vulnerable

on the vulnerable abnormal brain. It’s also important to keep in mind that each one of us is unique in terms of our genotype (DNA) and phenotype (how genes express themselves in their environment). Unchecked inflammation in me could result in obesity and heart disease, whereas the same condition in you could translate to an autoimmune disorder. Once again, it helps to turn to the literature on celiac disease, since celiac reflects an extreme case; it allows us to identify patterns in the course of the disorder that can have implications for anyone who consumes gluten, regardless of celiac. Multiple studies, for example, have shown that people with celiac have significantly increased production of free radicals, and they exhibit free radical damage to their fat, protein, and even DNA. 16 In addition, they also lose their ability to produce antioxidant substances in the body as a result of the immune system’s response to gluten. In particular, they have reduced levels of glutathione, an important antioxidant in the brain, as well as vitamin E, retinol, and vitamin C in their blood—all of which are key players in keeping the body’s free radicals in check. It’s as if the presence of gluten disables the immune system to such a degree that it cannot fully support the body’s natural defenses. My question is, if gluten sensitivity can compromise the immune system, what else does it open the door to? Research has also shown that the immune system’s reaction to gluten leads to activation of signaling molecules that basically turn on inflammation and induce what’s called the COX-2 enzyme, which leads to increased production of inflammatory chemicals. 17 If you’re familiar with drugs like Celebrex, ibuprofen, or even aspirin, you’re already familiar with the COX-2 enzyme, which is responsible for inflammation and pain in the body. These drugs effectively block that enzyme’s actions, thus reducing inflammation. High levels of another inflammatory molecule called TNF alpha have also been seen in celiac patients. Elevations of this cytokine are among the hallmarks of Alzheimer’s disease and virtually every other neurodegenerative condition. Bottom line: Gluten sensitivity—with or without the presence of celiac—increases the production of inflammatory cytokines, and these inflammatory cytokines are pivotal players in neurodegenerative conditions. Moreover, no organ is more susceptible to the deleterious effects of inflammation than the brain. It’s one of the most active organs in the body, yet it lacks bulletproof protective factors. Although the blood-brain barrier acts as a gatekeeper of sorts to keep certain molecules from crossing over from the bloodstream into our brain, it’s not a foolproof system. Plenty of substances sneak past this portal and provoke undesirable effects. (Later in the book I’ll go into richer detail about these inflammatory molecules and the ways in which we can use the power of food to combat them.) It’s time we created new standards for what it means to be “gluten sensitive.” The problem with gluten is far more serious than anyone ever imagined, and its impact on society is far greater than we’ve ever estimated. A GLUT OF GLUTEN IN MODERN FOOD If gluten is so bad, how have we managed to survive so long while eating it? The quick answer is that we haven’t been eating the same kind of gluten since our ancestors first figured out how to farm and mill wheat. The grains we eat today bear little resemblance to the grains that entered our diet about ten thousand years ago. Ever since the seventeenth century, when Gregor Mendel described his famous studies of crossing different plants to arrive at new varieties, we’ve gotten good at mixing and matching strains to create some wild progeny in the grain department. And while our genetic makeup and physiology haven’t changed much since the time of our ancestors, our food chain has had a rapid makeover during the past fifty years. Modern food manufacturing, including genetic bioengineering, have allowed us to grow grains that contain up to forty times the gluten of grains cultivated just a few decades ago. 18 Whether this has been intentional to increase yield, appeal to people’s palates, or both is anyone’s guess. But one thing we do know: Modern gluten-containing grains are more addictive than ever. If you’ve ever felt a rush of euphoric pleasure following the consumption of a bagel, scone, doughnut, or croissant, you’re not imagining it and you’re not alone. We’ve known since the late 1970s that gluten breaks down in the stomach to become a mix of polypeptides that can cross the blood-brain barrier. Once they gain entry, they can then bind to the brain’s morphine receptor to produce a sensorial high. This is the same receptor to which opiate drugs bind, creating their pleasurable, albeit addicting, effect. The original scientists who discovered this activity, Dr. Christine Zioudrou and her colleagues at the National Institutes of Health, named these brain-busting polypeptides exorphins, which is short for exogenous morphine-like compounds, distinguishing them from endorphins, the body’s naturally produced painkillers. 19 What’s most interesting about these exorphins, and further confirms their impact on the brain, is that we know they can be stopped by opiate-blocking drugs like naloxone and naltrexone—the same drugs used to reverse the action of opiate drugs such as heroine, morphine, and oxycodone. Dr. William Davis describes this phenomenon well in his book Wheat Belly: “So this is your brain on wheat: Digestion yields morphine-like compounds that bind to the brain’s opiate receptors. It induces a form of reward, a mild euphoria. When the effect is blocked or no exorphin-yielding foods are consumed, some people experience a distinctly unpleasant withdrawal.” 