Many of you know that the Wheat Belly concepts got their start when I was trying to help patients in my cardiology practice obtain better control over risk for coronary disease. An exceptionally common combination of abnormalities in people with heart attacks, survivors of sudden cardiac death, those who have undergone stent implantation or bypass surgery, or have high coronary calcium scores (an early quantifier of coronary atherosclerotic plaque): large quantities of small LDL particles and high blood sugars (high fasting glucose and/or hemoglobin A1c, HbA1c, reflecting long-term blood sugar fluctuations).
Because wheat is the most dominant grain in the modern diet as well as the most offensive, being a major contributor to formation of small LDL particles and raising blood sugar, I asked my patients to remove all wheat products from their diet. As seasoned Wheat Belliers know, this can be a tall order, as it means eliminating all bread, pasta, breakfast cereals, bagels, pretzels, breaded meats, breadcrumbs, rolls, and other popular foods. I also asked people to not seek replacements in the form of gluten-free products, as they also extravagantly trigger small LDL particles and rises in blood sugar.
Everyone here now knows what happens next: Yes, small LDL particles plummeted, HDL cholesterol levels increased, triglycerides dropped dramatically, blood pressure dropped, c-reactive protein dropped to zero, visceral fat shrunk, postprandial (after-meal) lipoproteins normalized–all adding up to dramatic reductions in the factors that cause coronary disease. Indeed, many people obtained reversal of coronary disease by this route, including reduction in coronary calcium scores and putting a stop to the need for repeated heart procedures (when combined with other strategies including vitamin D and fish oil supplementation, normalization of thyroid status, and some others). I did this in nearly everybody coming through my office at the time, anyone who was willing and able to follow such a dietary change.
As time passed, I also witnessed other changes outside of coronary disease that people reported to me. In addition to the often astounding quantities of weight loss, people asked me why their migraine headaches disappeared, why their seborrhea and psoriasis went away, why acid reflux and irritable bowel syndrome were gone within the first week, why their joint pain was gone . . . This prompted me to ask questions to understand why such health changes developed, questions such as “How has wheat changed?” and “What is in modern wheat that, upon removal, could account for such health changes?” answered by conversations with agricultural scientists in universities and the USDA. As I came to understand these issues better–that agribusiness and geneticists had introduced extensive changes into modern wheat, that the genetics of wheat overlapped considerably with other grains, that current dietary advice overlooked an amazing body of clinical data documenting the adverse health effects of wheat and grains–I urged more and more people to engage in this lifestyle. And I continued to see extravagant, life-changing results.
But it was one woman who persuaded me that delivering this message through my cardiology practice and my then modest online presence was not enough, that it was time to broadcast these issues to a larger audience and raise questions about the wisdom of modern dietary advice. It was the same woman I talked about at the start of the Wheat Belly Total Health Public Television Special. This woman was a 38-year old schoolteacher and mother of two children who was referred to me for evaluation of palpitations, a flip-flop feeling of her heart that was annoying and frightening. EKGs and Holter monitors (24-hour recordings of heart rhythm) and other basic assessments only revealed a benign heart irregularity in the form of premature atrial complexes, benign extra beats that can be annoying but are harmless. Because part of any cardiac evaluation is a full medical history, she also told me about her ulcerative colitis. She’d been struggling with this condition for 12 years, suffering daily around-the-clock abdominal pain, cramps, bloating, diarrhea, and bleeding in her bowel movements. The bleeding was bad enough that she required blood transfusions every 2 to 3 months. She was being treated with two oral medications and a (toxic and expensive) intravenous drug, but without improvement. Her gastroenterologist therefore recommended a total colectomy (complete removal of the colon) with creation of an ileostomy, i.e., a surface orifice cut into the abdominal wall to pass stool, rather than the colon and rectum, the usual route. It meant having to affix an adhesive bag to the abdominal skin, tolerating the noises that come from such a device (recall that she was a schoolteacher), risking infection of the artificial stoma (orifice), as well as the nutritional and health implications of no longer having a colon. The change in the self-perception of her body would also be irretrievably changed. In short, an awful path for a young woman.
I had not discussed diet with her up to this point, as I had viewed her consultation as limited only to an opinion about her benign palpitations, case closed. But when she told me all this about her colitis and her anticipated colectomy/ileostomy, I said to her,”I know you’re not here for your colitis, nor for nutritional consultation, but let me tell you about the diet approach I use for people with coronary disease but provides benefits in other areas of health. We start with elimination of all wheat.”
She looked at me, puzzled, and declared “My doctor tested me for celiac disease, did two biopsies and ran the blood tests. I don’t have celiac disease!”
“Yes, I understand. But there is more to this lifestyle than celiac disease. I don’t think you’ve got anything to lose. They are going to take your colon out, after all.”
So she reluctantly acquiesced, accepting the simple two-page handout that I had written detailing how to go about this process of wheat elimination.
She returned 3 months later, no ileostomy in sight nor any such sounds audible, with a big smile on her face. I asked her what happened. “Within a week, the bloating and pain stopped. Then the bleeding stopped. Every day I felt better and better. I’ve already stopped two of the drugs. And I lost 38 pounds and I wasn’t even trying!”
Indeed, she looked far healthier, alive, and vibrant than she had before, as well as thinner, now clearly at normal weight, no longer intermittently clutching her abdomen in pain. She returned to her gastroenterologist and said “Look at me: I’m essentially cured, off my medications, lost weight, and feel better than I have in years!”
Her gastroenterologist, the one who had prescribed the drugs and performed the biopsies, shrugged his shoulders and responded, “It’s just a coincidence. Go back to what you were doing.” In other words, confronted with an impressive remission of a dangerous and debilitating condition, rather than probing her experience with questions to understand the why and how, he dismissed it, even telling her that her efforts were pointless. I knew this gastroenterologist. He wasn’t a bad person, wasn’t stupid, and was honest. But he was afflicted with a disease that plagues many of my colleagues: If it doesn’t involve prescription drugs or procedures, or if it did not involve his/her advice (since many doctors are control freaks), then it must not be of any consequence–even if apparent cure is witnessed.
This pi—- me off so much, nagging at me for weeks, that I wanted to confront and shame this gastroenterologist into recognizing his enormous blunder. But I also understood that this disease-of-the-mind, this narrow-mindedness and indifference to genuine health, plagued most of my colleagues, not just this one gastroenterologist. And confronting him would make an enemy for life, not an enlightened convert.
So this was when it became clear that these issues needed to be discussed publicly, not just in my cardiology practice. More science required? The science already existed. All I did was put it all together and ask,”If we already have a substantial body of clinical evidence that associates wheat consumption with a multitude of diseases, if we know that the changes introduced into modern wheat amplified the problems they create for humans who consume it, now coupled with repeated, large scale anecdotal evidence that reverses hundreds of health conditions, why not broadcast these concerns?” This is what led me to write Wheat Belly, first a blog post on my old Heart Scan Blog (back then, I used to write extensively for people in my program showing them how heart scans to obtain coronary calcium scores could be used to track, even reverse, coronary atherosclerotic plaque), followed by Wheat Belly, the original book.
For me, the extraordinary experience of that one woman who had suffered from ulcerative colitis without relief for 12 years, who experienced cure of her disease (now off all medications, by the way), yet encountered the yawn of indifference of a conventionally-thinking gastroenterologist more interested in revenue-generating endoscopies rather than the welfare of his patients, the frustration and disappointment I felt towards conventional healthcare and notions of healthy eating–that’s what set me on this course of discussing this contrary lifestyle, but continuing to see thousands and thousands of other people also experiencing impressive turnarounds in health and weight.