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CHAPTER 5

YOUR WHEAT BELLY IS SHOWING: THE WHEAT/OBESITY CONNECTION

PERHAPS YOU’VE EXPERIENCED this scenario:

You encounter a friend you haven’t seen in some time and exclaim with delight: ‘Elizabeth! When are you due?’

Elizabeth: [Pause.] ‘Due? I’m not sure what you mean.’

You: Gulp . . .

Yes, indeed. Wheat belly’s abdominal fat can do a darn good imitation of a baby bump.

Why does wheat cause fat accumulation specifically in the abdomen and not, say, on the scalp, left ear or backside? And, beyond the occasional ‘I’m not pregnant’ mishap, why does it matter?

And why would elimination of wheat lead to loss of abdominal fat?

Let’s explore the unique features of the wheat belly habitus.

WHEAT BELLY, LOVE HANDLES, MAN BOOBS AND ‘FOOD BABIES’

These are the curious manifestations of consuming the modern grain we call wheat. Dimpled or smooth, hairy or hairless, tense or flaccid, wheat bellies come in as many shapes, colours and sizes as there are humans. But all share the same underlying metabolic cause.

I’d like to make the case that foods made with or containing wheat make you fat. I’d go as far as saying that overly enthusiastic wheat consumption is the main cause of the obesity and diabetes crisis in the United States. It explains why modern athletes, such as baseball players and triathletes, are fatter than ever. Blame wheat when you are being crushed in your airline seat by the twenty-stone man next to you.

Sure, sugary soft drinks and sedentary lifestyles add to the problem. But for the great majority of health-conscious people who don’t indulge in these obvious weight-gaining behaviours, the principal trigger for increasing weight is wheat.

In fact, the incredible financial bonanza that the proliferation of wheat in the American diet has created for the food and drug industries can make you wonder if this ‘perfect storm’ was somehow man-made. Did a group of powerful men convene a secret Howard Hughesian meeting in 1955, map out an evil plan to mass-produce high-yield, low-cost dwarf wheat, engineer the release of government-sanctioned advice to eat ‘healthy whole grains’, lead the charge of corporate Big Food to sell hundreds of billions of dollars worth of processed wheat food products – all leading to obesity and the ‘need’ for billions of dollars of drug treatments for diabetes, heart disease and all the other health consequences of obesity? It sounds ridiculous, but in a sense that’s exactly what happened. Here’s how.

Wheat Belly Diva

Celeste no longer felt ‘cool’.

At the age of sixty-one, Celeste reported that she’d gradually gained weight from her normal range of 18½ to 9½ stone in her twenties and thirties. Something happened starting in her mid-forties, and even without substantial changes in habits, she gradually ballooned up to 13 stone. ‘This is the heaviest I have ever been,’ she groaned.

As a professor of modern art, Celeste hung around with a fairly urbane crowd and her weight made her feel even more self-conscious and out of place. So I got an attentive ear when I explained my diet approach that involved elimination of all wheat products.

Over the first three months she lost 1½ stone, more than enough to convince her that the programme worked. She was already having to reach to the back of her closet to find clothes she hadn’t been able to wear for the past five years.

Celeste stuck to the diet, admitting to me that it had quickly become second nature with no cravings, a rare need to snack, just a comfortable cruise through meals that kept her satisfied. She noted that, from time to time, work pressures kept her from being able to have lunch or dinner, but the prolonged periods without something to eat proved effortless. I reminded her that healthy snacks such as raw nuts, linseed crackers, and cheese readily fit into her programme. But she simply found that snacks weren’t necessary most of the time.

Fourteen months after adopting the Wheat Belly diet, Celeste couldn’t stop smiling when she returned to my office at 9 stone – a weight she’d last seen in her thirties. She’d lost 3 stone 13 pounds from her high, including 12 inches off her waist, which shrank from 39 inches to 27. Not only could she fit into size 10 dresses again, she no longer felt uncomfortable mingling with the artsy set. No more need to conceal her sagging wheat belly under loose-fitting tops or layers. She could wear her tightest Oscar de la Renta cocktail dress proudly, no wheat belly bulge in sight.

