A lot of people are avoiding gluten and wheat and questioning if this is necessary for a healthy diet. Celiac disease and non-celiac gluten intolerance were addressed in part 1 of this article. Part 2 will explore a wheat-free diet.
Part 2: Wheat-Free Diets
Along with more awareness of celiac disease and identification of gluten-containing foods (including wheat), the bestselling book,
“Wheat Belly Diet” by Dr. William Davis, has moved the public toward thwarting wheat consumption in pursuit of a healthy diet. It is true that many Americans consume much more wheat products, mostly in the refined form, than they need and it shows in the waistline. However, wheat itself isn’t unhealthy unless there is an allergy or intolerance.
The “Wheat Belly” diet makes a lot of extraordinary claims, such as wheat is ubiquitous in our diets and has become addictive to many; it’s become so addictive it causes uncontrollable eating and causes symptoms of withdrawal when not consumed; and excluding wheat from the diet may cure a long list of problems including insomnia, diabetes type II, asthma, arthritis, osteoporosis, obesity and cognitive problems.
“Wheat Belly” also claims the wheat found in products today has been so genetically manipulated that it doesn’t even resemble the wheat of yesteryear and is to blame for the increase in celiac disease and inflammatory bowel disease. He also blames wheat for “central obesity” that is associated with diabetes, cardiac disease and some types of cancer. Studies do show that genetically engineered (GE) foods provide generally less nutritive value, but not only wheat is affected. It may be more important to avoid GE foods in general, choosing organic whenever possible.
It is true that wheat is found in a lot of products including not only bread, but cereals, snack foods and baked product and it’s true that grains vary in gluten content. However, claiming wheat as the culprit in causing obesity and the resulting increase in obesity-related diseases is without merit. I believe the real culprit is overeating refined, high- glycemic-load carbohydrates. These carbohydrates come from sugars and flours of all kinds, not just wheat. At the same time, many people are not physically active enough to burn these excess calories. Thus, we have our bulging waistlines.
In Dr. Davis’s book he states that when he told his patients to avoid wheat, they lost weight and became healthier. This isn’t really surprising at all when you consider how many foods are excluded when embarking on a wheat-free diet. Many diets that avoid whole categories of foods, thus cutting calories, work for a while.
There are people that have documented wheat allergies (confirmed by testing) that must avoid wheat and wheat products. There are others who may have food intolerances that are more difficult to define. Studies on non-celiac gluten intolerance are inconclusive. One of the best, though small, studies supporting the existence of non-celiac gluten sensitivity was completed in 2011 by a group of Australian researchers. They reported that 34 patients without celiac disease had fewer gastrointestinal (GI) symptoms on a gluten-free diet(1). However, in 2013, the Australians put 37 patients without celiac disease on a low FODMAPS (Fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet. FODMAPS include fructose, lactose, sorbitol and other short-chain carbohydrates that are poorly absorbed. A diet low in FODMAPS is also low in gluten, but not gluten-free. The patients GI symptoms decreased on the low FODMAPS diet, but did not change when adding back gluten vs. a placebo(2). This suggests their symptoms were probably not due to gluten. One of the FODMAPS categories, fructan, does include wheat, among other foods such as certain vegetables and fruit. It’s interesting to note that many people with diagnosed irritable bowel syndrome (IBS) do very well on the low FODMAPS diet. IBS is a GI disorder that relies only on symptoms to diagnose, including bloating, flatus, abdominal pain and constipation and/or diarrhea.
If you have persistent problems with abdominal pain and bloating and believe your symptoms are associated with consumption of wheat, it may be worth a one to two week trial of low FODMAPS eating. You may discover an intolerance to, not only wheat, but fructans.
For those without an intolerance, cutting down on wheat or gluten may help with weight loss and improve overall diet, providing they are substituted with lower calorie foods. Conversely, whole wheat and other whole grain products can fit well into a healthy diet in proper quantities. As is true for many nutrition concerns, moderation is crucial.
Note: For more information on FODMAPS, check out the book, “IBS, Free at Last” by Patsy Catsos MS, RD, LD.
(1) Am. J. Gastroenterol. 106:508, 2011
(2) Gastorenterol. 145:320, 2013
Part 1: Gluten-Free Diets