Wheat Belly

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