WHOLE GRAINS, HALF-TRUTHS

In nutrition circles, whole grain is the dietary darling du jour. In fact, this USDA-endorsed, ‘heart healthy’ ingredient, the stuff that purveyors of dietary advice agree you should eat more of, makes us hungry and fat, hungrier and fatter than any other time in human history.

Hold up a current picture of ten random Americans against a picture of ten Americans from the early twentieth century, or any preceding century where photographs are available, and you’d see the stark contrast: Americans are now fat. According to the CDC, 34.4 per cent of adults are now overweight (BMI of 25 to 29.9) and another 33.9 per cent are obese (BMI 30 or greater), leaving less than one in three normal weight.¹ Since 1960, the ranks of the obese have grown the most rapidly, nearly tripling over those fifty years.²

Few Americans were overweight or obese during the first two centuries of the nation’s history. (Most data collected on BMI that we have for comparison prior to the twentieth century come from body weight and height tabulated by the US military. The average male in the military in the late nineteenth century had a BMI of <23.2, regardless of age; by the 1990s, the average military BMI was well into the overweight range.³ We can easily presume that, if it applies to military recruits, it’s worse in the civilian population.) Weight grew at the fastest pace once the USDA and others got into the business of telling Americans what to eat. Accordingly, while obesity grew gradually from 1960, the real upwards acceleration of obesity started in the mid-eighties. In the UK, as of March 2013, the Department of Health reported that in England, most people are overweight or obese. This includes 61.9 per cent of adults and 28 per cent of children aged between 2 and 15. Health problems associated with being overweight or obese cost the NHS more than £5 billion every year.

Studies conducted during the eighties and since have shown that, when processed white flour products are replaced with whole-grain flour products, there is a reduction in colon cancer, heart disease and diabetes. That is indeed true and indisputable.

According to accepted dietary wisdom, if something that is bad for you (white flour) is replaced by something less bad (whole-wheat), then lots of that less-bad thing must be great for you. By that logic, if high-tar cigarettes are bad for you and low-tar cigarettes are less bad, then lots of low-tar cigarettes should be good for you. An imperfect analogy, perhaps, but it illustrates the flawed rationale used to justify the proliferation of grains in our diet. Throw into the mix the fact that wheat has undergone extensive agricultural genetics-engineered changes, and you have devised the formula for creating a nation of fat people.

The USDA and other ‘official’ opinion makers say that more than two-thirds of Americans are overweight or obese because we’re inactive and gluttonous. We sit on our fat behinds watching too much reality TV, spend too much time online and don’t exercise. We drink too many sugary fizzy drinks and eat too much fast food and too many junk snacks. Betcha can’t eat just one!

Certainly these are poor habits that will eventually take their toll on one’s health. But I meet plenty of people who tell me that they follow ‘official’ nutritional guidelines seriously, avoid junk foods and fast foods, exercise an hour every day, all while continuing to gain and gain and gain. Many follow the guidelines set by the USDA food pyramid (six to eleven servings of grain per day, of which four or more should be whole grain), the American Heart Association, the American Dietetic Association or the American Diabetes Association. The cornerstone of all these nutritional directives? ‘Eat more healthy whole grains’. This largely matches the advice given by the UK government and the NHS, which recommend that you ‘choose wholegrain varieties whenever you can’.

Are these organisations in cahoots with the wheat farmers and seed and chemical companies? There’s more to it than that. ‘Eat more healthy whole grains’ is really just the corollary of the ‘Cut the fat’ movement embraced by the medical establishment in the sixties. Based on epidemiologic observations that suggested that higher dietary fat intakes are associated with higher cholesterol levels and risk for heart disease, Americans were advised to reduce total and saturated fat intake. Grain-based foods came to replace the calorie gap left by reduced fat consumption. The whole-grain-is-better-than-white argument further fuelled the transition. The low-fat, more-grain message also proved enormously profitable for the processed food industry. It triggered an explosion of processed food products, most requiring just a few pence worth of basic materials. Wheat flour, cornflour, high-fructose corn syrup, sucrose, and food colouring are now the main ingredients of products that fill the interior aisles of any modern supermarket. (Whole ingredients such as vegetables, meats and dairy tend to be at the perimeter of these same stores.) Revenues for Big Food companies swelled. Kraft alone now generates $48.1 billion in annual revenues, an 1,800 per cent increase since the late eighties, a substantial portion of which comes from wheat- and corn-based snacks.

