Book 21: "Wheat Belly"

Yeah, that's not a wheat belly!

After reading Novak Djokovic's book, "Serve to Win," I knew I wanted to explore the gluten-free diet further. The Forward in Djokovic's book is written by Dr. William Davis, one of the preeminent experts on the effects of gluten on the human body. His book, "Wheat Belly," was a New York Times bestseller when it came out in 2011, so it seemed like a logical next step for me.

What I learned:

• Wheat belly is visceral fat contained within abdomen and encasing abdominal organs.
• Visceral fat provokes inflammatory phenomena, distorts insulin responses and issues abnormal metabolic symbols to the rest of the body.
• Inflammatory signals and abnormal cytokines (i.e. leptin, resistin and tumor necrosis factor). The more fat present, the greater the quantities of abnormal signals released into the bloodstream. 
• GI is the nutritionists's measure of how much blood sugar levels increase in 90-120 minutes after food is consumed. 
• Whole wheat bread (glycemic index 72) increases blood sugar as much or more than table sugar (GI 59).
• Hypoglycemia--inevitable drop in blood pressure after high insulin levels.
• Test animals fed glyphosphate-tolerant soybeans show alterations in liver, pancreatic, intestinal and testicular tissue compared to animals fed conventional soybeans.
• "Complex" means carbs in wheat are composed of polymers of the simple sugar, glucose, unlike simple carbs such as sucrose, which are one- or two-unit sugar structures. 
• Of the complex carbs in wheat, 75% is the chain of branching glucose units, amylopectin, and 25% is the linear chain of glucose units, amylose. Both are digested by amylase enzyme. Amylopectin is rapidly converted to glucose and absorbed into the bloodstream, amylose is less efficiently digested, moves to colon undigested. 
• Not all amylopectin is the same: A, B, C types. C (legumes) is least digestible, B (bananas, potatoes) resist digestion to some degree, A is most digestible, raises blood sugar the highest. 
• Complex carbs of wheat are no better than simple sucrose.
• Pasta elevates blood sugar for 4-6 hours after consumption.
• The higher the blood glucose after consumption of food, the greater the insulin, the more fat is deposited. The bigger your wheat belly, the poorer your response to insulin, since visceral fat is associated with poor responsiveness to insulin, need more and more insulin, leads to diabetes. Wheat belly inflammation leads to heart disease and cancer. 
• Gluten is degraded to polypeptide "exorphins" that can penetrate the blood-brain barrier. They bind to brain's morphine receptors.
• Digestion > Exorphins > Opiate receptors > Mild euphoria, when receptors blocked, people experience withdrawal.
• Naloxone (immediately reverses effects of heroin or opiates) blocks binding of wheat exorphins to morphine receptors.
• Naltrexone (oral naloxone) blocks mesolimbic reward system, people can no longer feel pleasure from opiates and exorphins.  
• Don't replace amylopectin A with rapidly absorbed carbs of rice starch, cornstarch, potato starch and tapioca starch that also yield insulin and visceral fat deposition. 
• Researchers found that celiac-triggering gluten proteins are expressed at a higher level in modern wheat, while non-celiac triggering proteins are expressed less. 
• Gliadin protein triggers intestinal release of zonulin, which disassembles tight junctions and increases intestinal permeability. Unwanted proteins enter bloodstream, lymphocytes begin inflammatory process against "self" proteins, leading to celiac, thyroid, joint diseases and asthma. 
• "Immune-mediated gluten intolerance" is an umbrella term that includes celiac disease. Can include non-intestinal conditions, such as, dermatitis herpetiformis, liver disease, autoimmune diseases, insulin-dependent diabetes, neurological impairment, nutritional deficiencies. 
• Remove wheat > less blood sugar spikes > no exorphins to drive constant consumption > no glucose-insulin cycles > appetite shrinks > calorie intake reduced > visceral fat disappears > insulin resistance improves > blood sugars fall. Poor glucose metabolism disappear, such as, high blood pressure, inflammatory phenomena, glycation, small LDL particles, triglycerides. 
• Early phase of growing visceral fat and diabetes accompanied by 50% increase in pancreatic beta cells for insulin production. 
• High blood sugar above 100 mg/dl leads to glucotoxicity (damage to pancreatic insulin-producing cells). Beta cells are never replaced once damaged. 
