Dr. Wayne Coghlan: Chiropractor
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Gluten, Grains, Seeds, and Nuts... and the link to inflammatory disease.
Gluten, Grains, Seeds, and Nuts... and the link to inflammatory disease.
Dear
Reader:
There
has been increasing awareness of gluten sensitivity such that the latest health
trend has been choosing gluten free products. It is not hard to find
advertisements and entire sections in the grocery being devoted to the trend
and it is curious to observe how the food industry is falling all over itself
trying to capture their corner of the market. The good news of all this is for the people
people who are truly gluten sensitive to now find a variety of suitable foods in
the grocery, without having to special order from the health food stores or
bring a carry-in bag to the restaurant. It’s becoming mainstream!
Depending
on the sources, there are some estimated 1-6% of people who are adversely sensitive
to gluten to the degree it creates clinical symptoms of gastric inflammation,
and for those people, avoiding gluten is a must. However, it seems to me that people
who are otherwise avoiding gluten have been doing so because it is trendy and
have had no real health reasons to do so … other than by avoiding gluten you also
avoid much of the tasty treats that make up our common empty and excessive
calories.Few of the trenders, it seems, have done any real
research to determine why they should otherwise avoid the evils of wheat and
its ilk.
Still…
I am aware of no few people who have gone on the gluten free kick and,
according to their reports, have never felt better!Placebo perhaps. Perhaps a coincident more
active awareness and selection of health promoting foods rather than empty
starchy calories? Perhaps mind over matter? Hmmm…
In
doing my own research, to be informed on the topic, and inspired by a patient
who was seeking answers to his own health concerns, it has come to my awareness
that not only gluten, but other proteins as well that that are found in all
grains, beans, seeds, and nuts … may have a more insidious and pervasive role
in many of the inflammatory disorders that seem to be becoming more common in
our western life.
I
am not saying that I am convinced that ages old wisdom of eating whole grains
and beans and lentils, and wholesome seeds and nuts has been wrong and perhaps
we ought to focus more on the fruits and leafy vegetables, and root veggies…. But
it does have my attention.
The gist of it, is that proteins in seeds, which includes grains, nuts, and beans
I
offer, therefore, several articles and sources that seem to me to a credible
investigation into gluten intolerance, celiac disease, non-gluten celiac
disease, general inflammatory diseases….. and why there may be some merit in a
seed free diet
All
credit to the originating authors and sources. If you like them… please
investigate further.
Best
regards,
Dr.
Wayne Coghlan
Collingwood
Chiropractor Clinic
Dr. Wayne Coghlan
Wayne Coghlan: A
graduate of the University of Guelph School of Human Biology, and the Canadian
Memorial Chiropractic
College. I have further education
in Sports Sciences, and completed a Master's degree in Counselling Psychology.
Played varsity sports – rugby and football. Worked my way through school doing
physical labour ... I know the realities of the work place. Gardening, canoe
trips, being a good parent and member of our community.
"Gluten
Sensitivity" May Be a Misnomer for Distinct Illnesses to Various Wheat
Proteins
Gluten
may not be the only wheat protein that can make people sick
Feb 1, 2014
Two years ago, at the
recommendation of a nutritionist, I stopped eating wheat and a few other
grains. Within a matter of days the disabling headaches and fatigue that I had
been suffering for months vanished. Initially my gastroenterologist interpreted
this resolution of my symptoms as a sign that I perhaps suffered from celiac
disease, a peculiar disorder in which the immune system attacks a bundle of
proteins found in wheat, barley and rye that are collectively referred to as
gluten. The misdirected assault ravages and inflames the small intestine,
interfering with the absorption of vital nutrients and thereby causing
bloating, diarrhea, headaches, tiredness and, in rare cases, death. Yet several
tests for celiac disease had come back negative. Rather my doctors concluded
that I had nonceliac “gluten sensitivity,” a relatively new diagnosis. The
prevalence of gluten sensitivity is not yet clear, but some data suggest it may
afflict as many as 6 percent of Americans, six times the number of people with
celiac disease.
