Wheat Belly: Lose the Wheat, Lose the Weight and Find Your Path Back to Health (14 page)

Celiac disease is a permanent condition. Even if gluten is eliminated for many years, celiac disease or other forms of immune-mediated gluten intolerance come rushing back on reexposure.

Because susceptibility to celiac disease is, at least partly, genetically determined, it doesn’t dissipate with healthy diet, exercise, weight loss, nutritional supplements, drugs, daily enemas, healing stones, or apologies to your mother-in-law. It stays with you as long as you are human and are unable to trade genes with another organism. In other words, you have celiac disease for a lifetime.

It means that even occasional casual exposure to gluten has health consequences to the celiac disease sufferer or the gluten-sensitive individual, even if immediate symptoms such as diarrhea are not provoked.

All is not lost if you have celiac disease. Food can be every bit as enjoyable without wheat, even more so. One of the essential but unappreciated phenomena accompanying wheat and gluten elimination, celiac or otherwise: You appreciate food more. You eat foods because you require sustenance and you enjoy their taste and texture. You are not driven by hidden uncontrollable impulses of the sort triggered by wheat.

Don’t think of celiac disease as a burden. Think of it as
liberation.

I’VE KICKED IT IN THE JAW,
beaten it, and called it names. Let’s now look this thing called diabetes square in the eye.

When I was a kid growing up in Lake Hiawatha, New Jersey, my mother used to point to one person or another and declare him or her the “president of the soup bone club.” That’s the title she gave local people who thought they were big shots in our little town of 5,000. One time, for instance, the husband of a friend of hers droned on about how he could fix all the ills of the country if only he were elected president—though he was unemployed, was missing two front teeth, and had been arrested twice for drunk driving over the past two years. Thus, my mother’s gracious appointment of the man as the president of the soup bone club.

Wheat, too, is the leader of an unenviable group, the worst carbohydrate in the bunch, the one most likely to lead us down the path of diabetes. Wheat is president of its own little soup bone club, chief among carbohydrates. Drunk, foul-mouthed, and unbathed, still wearing last week’s T-shirt, it gets elevated to special “fiber-rich,” “complex carbohydrate,” and “healthy whole grain” status by all the agencies that dispense dietary advice.

Because of wheat’s incredible capacity to send blood sugar levels straight up, initiate the glucose-insulin roller coaster ride that drives appetite, generate addictive brain-active exorphins, and grow visceral fat, it is the one essential food to eliminate in a serious effort to prevent, reduce, or eliminate diabetes. You could eliminate walnuts or pecans, but you will have no impact on diabetic risk. You could eliminate spinach or cucumbers and have no effect on diabetic risk. You could banish all pork or beef from your table and still have no effect.

But you could remove wheat and an entire domino effect of changes develop: less triggering of blood sugar rises, no exorphins to drive the impulse to consume more, no initiation of the glucose-insulin cycle of appetite. And if there’s no glucose-insulin cycle, there’s little to drive appetite except genuine physiologic need for sustenance, not overindulgence. If appetite shrinks, calorie intake is reduced, visceral fat disappears, insulin resistance improves, blood sugars fall. Diabetics can become nondiabetics, prediabet-ics can become nonprediabetics. All the phenomena associated with poor glucose metabolism recede, including high blood pressure, inflammatory phenomena, glycation, small LDL particles, triglycerides.

In short, remove wheat and thereby reverse a
constellation
of phenomena that would otherwise result in diabetes and all its associated health consequences, three or four medications if not seven, and years shaved off your life.

Think about that for a moment: The personal and societal costs of developing diabetes are substantial. On average, one person
with diabetes incurs $180,000 to $250,000 in direct and indirect health care costs if diagnosed at age fifty
¹
and dies eight years earlier than someone without diabetes.
²
That’s as much as a quarter of a million dollars and half the time spent watching your children grow up that you sacrifice to this disease, a disease caused in large part by food—in particular, a specific list of foods. President of this soup bone club: wheat.

The clinical data documenting the effects of wheat elimination on diabetes are somewhat blurred by lumping wheat into the larger category of carbohydrates. Typically, health-conscious people who follow conventional dietary advice to reduce fat and eat more “healthy whole grains” consume approximately 75 percent of their carbohydrate calories from wheat products. That’s more than enough hobnobbing with the soup bone club to take you down the road to the increased medical costs, health complications, and shortened life span of diabetes. But it also means that, if you knock off the top dog, the pack disperses.

Wheat and diabetes are closely interwoven. In many ways, the history of wheat is also the history of diabetes. Where there’s wheat, there’s diabetes. Where there’s diabetes, there’s wheat. It’s a relationship as cozy as McDonald’s and hamburgers. But it wasn’t until the modern age that diabetes became not just a disease of the idle rich but of every level of society. Diabetes has become Everyman’s Disease.

