Your Personal Paleo Code: The 3-Step Plan to Lose Weight, Reverse Disease, and Stay Fit and Healthy for Life (9 page)

Dr. Lalonde’s scale, which utilized a wide-ranging and exhaustive amount of nutritional data and science, suggests that a diet based on fish, meat, eggs, dairy, vegetables, nuts and seeds, fruits, and herbs and spices provides all of the essential nutrients we require and in sufficient quantities, an approach that is consistent with the Personal Paleo Code. Despite some nutrition experts’ claims to the contrary, there is absolutely no need for grains or legumes in the human diet—these foods have been part of our species’ diet for only a tiny fraction of our evolutionary history.

Notes for this chapter may be found at ChrisKresser.com/ppcnotes/#ch3.

If exchanging the standard American diet for a full-scale Paleo diet feels overwhelming, you can still take a major step toward hitting the reset button by eliminating three toxins that contribute significantly to modern disease. Here they are:

At the simplest level, a toxin is something capable of causing disease or damaging tissue when it enters the body. When most people hear the word
toxin,
they think of pesticides, heavy metals, and industrial pollutants. But even beneficial substances, like water, which is necessary to sustain life, are toxic at high doses.

The body has a built-in detoxification system that was designed to process and excrete toxins in small amounts. However, the detox system evolved over millions of years in an environment that was relatively pristine in comparison to the modern environment; earlier humans were simply not exposed to the range or volume of toxins we face today.

This is important to understand as we examine the role of dietary toxins in contributing to modern disease. Most people won’t get sick from eating a small amount of the foods I discuss in this section. But if we eat them in excessive quantities, the risk of developing modern diseases rises significantly.

That’s exactly what’s happening today. These three food toxins—gluten-containing grains, industrial seed oils, and refined sugar—make up the bulk of the modern diet. Bread, pastries, muffins, crackers, cookies, soda, fruit juice, and fast food and other convenience foods are all loaded with these toxins. In the United States, vegetable oils, grain flour, and table sugar (along with dairy and alcohol) make up 70 percent of the total calories Americans consume each day. When the majority of what most people eat on a daily basis is toxic, it’s not hard to understand why their health is failing.

Let’s look at each of these food toxins in more detail.

Plants, like animals, have a biological imperative to survive and reproduce. But unlike animals, plants can’t run away from predators (like humans). They have had to evolve other mechanisms for protecting themselves. These include:

One of these toxic compounds is the protein gluten, which makes up 80 percent of the protein found in wheat, barley, and rye. Due to modern food-processing techniques, gluten can often be found in trace amounts in products containing other grains, such as oats and corn.

Celiac disease (CD) was initially described in the first century by a Greek physician named Aretaeus of Cappadocia. But neither Aretaeus
nor anyone else knew that CD was caused by an autoimmune reaction to gluten, a protein in wheat. That didn’t become clear until 1950—almost two millennia later—when Willem Dicke, a Dutch pediatrician, conclusively proved that gluten was the culprit. Dicke’s discovery saved millions of people from the dangers of untreated celiac disease, which include malnutrition, stunted growth, cancer, severe neurological and psychiatric illness, and even death.

Since then, the mainstream view of gluten intolerance has been relatively black and white: Either you have celiac disease, in which case even a small amount of gluten will send you running to the bathroom in three seconds flat, or you don’t, and you can chug down beer and munch bagels without fear. This all-or-nothing view has led some doctors to tell patients who suspect they’re sensitive to gluten but who test negative for CD that they’re simply imagining the affliction.

It turns out those doctors are wrong. We now know that
it’s possible to have gluten intolerance without having celiac disease
—a condition known as non-celiac gluten sensitivity (NCGS)—and that gluten intolerance is more a spectrum of conditions than a single condition, with full-blown CD on one end, complete tolerance on the other, and NCGS in the middle. Let’s discuss each of these three possible reactions to gluten in more detail.

