Even more telling, the NIH group found that the brain effects of gluten-derived polypeptides are blocked by administration of the opiate-blocking 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 trauma emergency room. Because you’re high on heroin, you kick and scream at the ER 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 receptors 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 to reverse life-threatening overdose 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.17 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 and peculiar effects on the brain. Those of us without schizophrenia don’t experience auditory hallucinations from exorphins resulting from a cinnamon raisin bagel, but these compounds are still there in the brain, no different from in a schizophrenic. It also highlights how wheat is truly unique among grains, since other grains such as millet and oats do not generate exorphins (because they lack the gliadin protein from gluten), nor do they cultivate obsessive behavior or opiate 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, many people experience a distinctly unpleasant withdrawal.
What happens if normal (i.e., non-schizophrenic) 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 percent fewer calories at lunch and 23 percent fewer calories at dinner (a total of approximately 400 calories less over the two meals) than participants given a placebo.18 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 percent fewer wheat crackers, breadsticks, and pretzels with the administration of naloxone.19
In other words, block the euphoric reward of wheat and calorie intake goes down, since wheat no longer generates the favorable feelings and addictive behavior that encourage repetitive consumption. (Predictably, this strategy has been pursued by the pharmaceutical industry to commercialize 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 responsible for generating pleasurable feelings from heroin, morphine, and other substances. Because naltrexone administration alone can replace pleasurable feelings with feelings of dysphoria, or unhappiness, naltrexone has been combined with the antidepressant and smoking-cessation drug bupropion in the recently FDA-approved drug Contrave.)
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 caloric 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 favorite merlot or chardonnay), wheat is one of the few foods that can alter behavior, 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 CRAVING CONQUERED
For as long as he could remember, Larry struggled with weight.
It never made sense to him: He exercised, often to extremes. A fifty-mile bike ride was not unusual, nor was a fifteen-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, 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 concern. 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 percent 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, even while sitting quietly. Larry was also, at 5 feet 8 inches and 243 pounds, about 80 pounds 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 programs, “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 multi-grain crackers I have with a yogurt 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 counseled 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 caloric intake and portion size was a fraction of its former level. With no change in his exercise habits, he’d lost “only” 11 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 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 rancor you incur from your irritated spouse, friends, and co-workers), hunger and cravings diminish, caloric 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 behavior, and appetite stimulation means that we have a potential means of taking back control over eating habits and weight: Lose the wheat and lose the weight, as well as the myriad effects this never-should-have-been-food-in-the-first-place thing has over us.
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–body configuration.
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, colors, and sizes as there are humans. But all share the same underlying metabolic cause.
I’d like to make the case that foods produced 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’s a big part of the reason why Jillian Michaels needed to badger The Biggest Loser contestants. It explains why modern athletes, such as baseball players and triathletes, are fatter than ever, and why the most popular dress sizes are now 16 to 18. Blame wheat when you are being crushed in your airline seat by the 280-pound 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 behaviors, 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 semi-dwarf wheat, engineer the release of government-sanctioned advice to eat plenty of “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? It may sound ridiculous, but in a sense that’s exactly what happened. Here’s how.
WHEAT BELLY DIVA
Celeste no longer felt “cool.”
At age sixty-one, Celeste reported that she’d gradually gained weight from her normal range of 120 to 135 pounds in her twenties and thirties. Something happened starting in her mid-forties, and even without substantial changes in habits, she gradually ballooned up to 182 pounds. “This is the heaviest I have ever been,” she groaned.
As a professor of modern art, Celeste hung around with a fairly urbane crowd. Her weight made her feel 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 21 pounds, more than enough to convince her that the program worked. She was already having to reach into the back of her closet to find clothes she hadn’t been able to wear for the past five years.
Celeste stuck to the lifestyle, 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, flaxseed crackers, and cheese readily fit into her program. But she simply found that snacks weren’t necessary most of the time.
