Wheat Belly: Lose the Wheat, Lose the Weight and Find Your Path Back to Health (23 page)

Think of it this way: Anything that provokes an increase in blood sugar will also, in parallel, provoke small LDL particles. Anything that keeps blood sugar from increasing, such as proteins, fats, and reduction in carbohydrates such as wheat, reduces small LDL particles.

Note that the insight gained by looking at LDL particles, rather than LDL cholesterol, leads us to conclusions about diet that are in stark contrast to the conventional advice for heart health. In effect, the popular fiction of calculated LDL cholesterol has perpetuated another fiction, that of the health benefits of reducing fat and increasing consumption of “healthy whole grains.” All the while, when viewed from the deeper insights gained from techniques such as lipoprotein analysis, we see that this advice achieved the
opposite
of what it intended.

CHAPTER 11
IT’S ALL IN YOUR HEAD: WHEAT AND THE BRAIN

OKAY. SO WHEAT MESSES WITH
your bowels, amps up your appetite, and makes you the brunt of beer belly jokes. But is it really that bad?

Wheat’s effects reach the brain in the form of opiate-like peptides. But the polypeptide exorphins responsible for these effects come and go, dissipating over time. Exorphins cause your brain to instruct you to eat more food, increase calorie consumption, and desperately scratch at the stale crackers at the bottom of the box when there’s nothing else left.

But all these effects are reversible. Stop eating wheat, the effect goes away, the brain recovers, and you’re again ready to help your teenager tackle quadratic equations.

But wheat’s effects on the brain don’t end there. Among the most disturbing of wheat’s effects are those exerted on brain tissue itself—not “just” on thoughts and behavior, but on the cerebrum, cerebellum, and other nervous system structures, with consequences ranging from incoordination to incontinence, from
seizures to dementia. And, unlike addictive phenomena, these are
not
entirely reversible.

WATCH WHERE YOU STEP: WHEAT AND CEREBELLAR HEALTH

Imagine I was to blindfold you and set you loose in an unfamiliar room full of odd angles, nooks and crannies, and randomly placed objects to stumble over. Within a few steps you’re likely to find yourself face-first in the shoe rack. Such are the struggles of someone with a condition known as cerebellar ataxia. But these people struggle with eyes wide open.

These are the people you often see using canes and walkers, or stumbling over a crack in the sidewalk that results in a fractured leg or hip. Something has impaired their ability to navigate the world, causing them to lose control over balance and coordination, functions centered in a region of the brain called the cerebellum.

The majority of people with cerebellar ataxia consult with a neurologist, often to have their condition deemed idiopathic, without known cause. No treatment is prescribed, nor has a treatment been developed. The neurologist simply suggests a walker, advises removing potential stumbling hazards in the home, and discusses adult diapers for the urinary incontinence that will eventually develop. Cerebellar ataxia is progressive, getting worse with each passing year until the sufferer is unable to comb his hair, brush his teeth, or go to the bathroom alone. Even the most basic self-care activities will eventually need to be performed by someone else. At this point, the end is near, as such extreme debilitation hastens complications such as pneumonia and infected bedsores.

Between 10 and 22.5 percent of people with celiac disease have nervous system involvement.
1,
2
Of all forms of ataxia that are diagnosed, 20 percent have abnormal blood markers for gluten. Of people with unexplained ataxia—i.e., no other cause can be
identified—abnormal blood markers for gluten are measured in 50 percent of the afflicted.
3

Problem: The majority of people with ataxia triggered by wheat gluten have no signs or symptoms of intestinal disease, no celiac-like warnings to send the signal that gluten sensitivity is at work.

