Monthly Archives: January 2012

The Trouble With Wheat # 7: LDL Particle Size and Heart Disease

The Trouble With Wheat # 7:  LDL Particle Size and Heart Disease

Reference:  Wheat Belly by Bill Davis,  Eric Westman: The Ultimate Diet for Shedding Weight

You should know about LDLs from all the ads on TV.  “Lower your cholesterol and prevent a heart attack” they promise.  “Take our statin!”, they hawk.  It’s your LDL’s they are after, not your cholesterol per se.  And your money.  The current understanding is that it’s not really your cholesterol they are after but the number and size of your LDL particles. Small, dense, oxidized LDLs are troublesome.  They are the ones that weasel their ways into your arteries and start the plaque formation in your artery walls.  Just take a pill and don’t change anything.  We’ll allow you to live the lifestyle your are used to.  (SAD but true: SAD stands for Standard American Diet)

We have done articles before about LDLs and HDLs.  By and large, HDLs are protective and function as your body’s garbage trucks. They scour your arteries for left-over cholesterol and take it back to your liver for reprocessing.  You want a high HDL count.  But more importantly, you want a low LDL count.  They are your body’s teenagers, carelessly throwing garbage out the window of their cars, littering your body with trash.  But LDLs aren’t so bad in and off themselves.  Large, fluffy LDLs are benign cholesterol carriers.  Your body needs cholesterol in all of its membranes, so having a means of transporting it isn’t so bad.  Your liver receptors recognize large LDLs, pull them out of circulation and reprocess them.  It’s the little, dense LDLs that don’t fit in the liver LDL receptor so last longer in the blood (5 days versus 3).  And small LDLs get oxidized easier and get glycated easier, both of which cause them to participate in plaque formation more readily.

The question arises, “What does wheat do to my LDLs?”.  Simple.  The more you eat, the smaller, denser, more inflamed and glycated your LDLs.  And the more wheat you eat, the lower your HDLs.  Pretty simple.  Both change.  The bad get worse.  The good get worse.  The reason is wrapped around the easily digested glucose, the rapid rise of sugar and the subsequent quick response of insulin.

And that’s the trouble with wheat.  We grind it up into talcum powder flour and then process that into 20% of the calories we eat.  It’s not just bread, but cookies, cakes, donuts, tacos, cereals, bagels, muffins, brownies, croissants, pita, chapattis, breading on your fried food, croutons in your salad…..on and on.  Try going gluten free and you will find just how ubiquitous wheat is.  Roughly 20% of America’s calories come from wheat.  In that regard, wheat is not alone in causing trouble.  Any freely available carbs will do the same.  Potatoes and rice aren’t much better. They just aren’t as common and don’t participate in as many products.

In fact, you can look at your HDLs and measure how well you are doing at a low carb diet.  Dr Westman, at Duke, professes that he uses HDLs to measure compliance with  low carb diets.  Each person has an individual HDL sensitivity which can be discovered by measuring your HDLs as you gradually add carbs back.  Dr. Westman  has observed HDLs as high as 100 for folks on low carb diets for 5 years.

WWW. What Will Work for me!  The pattern is getting clearer.  We have an epidemic of heart disease, caused by small, dense, oxidized, glycated LDLs, caused by processed, refined carbohydrates, of which wheat is the most common.  Want to get better?  Cut the wheat!  Want big, fluffy, safe LDLs?  Eat more vegetables and meat.

Written by John E Whitcomb, MD  Brookfield Longevity and Healthy Living Clinic, 17585 W North Ave, Suite 160   Brookfield, WI 53045   262-784-5300

The Trouble with Wheat #6: Too Much Acid!

The Trouble with Wheat #6:  Too Much Acid!

Reference: Wheat Belly by Bill Davis (Milwaukee Native: Office at Mayfair Mall)

Massey. Sebastian et al Am J Clin Nutr 2002;76:1308-16

What’s the deal with acid?  One of the ways of explaining some of our health conundrums is along the acid base axis.  You’ve heard this before.  Acid foods are those that end up making a biological ash with more acid in it after you have digested it down to its final end products.  They tend to be animal based.  Alkaline foods are by and large plant based.  Our bodies can easily dispose of alkali. We struggle with acid.  It is so important to maintain a precise acid base balance that we have exquisitely sensitive mechanisms by which to do so.

