000 inhabitants. As Western eating habits infiltrated the New Guinean population and cultivated wheat products, beer made from barley, and corn were introduced, Dr Dohan watched the incidence of schizophrenia skyrocket sixty-five-fold.² On this background, he set out to develop the observations that established whether or not there was a cause-and-effect relationship between wheat consumption and schizophrenia.

In the mid-sixties, while working at the Veterans Administration Hospital in Philadelphia, Dr Dohan and his colleagues decided to remove all wheat products from meals provided to schizophrenic patients without their knowledge or permission. (This was in the era before informed consent of participants was required, and before the infamous Tuskegee syphilis experiment became publicised, which triggered public outrage and led to legislation requiring fully informed participant consent.) Lo and behold, four weeks sans wheat and there were distinct and measurable improvements in the hallmarks of the disease: a reduced number of auditory hallucinations, fewer delusions, less detachment from reality. Psychiatrists then added the wheat products back into their patients’ diets and the hallucinations, delusions and social detachment rushed right back. Remove wheat again, patients and symptoms got better; add it back, they got worse.³

The Philadelphia observations in schizophrenics were corroborated by psychiatrists at the University of Sheffield, with similar conclusions.⁴ There have since even been reports of complete remission of the disease, such as the seventy-year-old schizophrenic woman described by Duke University doctors, suffering with delusions, hallucinations and suicide attempts with sharp objects and cleaning solutions over a period of fifty-three years, who experienced complete relief from psychosis and suicidal desires within eight days of stopping wheat.⁵

While it seems unlikely that wheat exposure caused schizophrenia in the first place, the observations of Dr Dohan and others suggest that wheat is associated with measurable worsening of symptoms.

Another condition in which wheat may exert effects on a vulnerable mind is autism. Autistic children suffer from impaired ability to interact socially and communicate. The condition has increased in frequency over the past forty years, from rare in the mid-twentieth century to 1 in 150 children in the twenty-first.⁶ Initial small samples have demonstrated improvement in autistic behaviours with wheat-gluten removal.⁷, ⁸ The most comprehensive clinical trial to date involved fifty-five autistic Danish children, with formal measures of autistic behaviour showing improvement with gluten elimination (along with elimination of casein from dairy).⁹

While it remains a topic of debate, a substantial proportion of children and adults with attention deficit/hyperactivity disorder (ADHD) may also respond to elimination of wheat. However, responses are often muddied due to sensitivities to other components of diet, such as sugars, artificial sweeteners, additives and dairy.¹⁰

It is unlikely that wheat exposure was the initial cause of autism or ADHD but, as with schizophrenia, wheat appears to be associated with worsening of the symptoms characteristic of the conditions.

Though the laboratory rat treatment of the unsuspecting schizophrenic patients in the Philadelphia VA Hospital may send chills down our spines from the comfort of our fully informed and consenting twenty-first century, it is nevertheless a graphic illustration of wheat’s effect on mental function. But why in the world are schizophrenia, autism and ADHD exacerbated by wheat? What is in this grain that worsens psychosis and other abnormal behaviours?

Investigators at the National Institutes of Health (NIH) set out to find some answers.

EXORPHINS: THE WHEAT–MIND CONNECTION

Dr Christine Zioudrou and her colleagues at the NIH subjected gluten, the main protein of wheat, to a simulated digestive process to mimic what happens after we eat bread or other wheat-containing products.¹¹ Exposed to pepsin (a stomach enzyme) and hydrochloric acid (stomach acid), gluten is degraded to a mix of polypeptides. The dominant polypeptides were then isolated and administered to laboratory rats. These polypeptides were discovered to have the peculiar ability to penetrate the blood–brain barrier that separates the bloodstream from the brain. This barrier is there for a reason. The brain is highly sensitive to the wide variety of substances that gain entry to the blood, some of which can provoke undesirable effects should they cross into your amygdala, hippocampus, cerebral cortex or other brain structure. Once having gained entry into the brain, wheat polypeptides bind to the brain’s morphine receptor, the very same receptor to which opiate drugs bind.