• Lipotoxicity, loss of beta cells due to increased triglycerides and fatty acids. Carb diets increase VLDL particles and triglycerides. 
• Beta cells also killed by inflammatory phenomena, such as oxidative injury, leptin, interleukins, tumor necrosis factor.
• Diabetes starts when less than 50% of beta cells are left. 
• Elimination of carbohydrates not only improves blood sugar control, but can erase the need for insulin and diabetes medications in adult diabetes. 
• If sufficient pancreatic beta cells remain and have not been destroyed by glucotoxicity, lipotoxicity and inflammation, it's possible to be cured of diabetes.
• Normal body pH is 7.4. Metabolism creates acids, driving pH down, body draws from alkaline stores (i.e. bicarbonate in blood and alkaline calcium salts--calcium carbonate and calcium phosphate--in bones), leading to acidosis.
• Acids also come from diet: soda (carbonic acid, phosphoric acid), animal by-products--meat (uric, sulfuric acid) and cheese.
• Alkaline foods are vegetables and fruits, neutralize animal product acids.
• The higher the ratio of protein intake from vegetables to protein intake from animal products, the fewer hip fractures.
• We build bones till 18, then break it down when acidosis occurs. Demineralization results in osteopenia (mild) then osteoporosis (severe) then frailty and fractures. Taking calcium supplements does not reverse bone loss. 
• Bone density declines start at 25 for women and 40 for men, accelerated at 70 onward.
• Wheat is the only plant to generate acidic by-products (sulfuric acid).
• Urinary calcium loss increases by 63% after eating bread.
• Inflammation from wheat belly visceral fat leads to joint inflammation through tumor necrosis factor-alpha, interleukins, leptin is the worst (higher BMI, higher leptin).
• Having belly fat = greater risk of arthritis. 
• Joint cartilage susceptible to glycation, do not recover.
• Advanced Glycation End Products (AGE) cause atherosclerosis, cataracts, dementia. 
• High blood glucose leads glucose to bind to proteins, creating glucose-protein molecule--AGEs, which form chains and accumulate as debris. 
• The higher blood glucose, more AGEs accumulate, faster decaying. 
• AGEs lead to expression of oxidative stress and inflammatory markers. Receptor for AGEs (RAGE) lead to inflammatory cytokines, vascular endothelial growth factor and tumor necrosis factor, leading to heart disease, cancer, diabetes and more. 
• Fructose increases AGE formation several hundred times more than glucose.
• Foods highest in AGEs: animal products that have been heated to high temperatures, cooked longer.
• Hemoglobin A1c (HbA1c) is an index for glycation. When HbA1c is glycated it is irreparable. Measuring percentage glycated shows how high blood sugar has been in the past 60-90 days. The higher HbA1c, faster you're aging. 
• Small low-density lipoproteins (LDL) cause heart disease (heart attacks, angioplasty, stents, bypass, etc. atherosclerotic coronary disease). 
• Small LDL are 8x more susceptible to endogenous glycation. Small LDL formed when plentiful carbs in diet, also increase blood glucose that glycates small LDL. 
• Very low-density lipoproteins (VLDL) are parents of small LDL, released by liver. Anything that increases liver production of VLDL or increase triglyceride content of VLDL leads to increased small LDL. 
• Carbs have few triglycerides but stimulate insulin, which triggers fatty acid synthesis in the liver, leading to increased triglycerides in the blood. 
• Visceral fat is a repository, triglycerides go in and out of fat cells, liver exposed to higher levels of triglycerides, further drives VLDL production. 
• Destructive immune response in celiac disease can be directed at the brain. 
• Antigliadin antibodies from gluten bind to Purkinje cells found only in cerebellum, do not regenerate. Leads to loss of balance and coordination and other symptoms of cerebellar ataxia. Can lead to gluten encephalopathy. 
• Peripheral neuropathy: wheat-triggered immune reaction in nerves of legs, pelvis, other organs, caused by diabetes. 
• Nerve damage > reduced sensation, diminished control over blood pressure and heart rate, sluggish emptying of stomach.
• Japanese-Okinawans, longest lived on earth, only consumed diet of diverse vegetables, sweet potato, soy, pork and fish > no acne. 
• Insulin > release of insulin-like growth factor-I (IGF-I) > stimulates tissue growth in hair follicles and dermis, sebum > pimples.
• Other skin problems: rashes, alopecia. 