Our first acid base-balancing tool is to excrete extra acid in our urine.  When that is limited, in the extremely short term, we can breath a little harder, blowing off carbon dioxide and thereby balancing a sudden rush of acid.  Finally, in the long term, we borrow calcium bicarbonate from our blood, and ultimately from our bones.  America eats such an acidic diet that we have osteoporosis as an epidemic of historical proportion.  Something is very wrong in America.  Our rate of hip and bone fractures is 60-100 times greater than other parts of the world where diets are different.  A woman over age 65 has a greater risk of premature death from the complications of a fall and a fracture than heart attack or stroke.  Authors writing best selling books plead with us to have an “alkaline diet” which is code for “eat more vegetables”.  And, in truth, those who do have reversed their osteoporosis by doing so.  That strategy works.   Now, vegetables have much more than alkali, but, that’s part of the solution.

You can’t measure the pH changing in your blood by dietary changes because it is so  subtle.  That’s because it is so critical to maintain precise acid-base balance that blood pH tests don’t show the change.  The subtle changes in your blood pH are within the range of random measurement error. But you can measure pH changes in your urine, which is a compilation or summary of what you have eaten in the last 12 hours.  You can also look under a microscope and see that red cell morphology changes in sync with your urinary pH changes.   (Is this real?)

And where does wheat fit in?  Actually, this is a surprise.  Wheat is pretty acidic.  It supplies about 37% of the acid in the American diet.  Wheat, alone among grains has a lot of sulfur in it that turns into acid.  Our ancient Paleolithic diet likely had a fair amount of meat in it: but it was omega acid containing and often had lots of fat along with it (Inuit for example).  The shift that occurs in our metabolic pH from wheat, and thereby the change in urinary pH and red cell morphology follows.  So, is this change in RBC morphology real?  It needs research and confirmation!

WWW.  What will work for me.  Successful long-term weight loss occurs with low carb diets, or extreme willpower and exercise.  That wheat is relatively new in human experience points to something we have to adjust to, and maybe haven’t quite yet.  That our bones heal with alkaline diets is an important clue.  The tool of red cell morphology changing needs more research.  But it could open the door to the concept of “alkaline” diets.  For now, I’m trying to eat more vegetables.

Written by John E Whitcomb, MD  Brookfield Longevity and Healthy Living Clinic, 17585 W North Ave, Suite 160   Brookfield, WI 53045   262-784-5300


The Trouble With Wheat #5: Leaky Gut and Celiac Disease

The Trouble With Wheat #5: Leaky Gut and Celiac Disease

Reference:  Wheat Belly by Bill DavisScientific American

Now it was the Greek physician Aretaeus in 100 AD who first told patients with celiac disease to fast and avoid food to cure those folks who got diarrhea, cramping pain and progressive weight loss from eating wheat.  But it wasn’t until World War II that a curious Dutch physician, Willem Dicke, at the prompting of an observant mother who had noted that her child kept getting sick whenever he ate wheat, that the disease was named in the modern era.  Dr Dicke had noted that some of his kids had actually improved during the horrible Dutch famine the Nazis inflicted on Holland, and got worse when Sweden airlifted life saving bread.  So, celiac has been around since we discovered wheat.  But now, it is doubling in frequency every 20 years.  It’s not rare any more.  And what’s changed?  Wheat!  It’s genes have been tripled and manipulated with a huge increase in the gluten component.  And it’s not just celiac that’s increasing.

