Dispelling nutrition myths, ranting, and occasionally, raving


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Parasites for gluten!

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A friend alerted me to this article last week. Before we look at the actual research study, I need to say this is terrible reporting. The headline proclaims: Gluten allergies may be reduced using hookworms. No. Well, maybe. But probably not, and that’s certainly not what the study was looking at. No wonder people are confused about gluten. The study looked at the effect of hookworms on gluten tolerance in individuals with celiac disease. Which, we know, is not an allergy. Celiac disease is an autoimmune disease in which consumption of gluten results in the destruction of microvilli in the small intestine in sufferers. Gluten allergy is a hypersensitivity of the immune system to the gluten (or one of its component proteins) protein. So… if you are allergic to gluten, don’t go infect yourself with hookworms and eat a sandwich. I wouldn’t recommend doing this if you have celiac disease either.

Looking at the actual study… It was very small (12 people, two of whom withdrew from the study before completion). When a study is so small, it’s impossible to say if the results would extend to the majority of those with celiac disease. Setting aside the fact that I’m doubtful that the majority of celiac disease sufferers would willingly ingest hookworms in order to be able to consume gluten again. That being said, it’s quite interesting that the study participants were able to gradually increase their gluten intake to 3 g of spaghetti a day without experiencing any overt, nor covert (i.e. intestinal damage) symptoms of celiac disease. Of course, that’s not a lot of gluten (about one cup of pasta a day) and the study took place over 12 weeks, with the largest quantity of pasta being consumed over the final two weeks. It would be interesting to see if intestinal damage was visible after an extended period of time or if greater quantities of gluten could be consumed.

Something else that I wondered about when reading the article was any potential complications from the use of hookworms. According to the Centre for Disease Control, most people with hookworms experience no symptoms. However, some many experience gastrointestinal distress and the most serious complication is blood loss leading to anemia, and protein loss.

Essentially, celiac disease leads to nutritional deficiencies when gluten is consumed. Introducing hookworms may allow celiac disease sufferers to consume gluten but may also lead to nutrient deficiencies. Alternatively, celiac disease sufferers can follow a nutritious gluten-free diet.


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Book review: Gluten Freedom

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After I wrote my post on Grain Brain I was contacted by the publisher of a new book about gluten Gluten Freedom. They offered to send me an advance reading copy with the hope that I would love it and share my love of it with others. Or, most likely, at the very least, not write a scathing review. Fortunately for them, I quite liked it.

Unlike other books about gluten *ahem* Wheat Belly, Grain Brain, this book isn’t about vilifying gluten or wheat. Dr Fasano even states that for anyone who doesn’t have celiac disease, a wheat or gluten allergy, or gluten sensitivity, there’s no reason to avoid gluten. This book is not about eliminating gluten to cure all ailments. It’s about how to deal with specific gluten disorders (primarily celiac disease).

I respect the fact that Dr Fasano is a researcher and not just a doctor aiming to prey on people who are desperate to lose weight. He actually conducts research experiments to examine celiac disease and the effects of gluten on other conditions. Gluten Freedom is not about fear mongering. It’s about how people with gluten-related disorders can live normal healthy lives.

This book isn’t for everyone. It’s more of a handbook to help people suffering from celiac disease (and their families) develop ways to live without gluten. There’s great information about addressing situations at school and for seniors. There’s also a couple of interesting chapters at the end discussing new preventions and treatments for celiac disease. In addition to being a handbook it’s also an informative read for health care practitioners and for an antidote for devotees of Davis and Perlmutter.


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Dissecting the Wheat Belly

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I wasn’t planning on blogging about Wheat Belly. I just thought that I should actually read it so that I could discuss it knowledgeably. However, I made the mistake of starting to read it right before bed and was seething with frustration by the end of the introduction! I’ve decided to record my thoughts in response to particular statements in the book as a cathartic exercise.

I am going to argue that the problem with the diet and health of most Americans is not fat, not sugar, not the rise of the Internet and the demise of agrarian lifestyle. It’s wheat – or what we are being sold that is called wheat.

