By Dr. Shawna Darou, ND
There is so much discussion lately on gluten-intolerance and wheat-free diets, that I thought I would address it here. In my practice, I am seeing a huge rise in gluten intolerance – both ones that show up clearly on testing (for celiac markers or gluten-intolerance), and in those patients who test negative but simply feel much healthier on a gluten-free diet. Why has this grain that most of us considered healthy become so problematic?
Wheat is the most consumed grain on earth, containing 20% of all calories consumed and it is everywhere – breads, pasta, crackers, cookies, pastries and the list goes on and on. Unless we are actively avoiding wheat, it is most likely in every meal that we eat, either as the main event or as a binder, filler, flavor additive or product processed in a facility that produces wheat. North Americans have come to rely of wheat as a staple of our diet and this over consumption of wheat could be a very likely cause of many of our health problems, including chronic low energy and fatigue.
But, the even greater issue with wheat is that it is very different from the original grain 100 or more years ago, with crop selection and genetic modification. These changes in wheat protein structure have resulted in a number of negative effects on our immune, hormonal and gastrointestinal systems.
New issues with modern wheat:
- Blood Sugar – Modern wheat is 70% carbohydrate, mostly in the highly absorbable form called amylopectin and 10-15% each of protein (gluten) and fibre. This “highly absorbable” amylopectin means that carbohydrate from wheat is rapidly converted to glucose, absorbed in the bloodstream and spikes blood sugar at a level greater than that of sucrose (table sugar). The higher the level of blood glucose, the higher the level of insulin released into the blood stream after a meal. High insulin levels cause fat to be deposited, particularly in the abdomen, and this constant cycling will lead to unwanted weight gain. High blood glucose also leads to a “crash” as blood sugar drops, and this low creates mental fatigue, fogginess and carbohydrate cravings as your body tries to encourage you to eat more carbohydrates to bring blood sugar back up. This glucose-insulin cycle suggests wheat is an appetite stimulant, and it can lead to rapid swings in blood sugar levels.
- Appetite and addiction – Wheat has been shown to have a morphine like effect in the body. Wheat gluten is broken down into polypeptides, which can cross the blood-brain barrier and bind to the brain’s morphine centre. In one study, subjects were given opiate blocking drugs and ate 400 less calories a day compared to those who were given placebo. Therefore blocking the “happy” feelings from eating wheat means you eat less. Wheat is also an appetite stimulant, when you eat it you want more! Knowing that wheat is addictive via its effects on the brain means that eliminating wheat from the diet is a way to counter its appetite stimulating, addictive qualities and the unpleasant drop in energy after consuming a carbohydrate load.
- Gastrointestinal – Proteins in wheat, especially gluten and gliadin can cause gastrointestinal irritation. This leads to symptoms of bloating, constipation or diarrhea, and overall digestive distress. Usually in someone with celiac disease, their digestive symptoms will be dramatic with pain and diarrhea, but in those with a long-term gluten intolerance the more common signs are significant daily bloating, and persistent constipation. Due to long term intestinal irritation, in both celiac and gluten-intolerance, there may be nutrient deficiencies from poor absorption of: iron, vitamin B12 and the fat soluble vitamins: vitamin A, D, E and K. In particular, a low vitamin B12 level in someone who regularly eats meat or any animal products is often a red flag for gluten-intolerance.
- Immune system and inflammation – Because reactions to gluten stimulate the immune system, gluten intolerance is often associated with immune-mediated conditions such as allergies, eczema, asthma and autoimmune disease (ex. hypothyroidism, rheumatoid arthritis). And due to immune reactions, there is also increased inflammation. Inflammation is interesting in that it is like a fire that spreads. If you have an inflammatory condition such as migraines, autoimmune thyroid disease, colitis or arthritis, eating a food that causes an immune response can fire up an inflammatory cascade, resulting in more body inflammation and more symptoms.
As you can see, in many people and not just those with diagnosed celiac disease, eating a diet high in wheat products can cause significant health problems. The difficulty is sometimes in diagnosing gluten-intolerance which is more of the gray-zone of gluten problems. A blood celiac panel is one option, as are food intolerance tests.
Another method to clarify whether gluten is affecting your health is to do a 1 month gluten-free trial. This means strictly avoiding gluten-containing grains in your diet for 1 full month (wheat, spelt, kamut, rye, barley and oats). This should give you a clear indication on whether gluten is affecting your health. If it is not clear, the next step is to ‘challenge’ gluten back into your diet to see if you get a reaction – this means eating a couple of slices of bread or a bowl of pasta to determine whether there is a clear difference.
Health conditions gluten intolerance is associated with:
- digestive upset – bloating, diarrhea, and even constipation (most people who I have worked with who have chronic constipation since childhood have a gluten intolerance)
- fatigue or brain fog after eating meals containing wheat / gluten
- autoimmune disease
- neurological symptoms – dizziness, feeling off balance
- unexplained infertility
- chronic fatigue and fibromyalgia
- swelling in hands, feet, legs commonly
- mood disorders – anxiety, depression, mood swings, ADD
- painful joints
- and a recent study showed that 12 months of a gluten free diet significantly improves endometriosis symptoms
If you have questions about whether gluten-free may be appropriate for you, please ask during your next appointment.