Zioudrou and her colleagues dubbed these polypeptides ‘exorphins’, short for exogenous morphine-like compounds, distinguishing them from endorphins, the endogenous (internally sourced) morphine-like compounds that occur, for instance, during a ‘runner’s high’. They named the dominant polypeptide that crossed the blood–brain barrier ‘gluteomorphin’, or morphine-like compound from gluten (though the name sounds to me more like a morphine shot in the butt). The investigators speculated that exorphins might be the active factors derived from wheat that account for the deterioration of schizophrenic symptoms seen in the Philadelphia VA Hospital and elsewhere.

Even more telling, the brain effect of gluten-derived polypeptides is blocked by administration of the drug naloxone.

Let’s pretend you’re an inner-city heroin addict. You get knifed during a drug deal gone sour and get carted to the nearest A&E. Because you’re high on heroin, you kick and scream at the staff trying to help you. So these nice people strap you down and inject you with a drug called naloxone, and you are instantly not high. Through the magic of chemistry, naloxone immediately reverses the action of heroin or any other opiate drug such as morphine or oxycodone.

In lab animals, administration of naloxone blocks the binding of wheat exorphins to the morphine receptor of brain cells. Yes, opiate-blocking naloxone prevents the binding of wheat-derived exorphins to the brain. The very same drug that turns off the heroin in a drug-abusing addict also blocks the effects of wheat exorphins.

In a World Health Organization study of thirty-two schizophrenic people with active auditory hallucinations, naloxone was shown to reduce hallucinations.¹² Unfortunately, the next logical step – administering naloxone to schizophrenics eating a ‘normal’ wheat-containing diet compared to schizophrenics administered naloxone on a wheat-free diet – has not been studied. (Clinical studies that might lead to conclusions that don’t support drug use are often not performed. In this case, had naloxone shown benefit in wheat-consuming schizophrenics, the unavoidable conclusion would have been to eliminate wheat, not prescribe the drug.)

The schizophrenia experience shows us that wheat exorphins have the potential to exert distinct effects on the brain. Those of us without schizophrenia don’t experience auditory hallucinations from exorphins resulting from an onion bagel, but these compounds are still there in the brain, no different than in a schizophrenic. It also highlights how wheat is truly unique among grains, since other grains such as millet and flax do not generate exorphins (since they lack gluten), nor do they cultivate obsessive behaviour or withdrawal in people with normal brains or people with abnormal brains.

So this is your brain on wheat: digestion yields morphine-like compounds that bind to the brain’s opiate receptors. It induces a form of reward, a mild euphoria. When the effect is blocked or no exorphin-yielding foods are consumed, some people experience a distinctly unpleasant withdrawal.

What happens if normal (i.e., nonschizophrenic) humans are given opiate-blocking drugs? In a study conducted at the Psychiatric Institute of the University of South Carolina, wheat-consuming participants given naloxone consumed 33 per cent fewer calories at lunch and 23 per cent fewer calories at dinner (a total of approximately 400 calories less over the two meals) than participants given a placebo.¹³ At the University of Michigan, binge eaters were confined to a room filled with food for one hour. (There’s an idea for a new TV show: The Biggest Gainer.) Participants consumed 28 per cent less wheat crackers, bread sticks and pretzels with administration of naloxone.¹⁴

In other words, block the euphoric reward of wheat and calorie intake goes down, since wheat no longer generates the favourable feelings that encourage repetitive consumption. (Predictably, this strategy is being pursued by the pharmaceutical industry to commercialise a weight loss drug that contains naltrexone, an oral equivalent to naloxone. The drug is purported to block the mesolimbic reward system buried deep within the human brain that is responsible for generating pleasurable feelings from heroin, morphine and other substances. Pleasurable feelings can be replaced by feelings of dysphoria, or unhappiness. Naltrexone will therefore be combined with the antidepressant and smoking-cessation drug bupropion.)

From withdrawal effects to psychotic hallucinations, wheat is party to some peculiar neurological phenomena. To recap:

 Common wheat, upon digestion, yields polypeptides that possess the ability to cross into the brain and bind to opiate receptors.

 The action of wheat-derived polypeptides, the so-called exorphins such as gluteomorphin, can be short-circuited with the opiate-blocking drugs naloxone and naltrexone.