Diabetes was virtually unknown in the Neolithic Age, when Natufians first began to harvest wild einkorn wheat. It was certainly unknown in the Paleolithic Age, the millions of years preceding the agricultural ambitions of Neolithic Natufians. The archaeological record and observations of modern hunter-gatherer societies suggest that humans almost never developed diabetes nor died of
diabetic complications before grains were present in the diet.
^3,
4
The adoption of grains into the human diet was followed by archaeological evidence of increased infections, bone diseases such as osteoporosis, increased infant mortality, and reduction in life span, as well as diabetes.
⁵

For example, the 1534
BC
Egyptian “Eber’s papyrus,” discovered in the Necropolis of Thebes and harking back to the period when Egyptians incorporated ancient wheat into their diet, describes the excessive urine production of diabetes. Adult diabetes (type 2) was described by the Indian physician Sushruta in the fifth century
BC
, who called it
madhumeha,
or “honey-like urine,” due to its sweet taste (yes, he diagnosed diabetes by tasting urine) and the way the urine of diabetics attracted ants and flies. Sushruta also presciently ascribed diabetes to obesity and inactivity and advised treatment with exercise.

The Greek physician Aretaeus called this mysterious condition diabetes, meaning “passing water like a siphon.” Many centuries later, another urine-tasting diagnostician, Dr. Thomas Willis, added “mellitus,” meaning “tasting like honey.” Yes, passing water like a siphon that tastes like honey. You’ll never look at your diabetic aunt the same way again.

Starting in the 1920s, diabetes treatment took a huge leap forward with the administration of insulin, which proved lifesaving for diabetic children. Child diabetics experience damage to the insulin-producing beta cells of the pancreas, impairing its ability to make insulin. Unchecked, blood glucose climbs to dangerous levels, acting as a diuretic (causing urinary water loss). Metabolism is impaired, since glucose is unable to enter the body’s cells due to lack of insulin. Unless insulin is administered, a condition called diabetic ketoacidosis develops, followed by coma and death. The discovery of insulin earned Canadian physician Sir Frederick Banting the Nobel Prize in 1923, spawning an era in which all diabetics, children and adults, were administered insulin.

While the discovery of insulin was truly lifesaving for children, it sent the understanding of adult diabetes off course for many
decades. After insulin was discovered, the distinction between type 1 and type 2 diabetes remained blurred. It was therefore a surprise in the fifties when it was discovered that adult type 2 diabetics don’t lack insulin until advanced phases of the disease. In fact, most adult type 2 diabetics have high quantities of insulin (several times greater than normal). Only in the eighties was the concept of insulin resistance discovered, explaining why abnormally high levels of insulin were present in adult diabetics.
⁶

Unfortunately, the discovery of insulin resistance failed to enlighten the medical world when the eighties’ notion of reducing fat and saturated fat in the diet led to a nationwide open season on carbohydrates. In particular, it led to the idea that “healthy whole grains” would salvage the health of Americans believed to be threatened by overconsumption of fats. It inadvertently led to a thirty-year experiment in what can happen to people who reduce fats but replace lost fat calories with “healthy whole grains” such as wheat.

The result: weight gain, obesity, bulging abdomens of visceral fat, prediabetes and diabetes on a scale never before witnessed, affecting males and females alike, rich and poor, herbivores and carnivores, reaching across all races and ages, all “passing water like a siphon that tastes like honey.”

Adult diabetes through the ages was mostly the domain of the privileged who didn’t have to hunt for their food, farm the land, or prepare their own meals. Think Henry VIII, gouty and obese, sporting a fifty-four-inch waistline, gorging nightly on banquets topped off with marzipan, loaves of bread, sweet puddings, and ale. Only during the last half of the nineteenth century and into the twentieth century, when sucrose (table sugar) consumption increased across all societal levels, common laborer on up, did diabetes become more widespread.
⁷

The transition of the nineteenth into the twentieth century therefore witnessed an increase in diabetes, which then stabilized for many years. For most of the twentieth century, the incidence of adult diabetes in the United States remained relatively constant—until the mid-eighties.

Then things took an abrupt turn for the worse.

Percentage of US adults with diabetes, 1980-2009. The late 1980s marked a sharp upward trend, with the most dramatic spikes in 2009 and2010 (not shown).
Source: Centers for Disease Control and Prevention

Today diabetes is epidemic, as common as tabloid gossip. In 2009, twenty-four million Americans were diabetic, a number that represents explosive growth compared to just a few years earlier. The number of Americans with diabetes is growing faster than any other disease condition with the exception of obesity (if you call obesity a disease). If you’re not diabetic yourself, then you likely have friends who are diabetic, coworkers who are diabetic, neighbors who are diabetic. Given the exceptionally high incidence in the elderly, your parents are (or were) likely to be diabetic.

And diabetes is just the tip of the iceberg. For every diabetic, there are three or four people with prediabetes (encompassing the conditions impaired fasting glucose, impaired glucose tolerance,
and metabolic syndrome) waiting in the wings. Depending on whose definition you use, an incredible 22 to 39 percent of all US adults have prediabetes.
⁸
The combined total of people with diabetes and prediabetes in 2008 was eighty-one million, or one in three adults over eighteen years of age.
⁹
That’s more than the total number of people, adults and children, diabetic and nondiabetic, living in the entire United States in 1900.

If you also count the people who don’t yet meet full criteria for prediabetes but just show high after-meal blood sugars, high triglycerides, small LDL particles, and poor responsiveness to insulin (insulin resistance)—phenomena that can still lead to heart disease, cataracts, kidney disease, and eventually diabetes—you would find few people in the modern age who are
not
in this group, children included.