 | | Bread contains gluten which has a glycemic index of 70+. |
Neurological Diseases
Last month, I discussed how gluten leads to a leaky gut and how one's unique physiology determines one's own immune system reactions. Unfortunately, gluten has another unfavorable effect, a glycemic index of 70 +, higher than any other natural food. This high glucose content causes glycation, where elevated blood sugar binds to protein. When this happens, free radical production increases and damages everything in sight (DNA, fat, protein etc.), according to Dr. David Perlmutter, neurologist and associate professor at the University of Miami School of Medicine. The resulting inflammation is devastating to the human brain.
Dr. Perlmutter mentioned that there is a direct relationship between blood sugar elevation and Alzheimer's (sometimes called Type 3 diabetes). Perlmutter stated that elevated glucose correlated with dementia according to a study in the New England Journal of Medicine (NEJM). Even a mild elevation of glucose, slightly over 100 mg/dL, is an early warning sign.
His recommendation is to eliminate carbohydrates from the diet, particularly wheat, rye and barley, because gliadin antibiodies have been found in the spinal fluid and some have developed cerebellum ataxia that affects arms, legs and coordination due to gluten sensitivity. This relates back to the leaky gut and gluten. One can measure tissue transglutaminase 6 (tTG6) as an indicator for gluten ataxia. tTG6 is a component of the blood-brain barrier which protects the brain. If you produce antibodies against tTG6, large molecules can enter the brain, resulting in "leaky brain" that can cause cognitive symptoms. Once these patients were on a gluten - free diet, cognitive function improved. Dr. Perlmutter predicts that tTG6 could become a marker for schizophrenia.
 | | Pasta contains gluten which has a glycemic index of 70+. |
Cardiac Disease
Cardiologist William Davis, MD, also spoke at the Gluten Summit, to explain how increased glucose levels can lead to coronary disease. Dr. Davis gave a couple of examples of his patients who were put on a gluten-free diet. Not only did his patients lose weight, but if they had reflux, their reflux was reduced; blood pressure and cholesterol decreased and their energy increased; moods were stabilized; they slept more deeply; and inflammation measurements signaled relief from arthritis symptoms.
Gluten has a higher glycemic index than sugar. Other foods with a high glycemic index-- 69 --are dates; figs; gluten-free foods that use cornstarch, rice flour, tapioca starch, and potato starch; whole wheat flour; and white flour.
Dr. Davis explained that eating gluten is like a vicious blood sugar cycle, with high blood sugar leading to low blood sugar. Low blood sugar causes hunger to kick in about 2 hours after onset. Peptides from gliadin act like opiates, further stimulating appetite and causing a craving for even more carbohydrates.
When we have high glucose levels, insulin is produced. But when there are very high insulin levels, this triggers resistance, or poor responsiveness to insulin. Type 2 diabetes is classified as insulin resistance. Type 2 diabetics can produce insulin, but it doesn't work in their cells. High blood sugar and insulin can cause inflammation in the body.
As mentioned previously, high glucose content causes glycation, where glucose binds to proteins and damages everything in sight. This can lead to cataracts, hypertension, rigid arteries, coronary atherosclerosis, arthritis and other maladies. "Glycation from high blood sugar is a fundamental process underlying multiple disease states and aging," said Dr. Davis.
When normal bowel flora is disrupted (gut microbiome), this leads to an increase in small low density lipoproteins (LDLs) in the blood stream, according to Davis. Excess small LDL particles are commonly abnormal in coronary disease. These small LDLs are of different shapes and conformations and they are more likely to adhere to connective tissue. They are also present in the bloodstream longer, at least a week more than normal LDLs. High blood sugar also leads to the formation of small LDLs.
When small LDLs become glycated, this leads to more oxidation or glycoxidated (glycated + oxidized) LDL particles, that can cause heart disease. Reducing grains, sugars and starchy legumes can reduce small LDL formation. Grains also contribute to an increase in triglycerides, due to de novo lipogenesis that occurs in the liver, according to Davis.
Davis puts his patients who have suffered a heart attack or have coronary disease, on a no grain, no sugar diet. He tries to raise their 25-hydroxy vitamin D to 60-70 ng/ml, and supplements with omega3 fatty acid, 3,000- 3,600 mg/day of EPA & DHA. He makes sure that their TSH is 1.5 or less and their free T4 and T3 are in the upper half of normal. Dr. Davis also does liproprotein testing, NMR LipoProfile, an FDA-cleared blood test that directly quantifies low density lipoprotein particles (LDL-P) circulating in the body.
Additionally, he does lipoprotein testing to determine whether his patients are ApoE 2, ApoE 3 or ApoE 4. He explains that we all have two ApoE genes. Most people are ApoE 3/3, some are ApoE 3/4 and a few are ApoE 4/4. Those that are ApoE 4/4 are hyper-absorbers of dietary fat (helps humans survive during periods of deprivation) and they need to be put on a low-fat diet, in contrast to the others, who do well on a low-carbohydrate diet.
A typical response for non-ApoE 4 patients who may start with a 1,800 nmol/L of small LDLs, when they eliminate wheat, grain and sugar, they lose 40 lbs and their small LDLs drops from 1,800 to 180 or sometimes zero. An ApoE 4 patient, starting at 2,500 nmol/L of small LDLs and eliminating the same foods will lose weight, but their small LDLs drop only from 2,500 to 1,400 nmol/L. These people need to reduce dietary fat to reduce their numbers.
In a meta-analysis of ApoE, there was an association between those with ApoE 4 and an increased risk of coronary disease. Interestingly, in another study looking at coronary disease and Alzheimer's disease neuropathy, the authors found that those who had coronary disease and Alzheimer's were ApoE 4 carriers.
A 2008 study in the NEJM looked at 3 types of diets: low carbohydrate diet vs. Mediterranean diet vs. low fat diet, to see which diet had the best weight loss results in obese people. The low carbohydrate diet had the greatest weight loss plus the additional benefits of increased HDL, decreased triglycerides and decreased LDL. Among the 36 diabetic subjects, changes in fasting plasma glucose and insulin levels were more favorable among those on the Mediterranean diet vs. the low-fat diet.
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