Originally posted by Dr. Davis on 2015-03-28
on the Wheat Belly Blog,
sourced from and currently found at: Infinite Health Blog.
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of WB Blog articles.
The ABCs of your post-grain experience
Wheat/grain elimination is an exceptionally powerful
tool for restoring health, reducing inflammation, returning metabolic
distortions such as high blood sugar and blood pressure back to normal,
and for losing weight. But many of the adverse health effects of years of
grain consumption do not fully reverse with their elimination.
Specific efforts may therefore need to be undertaken to accelerate your
return to full health. Taking these extra steps stacks the odds heavily
in your favor that you will enjoy full recovery from abnormal health conditions.
Among the strategies to consider are:
Cultivate and nourish healthy bowel flora
I like to think of bowel flora, the thousand or so species of
microorganisms that inhabit the human gastrointestinal tract, as a
garden. Probiotics, i.e., anything that provides
microorganisms believed to be among the desired inhabitants such as
the various Lactobacillus or Bifidobacteria species, are like
planting seeds for peppers and zucchini in your garden in spring time.
But what if you planted your seeds, then
neglected to water and fertilize your garden? If you’re lucky,
you might have a few peppers and zucchini after a few weeks, but
you’re more likely to have a few stunted vegetables or
nothing except a few shriveled vines. A successful garden
requires water and fertilizer.
So it goes with bowel flora. You eliminate
the extraordinary bowel-disruptive effects of grains–gliadin,
gliadin-derived peptides, wheat germ agglutinin, indigestible D-amino
acids, trypsin inhibitors, and others–then “plant”
some desired species from a probiotic preparation or fermented food,
but then fail to nourish them. It means that desired species
may not proliferate, they may not outnumber and overpower unhealthy
species such as E. coli, Staphylococcus aureus,
Clostridium difficile, and Firmicutes. Unhealthy species
are allowed to proliferate, thereby increasing intestinal permeability
and resulting in higher blood levels of the bacterial byproduct,
lipopolysaccharide, that is highly inflammatory. It also means that
healthy bacteria fail to produce fatty acids, especially propionate
and butyrate, that are required by intestinal cells for normal
metabolism, heal “tight junctions” between cells
(disrupted in conditions such as ulcerative colitis), and reduce
potential for colon cancer. It also means that metabolic benefits,
such as reduced insulin and blood sugar levels, reduced triglycerides,
reduced blood pressure, and reduced visceral fat do not result–all
because desirable bowel flora were not “fertilized.”
So what acts as water and fertilizer to bowel
flora? What feeds them, allows them to proliferate and yield factors
such as butyrate? Fibers. But not all fibers.
In a fascinating tale of symbiosis, the
coexistence of microorganisms and Homo sapiens, a specific
class of fibers, i.e., polysaccharides or polymeric sugars, that are
indigestible to the human digestive apparatus but digestible via the
enzymes expressed by specific bacterial species, allow all these
beneficial health effects to occur. It means that food, chewed,
swallowed, bathed in stomach acid, emulsified by bile, broken down
into constituents by pancreatic enzymes, exposed to 20-some feet of
small intestine, finally reaching the colon where most microorganisms
dwell, contains little remaining nutrients to nourish bacteria. The
desirable species that thrive in this unique environment are those
that can digest the undigested remains of your meal–fibers. But
not cellulose fibers, i.e., wood fiber, of the sort that
dominates in grains and is found in bran cereals. Cellulose is
essentially indigestible by both our own digestive apparatus, as well
as the bacteria that humans are capable of carrying. (It is
digestible by ruminants.)
The proper care and feeding of bowel flora
therefore causes proliferation of healthy Bacterioidetes,
Lactobacillus, and Bifidobacteria that produce bacteriocins
that suppress growth of unhealthy species, metabolize fibers to
butyrate that yields metabolic benefits, even improves bowel
habits and allows you to have normal, healthy bowel movements
without “crutches” like the bulk of cellulose fibers,
laxatives, or enemas.
Is this evolutionarily appropriate? Is there
precedent in human adaptation on this planet for such unique fibers?