What happens in celiac disease? Gluten has the unique ability to soak through the intestinal wall and set off antibodies that attack the small bowel.  Those who actually make the antibodies can be measured with blood tests and biopsied in their small bowel to diagnose the actual disease called “celiac”.  But only about 1% of the population has celiac.  That’s not the whole story – though for those with celiac it is a huge story that is life changing and very restrictive.   The core problem is that gluten, and one of its core components called gliadin have the ability to induce your gut to make another protein called zonulin.  Zonulin regulates the leakiness of your gut.  Your intestinal cells are held together with just a few connections, and zonulin undoes them, just like a seamstress taking out some stitches that hold fabric together.  With that loosening, all sorts of other large molecules that are in your gut can leak into your tissue and blood stream.  And the gliadin-zonulin thing happens to many, many more than those with pure celiac disease.  That could include you!

With that leakiness, your immune system goes nuts and frantically tries to reply to this flood of unexpected foreign antigen.   Immune markers of inflammation start poring out of your gut and all sorts of unexpected things start to happen all over the body as those immune cells and markers target all sorts of other tissues.   For example, there are strong connections made with many auto-immune diseases like Hashimoto’s thyroiditis, rheumatoid arthritis, asthma, diabetes, Crohn’s disease…

That’s the new insight you need to know.  Celiac is only 1% of the population, but likely 60% (I’m guessing but the number is huge) are affected to some degree by their leaky gut.  The effect is subtle, long term and pervasive.  I’m going to address about 6 more issues to try to convince you of this hypothesis.  Keep reading!

WWW. What will work for me?  Isn’t this terribly ironic?  Wheat, the staff of life. The foundation of civilization.   Addictive!  Yummy!  20% of our calories.  In all our food.  It damages our guts, loosens our membranes and sets off trouble.  You thought you were in the “zone”? Not if your zonulin is exposed to wheat.  This is compelling.  Buy Bill Davis’s book.  He has written a clarion call.

The Trouble with Wheat #4: Addiction!

The Trouble with Wheat #4:  Addiction!

Reference:  Wheat  Belly by Bill Davis, MD (Milwaukee Cardiologist:

Ever been accused of being an addict!  Well, we’ll take care of that in just four short paragraphs.  Wheat is yummy.  We love warm bread.  Every culture around the globe makes warm bread and we find it irresistible.  Have a little more.  And a little more.  A little olive oil and balsamic vinegar.  Or, a touch of butter and jam.  Or some cheese, tomatoes and pepperoni.  We love our wheat.

The problem is that we like it just a bit more than we realize.  In fact, we eat that little bit more with just a touch of compulsion.  We can’t really resist it.  Munching on some pretzels?  Chewing on a breadstick?  You find yourself unconsciously being directed to eat a bit more.  Why?  Because the proteins in wheat get broken down into characteristic pieces that penetrate both the gut and the blood brain barrier. (Other foods don’t do this – it’s characteristic of gluten from wheat)  And there those peptides bind to the brains opiate receptors.  Well, that sets off your internal fix and your brain says, “Whoopee” and you eat some more.

Now, the house of medicine has invented some marvelous drugs that reverse and completely block the opiate receptor.  If you give it to an overdosed heroin addict in the ER, and give them an IV opiate blocker they get really, really mad because you take away their high.  (Never mind you saved their lives) Naloxone and naltrexone are two examples.  Guess what happens when you give these drugs to people who are trying to lose weight and being fed a diet of wheat?  Come on, commit yourself to a guess!  Correct!  You give up eating as much.  Bill Davis documents in Wheat Belly that folks put on naltrexone will lose as much as 24 pounds in a few months because they just don’t have the inclination to eat that 6th piece of pizza, or 12th bread stick, or 100th Wheat Thin, or……   (My personal record is a clean 12  Krispy Kremes) Twenty percent of human calories come from wheat.  If you are inclined to have 10% fewer calories because you eat one piece of french toast instead of three, you might start to lose weight too.

Exorphins is the name for those peptides, and we’ve known about them since the 1970s.  There are few other foods that make them.  Wheat makes a bunch and we eat a lot of wheat.  Combine that with it’s freely and rapidly digested amylopectin carbohydrate, and consequent fast release of insulin, and you take in calories compulsively and your insulin then stores those calories assiduously.  You lose.

That’s the argument.  Unique among food, wheat provides the easy calories and the addicting exorphins to make each of us “wheat addicts”.  And you get fat, from wheat.