Fourteen months after adopting the Wheat Belly lifestyle, Celeste couldn’t stop smiling when she returned to my office at 127 pounds—a weight she’d last seen in her thirties. She’d lost 55 pounds from her high, including 12 inches off her waist, which shrank from 39 inches to 27. Not only could she fit into size 6 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 grains are 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, even dominate diet, 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 or preceding century, and you’ll see the stark contrast: Americans are now fat. According to the CDC, 39.6 percent of adults are obese (BMI 30 or greater), another 36 percent are overweight (BMI of 25 to 29.9), leaving only one in four at normal weight. Since 1960, the ranks of the obese have grown the most rapidly, nearly tripling over those sixty years.1
Few Americans were overweight or obese during the first two centuries of the nation’s history. (Most actual data collected on BMI that we have for comparison prior to the twentieth century come from body weight and height tabulated by the U.S. 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.2 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 upward acceleration of obesity started in the mid-eighties.
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, type 2 diabetes, and less weight is gained. All that is indeed true, an indisputable half-truth.
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. This is 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 a formula for creating a nation of fat, unhealthy people. Less bad is not necessarily good.
Let’s look a bit closer, for instance, at the notion that “healthy whole grains” are part of an effort to maintain a healthy weight. Time and again, studies have demonstrated that people who consume greater proportions of whole grains weigh less than those who consume white flour—no argument here. But look closer: What studies like the Nurses’ Health Study and the Physicians’ Health Study really show is that people who consume white flour products gain substantial weight, while people who consume whole grains gain less weight—but both gain weight. Once again, less bad is not necessarily good. Whole grains have most definitely not been associated with weight loss but with less weight gain.3 Yet, this has been reported as better weight management, with whole grain consumption, trumpeted by the media, doctors, dietitians, and the grain industry, heard by Mary and John Q. Public as “whole grains are part of a healthy weight control program.” (This flawed sequence of logic, by the way, is a problem that shows itself over and over again in nutritional thinking and is responsible for a number of other common misconceptions that I shall touch on later.)
The USDA and other “official” opinion makers insist 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 much sugary soda and eat too much fast food and junk snacks. Betcha can’t eat just one!
Certainly these are poor habits that will eventually take their toll on health. But I meet plenty of people who tell me that they follow nutritional guidelines seriously, avoid junk foods and fast foods, exercise an hour every day, all while continuing to gain and gain and gain. Many very seriously adhere to the guidelines set by the USDA food pyramid and food plate (six to eleven servings of grain per day, of which four or more should be whole grain), the American Heart Association, the Academy of Nutrition and Dietetics, or the American Diabetes Association. The cornerstone of all these nutritional directives? “Eat more healthy whole grains.”
Are these organizations 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 since the sixties. Based on epidemiological observations (as well as misinterpretations, misrepresentations, and concealed, unreported findings to the contrary) suggesting 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 filled the calorie gap left by reduced fat consumption. The blundering logic of whole-grain-is-better-than-white argument further fueled 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 nickels’ worth of basic materials. Wheat flour, cornstarch, high-fructose corn syrup, sucrose, and food coloring are now the main ingredients in thousands of products that fill the interior aisles of any modern supermarket. (Non-grain foods such as vegetables, meats, and dairy tend to be at the perimeter.) Revenues for Big Food companies swelled. Breakfast cereals alone generate nearly $8 billion per year built on claims of fiber, bowel regularity, B vitamins, better school performance, and part of a “healthy breakfast to start your day.”
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 the U.S. government urging Americans 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 so much fat deposition in the arms, buttocks, or thighs, but the saggy ridge encircling the abdomen accompanied 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. 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. It produces inflammatory signals and abnormal cytokines, or cell-to-cell hormone signal molecules, such as leptin, resistin, and tumor necrosis factor.4, 5 The more visceral fat present, the greater the quantities of abnormal signals released into the bloodstream, the “louder” the blare of inflammation throughout the body.
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, tumor 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 for mortality.9