The advice we’ve been given to eat more “healthy whole grains” has deprived us of control over appetites and impulses…

Hold up! So, is wheat the problem? Or are grains in general the problem? After all, there are many other grains besides wheat. I sure hope that Davis can make up his mind before the end of the book.

Davis provides a couple of examples of people benefiting from eliminating wheat from their diets. Are these your average overweight Americans? Nope. A woman with ulcerative colitis and a man with joint pain. It’s entirely possible that these two people were suffering from some form of wheat allergy. Two people with specific health conditions are not enough to prove that wheat is what’s making everyone fat.

Just looking at the cover… Those bagels look delicious. I never eat bagels. What voodoo is this book?

Chapter One: Davis keeps mentioning weight gain being concurrent with the increased consumption of “healthy whole grains”. Then he uses whole wheat bread as the example because it has a high glycemic index (putting aside the fact that this would likely be mitigated by consuming bread with other foods). To me, this is not a healthy whole grain. How about wheat berries? One quarter of a cup of which contains only 170 calories, 6 grams of fibre, and 7 grams of protein. The problem here is not the grain, it’s the processing. Oh, and let’s not forget the consumption of excess calories!

Chapter 2: All this talk about the message from health organizations being to “eat more healthy whole grains”. Funny, I always thought the message was to make more of your grain servings whole grain. Not simply to eat more whole grains overall.

This chapter focuses on the vast genetic difference between modern wheat and its ancestors. Haven’t we hugely altered the genetic profile of all of our crops though? None of them would be the same as those consumed by previous generations. This loss of diversity is certainly unfortunate from an environmental as well as a culinary standpoint. However, I’m not sure why wheat has been singled out here. Why not corn, or milk, or honeycrisp apples? Etc.

I also love Davis’s little “experiment” on himself (wherein he feels fab after eating a three egg cheese omelette for breakfast but foggy after toast). Of course there could be no bias or psychological factors involved when he has a vested interest in the results showing that modern wheat is toxic. (Please read the previous sentence in sarcasm font).

Chapter 3: Where we learn that wheat is dangerous for numerous reasons. One reason: it’s abundant in carbohydrate which gives it a high glycemic index. I’ve blogged before about the foolishness of claiming a snickers bar is healthier than whole wheat bread simply because it has a lower GI. In addition to the carbohydrate, wheat is uniquely dangerous because it contains gluten which causes illness in those with celiac disease and wheat allergy. Funny that this should also make wheat perilous for those of us without those conditions to consume. People can be allergic to any food. Just because some people react badly to a food doesn’t mean that no one should consume it. If that were the case we would all be extremely malnourished.

Chapter 4: Some mention of interesting sounding research involving gluten and the brain. As my first degree was in psychology I love research that marries nutrition and psych. Must check-out the original articles to see if it was good research.

Can’t help but wonder why it’s necessarily a bad thing that wheat is allegedly a mood enhancer. Perhaps there may be psychological benefits to wheat consumption.

Chapter 5: Am starting to get very annoyed with Davis’s persistent claim that the health care industry pushes “more healthy whole grains”. 1. We do not. We push more vegetables and to choose whole grains instead of white flours. 2. There are many grains other than wheat. We encourage variety

I am also getting frustrated with the yammering on about the high GI (glycemic index) of whole wheat bread. GI isn’t very meaningful. GL (glycemic load – how much an actual serving of a food increases blood sugar) is more helpful. Still not the be all and end all in diet but better than GI. The GL for whole wheat bread is only 9. That’s a low glycemic load food.

Now he’s using celiac disease as an example. Yes, of course people lose weight if they give up gluten (which is in more grains than just wheat; negating the blame wheat for everything theory) and don’t replace it with calorie dense gluten-free alternatives. This is because they are consuming fewer calories! I will give Davis credit for advising people not to replace glutenous foods with highly processed gluten-free alternatives.

Chapter 6: I’m mostly fine with the information about celiac disease although there is some manipulation of stats to make it appear as if gluten is also the cause of other ailments such as diabetes, cancer, gastric reflux, and IBS. I’m finding myself wondering if every little ailment I have might be cured by the elimination of wheat.

