Sunday, September 30, 2012

Don't Get Caught Up In The Gluten Free Or Wheat Belly Mania

The book, Wheat Belly, is a perfect example of why I often say, Caveat Lector, 'let the reader beware.'  It is yet another example of a writer, in this case a physician, selectively picking and choosing facts, and sometimes even distorting the truth to push a particular agenda, in this case the benefits of a gluten-free diet. However, to say that the book is nonsensical would also be unfair. The reality is that some people have problems with gluten, a protein composite found in wheat, barley, rye and triticale (a wheat/rye hybrid).

The general argument often raised against gluten is that it is a protein that triggers an immune or allergic response. Pundits recommend avoiding it because they claim all wheat has been genetically modified and our bodies are not well equipped to process the new increased chromosome varieties. (By the way, the more ancient grains like Kamut, have not been altered.)

About 1% of the population suffers from a disease called Celiac-Sprue which is an auto-immune disease and about another 2% or so (some say as many as 15%, but I'm not buying it) are gluten sensitive. Gluten sensitivity has been implicated in a wide variety of abdominal symptoms including bloating, discomfort, cramps, pain, and diarrhea, as well as a number of non-abdominal symptoms including headaches and migraines, lethargy and tiredness, attention-deficit disorder and hyperactivity, schizophrenia, muscular disturbances as well as bone and joint pain.

The point of today's blog is not to exhaustively review the state of the science related to gluten and its health consequences. Rather, I hope to point out that everything you've ever heard about gluten and the problems it causes based on statistics probably doesn't apply to YOU.  97% (some claim as low as 85%) of the population does not seem to have any problems with gluten despite the recent hoopla. If you are among the unlucky 3% (or15% by some exaggerated accounts), then you should avoid it.

How do you know if it is a problem for you? First, if you don't have any of the problems mentioned above, gluten is not a problem for you. If you have such symptoms, simple blood tests can detect if gluten is causing celiac disease or if you have a wheat allergy. If both these tests are normal, but you have these problems, gluten may still be the culprit. Eliminating gluten products for three weeks and watching if symptoms disappear is a great way to check. I suggest restarting the gluten products in moderation after three weeks to see if symptoms return.

You may ask why bother and not just eliminate gluten? According to Peter H.R. Green, MD, director of the Celiac Disease Center at Columbia University, "For people with celiac disease, a gluten-free diet is essential. But for others, "unless people are very careful, a gluten-free diet can lack vitamins, minerals, and fiber." The facts are that although gluten itself doesn’t appear to offer unique nutritional benefits, the whole grains that one would need to stop consuming to avoid gluten are a rich source of fiber and contain an array of vitamins and minerals, including B vitamins and iron. Whole grain foods should be considered part of a healthy diet which lowers the risk of heart disease, type-2 diabetes, and some forms of cancer.

So most people have no problem with gluten and shouldn't avoid it and some people do and have to eliminate it from their diets. The best way to figure it out is with a knowledgeable primary care physician or gastroenterologist. Don't self-diagnose and unnecessarily deprive yourself of healthy whole grains. There is no reason to single out gluten as a food to eliminate without good cause. 

But I'm not done yet. But what really gets me is that gluten has taken on a hyperbolic, almost mythical status.

The author of Wheat Belly, in an interview published in Natural Awakenings, describes his almost miraculous transformation when he abandoned gluten. He states how while eating gluten his triglycerides were very high, he was diabetic, and had high blood pressure and excess weight around his middle, but when he stopped everything went to normal including his developing increased focus and attention. I'm calling him out that it wasn't the elimination of gluten that gave him these results even if he's telling the truth and it actually happened. Why? Gluten is a protein, not a carbohydrate. Eliminating a protein such as gluten shouldn't provide all these benefits. Also, the author advocates for increased consumption of other proteins mostly derived from animals that eat gluten in large quantities. Finally, my personal experience is just the opposite. I consume gluten every day for breakfast and lunch. Instead of cutting out gluten from my diet, I eliminated or restrict a host of other foods.

I severely limit my meat and chicken consumption, limit starchy vegetables such as potatoes and corn, eat no pasta, cakes, cookies, ice cream or other milk products (I'm lactose intolerant), or any processed foods other than non-preservative, non-sugar added breakfast cereals (with kamut and other whole grains) and freezer section breads (with sprouted grain and spelt).

I also markedly increased my consumption of wild fish, such as salmon and cod, to at least 4 times a week, added unlimited fruits (and by unlimited I mean at least ten portions a day) and vegetables, and a fair share of nuts, seeds and beans (including lentils and chickpeas as chummus).

My verifiable results including dropping my cholesterol from 290 to 160 without a statin, shedding about 25 pounds, decreasing my blood sugar from pre-diabetic to normal, eliminating my irritable bowel syndrome and reflux, and markedly decreasing my osteoarthritis in my left hip. I can't tell you what exactly did the trick other than sharing exactly what happened and telling you that my diet INCLUDES gluten. I know that what works for me or anyone else for that matter may not work for others and it is ridiculous for people to suggest otherwise.

So if you haven't read Wheat Belly, save your money and forget it. If a friend tells you how great they feel on a gluten-free diet, be happy for your friend, but realize that it may have no bearing to you and it may also be a self-described placebo effect.

If you have the symptoms described above, don't ignore them and have them checked out. You may actually be part of the small minority that have a gluten problem and there is no reason to suffer needlessly.

Either way, maintain a healthy level of skepticism about things that sound miraculous or like quick fixes. Gluten seems to fit that bill for most people. To belabor the point, Caveat Lector.

The best thing you can do to live a healthy life is to stay informed, but share any concerns with a doctor you trust. Find one that invests the time to really know you, is willing to discuss your issues, and patiently explains decisions. Think like a doctor, but act like a patient.


  1. My critique of Bill Sardi seems to generate a lot of anti-big pharma sentiment. Personally, I am amazed given the well documented fact that big pharma owns some of the largest supplement companies and the large supplement companies have also been implicated in influence peddling. Nevertheless,let me set the record straight about those that believe all doctors are undertone influenced the drug companies.
    1. I have not met with a drug rep in over twenty years,
    2. I have no drug samples in my office
    3. I receive zero compensation of any form from a drug company.
    4. For that matter, I take no compensation from my practice.
    5. I have read nearly thirty thousand abstracts and studies about nutrition and supplements. My concerns about these products stem from my readings
    6. I reviewed Bill Sardi's book about multivitamins and found it to be completely self-serving as heusesthebook to sell his own product,
    9. Bad or useless drugs doesn't mean supplements are good
    10. Using untested products is just plain dangerous. Why take the risk?

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