Just as the tobacco industry created and sustained its market with the addictive property of cigarettes, so does wheat in the diet make for a helpless, hungry consumer. From the perspective of the seller of food products, wheat is a perfect processed food ingredient: the more you eat, the more you want. The situation for the food industry has been made even better by the glowing endorsements provided by governments urging people to eat more ‘healthy whole grains’.

GRAB MY LOVE HANDLES: THE UNIQUE PROPERTIES OF VISCERAL FAT

Wheat triggers a cycle of insulin-driven satiety and hunger, paralleled by the ups and downs of euphoria and withdrawal, distortions of neurological function, and addictive effects, all leading to fat deposition.

The extremes of blood sugar and insulin are responsible for growth of fat specifically in the visceral organs. Experienced over and over again, visceral fat accumulates, creating a fat liver, two fat kidneys, a fat pancreas, fat large and small intestines, as well as its familiar surface manifestation, a wheat belly. (Even your heart gets fat, but you can’t see this through the semi-rigid ribs.)

So the Michelin tire encircling your or your loved one’s waistline represents the surface manifestation of visceral fat contained within the abdomen and encasing abdominal organs, resulting from months to years of repeated cycles of high blood sugar and high blood insulin, followed by insulin-driven fat deposition. Not fat deposition in the arms, buttocks or thighs, but the saggy ridge encircling the abdomen created by bulging fatty internal organs. (Exactly why disordered glucose-insulin metabolism preferentially causes visceral fat accumulation in the abdomen and not your left shoulder or the top of your head is a question that continues to stump medical science.)

Buttock or thigh fat is precisely that: buttock or thigh fat – no more, no less. You sit on it, you squeeze it into your jeans, you lament the cellulite dimples it creates. It represents excess calories over caloric expenditure. While wheat consumption adds to buttock and thigh fat, the fat in these regions is comparatively quiescent, metabolically speaking.

Visceral fat is different. While it might be useful as ‘love handles’ grasped by your partner, it is also uniquely capable of triggering a universe of inflammatory phenomena. Visceral fat filling and encircling the abdomen of the wheat belly sort is a unique, twenty-four-hour-a-day, seven-day-a-week metabolic factory. And what it produces is inflammatory signals and abnormal cytokines, or cell-to-cell hormone signal molecules, such as leptin, resistin and tumour necrosis factor.^{4, 5} The more visceral fat present, the greater the quantities of abnormal signals released into the bloodstream.

All body fat is capable of producing another cytokine, adiponectin, a protective molecule that reduces risk for heart disease, diabetes and hypertension. However, as visceral fat increases, its capacity to produce protective adiponectin diminishes (for reasons unclear).⁶ The combination of lack of adiponectin along with increased leptin, tumour necrosis factor and other inflammatory products underlies abnormal insulin responses, diabetes, hypertension and heart disease.⁷ The list of other health conditions triggered by visceral fat is growing and now includes dementia, rheumatoid arthritis and colon cancer.⁸ This is why waist circumference is proving to be a powerful predictor of all these conditions, as well as of mortality.⁹

Visceral fat not only produces abnormally high levels of inflammatory signals but is also itself inflamed, containing bountiful collections of inflammatory white blood cells (macrophages).¹⁰ The endocrine and inflammatory molecules produced by visceral fat empty (via the portal circulation draining blood from the intestinal tract) directly into the liver, which then responds by producing yet another sequence of inflammatory signals and abnormal proteins.

In other words, in the human body, all fat is not equal. Wheat belly fat is a special fat. It is not just a passive repository for excess pizza calories; it is, in effect, an endocrine gland much like your thyroid gland or pancreas, albeit a very large and active endocrine gland. (Ironically, people were correct forty years ago when they labelled an overweight person as having a ‘gland’ problem.) Unlike other endocrine glands, the visceral fat endocrine gland does not play by the rules, but follows a unique handbook that works against the body’s health.