Chapter 7: I agree that carbohydrate reduction may be beneficial to glucose control for those with diabetes. However, I disagree with Davis laying the blame on wheat. There are many sources of carbohydrate and blood glucose control would likely be seen by limiting all sources, not just wheat.

Chapter 8: Davis writes about the association between celiac disease and osteoporosis. The problem with association is that it doesn’t equate to causation. Isn’t it likely that the cause of osteoporosis in celiac sufferers is due to chronic nutrient malabsorption? Therefore, extrapolating that wheat causes osteoporosis to non-celiac sufferers is quite a stretch.

Chapter 9: I find it interesting that Davis states that eliminating wheat will reduce blood acidity. Unless you have a medical condition, our bodies are excellent at regulating blood pH balance. In addition, the ketosis that Davis encouraged with his low-carb diet can, if extreme enough, actually increase the acidity of blood: keto acidosis.

Chapter 10: This chapter is all about how wheat causes heart disease through increased small particle LDL and triglycerides. While it’s true that wheat products may contribute to these undesirable particles in the blood it’s important to note that wheat is not the only culprit. Any simple carb can contribute to elevations in these particles. As can a lack of exercise/sedentary lifestyle, excessive alcohol consumption, and genetics. Wheat is the easy target because it’s dominant in our North American diet. This doesn’t mean that it’s to blame for heart disease.

Chapter 11: Absolutely terrifying to think that suddenly we could start suffering from cerebral ataxia. Davis sure is doing a good job of scaring the wheat out of us. It’s true that gluten may play a role in some cases of cerebral ataxia. However, how common is cerebral ataxia? According to the National Ataxia Foundation, an estimated 150, 000 Americans have hereditary or spontaneous ataxia. That’s about 0.04% of the population. If we look only at the prevalence of sporadiac ataxia, we’re looking at about 0.0084% of the population. Considering that some of these cases may be related to gluten, we’re looking at a really small percentage of the population. We already have so much to worry about. This is fear mongering.

Chapter 12:

Wheat is really the worst in carbohydrates. But other carbohydrates can be problem sources as well, though on a lesser scale compared to wheat.

Davis then goes on to list foods that should be reduced or eliminated: cornstarch and cornmeal, snack foods (e.g. Chips, pretzels, and crackers), desserts, rice, potatoes, legumes, gluten-free foods, fruit juices, soft drinks, dried fruit, other grains,

Are you thinking what I’m thinking? This sounds very much like many other low-carb fad diets with a touch of paleo thrown in for good measure.

Note that once wheat is eliminated and an otherwise thoughtful approach to diet is followed – I.e., eating a selection of foods not dominated by the processed food industry but rich in real food – there is no need to count calories or adhere to formulas that dictate optimal percentages of calories from fat or proteins. These issues, very simply, take care of themselves…

This is quite simply untrue. Calories do matter. If you consume more calories than you burn you will gain weight. If you consume fewer calories than you burn you will lose weight. Of course it’s not a simple mathematic equation but to suggest that the mere elimination of wheat will lead to weight loss is incredibly misleading.

As I was reading I made note of all the conditions which Davis stated that wheat elimination could alleviate or cure:

Obesity (especially visceral fat), schizophrenia, depression, breast cancer, various digestive problems, eating disorders, diabetes, IBS, GERD, cancer, hair loss, arthritis, LDL, heart disease, encephalopathy, peripheral neuropathy, cerebellar ataxia, seizures, and myriad skin conditions.

I’m sure that I missed a few in there. I don’t know about you, but when I hear about a cure-all like that I think “snake oil!”. There are too many promises here. Too good to be true? I’m afraid so.

While most of us could benefit from consuming more varied sources of grain and fewer processed foods, eliminating wheat is not a magical cure. It’s just another fad diet.


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Gluten 101

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Based on the number of frustrating conversations I’ve had with people regarding gluten it seems like there are a few things that need clarification. I know that you, my lovely regular readers don’t, but on the off chance that someone in need of guidance is googling gluten perhaps they’ll stumble across this post.