Foods to eliminate, besides wheat: 

• Cornstarch and cornmeal
• Snack foods
• Desserts
• Rice
• Potatoes
• Legumes
• Gluten-free foods
• Fruit juices, soft drinks
• Dried fruit
• Other grains

Foods to eat:

• Vegetables
• Some fruit--8-10 blueberries, 2 strawberries, wedges of apple/orange (avoid banana, mango, pineapple, papaya)
• Raw nuts--as much as you want; filling, fiber, monounsaturated oils, protein; reduce blood pressure, reduce LDL cholesterol. 
• Oils, generously--extra-virgin olive oil, coconut oil, avocado oil, cocoa butter; avoid polyunsaturated oils like sunflower, safflower, corn and vegetable.
• Meat and eggs--grass-fed (omega-3 fatty acids, less hormones/antibiotics), no frying.
• Dairy products--cheese, unlimited; limited others, unprocessed.
• Soy--fermented (tofu, tempeh, miso, natto) that have less lectins/phytates 
• Others: olives, avocados, pickled vegetables, raw seeds.
• Flaxseed--made of protein, fiber and oils, free of carbs
• Limit carbs to 50-100 grams per day.

Some perspectives on agriculture:

• "Agriculture yielded surpluses and allowed division of labor, it also entailed working harder and longer hours...narrowed crops that could be cultivated ..introduced new diseases."
• "We have unwittingly struck a Faustian bargain with nature, trading abundance for health."

Wheat can be found in:

• Beverages: ales, beers, lagers, blood Mary mixes, flavored coffee/tea, herbal tea, malt liquor, vodka distilled from wheat (Absolut, Grey Goose, Stolichnaya), wine coolers, whiskey. 
• Cereal
• Cheese: blue, cottage, gorgonzola, roquefort.
• Coloring/fillers/texturizers/thickeners: artificial coloring/flavors, caramel coloring/flavoring, dextrimaltose, emulsifiers, maltodextrin, modified food starch, stabilizers, textured vegetable protein.
• Energy, protein and meal replacement bars: Clif, Gatorade, GNC, Kashi, Power, Slim-Fast.
• Meats: breaded, canned, deli meats, hot dogs, imitation bacon/crabmeat, hamburger, sausage, turkey (self-basting).
• Sauces, salad dressings, condiments: gravies, ketchup, malt syrup/vinegar, marinade, miso, mustards, salad dressings, soy sauce, teriyaki sauce.
• Seasonings: curry powder, seasoning mixes, taco seasoning.
• Snacks and desserts
• Soups: Bisques, broths/bouillon, canned soups, soup mixes, soup stocks and bases.
• Soy and vegetarian products: veggie burgers (Boca, Garden, Morningstar Farms), vegetarian chicken strips, vegetarian chili/hot dogs/sausages/scallops/steak. 
• Sweeteners: barley malt/extract, dextrin/maltodextrin, malt/malt syrup/malt flavoring.

