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.
Linked to Monday Mania of the Healthy Home Economist
Prefer privacy says
I have to confess to not reading all of this, as I am chronically tired and ill. I am commenting on what I did read and what I personally have experienced.
You say that there are different types of people. I think I read in the Wheat Belly book that there are people who respond less significantly to the removal of wheat – which is sometimes because they are different types of people and, sometimes, because, they really haven’t gotten as free from wheat as they think they have.
Think about it! Many prescribed meds actually have wheat in or on them! If they go and eat french fries from McDonald’s, they are ingesting wheat. If they eat a candy bar, it may have been on a conveyor belt sprinkled with wheat. It’s very hard to get away from wheat if taking in anything that is packaged at all, including meds and vitamins, including over the counter and what is obtained from a pharmacy.
But, aside from that, wheat isn’t everything. It’s like if you take someone who is a drug addict, an alcoholic, a sex addict and a compulsive gambler and you manage to get them to quit drinking – their life improves, but, that doesn’t mean all their problems are solved.
Someone can have a problem with wheat. Maybe wheat started out as their main problem and maybe it didn’t. But, the fact that they had the problem with wheat, or, the fact that they had a problem with something else that caused them to later have a problem with wheat, could have set up a sort of chain reaction which led to other allergies and intolerances. This happens a lot when someone is allergic to/has an intolerance to one or two things.
I believe I may have a problem with wheat, then with grains in general. I KNOW I have a problem with dairy and soy. And, I can tell you that the problems I have with dairy are such that if I drank a big glass of milk and then came to your office the next day, you’d probably have me committed or on psych meds quicker than a wink. But, I don’t need to be committed or be on meds. I just need to avoid milk Oh, and, marijuana smokers, as that makes me feel very ill and also a bit homicidal – enraged, and, attacked. Because, in fact, I am being attacked by the smoke, since it is making me swell up and causing great pain, a rapid pulse and affecting my ability to breathe. It’s total fight or flight time. Fortunately, I manage to flee, instead of fight, but .. well .. the real point is:
Wheat may be less of a problem for some. So, it may be the beginning of their journey of detoxification from foods that make them hurt, depressed, angry, hallucinatory, etc. Or, it may be the end of that journey, because, that’s all that is needed. Or, it may not even be a problem for some, because, they eat little or none. Or, it might be such a slight problem that their ingesting it just masks what the real problem is.
Please don’t give up on thinking of food as part of the medicine, both what is ingested and what is not. Encourage patients to keep track of their symptoms, as well as what is going on in their lives, what they ate or drank, etc. Because, any allergy, yeast overgrowth, etc. can have a terrible impact on some people. I knew someone who was set off by Red Door perfume, just because something in it gave them an intense headache.
Thank you for your time.
Hi Dr. Judy,
Just came across your website and am really excited to have such an informative blog so accessible to me!
I have put my two daughters (7,9 who both have ADHD) and myself on the GAPS protocol since June. While I feel great that we are eating so much healthier diets, I am not seeing much improvement in my daughter’s behavior nor their ability to stay focused. I have also not seen much improvement with my own gut dysbiosis and chronic anxiety (in fact, I would say I am even more anxious than before). We have been very diligent about sticking to the diet and supplementing with probiotics and digestive enzymes. I was just wondering what your thoughts might be as to why we have not seen more progress? I know this is not a quick fix solution, however, at the same time I my older daughter is really struggling in school and her inability to keep up is really effecting her self-esteem. I also think I’m just really tired since this diet is a lot of work and allows very few if any short cuts! 🙂 This in and of itself is very stressful.
Also, just wondering if you’ve noticed a link with children with umbilical hernias and neurological issues? Both my daughters have umbilical hernias and have ADHD/OCD and I’ve met a few other mothers whose children with ADHD have umbilical hernias. Perhaps this is just a coincidence, but I find it rather interesting. Wondering if an umbilical hernia may interfere with digestion in some way.
I welcome your thoughts!
Thanks for writing. Though I have been recently certified as a GAPS practitioner, I honestly have only had the experience of doing GAPS myself and prescribing it to 5 adult patients in my practice who have mood and anxiety disorders. I have done well in terms of my digestive symptoms and mood, and my patients have all done well, but they also are all in therapy with me in addition to doing GAPS. So that is a confounding variable. I am really learning and gaining experience at the moment. Though Dr. Natasha reports good results with ADHD and many childhood psychiatric conditions, I don’t have the personal clinical experience yet to comment with authority.
Dr. Natasha conceived of GAPS as a self help program, so one should be able to do it on one’s own. It is certain that all of the home food preparation and avoidance of convenience food adds an extra burden of work for the one in charge of meals. That sounds like its weighing heavily on you.
I am really sorry to hear that you have had no improvement whatsoever. That is very discouraging. Dr. Natasha says it can take up to 2 years to heal. That is a long time to hang in there without improvement.
I did a guest blog post at Starlene Stewart’s GAPS Journey about the Practitioner Training. There were some very interesting comments about starting with Full GAPS vs starting with Intro. I have no idea which you have been doing. According to one of the commenters who completed the Practitioner Training in Seattle, Dr Natasha recommended starting with Intro for kids with severe learning disabilities. Here is a link to the post and comments:
Dr. Natasha also recommended supplemental oils; cod liver, fish and seed oils, as long as there is not a seizure disorder. Also 85% of what one eats should be savory and only 15% fruit or baked goods.
I have never heard of a link between umbilical hernias and neurological issues, but I have not had patients with that condition in my practice. Did you Google it? It might be interesting to ask Dr. Natasha on her GAPS.me site that question. She may be able to give you an answer. She is trained originally as a neurologist and has seen 1000’s of cases.