WWW.  What will work for me.  Try the experiment.  Go five days without wheat and see how you feel.  Watch your own behavior when you start eating it again.  The question arises, “what about trying long term naltrexone therapy as a way to lose 24 pounds”?  Now that we have named the enemy, you can stand up at group and confess that you too are an addict.  To wheat.  (Problem #4)

The Trouble with Wheat #3: Lectins and the Stealth Insulin Effect

The Trouble with Wheat #3: Lectins and the Stealth Insulin Effect

Reference:  Wikipedia, Various Internet Sites, British Medical Journal

Ever heard of “lectins”?  You must not have been cruising the obscure corners of the metabolic research libraries.  Scientists have been talking about them for over a century but only recently has the bigger picture started to coalesce about the role they might be playing.  Here is a primer for you that fits in this series on wheat.

In essence, lectins are proteins that attach to a specific sugar and latch on tight – like a lock on a key.  In that regard, the bacteria E. coli uses a specific surface lectin to attach to mannose, a sugar molecule on your bladder wall.  Plants have lots of lectins in them where they are thought to play a role in inhibiting bacterial invasion.  Sort of a plant based anti-biotic.  If that’s all they did, we would likely be fine.  The problem is that we eat plants.  And the chemicals and compounds in those plants, lectins for one, don’t always just turn into calories and food.  Lectins do a bunch of funny things that weren’t “on the menu”, so to speak.  For one, they bind to quite a few cells in the small bowel wall and are thought to cause “leaky gut”, allowing other chemicals to leak in.  Secondly, they get absorbed and find their way into our organs where their ability to set off chemical cascades sets them apart.

One of the cascades they can set off is the “complement” system.  This isn’t a social nicety.  The “complement system” is a cascade of inflammation that is usually set off by an antibody and antigen reacting together that signals danger and calls for an immune response.  It shouldn’t be called complement, it should be called the “defend and attack back” system, because that is what it does.  Lectins can set that off, without a real enemy being around.

Another system they set of f is the insulin receptor system.  The problem here is that lectins attach and don’t let go.  Insulin tells a cell to take up glucose and then it falls off the receptor when its deed is done.  Lectins attach and stay there, making the cell continue to take up glucose, and take it up, and take it up, and take it up.  Can you see the problem with that?  Lectins force you to keep storing sugar as fat, way beyond any normal feedback loop.  Your blood sugar falls too far!  You feel hungry!  You eat more!  You store more calories! (Does this strike you as a big problem?)

Where do we find lectins?  Wheat is a big source.  Beans are too.  Most grains have them.  Soy, peanuts, legumes have them.  They are present in all foods.  They are probably higher in GMO foods.  Modern drawf wheat has had its chromosome number tripled and many genes inserted into it.  It appears extra lectins came along for the ride.  Pasteurizing milk inactivates the natural antibodies that bind lectins…

You can block or wash out lectins by sprouting grains or soaking beans.  Eating some sugars, like mannose and fucose act like decoys and block the binding sites.  Glucosamine seems to also be a specific lectin blocker.  Maybe that’s how it helps joints – reducing the attendant inflammation.

WWW.  What will work for me?  I’m not sure we know this whole story.  But there are marketers out there selling you products to protect you from lectins.  On your doorstep and in your mailbox this year, you will likely get a mailing on “miracle cure for……yada, yada, yada.  There may be a tiny bit of truth in their claims, but maybe not as much as the mailing claims.  The research isn’t in yet.  But our current level of knowledge is still in its infancy compared to how complex our bodies really are.  This may be why low carb diets work, at least in part.  If lectins bind to insulin receptors and make you store calories as fat, we do have a problem.   With GMO wheat in every product we eat and every meal of every day, having extra lectins that act like insulin, in addition to our own insulin may doom us to storing all our calories as fat, unless we try and avoid wheat.  That’s problem #3.  Stay tuned.

Written by John Whitcomb, MD  Brookfield Longevity and Healthy Living Clinic,  17585 W North Ave, Suite # 160  Brookfield WI 53045  262-784-5300   Archives at    Please Visit