Celiac disease is an autoimmune disease characterized by an inflammatory response to gluten and damage to the tissue in the small intestine. Signs and symptoms typically include diarrhea, bloating, abdominal pain, fatigue, lethargy, and malnutrition. But CD can also manifest with atypical signs and symptoms, ranging from chronic headaches to dermatitis to joint pain to insomnia.

Celiac disease has become dramatically more common over the past half a century. According to a study that compared blood samples from U.S. Air Force recruits sixty years ago with more recent samples, CD has increased by 400 percent during that period. Today, official statistics indicate that celiac disease affects between 0.7 percent and 1 percent of the U.S. population, but many experts in the field of gluten intolerance
believe the actual prevalence is higher. Why the spike in CD? We don’t know for certain, but many scientists believe that changes in gut microbiota as well as changes in the way wheat is cultivated play roles.

Contrary to popular belief, celiac disease is not simply a digestive disorder. One in two new patients diagnosed with CD does not have gut symptoms. For every diagnosed case of CD, there are 6.4 cases that remain undiagnosed—the majority of which are atypical or silent forms with no damage to the gut. This silent form of CD is far from harmless, however; it is associated with a nearly fourfold increase in the risk of death from all causes.

These findings surprised many researchers and physicians, because it was long believed that the damage done by CD was limited to the gastrointestinal tract. But research over the past few decades has revealed that gluten intolerance can affect almost every other tissue and system in the body, including (but not limited to) the brain, endocrine system, stomach, liver, blood vessels, smooth muscle, and even the nuclei of cells.

This explains why CD is associated with numerous diseases. The following is only a partial list of them:

How could a single condition be associated with such an astonishing array of diseases? CD causes the gut barrier to become permeable. As
I explain in
chapter 10
, when this happens, large proteins and gut microbes leak across the gut barrier and provoke a chronic, low-grade inflammatory response. But this response isn’t limited to the gut; it can affect nearly every tissue in the body, as the list of conditions above suggests.

There’s no consensus on the exact definition of non-celiac gluten sensitivity yet, but the most common understanding is that it’s a reaction to gluten that is not autoimmune (like CD) or allergic (like wheat allergy). Another way of defining it is a reaction to gluten that resolves when gluten is removed from the diet and after CD and a gluten allergy have been ruled out. It’s difficult to estimate the prevalence of NCGS because there is no definitive diagnostic test for it (see the “Testing for Celiac Disease and Gluten Intolerance” sidebar below for more on this). Another problem is that the symptoms associated with NCGS are so broad and nonspecific (meaning they could be attributed to any number of causes) that many patients and doctors don’t suspect it, and thus doctors don’t order the necessary testing.

Even with these limitations, some estimates suggest NCGS may occur in as many as one in ten people, or approximately thirty million Americans.

While some mainstream medical professionals continue to insist that NCGS doesn’t exist, scientists have validated it as a distinct clinical condition. In one major study, researchers reviewed the charts of 276 patients with irritable bowel syndrome (IBS) who had been diagnosed with NCGS using a double-blind, placebo-controlled wheat challenge (patients were put on a gluten-free diet and then given capsules containing either wheat or an inert substance). As a whole, the NCGS group had a higher frequency of anemia, weight loss, self-reported wheat intolerance, and a history of childhood food allergies than those in the IBS without NCGS group. The authors concluded that their data “confirm the existence of non-celiac wheat sensitivity as a distinct clinical condition.”

As with celiac disease, NCGS can affect almost every cell, tissue, and system in the body. The list of documented signs and symptoms is diverse (and far too long to give in its entirety here!) but includes primarily:

There is a particularly strong connection between NCGS and neurological and psychiatric diseases, including schizophrenia, autism, and even depression. For example, studies suggest up to 40 percent of patients with ataxia (problems with balance and coordination) and 25 percent of schizophrenic patients produce antibodies to gluten. And while the relationship to autism is less clear in the scientific literature, anecdotal evidence from the autism community indicates that gluten-free diets are very effective in some cases.