I ask this question because this is my litmus test for the suitability
of any dietary strategy we consider. Recall, for instance, that grains
were added 300 generations ago, or 0.4% of our time on earth, a mere
moment in time ago. They are inappropriate for human consumption, now
made worse by the genetic fiddlings of agribusiness. (I have to concede
that grains do indeed have some fibers that have health benefits, such
as arabinoxylan in wheat and beta glucan in oats, but they come with
such undesirable other components that it is simply not worth it.) Yes,
consuming such fibers is evolutionarily appropriate,
as it dates back well over 8000 generations of human existence,
predating even the appearance of the Homo species, even predating
carnivory, as it was practiced by pre-Homo hominids, Australopithecus
(especially “robust” strains). It is therefore deeply
instilled (I almost said “ingrained”–acchhh!)
into the adaptive physiology of our species.
So how do we obtain such indigestible fibers
that nourish healthy bowel flora, so-called “prebiotics”
or “resistant starches”? Well, do what a member of the
Hadza of sub-Saharan Africa or Yanomamo of the Brazilian rainforest
would do and grab a stick, stone, or bone fragment and dig in a field
or forest for the underground tubers of plants. If you don’t
want to do that, you can incorporate foods available in modern grocery
stores that mimic such practices. Among the foods that yield such fibers:
- Green unripe bananas or plantains–with around 27 grams
prebiotic fibers per medium sized banana
- Raw peeled potato–with around 20 grams per 3½-inch medium
- Inulin powder–with 5 grams per teaspoon
- Bob’s Red Mill raw unmodified potato starch–8 grams per tablespoon
- Legumes, lentils, chickpeas, hummus–Around 3 grams per ¼-cup.
But we have to be careful here, as any more than this quantity and blood
sugars start to climb to unhealthy levels.
These are the most efficient sources, with lesser
quantities in other below-ground vegetables. I pick one of the above
foods and include them in a smoothie every morning along with, for instance,
a cup of unsweetened coconut milk, some blueberries or other berries, a
few drops of stevia, etc. If you choose the banana, peel it like an apple
or chop off the ends and slit the skin, as it is very tough to skin when
green. Chop both banana and potato coarsely before putting in the blender;
a blender with a strong motor is advised. Rely on NO MORE than 2 level
tablespoons of the potato starch, as more will raise blood sugar; use other
choices to amp up your intake.
The science that examines bowel flora composition
tells us that 20 grams of such fibers yield substantial effects.
While the average grain-consuming human obtains around 3 or 4 grams
per day, us grain-deniers can fall below this and experience undesirable
bowel and metabolic effects. Benefits begin around 8 or 9 grams per
day, with maximal benefit likely around 20 grams. (Interestingly,
there is anthropological evidence of intakes as high as 135 grams
per day.) When new to this experience, start with no more than
10 grams fiber per day; more and abdominal pain and bloating can
occur; build up over days to weeks. Full benefits, such as reductions
in blood pressure and blood sugar, require 4 to 8 weeks to show
themselves, likely due to the shifts in bowel flora species.
I rank correction of vitamin D deficiency as second only to wheat and
grain elimination as the two most powerful strategies for overall health
I have ever seen in my 20+ years of medical practice.
Vitamin D deficiency is rampant, given life in
northern climates, wearing clothes year-round, working indoors, and the
gradual loss of the ability to activate vitamin D in the skin as
we age. It means that having a favorable vitamin D level in the
body is uncommon outside of tropical climates or during summer months
with plenty of skin surface area exposure in young people.
Among the benefits of restoring vitamin D
are: improved mood and freedom from seasonal mood fluctuations; rise
in HDL, drop in triglycerides; reduction in insulin and blood sugar;
reduction in blood pressure; improved bone and joint health, including
increased bone density; reduction in coronary disease risk and cancer;
reduction in potential for dementia. And you just feel so much better.
The ideal approach to restoring vitamin D
is to take a dose that raises 25-hydroxy vitamin D blood levels
to 60-70 ng/ml (150-180 nmol/L). While dose needs vary from
individual to individual because of body weight, relative proportion
of body fat, time of year, age, and genetics, most people require
4000-8000 units per day in gelcap or droplet form (not tablets:
very poorly absorbed, sometimes not at all). Note that, if you are
following blood levels, it requires 3 months for levels
to stabilize after initiating supplementation or any change in dose.
Iron, zinc, magnesium
Absorption of positively-charged minerals, especially iron, zinc, and
magnesium, is blocked by the phytates of grains. The second most common
worldwide cause for iron deficiency anemia, for instance, is grain
consumption, second only to blood loss (e.g., menstrual cycles). The
phytate content of a bagel or two slices of whole wheat bread is
enough to block iron absorption by 90%. Iron deficiency results in
fatigue, lightheadedness, feelings of being cold, poor physical
performance. Zinc deficiency most commonly results in skin rashes,
itchiness, impaired growth in children, learning impairment, and
gastrointestinal distress. Magnesium deficiency shows up as muscle
cramps/”charlie horses,” higher blood pressure and
blood sugar, loss of bone density, and heart rhythm disorders.