 When administered to normal people or people with uncontrollable appetite, opiate-blocking drugs yield reductions in appetite, cravings, and calorie intake, as well as dampen mood, and the effect seems particularly specific to wheat-containing products.

Wheat, in fact, nearly stands alone as a food with potent central nervous system effects. Outside of intoxicants such as ethanol (like that in your favourite merlot or chardonnay), wheat is one of the few foods that can alter behaviour, induce pleasurable effects and generate a withdrawal syndrome upon its removal. And it required observations in schizophrenic patients to teach us about these effects.

NIGHT CRAVINGS CONQUERED

For as long as he could remember, Larry struggled with weight.

It never made sense to him. He exercised, often to extremes. A 50-mile bike ride was not unusual, nor was a 15-mile walk in the woods or desert. As part of his work, Larry enjoyed the terrain of many different areas of the United States. His travel often took him to the southwest, where he hiked for up to six hours. He also prided himself on following a healthy diet: limiting his red meat and oils and eating plenty of vegetables and fruit and, yes, an abundance of ‘healthy whole grains’.

I met Larry because of a heart rhythm problem, an issue we dealt with easily. But his blood work was another issue. In short, it was a disaster: blood glucose in the low diabetic range, triglycerides too high at 210 mg/dl, HDL too low at 37 mg/dl, and 70 per cent of his LDL particles were the small heart disease-causing type. Blood pressure was an important issue with systolic (‘top’) values ranging up to 170 mmHg and diastolic (‘bottom’) values of 90 mmHg. Larry was also, at 5 feet 8 inches and 17 stone 5 pounds, nearly 6 stone overweight.

‘I don’t get it. I exercise like nobody you know. I really like exercise. But I just cannot – cannot – lose the weight, no matter what I do.’ Larry recounted his diet escapades that included an all-rice diet, protein drink programmes, ‘detox’ regimens, even hypnosis. They all resulted in a few pounds lost, only to be promptly regained. He did admit to one peculiar excess: ‘I really struggle with my appetite at night. After dinner, I can’t resist the urge to graze. I try to graze on the good stuff, like whole-wheat pretzels and these multigrain crackers I have with a yoghurt dip. But I’ll sometimes eat all night from dinner until I go to bed. I don’t know why, but something happens at night and I just can’t stop.’

I counselled Larry on the need to remove the number one most powerful appetite stimulant in his diet: wheat. Larry gave me that ‘not another kooky idea!’ look. After a big sigh, he agreed to give it a go. With four teenagers in the house, clearing the shelves of all things wheat was quite a task, but he and his wife did it.

Larry returned to my office six weeks later. He reported that, within three days, his nighttime cravings had disappeared entirely. He now ate dinner and was satisfied with no need to graze. He also noticed that his appetite was much smaller during the day and his desire for snacks virtually disappeared. He also admitted that, now that his craving for food was much less, his calorie intake and portion size was a fraction of its former level. With no change in his exercise habits, he’d lost ‘only’ eleven pounds. But, more than that, he also felt that he’d regained control over appetite and impulse, a feeling he thought he’d lost years earlier.

WHEAT: APPETITE STIMULANT

Crackheads and heroin addicts shooting up in the dark corners of an inner-city drug house have no qualms about ingesting substances that mess with their minds. But how about law-abiding citizens like you and your family? I’ll bet your idea of mind bending is going for the strong brew rather than the mild stuff at Starbucks, or hoisting one too many Heinekens on the weekend. But ingesting wheat means you have been unwittingly ingesting the most common dietary mind-active food known.

In effect, wheat is an appetite stimulant: it makes you want more – more cookies, cupcakes, pretzels, candy, soft drinks. More bagels, muffins, tacos, submarine sandwiches, pizza. It makes you want both wheat-containing and non-wheat-containing foods. And, on top of that, for some people wheat is a drug, or at least yields peculiar drug-like neurological effects that can be reversed with medications used to counter the effects of narcotics.

If you balk at the notion of being dosed with a drug such as naloxone, you might ask, ‘What happens if, rather than blocking the brain effect of wheat chemically, you simply remove the wheat altogether?’ Well, that’s the very same question I have been asking. Provided you can tolerate the withdrawal (while unpleasant, the withdrawal syndrome is generally harmless aside from the rancour you incur from your irritated spouse, friends and co-workers), hunger and cravings diminish, calorie intake decreases, mood and well-being increase, weight goes down, wheat belly shrinks.