The destructive immune response responsible for the diarrhea and abdominal cramps of celiac disease can also be directed against brain tissue. While the gluten-brain connection underlying neurological impairment was suspected as long ago as 1966, it was thought to be due to the nutritional deficiencies accompanying celiac disease.
4
More recently, it has become clear that brain and nervous system involvement results from a direct immune attack on nerve cells. The antigliadin antibodies triggered by gluten can bind to Purkinje cells of the brain, cells unique to the cerebellum.
5
Brain tissue such as Purkinje cells do not have the capacity to regenerate: Once damaged, cerebellar Purkinje cells are gone … forever.

In addition to loss of balance and coordination, wheat-induced cerebellar ataxia can show such odd phenomena as, in the arcane language of neurology, nystagmus (lateral involuntary twitching of the eyeballs), myoclonus (involuntary muscle twitching), and chorea (chaotic involuntary jerking motions of the limbs). One study of 104 people with cerebellar ataxia also revealed impaired memory and verbal abilities, suggesting that wheat-induced destruction may involve cerebral tissue, the seat of higher thought and memory.
6

The typical age of onset of symptoms of wheat-induced cerebellar ataxia is forty-eight to fifty-three. On MRI of the brain, 60 percent show atrophy of the cerebellum, reflecting the irreversible destruction of Purkinje cells.
7

Only limited recovery of neurological function occurs with wheat gluten elimination due to the poor capacity of brain tissue to regenerate. Most people simply stop getting worse once the flow of gluten stops.
8

The first hurdle in diagnosing ataxia that develops from wheat exposure is to have a physician who even considers the diagnosis in the first place. This can be the toughest hurdle of all, since much of the medical community continues to embrace the notion that wheat is good for you. Once considered, however, the diagnosis is a bit trickier than just diagnosing intestinal celiac disease, especially since some antibodies (the IgA form specifically) are not involved in wheat-induced brain disease. Add to this the little problem that a brain biopsy is objectionable to most people, and it takes a well-informed neurologist to make the diagnosis. The diagnosis may rest on a combination of suspicion and positive HLA DQ markers, along with observation of improvement or stabilization with wheat and gluten elimination.
9

The painful reality of cerebellar ataxia is that, in the great majority of cases, you won’t know you have it until you start tripping over your own feet, drifting into walls, or wetting your pants. Once it shows itself, your cerebellum likely is already shrunken and damaged. Halting all wheat and gluten ingestion at this point is only likely to keep you out of the assisted living facility.

All of this due to the muffins and bagels you so crave.

FROM YOUR HEAD DOWN TO YOUR TOES: WHEAT AND PERIPHERAL NEUROPATHY

While cerebellar ataxia is due to wheat-triggered immune reactions on the brain, a parallel condition occurs in the nerves of the legs, pelvis, and other organs. It is called peripheral neuropathy.

A common cause of peripheral neuropathy is diabetes. High blood sugars occurring repeatedly over several years damage the nerves in the legs, causing reduced sensation (thus allowing a diabetic to step on a thumbtack without knowing it), diminished control over blood pressure and heart rate, and sluggish emptying of the stomach (diabetic gastroparesis), among other manifestations of a nervous system gone haywire.

Dance the Wheat Away

When I first met Meredith, she was sobbing. She’d come to me because of a minor heart question (an EKG variant that proved benign).

“Everything hurts! My feet especially,” she said. “They’ve treated me with all kinds of drugs. I hate them because I’ve had lots of side effects. The one I just started two months ago makes me so hungry that I can’t stop eating. I’ve gained fifteen pounds!”

Meredith described how, in her work as a schoolteacher, she was barely able to stand in front of her class any longer because of the pain in her feet. More recently, she had also started to doubt her ability to walk, since she was also starting to feel unsteady and uncoordinated. Just getting dressed in the morning was taking longer and longer due to both the pain as well as the increasing clumsiness that impaired such simple activities as putting on a pair of pants. Although only fifty-six years old, she was forced to use a cane.

I asked her if her neurologist had any explanations for her disability. “None. They all say there’s no good reason. I’ve just got to live with it. They can give me medicines to help with the pain, but it’s probably going to get worse.” That’s when she broke down and started crying again.

