I recently listened to an interview with the preventative cardiologist William Davis, MD on Jimmy Moore’s podcast “Living La Vida Low Carb“, (Dr. Davis begins at 41:20 of the podcast). He just published a book called Wheat Belly. His book describes the remarkable health benefits that he witnessed when his patients simply removed wheat from their diets. They experienced significant weight loss, reversal of diabetes, asthma, acid reflux, IBS, arthritis, and improved mood and sleep, to name a few of the good effects. Dr. Davis is one of the few cardiologists who recognizes that heart disease is not caused by high cholesterol, but rather from a diet rich in excess carbohydrates. He explicitly disagrees with the Surgeon General’s nutritional advice to promote heart health: “Eat a diet rich in “healthy whole grains” and low in fat.” And in fact believes, as do I, that it is a prescription for ill health.
I completely agree with Dr. Davis’s linking excess carbohydrate with heart disease, his recognition that for many patients, “healthy whole grains” is an oxymoron, and that it is a diet high in carbohydrate, that is contributing to many modern diseases. I, however, have not had the same miraculous experience in my practice of psychiatry, that by simply removing wheat from my patients’ diets, that they were rewarded with such dramatic results. It seems to me, that what is making many of my patients ill, is far more complicated than simply too many carbohydrates in their diet or gluten intolerance.
Four years ago, I too believed gluten was the chief cause of many of the ills troubling my patients and members of my family. I began to avoid wheat myself, put my 3 kids on a wheat free diet and exhorted the patients in my practice to follow a gluten free diet. Unfortunately, that measure alone did not make a significant difference in terms of physical and mental health, or did it result in significant weight loss for the majority. Dr. Davis’s report of the alleviation of the digestive issues, skin issues, asthma, depression, anxiety, insomnia and attentional issues by the simple removal of gluten did not materialize. There were a minority of patients who did feel much better, but for the most part, the miraculous reversals of conditions and symptoms enumerated by Dr. Davis, or as evidenced by enthusiastic readers’ reviews on Amazon of Dr. Davis’s book, was not my experience.
It seems that there are different sorts of people with quite varying nutritional needs. There are those who experience an enormous improvement in their health by simply cutting out gluten. There are others who need to eliminate all grains. Others do not do well until they eliminate grain and dairy. There are still others who need to maintain an extremely low level of carbohydrates in their diet, irrespective of the type, and then they feel much better. In my practice of psychiatry, a much more comprehensive approach is required for most patients to alleviate psychiatric symptoms.
If patients are motivated to work with me, I have been asking them to implement the GAPS healing protocol of Dr Natasha Campbell McBride, with very good results. Dr. McBride’s understanding of the fundamental problem underlying multiple psychiatric and medical conditions is dysbiosis, and its impact upon intestinal health. Our intestines are populated by both beneficial and harmful microflora. The beneficial microflora keep the harmful microorganisms in check. A number of conditions can cause the harmful microorganisms to gain the upper hand, such as antibiotic treatment, hormones like birth control pills. and diets high in refined carbohydrates and processed foods, to name a few common causes. When harmful microflora predominate, the lining of the gut wall becomes compromised, allowing microorganisms and the toxicity they produce, as well as food particles, which should remain inside the gut, to diffuse into the body. This causes inflammation and is commonly referred to as “leaky gut”.
The aim of the GAPS dietary recommendations and other detoxifications measures, is to “heal and seal” the gut. The recommendations include a nutrient dense whole foods diet with a particular focus on the benefits of mineral rich broths, which are particularly healing to the lining of the intestine, as well as healthful fats.The type of carbohydrates recommended starve the harmful microflora through the avoidance of grains, sugar and starchy vegetables. The protocol includes probiotic supplementation, enzymes and hydrochloric acid, and importantly, the inclusion of a variety of fermented foods in the diet. In addition, detoxification measures such as juicing and reduction of the toxic burden of the environment on the individual are prescribed. Dr. McBride views most food intolerances and sensitivities as a down stream consequence of a leaky gut, and not as a primary condition. That is to say, that if you heal the gut lining, foods that you reacted to in the past, will no longer cause a reaction.
Her healing protocol is not a quick fix. She recommends that most patients remain on it for at least two years. This is a daunting prospect for some people who feel like it is too much of a burden to give up their favorite foods and to learn to make broth. What appeals to me about Dr. Campbell-McBride’s approach is that it is a cure. It is not a band-aid or just symptomatic relief. Her treatment addresses the heart of the problem. According to Dr. Campbell-McBride, if you heal your intestine, you may eventually be able to enjoy pizza every once in a while. without ill consequences.
That being said, many patients, despite their suffering, are not ready to to learn to make broth and to give up bread and other favorite habitual foods. They find the thought of fermented vegetables too weird, and are simply not motivated to put in the effort and make the commitment needed to undertake the GAPS protocol. In these cases, I generally suggest that the greatest impact for the least amount of effort does seem to come from eliminating wheat and sugar from the diet as a first step. For many patients, this represents such a significant reduction in the load of carbohydrate they typically ingest, that they do feel somewhat better. It can be a valuable beginning.
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