Understanding that wheat, specifically exorphins from gluten, have the potential to generate euphoria, addictive behaviour and appetite stimulation means that we have a potential means of weight control. Lose the wheat, lose the weight.

CHAPTER 5

YOUR WHEAT BELLY IS SHOWING: THE WHEAT/OBESITY CONNECTION

PERHAPS YOU’VE EXPERIENCED this scenario:

You encounter a friend you haven’t seen in some time and exclaim with delight: ‘Elizabeth! When are you due?’

Elizabeth: [Pause.] ‘Due? I’m not sure what you mean.’

You: Gulp . . .

Yes, indeed. Wheat belly’s abdominal fat can do a darn good imitation of a baby bump.

Why does wheat cause fat accumulation specifically in the abdomen and not, say, on the scalp, left ear or backside? And, beyond the occasional ‘I’m not pregnant’ mishap, why does it matter?

And why would elimination of wheat lead to loss of abdominal fat?

Let’s explore the unique features of the wheat belly habitus.

WHEAT BELLY, LOVE HANDLES, MAN BOOBS AND ‘FOOD BABIES’

These are the curious manifestations of consuming the modern grain we call wheat. Dimpled or smooth, hairy or hairless, tense or flaccid, wheat bellies come in as many shapes, colours and sizes as there are humans. But all share the same underlying metabolic cause.

I’d like to make the case that foods made with or containing wheat make you fat. I’d go as far as saying that overly enthusiastic wheat consumption is the main cause of the obesity and diabetes crisis in the United States. It explains why modern athletes, such as baseball players and triathletes, are fatter than ever. Blame wheat when you are being crushed in your airline seat by the twenty-stone man next to you.

Sure, sugary soft drinks and sedentary lifestyles add to the problem. But for the great majority of health-conscious people who don’t indulge in these obvious weight-gaining behaviours, the principal trigger for increasing weight is wheat.

In fact, the incredible financial bonanza that the proliferation of wheat in the American diet has created for the food and drug industries can make you wonder if this ‘perfect storm’ was somehow man-made. Did a group of powerful men convene a secret Howard Hughesian meeting in 1955, map out an evil plan to mass-produce high-yield, low-cost dwarf wheat, engineer the release of government-sanctioned advice to eat ‘healthy whole grains’, lead the charge of corporate Big Food to sell hundreds of billions of dollars worth of processed wheat food products – all leading to obesity and the ‘need’ for billions of dollars of drug treatments for diabetes, heart disease and all the other health consequences of obesity? It sounds ridiculous, but in a sense that’s exactly what happened. Here’s how.

Wheat Belly Diva

Celeste no longer felt ‘cool’.

At the age of sixty-one, Celeste reported that she’d gradually gained weight from her normal range of 18½ to 9½ stone in her twenties and thirties. Something happened starting in her mid-forties, and even without substantial changes in habits, she gradually ballooned up to 13 stone. ‘This is the heaviest I have ever been,’ she groaned.

As a professor of modern art, Celeste hung around with a fairly urbane crowd and her weight made her feel even more self-conscious and out of place. So I got an attentive ear when I explained my diet approach that involved elimination of all wheat products.

Over the first three months she lost 1½ stone, more than enough to convince her that the programme worked. She was already having to reach to the back of her closet to find clothes she hadn’t been able to wear for the past five years.

Celeste stuck to the diet, admitting to me that it had quickly become second nature with no cravings, a rare need to snack, just a comfortable cruise through meals that kept her satisfied. She noted that, from time to time, work pressures kept her from being able to have lunch or dinner, but the prolonged periods without something to eat proved effortless. I reminded her that healthy snacks such as raw nuts, linseed crackers, and cheese readily fit into her programme. But she simply found that snacks weren’t necessary most of the time.