I suspected there was a wheat issue just by looking at Meredith. Beyond the obvious difficulty she had walking into the room, her face was
puffy and red. She described her struggles with acid reflux and the abdominal cramping and bloating diagnosed as irritable bowel syndrome. She was about sixty pounds overweight and had a modest quantity of edema (water retention) in her calves and ankles.

So I asked Meredith to venture down the wheat-free path. By this time, she was so desperate for any helpful advice that she agreed to try. I also took the gamble of scheduling her for a stress test that would require her to walk at a moderate speed up an incline on a treadmill.

Meredith returned two weeks later. I asked her if she thought she could manage the treadmill. “No problem! I stopped all wheat immediately after I talked to you. It took about a week, but the pain started to go away. Right now I have about ninety percent less pain than I had a couple of weeks ago. I’d say it’s nearly gone. I’ve already stopped one of the medicines for the pain and I think I’ll stop the other later this week.” She also clearly no longer needed her cane.

She related how her acid reflux and irritable bowel symptoms had also disappeared completely. And she’d lost nine pounds in the two-week period.

Meredith tackled the treadmill without difficulty, handily managing the 3.6-miles-per-hour, 14 percent grade.

A similar degree of nervous system chaos occurs with wheat exposure. The average age of onset of gluten-induced peripheral neuropathy is fifty-five. As with cerebellar ataxia, the majority of sufferers do not have intestinal symptoms that suggest celiac disease.
10

Unlike cerebellar Purkinje cells’ inability to regenerate, peripheral nerves have limited capacity to undergo repair once the offending wheat and gluten are removed, with the majority of people experiencing at least partial reversal of their neuropathy. In one study of thirty-five gluten-sensitive patients with peripheral neuropathy who were positive for the antigliadin antibody, the twenty-five participants on a wheat- and gluten-free diet improved over one year, while the ten control participants who did not remove wheat and gluten deteriorated.
11
Formal studies of nerve conduction were also performed, demonstrating improved nerve conduction in the wheat- and gluten-free group, and deterioration in the wheat- and gluten-consuming group.

Because the human nervous system is a complex web of nerve cells and networks, peripheral neuropathy triggered by wheat gluten exposure can show itself in a variety of ways, depending on what collection of nerves are affected. Loss of sensation to both legs along with poor leg muscle control is the most common, called sensorimotor axonal peripheral neuropathy. Less commonly, only one side of the body may be affected (asymmetrical neuropathy);
or the autonomic nervous system, the part of the nervous system responsible for automatic functions such as blood pressure, heart rate, and bowel and bladder control, can be affected.
12
If the autonomic nervous system is affected, such phenomena as losing consciousness or becoming light-headed while standing up due to poor blood pressure control, inability to empty the bladder or bowels, and inappropriately rapid heart rate can result.

Peripheral neuropathy, regardless of how it is expressed, is progressive and will get worse and worse unless all wheat and gluten are removed.

WHOLE GRAIN BRAIN

I think that we can all agree: “Higher” brain functions, such as thinking, learning, and memory, should be off-limits to intruders. Our minds are deeply personal, representing the summation of everything that is you and your experiences. Who wants nosy neighbors or marketing pitchmen to gain access to the private domain of the mind? While the notion of telepathy is fascinating to think about, it’s also really creepy to think that someone could read your thoughts.

For wheat,
nothing
is sacred. Not your cerebellum, not your cerebral cortex. While it can’t read your mind, it sure can influence what goes on inside it.

The effect of wheat on the brain is more than just influence over mood, energy, and sleep. Actual brain
damage
is possible, as seen in cerebellar ataxia. But the cerebral cortex, the center of memory and higher thinking, the storehouse of you and your unique personality and memories, the brain’s “gray matter,” can also be pulled into the immune battle with wheat, resulting in encephalopathy, or brain disease.

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