About 12 years ago, it was the experience of one woman who persuaded me that delivering this message through my cardiology practice and my 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.
The bulk of most cardiology practices involves dealing with coronary disease. Because I was dissatisfied with the standard tools of management–low-fat diet, aspirin, statin cholesterol drugs–and had contributed to a study that showed they had no impact whatsoever on the progression of coronary calcium scores by CT heart scan, I used diet to eradicate small LDL particles measured by NMR. This, along with strategies such as vitamin D and omega-3 fatty replacement, were the cornerstones for my coronary disease management efforts.
The 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 (bearing much of the crippling cost with her part-time schoolteacher salary and her policeman husband’s salary). 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 into a plastic bag affixed to the skin. It meant having to wear an adhesive bag on her abdomen, 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 profound 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, then it must not be of any consequence–even if apparent cure is witnessed.
This annoyed me deeply, 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.
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 (she eventually got off all medications), 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.