Fourteen months after adopting the Wheat Belly diet, Celeste couldn’t stop smiling when she returned to my office at 9 stone – a weight she’d last seen in her thirties. She’d lost 3 stone 13 pounds from her high, including 12 inches off her waist, which shrank from 39 inches to 27. Not only could she fit into size 10 dresses again, she no longer felt uncomfortable mingling with the artsy set. No more need to conceal her sagging wheat belly under loose-fitting tops or layers. She could wear her tightest Oscar de la Renta cocktail dress proudly, no wheat belly bulge in sight.

WHOLE GRAINS, HALF-TRUTHS

In nutrition circles, whole grain is the dietary darling du jour. In fact, this USDA-endorsed, ‘heart healthy’ ingredient, the stuff that purveyors of dietary advice agree you should eat more of, makes us hungry and fat, hungrier and fatter than any other time in human history.

Hold up a current picture of ten random Americans against a picture of ten Americans from the early twentieth century, or any preceding century where photographs are available, and you’d see the stark contrast: Americans are now fat. According to the CDC, 34.4 per cent of adults are now overweight (BMI of 25 to 29.9) and another 33.9 per cent are obese (BMI 30 or greater), leaving less than one in three normal weight.¹ Since 1960, the ranks of the obese have grown the most rapidly, nearly tripling over those fifty years.²

Few Americans were overweight or obese during the first two centuries of the nation’s history. (Most data collected on BMI that we have for comparison prior to the twentieth century come from body weight and height tabulated by the US military. The average male in the military in the late nineteenth century had a BMI of <23.2, regardless of age; by the 1990s, the average military BMI was well into the overweight range.³ We can easily presume that, if it applies to military recruits, it’s worse in the civilian population.) Weight grew at the fastest pace once the USDA and others got into the business of telling Americans what to eat. Accordingly, while obesity grew gradually from 1960, the real upwards acceleration of obesity started in the mid-eighties. In the UK, as of March 2013, the Department of Health reported that in England, most people are overweight or obese. This includes 61.9 per cent of adults and 28 per cent of children aged between 2 and 15. Health problems associated with being overweight or obese cost the NHS more than £5 billion every year.

Studies conducted during the eighties and since have shown that, when processed white flour products are replaced with whole-grain flour products, there is a reduction in colon cancer, heart disease and diabetes. That is indeed true and indisputable.

According to accepted dietary wisdom, if something that is bad for you (white flour) is replaced by something less bad (whole-wheat), then lots of that less-bad thing must be great for you. By that logic, if high-tar cigarettes are bad for you and low-tar cigarettes are less bad, then lots of low-tar cigarettes should be good for you. An imperfect analogy, perhaps, but it illustrates the flawed rationale used to justify the proliferation of grains in our diet. Throw into the mix the fact that wheat has undergone extensive agricultural genetics-engineered changes, and you have devised the formula for creating a nation of fat people.

The USDA and other ‘official’ opinion makers say that more than two-thirds of Americans are overweight or obese because we’re inactive and gluttonous. We sit on our fat behinds watching too much reality TV, spend too much time online and don’t exercise. We drink too many sugary fizzy drinks and eat too much fast food and too many junk snacks. Betcha can’t eat just one!

Certainly these are poor habits that will eventually take their toll on one’s health. But I meet plenty of people who tell me that they follow ‘official’ nutritional guidelines seriously, avoid junk foods and fast foods, exercise an hour every day, all while continuing to gain and gain and gain. Many follow the guidelines set by the USDA food pyramid (six to eleven servings of grain per day, of which four or more should be whole grain), the American Heart Association, the American Dietetic Association or the American Diabetes Association. The cornerstone of all these nutritional directives? ‘Eat more healthy whole grains’. This largely matches the advice given by the UK government and the NHS, which recommend that you ‘choose wholegrain varieties whenever you can’.