20 Given what I just explained, is it any wonder that food manufacturers try to pack as much gluten into their products as possible? And is it any surprise to find so many people addicted to gluten-filled foods today—fanning the flames of not just inflammation but the obesity epidemic? I think not. Most of us have known and accepted the fact that sugar and alcohol can have feel-good properties that entice us to come back for more. But gluten-containing foods? Your whole-wheat bread and instant oatmeal? The idea that gluten can change our biochemistry down to our brain’s pleasure and addiction center is remarkable. And scary. It means we need to re-think how we categorize these foods if they are indeed the mind-altering agents that science proves they are. When I watch people devour gluten-laden carbohydrates, it’s like watching them pour themselves a cocktail of gasoline. Gluten is our generation’s tobacco. Gluten sensitivity is far more prevalent than we realize—potentially harming all of us to some degree without our knowing it—and gluten is hiding where you least suspect it. It’s in our seasonings, condiments, and cocktails, and even in cosmetics, hand cream, and ice cream. It’s disguised in soups, sweeteners, and soy products. It’s tucked into our nutritional supplements and brand-name pharmaceuticals. The term “gluten-free” is becoming just as vague and diluted as “organic” and “all natural” have become. For me, it’s no longer a mystery why going gluten-free can have such a positive impact on the body. For the greater part of the past 2.6 million years, our ancestors’ diets consisted of wild game, seasonal plants and vegetables, and the occasional berries. As we saw in the previous chapter, today most people’s diets are centered on grains and carbs—many of which contain gluten. But even casting the gluten factor aside, I should point out that one of the main reasons why consuming so many grains and carbs can be so harmful is that they raise blood sugar in ways other foods, such as meat, fish, poultry, and vegetables, do not. High blood sugar, you’ll recall, produces high insulin, which is released by the pancreas to move sugar into the body’s cells. The higher the blood sugar, the more insulin must be pumped from the pancreas to deal with the sugar. And as the insulin increases, cells become less and less sensitive to the insulin signal. Basically, cells cannot hear insulin’s message. What the pancreas does, as anyone would do if a person couldn’t hear your message, is speak louder—that is, it increases its insulin output, creating a life-threatening feed-forward process. Higher levels of insulin cause the cells to become even less responsive to the insulin signal, and in order to deal with lowering the blood sugar, the pancreas works overtime, increasing its insulin output further, again to maintain a normal blood sugar. Even though the blood sugar is normal, the insulin level is climbing. Since cells are resistant to the insulin signal, we use the term “insulin resistance” to characterize this condition. As the situation progresses, the pancreas finally maximizes its output of insulin, but it’s still not enough. At that point, cells lose their ability to respond to the insulin signal, and ultimately, blood sugar begins to rise, resulting in type 2 diabetes. The system has essentially broken down and now requires an outside source (i.e., diabetes drugs) to keep the body’s blood sugars balanced. Remember, though, that you don’t have to be diabetic to suffer from chronic high blood sugar. When I give lectures to members of the medical community, one of my favorite slides is a photo of four common foods: (1) a slice of whole-wheat bread, (2) a Snickers bar, (3) a tablespoon of pure white sugar, and (4) a banana. I then ask the audience to guess which one produces the greatest surge in blood sugar—or which has the highest glycemic index (GI), a numerical rating that reflects a measure of how quickly blood sugar levels rise after eating a particular type of food. The glycemic index encompasses a scale of 0 to 100, with higher values given to foods that cause the most rapid rise in blood sugar. The reference point is pure glucose, which has a GI of 100. Nine times out of ten, people pick the wrong food. No, it’s not the sugar (GI = 68), it’s not the candy bar (GI = 55), and it’s not the banana (GI = 54). It’s the whole-wheat bread at a whopping GI of 71, putting it on par with white bread (so much for thinking whole wheat is better than white). We’ve known for more than thirty years that wheat increases blood sugar more than table sugar, but we still somehow think that’s not possible. It seems counterintuitive. But it’s a fact that few foods produce as much of a surge in blood glucose as those made with wheat. It’s important to note that the rise in gluten sensitivity is not only the outcome of hyper-exposure to gluten in today’s engineered foods. It’s also the result of too much sugar and too many proinflammatory foods. We can also make a case for the impact of environmental toxins, which can change how our genes express themselves and whether or not autoimmune signals start to fire. Each of these ingredients—gluten, sugar, pro-inflammatory foods, and environmental toxins—combines to create a perfect storm in the body, and especially the brain. If any food that foments a biological storm—despite the presence of gluten—is hazardous to our health, then we must raise another critically important question in terms of brain health: Are carbs— even “good carbs”—killing us? After all, carbs are often the main source of these antagonizing ingredients. Any conversation about blood sugar balance, gluten sensitivity, and inflammation has to revolve around the impact carbohydrates can have on the body and brain. In the next chapter, we’ll look at how carbs in general raise risk factors for neurological disorders, often at the expense of our brain’s real lover: fat. When we consume too many carbs, we eat less fat—the very ingredient our brain demands for health. SIGNS OF GLUTEN SENSITIVITY The best way to know if you’re sensitive to gluten is to get tested. Unfortunately, traditional blood tests and small-intestine biopsies are not nearly as accurate as the newer tests that can identify gluten antibodies just as well as genetic testing.