Wheat Belly. William Davis, MD

on girls beginning at puberty, such as widening of the hips and growth of the breasts. Estrogen levels are oddly jacked up by visceral fat of the wheat belly and peculiar and unwanted effects in both women and men follow.

      Until menopause, adult females have high levels of estrogen. Surplus estrogen, however, produced by visceral fat adds considerably to breast cancer risk, since estrogen at high levels stimulates breast tissue.¹¹ Thus, increased visceral fat on females has been associated with as much as fourfold increased risk for breast cancer. 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 Despite the apparent connection, no study—incredibly—has examined the results of a wheat-free, lose-the-visceral-fat-wheat-belly diet and its effect on the incidence of breast cancer. If we simply connect the dots, a marked reduction in risk would be predicted.

      Males, having only a tiny fraction of the estrogen of females, are sensitive to anything that increases estrogen. The bigger the wheat belly in males, the more testosterone is converted to estrogen by visceral fat tissue via the aromatase enzyme. Since estrogen stimulates growth of breast tissue, elevated estrogen levels can cause men to develop larger breasts—those dreaded “man boobs,” “man cans,” or, for you professional types, gynecomastia.¹³ Levels of the hormone prolactin are also increased substantially by visceral fat.¹⁴ As the name suggests (prolactin means “stimulating lactation”), high prolactin levels stimulate breast tissue growth and milk production. To make matters worse, one of the exorphin breakdown products of wheat gliadin, called the B₅ pentapeptide, is another potent stimulator of the pituitary gland’s release of prolactin in males.¹⁵

      Enlarged breasts on a male are therefore not just the embarrassing body feature that your annoying nephew snickers at, but B-cup evidence that estrogen and prolactin levels are increased due to the inflammatory and hormonal factory hanging around your waist, as well as peculiar digestive by-products of gliadin that make your body do things it should not.

      An entire industry has emerged to help men embarrassed by their enlarged breasts. Male breast reduction surgery is booming, growing nationwide at double-digit rates. Other “solutions” include special clothing, compression vests, and exercise programs. (Maybe Seinfeld’s Kramer wasn’t so crazy when he invented the mansierre.)

      Increased estrogen, breast cancer, man boobs … all from the bag of bagels shared at the office.

      CELIAC DISEASE: A WEIGHT LOSS LABORATORY

      As noted earlier, the one ailment to which wheat has been conclusively linked even among conventional dietary thinkers is celiac disease. Celiac sufferers are counseled to remove wheat products and other gluten-containing grains from their diet, lest all manner of nasty complications of their disease develop. What can their experience teach us about the effects of wheat elimination? In fact, there are unclaimed gems of important weight loss lessons to be gleaned from clinical studies of people with celiac disease who remove wheat gluten–containing foods.

      The lack of appreciation of celiac disease among physicians, coupled with its many unusual presentations (for example, fatigue or migraine headaches without intestinal symptoms), means an average delay of eleven years from symptom onset to diagnosis.^{16, 17} Some celiac sufferers therefore develop a severely malnourished state due to impaired nutrient absorption at the time of diagnosis. This is especially true for children with celiac disease, who are often both underweight and underdeveloped for their age.¹⁸

      Some celiac sufferers become positively emaciated before the cause of their illness is determined. A 2010 Columbia University study of 369 people with celiac disease enrolled 64 participants (17.3 percent) with an incredible body mass index of 18.5 or less.¹⁹ (A BMI of 18.5 in a 5-foot-4 female would equate to a weight of 105 pounds, or 132 pounds for a 5-foot-10 male.) Years of poor nutrient and calorie absorption, worsened by frequent diarrhea, leave some celiac sufferers underweight, malnourished, and struggling just to maintain weight.

      Elimination of wheat gluten removes the offensive agent that destroys the intestinal lining. Once the intestinal lining regenerates, better absorption of vitamins, minerals, and calories becomes possible, and weight begins to increase due to improved nutrition. Such studies document the weight gain with wheat removal experienced by underweight, malnourished celiac sufferers.

      For this reason, celiac disease has traditionally been regarded as a plague of children and emaciated adults. However, celiac experts have observed that, over the past forty to fifty years, newly diagnosed patients with celiac disease are more and more often overweight or obese. One such recent ten-year tabulation of newly diagnosed celiac patients showed that 39 percent started overweight (BMI 25 to 29.9) and 13 percent started obese (BMI ≥ 30).²⁰ By this estimate, more than half the people now diagnosed with celiac disease are therefore overweight or obese.

      If we focus only on overweight people who are not severely malnourished at the time of diagnosis, celiac sufferers actually lose a substantial quantity of weight when they eliminate gluten. A Mayo Clinic/University of Iowa study tracked 215 celiac patients after wheat gluten elimination and tabulated 27.5 pounds of weight loss in the first six months in those who started obese.²¹ In the Columbia University study cited above, wheat elimination cut the frequency of obesity in half within a year, with more than 50 percent of the participants with a starting BMI in the overweight range of 25 to 29.9 losing an average of 26 pounds.²² Dr. Peter Green, lead gastroenterologist in the study and professor of clinical medicine at Columbia, speculates that “it is unclear whether it is reduced calories or another factor in diet” responsible for the weight loss of the gluten-free diet. With all you’ve learned, isn’t it clear that it’s the elimination of wheat that accounts for the extravagant weight loss?

      Similar observations have been made in children. Kids with celiac disease who eliminate wheat gluten gain muscle and resume normal growth, but also have less fat mass compared to kids without celiac disease.²³ (Tracking weight changes in kids is complicated by the fact that they are growing.) Another study showed that 50 percent of obese children with celiac disease approached normal BMI with wheat gluten elimination.²⁴

      What makes this incredible is that, beyond gluten removal, the diet in celiac patients is not further restricted. These were not purposeful weight loss programs, just wheat and gluten elimination. No calorie counting was involved, nor portion control, exercise, or any other means of losing weight … just losing the wheat. There are no prescriptions for carbohydrate or fat content, just removal of wheat gluten. It means that some people incorporate “gluten-free” foods, such as breads, cupcakes, and cookies, that cause weight gain, sometimes dramatic. (As we will discuss later, if you have a goal of weight loss or any health concerns, it will be important not to substitute one weight-increasing food, wheat, with yet another collection of weight-increasing and unhealthy gluten-free items.) In many gluten-free programs, gluten-free foods are actually encouraged. Despite this flawed diet prescription, the fact remains: Overweight celiac sufferers experience marked weight loss with elimination of wheat gluten.

      Investigators performing these studies, though suspecting “other factors,” never offer the possibility that weight loss is from elimination of a food that causes extravagant weight gain—i.e., wheat.

      Interestingly, these people have substantially lower caloric intake once on a gluten-free diet, compared to people not on a gluten-free diet, even though other foods are not restricted. Caloric intake measured 14 percent less per day on gluten-free diets.²⁵ Another study found that celiac patients who strictly adhered to gluten elimination consumed 418 calories less per day than celiac patients who were non-compliant and permitted wheat gluten to remain in their diets.²⁶ For someone whose daily caloric intake is 2,500 calories, this would represent a 16.7 percent reduction in caloric intake. Guess what that does to weight?

      Symptomatic of the bias of conventional nutritional dogma, the investigators in the first study labeled the diet followed by participants recovered from celiac disease “unbalanced,” since the gluten-free diet contained no pasta, bread, or pizza but included more “wrong natural foods” (yes, they actually said this)