Are these organisations in cahoots with the wheat farmers and seed and chemical companies? There’s more to it than that. ‘Eat more healthy whole grains’ is really just the corollary of the ‘Cut the fat’ movement embraced by the medical establishment in the sixties. Based on epidemiologic observations that suggested that higher dietary fat intakes are associated with higher cholesterol levels and risk for heart disease, Americans were advised to reduce total and saturated fat intake. Grain-based foods came to replace the calorie gap left by reduced fat consumption. The whole-grain-is-better-than-white argument further fuelled the transition. The low-fat, more-grain message also proved enormously profitable for the processed food industry. It triggered an explosion of processed food products, most requiring just a few pence worth of basic materials. Wheat flour, cornflour, high-fructose corn syrup, sucrose, and food colouring are now the main ingredients of products that fill the interior aisles of any modern supermarket. (Whole ingredients such as vegetables, meats and dairy tend to be at the perimeter of these same stores.) Revenues for Big Food companies swelled. Kraft alone now generates $48.1 billion in annual revenues, an 1,800 per cent increase since the late eighties, a substantial portion of which comes from wheat- and corn-based snacks.

Just as the tobacco industry created and sustained its market with the addictive property of cigarettes, so does wheat in the diet make for a helpless, hungry consumer. From the perspective of the seller of food products, wheat is a perfect processed food ingredient: the more you eat, the more you want. The situation for the food industry has been made even better by the glowing endorsements provided by governments urging people to eat more ‘healthy whole grains’.

GRAB MY LOVE HANDLES: THE UNIQUE PROPERTIES OF VISCERAL FAT

Wheat triggers a cycle of insulin-driven satiety and hunger, paralleled by the ups and downs of euphoria and withdrawal, distortions of neurological function, and addictive effects, all leading to fat deposition.

The extremes of blood sugar and insulin are responsible for growth of fat specifically in the visceral organs. Experienced over and over again, visceral fat accumulates, creating a fat liver, two fat kidneys, a fat pancreas, fat large and small intestines, as well as its familiar surface manifestation, a wheat belly. (Even your heart gets fat, but you can’t see this through the semi-rigid ribs.)

So the Michelin tire encircling your or your loved one’s waistline represents the surface manifestation of visceral fat contained within the abdomen and encasing abdominal organs, resulting from months to years of repeated cycles of high blood sugar and high blood insulin, followed by insulin-driven fat deposition. Not fat deposition in the arms, buttocks or thighs, but the saggy ridge encircling the abdomen created by bulging fatty internal organs. (Exactly why disordered glucose-insulin metabolism preferentially causes visceral fat accumulation in the abdomen and not your left shoulder or the top of your head is a question that continues to stump medical science.)

Buttock or thigh fat is precisely that: buttock or thigh fat – no more, no less. You sit on it, you squeeze it into your jeans, you lament the cellulite dimples it creates. It represents excess calories over caloric expenditure. While wheat consumption adds to buttock and thigh fat, the fat in these regions is comparatively quiescent, metabolically speaking.

Visceral fat is different. While it might be useful as ‘love handles’ grasped by your partner, it is also uniquely capable of triggering a universe of inflammatory phenomena. Visceral fat filling and encircling the abdomen of the wheat belly sort is a unique, twenty-four-hour-a-day, seven-day-a-week metabolic factory. And what it produces is inflammatory signals and abnormal cytokines, or cell-to-cell hormone signal molecules, such as leptin, resistin and tumour necrosis factor.⁴, ⁵ The more visceral fat present, the greater the quantities of abnormal signals released into the bloodstream.

All body fat is capable of producing another cytokine, adiponectin, a protective molecule that reduces risk for heart disease, diabetes and hypertension. However, as visceral fat increases, its capacity to produce protective adiponectin diminishes (for reasons unclear).⁶ The combination of lack of adiponectin along with increased leptin, tumour necrosis factor and other inflammatory products underlies abnormal insulin responses, diabetes, hypertension and heart disease.⁷ The list of other health conditions triggered by visceral fat is growing and now includes dementia, rheumatoid arthritis and colon cancer.⁸ This is why waist circumference is proving to be a powerful predictor of all these conditions, as well as of mortality.⁹

Visceral fat not only produces abnormally high levels of inflammatory signals but is also itself inflamed, containing bountiful collections of inflammatory white blood cells (macrophages).¹⁰ The endocrine and inflammatory molecules produced by visceral fat empty (via the portal circulation draining blood from the intestinal tract) directly into the liver, which then responds by producing yet another sequence of inflammatory signals and abnormal proteins.

