• WHY GO GLUTEN-FREE?

    by Dr. Matthew Cavaiola
    on Sep 14th, 2016

Did you know that in the year 2000, the United States grew over 62 million acres of wheat and worldwide 21 billion bushels of wheat were grown?  Wheat is grown on more land area worldwide than any other crop and is a close third to rice and corn in total world production.  Wheat is an attractive grain to grow for farmers and the food industry because wheat is well adapted to harsh conditions and can be grown on wind swept areas that are too dry and cold for crops that typically grow better in tropical climates, such as rice and corn.

 
Although wheat is believed to have originated in southwestern Asia at least 5000 years ago, wheat was first grown here in the United States in the 1600’s by some of the first settlers in Massachusetts.  Wheat is nutritious, concentrated, easily stored and transported and easily processed into various types of food.  Unlike any other plant-derived food, wheat, and many grains similar to wheat, contain gluten protein, which enables a leavened dough to rise by forming minute gas cells that hold carbon dioxide during fermentation.  This helps to produce the light and fluffy textured breads, rolls, muffins and cakes that hit the shelves of every major grocery store in this country.
 
However, it is this gluten and another protein called gliadin found in all forms of wheat, which cause immune system dysfunction and a myriad of symptoms and related conditions in those individuals who are sensitive to these proteins.  The wheat forms that seem to cause the biggest problems for people include durum, semolina, spelt, kamut, malt, couscous, bulgar and related grains rye and barley.   Although rice, buckwheat, corn, oats and other grains do contain some gluten, the gluten found in these grains usually don’t cause any symptoms in people who are sensitive to gluten and gliadin.
 
Gluten sensitivity, also termed Celiac’s Disease (CD) or celiac sprue, is an autoimmune disease that causes gluten intolerance in nearly 1% of the total U.S. population.  Research out of the United States, Europe and elsewhere have indicated that the prevalence of CD has increased by a factor of 4 over the last 20 to 30 years, which could be due in part to the fact that wheat is found in almost every product sold in both conventional grocery stores and to a lesser degree in specialty and health food stores.
 
Classic presentation of CD includes diarrhea and/or constipation, fatty stools and gas and bloating.  These gastrointestinal symptoms are related to malabsorption that occurs because of the destruction of the absorptive surface of the duodenum and jejunum found in the small intestine.  Although this classic presentation makes diagnosis easy to detect early in childhood, the majority of cases are delayed until adulthood.  As the destruction of the small intestine continues for years, with sometimes only minor symptoms occurring along the way, the underlying immune system dysfunction, nutritional deficiencies and organ pathologies associated with this disease progress.  With that being said, the range in symptomatology is vast and the conditions and diseases resultant from years of exposure to gluten and gliadin can be mild to extremely serious.
 
 
Here is a list of some of these symptoms and conditions:
 
Addison’s Disease
Alopecia (hair loss)
Anemia
Anxiety and/or Depression
Arthritis
Ataxia
ADHD
Autism
Autoimmune Hepatitis
Celiac Disease
Cerebellar Atrophy
Chronic Fatigue Syndrome
Crohn’s Disease
Congenital Heart Disease
Cystic Fibrosis
Dental Enamal Erosion
Dermatitis Herpetiformis
Dyspepsia
Epilepsy
Fetal Growth Retardation
Fibromyalgia
Gastroparesis
Headaches/Migraines
Irritable Bowel Syndrome (IBS)
Impotency
Infertility/Miscarriages
Type I Diabetes Mellitus
Multiple Sclerosis
Myasthenia Gravis
Osteoporosis
Pancreatic Disorders
Peripheral Neuropathy
Sarcoidosis
Schizophrenia
Scleroderma
Short Stature/Delayed Puberty
Systemic Lupus Erythematosus (Lupus)
Thrombocytopenia
Thyroiditis (Autoimmune Thyroid/Hashimoto’s)
Vitamin K Deficiency
Vasculitis
 
 
Because CD can often times be asymptomatic or only cause mild effects, this disease goes widely undetected and is grossly underdiagnosed.  It is estimated that worldwide over 2/3 of people who have CD have not been given a formal diagnosis by their physicians.  Because CD can manifest itself in so many ways, most physicians don’t investigate CD as the root cause of their patient’s illness, but rather treat only the presenting illness.
 
However, many naturopathic physicians turn to CD or other dietary and lifestyle factors first in their investigation of their patient’s conditions.  Simple blood tests and specialized lab tests run by naturopathic physicians can determine if a patient has a gluten/gliadin sensitivity and how severe this intolerance is.  Gluten intolerance is just one food sensitivity that can cause illness.  It is estimated that 90% of the population has what is known as IgG food sensitivities, or delayed sensitivity food intolerances. These, again, can manifest in a myriad of symptoms and associated pathologies.  The most common food sensitivities are to wheat, dairy, corn, eggs and soy.  No two people are sensitive to the same foods nor will they experience the same symptoms from the foods to which they are sensitive.  For more on IgG Food Sensitivity Testing, please click here.
 
Treatment for CD involves two main elements: the elimination of the inciting gluten containing foods (wheat, barley, rye, some oats) and the repair of the damaged intestinal lining after years of exposure to these and other problematic foods.
 
After informing patients with varying degrees of CD that in order to feel better they should eliminate gluten containing foods from their diet, many patients ask me “Now what am I supposed to eat?”  Fortunately for them, over the last 5 to 10 years, the majority of grocery stores, especially specialty stores like Whole Foods and Trader Joe’s, have begun to carry a wide variety of foods geared towards those people who have CD and many other health conditions and food sensitivities.  Many more food companies are cropping up that manufacture gluten-free breads, pastas, crackers, chips, cakes, cookies and muffins.  Most people associate eating these foods with feeling bloated, lethargic and experiencing flare-ups of their gluten related condition after eating these types of foods.  However, having gone completely gluten-free myself for the past 3 years, I have noticed that after eating gluten-free foods, the majority of all the symptoms that I used to experience have gone away, I feel energized after eating and it is easier to maintain a healthy weight.
 
“Gluten-free” essentially means that the foods have been made without wheat, barley or rye and/or the manufacturers have used other gluten-free grains like brown rice, quinoa, oats, millet or buckwheat as substitute ingredients. This is not to say that eating these foods will be entirely guilt-free.  Some of these foods are still very high in sugar and other sweeteners.  Therefore, the usual rules apply when looking at a food’s nutritional label to assure that even though the food has been termed “gluten-free”, that it is not loaded with other ingredients like heavy amounts of sugar, artificial sweeteners or other additives.
 
Here are a few gluten-free food companies that I often recommend to my patients:
 
·      Andean Dream quinoa pasta (Click here for the Andean Dream website),
·      Lundberg brown rice gluten-free products (Click here for the Lundberg product website)
·      Udi’s gluten-free foods (Click here for the Udi’s gluten-free website)
·      Bob’s Red Mill (Click here for the Bob’s Red Mill Gluten-Free section)
 
In conclusion, CD is a grossly underdiagnosed food sensitivity that has the potential to create widespread inflammation in the body.  As the level of inflammation caused by this food sensitivity and a lifetime of other environmental influences increases over time, we are finding out that it is most often this inflammation, and to a lesser degree genetic factors, that are the precursor to developing more serious conditions as we age.  Even if you are not deemed gluten-sensitive or diagnosed with CD, going gluten-free can be extremely beneficial to help decrease your body’s overall inflammatory load, helping you to age more successfully and optimize your health.
Author Dr. Matthew Cavaiola

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