I'll spare you (or the future me) a look at my belly, but I'm pretty sure it qualifies as a wheat belly. I've been having the hardest time getting rid of, what I thought was, subcutaneous fat. I dedicated myself to working out regularly at the start of the new year, but despite a fairly consistent effort and multiple cycles of changing workouts and diet plans, I've haven't really slimmed down. It's especially frustrating to see friends' "before and after" pictures on Instagram, and realizing that I haven't had the same dramatic transformation to the body of my dreams. What I like about the Wheat Belly diet is that a lot of it is based on common sense, which is a build up of what I already know. Putting all the pieces together and realizing that, to a certain extent, I fit the ideal clientele for this diet, was a relief. Since the book is based on hard science, I'm more apt to think it'll work. At this point, I can't say for sure if the Wheat Belly diet will work for me, but I plan on taking it slow, cutting out wheat products (and definitely sugar drinks, i.e. sweetened coffee or tea) from my diet. If I see a change, I'll try to cut down on the rest of my "indulgences," like rice. 

Even if the Wheat Belly diet doesn't work for me, the book is an engaging read that builds up from beginning to end. Like any diet/lifestyle book, it felt a little exaggerated at times, almost as though Dr. Davis wanted to instill fear and panic in the audience in an attempt to sway them towards adopting his plan. The reasoning behind his statements are based on scientific studies and real-life experience. I'm not capable of accurately judging his determinations, but I think it goes without saying that it's up to the reader to decide whether or not the prescriptions are suitable for their life. I'm certainly at a point where I'm open to trying a new approach, so the book felt beneficial and substantive at the end. (Note to vegetarians: the Wheat Belly diet will be extremely limiting, and I think more challenging to adhere to). 

As a bonus, the author included a sample meal plan and recipes for dishes a Wheat Belly participant can partake in. 

Rating: A-

Book 20: "Serve to Win"

Tennis pro turned author, Novak Djokovic, doesn't eat wheat and claims to love his severely restricted diet. 

I know it's been a really long time since I last posted :( Between my trip to NYC and LA and the start of my new job, I haven't had much time to read. Somehow, I managed to finish two books in the last week and a half, so that's nice. 

The first book I read since the trip, "Serve to Win," by Novak Djokovic was a really easy read. I finished it on the plane ride from LAX to HNL, even with a nap, lunch break and "Star Trek: Into Darkness." I bought the book because I thought it was going to be partly autobiographical, maybe a look into his life up to this point. Unfortunately, the book was light on personal epithets, and readers even vaguely familiar with his life's story will not have any revelations about who Djokovic truly is. All threads of personal information serve to support his triumphs as a gluten-free athlete and number-one tennis player in the world. I give him a few concessions: 1) He's still a current player, so revealing too much could be potentially disruptive for his career (on- and off-court); 2) His story is still "unwritten" in that, who he ends up being and what legacy he leaves in tennis has yet to be determined; 3) The (hidden) point of "writing" the book is to testify for the gluten free lifestyle, not to shock and awe; and 4) English is not Djokovic's first language, so everything is a bit basic. 

The true issue I had with the book is that there's so much self-promotion, so much repetitive muck to wade through, in order to get to the good stuff. Yes, Djokovic had a very good 2011 season, and yeah he's the current world number 1 (as of 09/23/2013--a dethroning is almost guaranteed when Rafael Nadal surpasses his points total by years-end) and will most definitely go down in history books as one of the best tennis players of all time, but I like my heroes humble, not obnoxiously self-elevating (how many times can someone repeat that they are a "tennis great" before people throw up?). (Nadal, by contrast, is always humble and concedes to reality.) There are a few unbelievable, "wow," moments in the book, such as when he recounts the daily air raids in Belgrade, but far too little of it to count this as a truly great autobiography. Perhaps years after he retires, he'll come out with a "tell-all," but I sincerely hope he doesn't try to write gluten-free books after this. 

What I liked about the book was that it contains plenty of gluten-free recipes, many of which I intend to try. I could also vaguely relate to Djokovic's desperation in finding the perfect combination of physical, mental and nutritional inputs that would allow him to perform at his peak. Although most people will never have to put out at his level, everyone can relate to his dietary struggles and exhaustive effort to maximize his potential as a human being. 

In the end, though, there aren't enough recipes or hard science about gluten-free diets, nor are we given enough to digest about the author himself to justify giving "Serve to Win" a prominent place on my bookshelf of fame. 

Rating: B-

Congrats to Djokovic, who is now engaged to Jelena Ristic, his long-time girlfriend.