In other words, in the human body, all fat is not equal. Wheat belly fat is a special fat. It is not just a passive repository for excess pizza calories; it is, in effect, an endocrine gland much like your thyroid gland or pancreas, albeit a very large and active endocrine gland. (Ironically, people were correct forty years ago when they labelled an overweight person as having a ‘gland’ problem.) Unlike other endocrine glands, the visceral fat endocrine gland does not play by the rules, but follows a unique handbook that works against the body’s health.

So a wheat belly is not just unsightly, it’s also dreadfully unhealthy.

GETTING HIGH ON INSULIN

Why is wheat so much worse for weight than other foods?

The essential phenomenon that sets the growth of the wheat belly in motion is high blood sugar (glucose). High blood sugar, in turn, provokes high blood insulin. (Insulin is released by the pancreas in response to the blood sugar. The higher the blood sugar, the more insulin must be released to move the sugar into the body’s cells, such as those of the muscle and liver.) When the pancreas’s ability to produce insulin in response to blood sugar rises is exceeded, diabetes develops. But you don’t have to be diabetic to experience high blood sugar and high insulin. Nondiabetics can easily experience the high blood sugars required to cultivate their very own wheat belly, particularly because foods made from wheat so readily convert to sugar.

High blood insulin provokes visceral fat accumulation, the body’s means of storing excess energy. When visceral fat accumulates, the flood of inflammatory signals it produces causes tissues such as muscle and liver to respond less to insulin. This so-called insulin resistance means that the pancreas must produce greater and greater quantities of insulin to metabolise the sugars. Eventually, a vicious circle of increased insulin resistance, increased insulin production, increased deposition of visceral fat, increased insulin resistance, etc., etc., ensues.

Nutritionists established the fact that wheat increases blood sugar more profoundly than table sugar thirty years ago. As we’ve discussed, the glycaemic index, or GI, is the nutritionist’s measure of how much blood sugar levels increase in the 90 to 120 minutes after a food is consumed. By this measure, whole-wheat bread has a GI of 72, while plain table sugar has a GI of 59 (though some labs have observed results as high as 65). In contrast, kidney beans have a GI of 51, grapefruit comes in at 25, while noncarbohydrate foods such as salmon and walnuts have GIs of essentially zero: eating these foods has no effect on blood sugar. In fact, with few exceptions, few foods have as high a GI as foods made from wheat. Outside of dried sugar-rich fruits such as dates and figs, the only other foods that have GIs as high as wheat products are dried, pulverised starches such as cornflour, rice starch, potato starch and tapioca starch. (It is worth noting that these are the very same carbohydrates often used to make ‘gluten-free’ food. More on this later.)

Because wheat carbohydrate, the uniquely digestible amylopectin A, causes a greater spike in blood sugar than virtually any other food – more than a chocolate bar, table sugar or ice cream – it also triggers greater insulin release. More amylopectin A means higher blood sugar, higher insulin, more visceral fat deposition . . . bigger wheat belly.

Throw in the inevitable drop in blood sugar (hypoglycaemia) that is the natural aftermath of high insulin levels and you see why irresistible hunger so often results, as the body tries to protect you from the dangers of low blood sugar. You scramble for something to eat to increase blood sugar, and the cycle is set in motion again, repeating every two hours.

Now factor in your brain’s response to the euphoric exorphin effects induced by wheat (and the attendant potential for withdrawal if your next ‘fix’ is missed), and it’s no wonder the wheat belly encircling your waist continues to grow and grow.

MEN’S LINGERIE IS ON THE SECOND FLOOR

Wheat belly is not just a cosmetic issue, but a phenomenon with real health consequences. In addition to producing inflammatory hormones such as leptin, visceral fat is also a factory for oestrogen production in both sexes, the very same oestrogen that confers female characteristics on girls beginning at puberty, such as widening of the hips and growth of the breasts.

Until the menopause, adult females have high levels of oestrogen. Surplus oestrogen, however, produced by visceral fat adds considerably to breast cancer risk, since oestrogen at high levels stimulates breast tissue.¹¹ Thus, increased visceral fat on a female has been associated with an increased risk for breast cancer as high as fourfold. Breast cancer risk in postmenopausal women with the visceral fat of a wheat belly is double that of slender, non-wheat-belly-bearing postmenopausal females.¹²

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