So a wheat belly is not just unsightly, it’s also dreadfully unhealthy.

GETTING HIGH ON INSULIN

Why is wheat so much worse for weight than other foods?

The essential phenomenon that sets the growth of the wheat belly in motion is high blood sugar (glucose). High blood sugar, in turn, provokes high blood insulin. (Insulin is released by the pancreas in response to the blood sugar. The higher the blood sugar, the more insulin must be released to move the sugar into the body’s cells, such as those of the muscle and liver.) When the pancreas’s ability to produce insulin in response to blood sugar rises is exceeded, diabetes develops. But you don’t have to be diabetic to experience high blood sugar and high insulin. Nondiabetics can easily experience the high blood sugars required to cultivate their very own wheat belly, particularly because foods made from wheat so readily convert to sugar.

High blood insulin provokes visceral fat accumulation, the body’s means of storing excess energy. When visceral fat accumulates, the flood of inflammatory signals it produces causes tissues such as muscle and liver to respond less to insulin. This so-called insulin resistance means that the pancreas must produce greater and greater quantities of insulin to metabolise the sugars. Eventually, a vicious circle of increased insulin resistance, increased insulin production, increased deposition of visceral fat, increased insulin resistance, etc., etc., ensues.

Nutritionists established the fact that wheat increases blood sugar more profoundly than table sugar thirty years ago. As we’ve discussed, the glycaemic index, or GI, is the nutritionist’s measure of how much blood sugar levels increase in the 90 to 120 minutes after a food is consumed. By this measure, whole-wheat bread has a GI of 72, while plain table sugar has a GI of 59 (though some labs have observed results as high as 65). In contrast, kidney beans have a GI of 51, grapefruit comes in at 25, while noncarbohydrate foods such as salmon and walnuts have GIs of essentially zero: eating these foods has no effect on blood sugar. In fact, with few exceptions, few foods have as high a GI as foods made from wheat. Outside of dried sugar-rich fruits such as dates and figs, the only other foods that have GIs as high as wheat products are dried, pulverised starches such as cornflour, rice starch, potato starch and tapioca starch. (It is worth noting that these are the very same carbohydrates often used to make ‘gluten-free’ food. More on this later.)

Because wheat carbohydrate, the uniquely digestible amylopectin A, causes a greater spike in blood sugar than virtually any other food – more than a chocolate bar, table sugar or ice cream – it also triggers greater insulin release. More amylopectin A means higher blood sugar, higher insulin, more visceral fat deposition . . . bigger wheat belly.

Throw in the inevitable drop in blood sugar (hypoglycaemia) that is the natural aftermath of high insulin levels and you see why irresistible hunger so often results, as the body tries to protect you from the dangers of low blood sugar. You scramble for something to eat to increase blood sugar, and the cycle is set in motion again, repeating every two hours.

Now factor in your brain’s response to the euphoric exorphin effects induced by wheat (and the attendant potential for withdrawal if your next ‘fix’ is missed), and it’s no wonder the wheat belly encircling your waist continues to grow and grow.

MEN’S LINGERIE IS ON THE SECOND FLOOR

Wheat belly is not just a cosmetic issue, but a phenomenon with real health consequences. In addition to producing inflammatory hormones such as leptin, visceral fat is also a factory for oestrogen production in both sexes, the very same oestrogen that confers female characteristics on girls beginning at puberty, such as widening of the hips and growth of the breasts.

Until the menopause, adult females have high levels of oestrogen. Surplus oestrogen, however, produced by visceral fat adds considerably to breast cancer risk, since oestrogen at high levels stimulates breast tissue.¹¹ Thus, increased visceral fat on a female has been associated with an increased risk for breast cancer as high as fourfold. Breast cancer risk in postmenopausal women with the visceral fat of a wheat belly is double that of slender, non-wheat-belly-bearing postmenopausal females.¹²