I wish I could be more helpful. I wish you all the best.
good day I read your comment and I think you’re blog will be one of the bests if you keep up the good work!
Thank you so much. You totally made my day. I am loving blogging. I typically spend my days one to one with patients in my office. It has been so exciting to have a larger reach and to hear from people I never met who respond to what I have written. Its my new favorite activity! I have so many ideas that I would like to share and I am particularly eager to get the message about Dr. Natasha Campbell’s McBride’s healing protocol out there, because I believe there are so many people who could benefit. People who never have been able to be helped before and who have suffered enormously. Now there will be help for them.
Susan Bensman says
Don’t know if “cavegirl” will find this but just wanted to tell her that if she valued “Molecules of Emotion” she might very well be excited by Bruce Lipton’s “The Biology of Belief”.
Great blog, Judy. Lots of great information here and in the links you provide.
Thanks, Susan, for the encouragement. Its a new endeavor and it feels really supportive to hear that you find it useful.
bob hansen md says
Great discussion of the wheat-centric book. I follow Dr. Davis’s discussions and agree with much but not all of what he has to say. Dysbiosis is definitely a major issue, now entering the paleo blogosphere and well represented at the ancestral health symposium this summer at UCLA. Wheat has over 1000 proteins, some of which can cause problems. The synergy of dysbiosis with the resistance of several wheat proteins to complete proteolysis in the gut wreaks havoc. Many non celiacs are gluten intolerant, mechanisms still elusive, but dysbiosis likely contributes. Endorphin like proteins also problematic. thanks also for your discussion on global warming. I concur and will post a comment there as well.
Thanks, Dr. Hansen. I predict that in the future the role our microflora plays in health and disease states will be increasingly recognized as totally central. I believe that it is at the heart of the matter in most conditions.
I came across your blog through Emily Deans blog, which I have been reading for about a year. A year ago I decide to eat only those things I truly liked as a child, avoiding grains, legumes and most dairy as an experiment. I planned to reintroduce some of these foods in 6 months. Within 48 hours my presumed IBS, difficulty recovering from exercise, mental fogginess and irritability disappeared. Within 2 weeks I lost 2 inches around my waist, I could skip meals again, mostly because I forgot to eat. Six months later, my seasonal allergies did not recur. Unfortunately the weight loss I experienced did not cure my sleep apnea…hence my blog. It is heartening to see physicians from Boston writing about these topics. When I was in training in Boston, I would describe the attitude of the medical establishmen as “300 years of history unhampered by the flow of progress.”. Though it is an attitude that does have its advantages. Keep up the good work. Maura
It is truly remarkable how something so incontrovertible like the improvement of your symptoms when avoiding certain foods can be so denied by conventional medicine. Patients with debilitating arthritis are routinely told that there is no dietary connection and no need to avoid any particular food. The only word for it is bizarre. And yes, Boston is a very conservative place. That’s why is great to meet people like Emily Deans and to get e-mails from people like you.
Dr. Judy ,
Great post and I am excited to work with you to implement the GAPS diet into my physical regime. Looking forward to exploring GAPS and feeling better soon!
I am confident from what you told me that you will be very much helped by the GAPS healing protocol. The reason that there is so much Lyme’s Disease these days is that many people’s immune systems are compromised by our diets and the toxicity of the environment and our life styles. We need to rebuild your immunity. There is a method that works to do that. Its not a quick fix, but you will feel better in time.
Just ran across your blog on Emily’s site. Great post, and welcome to the blogosphere!
I hate to be Negative Nancy but I strongly recommend changing the font — I find it pretty much unbearable, especially with white on a black background. Something more normal would be dynamite. 🙂
Thank you, Kilton for welcoming me and for liking my post! You are the second person today to tell me that my choice of font and background were hard to read. I am going to change it because I do want you to be able to read it without having to strain. Thanks for letting me know. 🙂
Great post Dr. Tsafrir! I was linked here today by Emily Deans. One thing puzzles me, though. This post and your global warming post look like they were written by two different people. How can someone who is so skeptical about the government’s positions on dietary issues be so credulous about the pro-government position on AGW? The special interest money argument is preposterous. Warmist scientists are funded over 1000-fold more than skeptics ( http://joannenova.com.au/2009/12/we-paid-to-find-a-%E2%80%9Ccrisis%E2%80%9D/ ).
At any rate, I look forward to reading more of your insights on diet and behavior.
Thank you for liking my post. What is AGW?
sorry for the abbreviation; AGW=anthropogenic global warming
Thanks for clarifying, Ed. I guess we will just have to agree to disagree here. I cannot imagine how anyone could be skeptical about the human contribution to global warming. I will not be posting many posts like that. I intend to focus primarily on healing, so most future posts will likely be more to your taste. 🙂
For me no dairy (due to its insulinogenic effect), no grains and minimal sugar (around 50-80 g of carb a day) allowed recovery from bipolar – this was an unexpected benefit of moving to a pre-industrial/pre-agricultural eating regime.
The mental clarity I gained then allowed further investigation into the psychological and emotional aspects and I’m now using acupuncture to address the root causes. Reading Candace Pert’s Molecules of Emotion was really eye opening and has given me the scientific understanding I desired!
I have found so many who simply lack the motivation to make the changes necessary. It’s very frustrating when you can see how easily they could improve their lives. For many though they have a great deal (unconsciously) invested in being as they are and although they profess to want to be well they don’t seem willing to try something new. My mantra is thus ‘insanity is doing the same thing over and over and expecting a different result’.
It has to be a holistic approach.
Its terrific that you were able to take your health into your own hands and had the wherewith all to implement the measures that you needed to do to heal. Its hard to watch people suffer who could do something to help themselves. For many people changing diet is not easy at all.