Let’s start with the fact that going gluten-free is not the magical cure-all that many self-appointed nutrition gurus would have you believe. Yes, people with celiac disease, gluten allergies and intolerances will most definitely benefit from eliminating sources of gluten from their diets. However, if you are not suffering from any of these conditions (I might add self-diagnosis is not advisable) there is absolutely no need to eliminate gluten from your diet. I do believe that variety is more than the spice of life and it’s important to consume a variety of grains, too much of any one food is not going to be of benefit to your body. That being said, eliminating gluten is not a magical weight loss cure. It’s the same as eliminating any major contributor of calories; if you consume fewer calories as a result of eliminating it you will lose weight, if you simply replace those calories with those from other foods you will not lose weight. It seems like gluten is the latest villain in the dietary world. If only we could eliminate gluten then we would all be migraine-free, cured of diverticulitis,  there would be no more arthritis, or ADHD, perhaps we could even attain world peace!

Okay… so going gluten-free won’t cure everything but if you are going gluten-free the first thing you need to know is what foods contain gluten, and what foods don’t. I’ve had the fun time of trying to explain to people that if a food is gluten-free then it’s also wheat-free while they have been adamant that the reverse is true. It reminds me of the logic lessons in elementary school: all tulips are flowers, that doesn’t mean that all flowers are tulips. Gluten is found in a number of grains: wheat, rye, barley, triticale, and often oats (most oats are cross contaminated but some gluten-free oats are available and may be tolerated by people who cannot consume gluten). For a complete list of ingredients to avoid if you’re going gluten-free visit celiac.ca. You also need to be aware that there’s a risk of cross-contamination if foods are grown, processed, or prepared in close proximity to gluten-containing foods.

If you’re going gluten-free you don’t need to eliminate all grains and starchy foods. Despite what some people have tried to tell me, rice, potatoes, corn, and quinoa do not contain gluten. Celiac.ca has another great list of foods that you can eat if you’re unable to consume gluten.


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Breaking the (food labelling) law

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A little over a year ago Canada changed the food labelling laws for common allergens. With the growing prevalence of food allergies and celiac disease this change in the law was intended to provide clarity for the consumer. No longer could food manufacturers use the statement “may contain x, y, z, etc” to cover their butts. That statement was now to only be used if there was a real risk of an allergen being present in a food. Consumers were advised to treat any allergen identified in this manner as being present in the ingredient list. Despite this, it seems that some companies are just not getting it.

There are a couple of areas that I’m not sure about as they don’t seem to be clearly covered in the labelling laws: restaurants and supplements. Neither of these are packaged foods; however, it seems to me as they are ingested by consumers they really should have to comply to the same regulations. Then again, we all know how closely the supplement industry is regulated by Health Canada and the CFIA. Despite foods listing “hydrolyzed vegetable protein” on their ingredient lists having to identify the specific vegetable source of the protein in their allergen statement, it seems that supplements do not have to as I have seen many vitamins listing HVP without stating the source.

Not very long ago I was out for dinner with my family. I noticed that the menu offered “gluten-free” pizzas. However, a disclaimer stated that, because the kitchen was not gluten-free there may be cross-contamination of the pizzas. I went on a little tirade to my family about how they shouldn’t make the statement that their pizza crusts are gluten-free if they can’t guarantee that they haven’t been cross-contaminated. I’m sure they meant well but for someone with celiac disease it’s like saying “here, you can eat this, oh, maybe not”. It only takes a very small amount of gluten for someone with celiac disease to become quite ill.

The worst offender though are the Beanitos chips. They’re a relatively new tortilla chip made from beans rather than from corn. The package proudly proclaims that they’re gluten-free yet, if you read the allergen statement it says that they’re “made in a facility that also processes wheat.” Hmm…. Pretty sure that this is contrary to the new labelling laws. If there is enough risk of cross-contamination then you can’t say that your product is gluten-free. This is the butt-covering that the new labelling laws were designed to curtail. Your product is either gluten-free or it’s not.