While mineral absorption improves dramatically
with wheat and grain elimination, iron and magnesium typically need
to be supplemented to make up for severe deficiency. Iron is best
managed by checking a blood level of ferritin and a complete blood
count (CBC), as iron overload can also occur. Magnesium can be safely
supplemented on your own by the vast majority of people;
I recommend taking the magnesium malate form, 1200 mg twice
per day (180 mg “elemental” magnesium twice per day).
Zinc can also be safely supplemented, 10-15 mg once per day.
Most of us have forgotten that, up until the early 20th century,
iodine deficiency and goiters (enlarged thyroid glands) were major
health problems worldwide, affecting 20% of people in most regions.
The addition of iodine to table salt, along with encouragement to
use plentiful salt solved the issue of iodine deficiency . . .
but then led to adverse effects of overuse of salt in at least some people.
So modern people have been advised to cut back
on salt–but everyone forgot about the iodine. Iodine deficiency
has numerous health implications. It can take on special significance
in the early wheat- and grain-free experience in that it can impair
your ability to lose weight and impair full recovery of health.
I therefore urge people to obtain an inexpensive
iodine supplement such as iodine drops or kelp tablets (dried seaweed)
that provides 500 mcg of iodine per day, what I believe to be the
ideal intake of iodine. People with Hashimoto’s disease,
Grave’s disease, or history of thyroid nodules or thyroid cancer
should work with their doctors on iodine issues (though seek out a
healthcare practitioner knowledgeable about this issue–most
doctors are not), since iodine restoration needs to be managed
carefully in these situations. However, those of us without these
conditions can simply supplement iodine, allowing the thyroid gland
to operate at full capacity.
Omega-3 fatty acids
The omega-3 fatty acids, EPA and DHA, available only from fish oil
in truly healthy quantities (NOT flaxseed, chia seed, nor krill oil)
yield considerable health benefits that include accelerated clearance
of the byproducts of digestion (that contribute to heart disease),
reduced triglycerides, and reduced overall cardiovascular risk and cancer risk.
However, a sufficient dose needs to be taken to
achieve such benefits. I therefore advise people to take
3000 mg per day of EPA and DHA, divided in two. This is the
level that raises the level of omega-3 fatty acids in blood cells
to 10% or greater in most people, the level associated with maximum
benefit. The best fish oil is the triglyceride form, i.e., the form
that occurs naturally in fish. This is available as liquid fish oil
from producers such as Halifax’s Ascenta NutraSea.
No gluten-free junk carbs
This bears repeating, as so many people interpret the Wheat Belly
message as a “gluten-free” message, then booby-trap their
health with gluten-free foods.
Let me be very clear: I do NOT advocate
consumption of gluten-free processed foods made with cornstarch,
tapioca starch, potato flour, or rice flour–they raise blood
sugar sky-high, cause visceral fat accumulation, inflammation, and
increase risk for cataracts, hypertension, diabetes, heart disease,
cancer, and dementia.
We therefore replace wheat and grains with
healthy choices that do not cause such problems. Don’t
replace a problem–wheat and grains–with another
problem–gluten-free junk carbohydrates.
Be aware of dairy casein beta A1
There are a number of tricky issues with dairy products, including
lactose, potential exposure to antibiotic residues and bovine growth
hormone, and estrogens. However, the real problem for many people may
be a form of casein dairy protein produced by North American cows
called casein beta A1.
Casein beta A1 is an immunogenic (immune system
stimulating) form of casein that appeared through a chance mutation in
cows around 6000 years ago. It is believed to underlie at least
some cases of type 1 diabetes in children, some instances of
autoimmune diseases like rheumatoid arthritis, heart disease, even
sudden infant death syndrome.
Most dairy products in North America contain
the casein beta A1 form, though it is present in small quantities
in cheese and butter. Goat and sheep products do not have this form of casein.
Yes, it takes a bit of effort. But if your goal is to stack the odds
in favor of full recovery from any condition, or to powerfully prevent
such conditions, these strategies are your best, most accessible,
inexpensive, yet effective ways to do so.
More discussions like this can be found in Wheat Belly Total Health.