Although gluten sensitivity
and celiac disease share many symptoms, the former is generally less severe.
Compared with individuals with celiac disease, people with gluten sensitivity
are more likely to report nondigestive symptoms such as headaches and do not
usually suffer acute intestinal damage and inflammation. Lately, however, some
researchers are wondering if they were too quick to pin all the blame for these
problems on gluten. A handful of new studies suggest that in many cases gluten
sensitivity might not be about gluten at all. Rather it may be a misnomer for a
range of different illnesses triggered by distinct molecules in wheat and other
grains.
“You know the story of the
blind man and the elephant? Well, that's what gluten-sensitivity research is
right now,” says Sheila Crowe, head of research at the gastroenterology
division at the School of Medicine at the University of California, San Diego. As doctors continue to tease apart
the diverse ways that the human body reacts to all the proteins and other
molecules besides gluten that are found in grains, they will be able to develop
more accurate tests for various sensitivities to those compounds. Ultimately
clinicians hope such tests will help people who have a genuine medical
condition to avoid the specific constituents of grains that make them ill and
will stop others from unnecessarily cutting out nutrient-dense whole grains.
Seeds of Sickness
Among the most commonly consumed grains, wheat is the chief troublemaker.
Humans first domesticated the wheat plant about 10,000 years ago in the Fertile Crescent in the Middle East. Since then, the amount of wheat in
our diet—along with all the molecules it contains—has dramatically increased.
Of all these molecules, gluten is arguably the most important to the quality of
bread because it gives baked goods their structure, texture and elasticity.
When bakers add water to wheat flour and begin to knead it into dough, two
smaller proteins—gliadin and glutenin—change shape and bind to each other,
forming long, elastic loops of what we call gluten. The more gluten in the
flour, the more the dough will stretch and the spongier it will be once baked. Until the Middle Ages, the
types of grain that people cultivated contained far smaller amounts of gluten
than the crops we grow today. In the following centuries—even before people
understood what gluten was—they selectively bred varieties of wheat that
produced bread that was lighter and chewier, inexorably increasing consumption
of the protein. As technology for breeding and farming wheat improved,
Americans began to produce and eat more wheat overall. Today the average person
in the U.S. eats around 132 pounds of wheat a year—often in the form of bread,
cereal, crackers, pasta, cookies and cakes—which translates to about 0.8 ounce
of gluten each day. Although historical records
dating from the first century a.d. mention a disorder that sounds a lot like
celiac disease, it was not until the mid-1900s that doctors realized the gluten
in wheat was to blame. During World War II, Dutch physician Willem-Karel Dicke
documented a sharp drop in the number of deaths among children with the
severest forms of celiac disease in parallel with a bread shortage. In a
follow-up study, researchers removed different components of wheat from the
diet of 10 children with the intestinal illness. Adding back gluten caused
symptoms such as diarrhea to resurface, but reintroducing a different complex
molecule found in wheat, namely starch, did not. Thus, gluten was shown to be
responsible for celiac disease.
Later experiments by other
researchers revealed which component of gluten provokes the immune system. When
digested, gluten splits back into gliadin and glutenin. For reasons that remain
unclear, the immune system of people with celiac disease treats gliadin in
particular as though it were a dangerous invader.
For years doctors used diet
to diagnose the gut disorder: if someone's symptoms disappeared on a
gluten-free diet, then that person had celiac disease. Over time, however,
clinicians developed more sophisticated ways to identify celiac disease, such
as tests that look for immune system molecules known as antibodies that
recognize and cling to gliadin. With the advent of such tests, clinicians soon
discovered that some people who became mildly ill after eating bread and pasta
did not in fact have celiac disease: biopsies revealed little or no intestinal
damage, and blood tests failed to find the same antibodies associated with the
disorder. In the process, the new condition became known as nonceliac gluten
sensitivity.
Now several studies hint
that so-called gluten sensitivity might not always be caused by gluten. In some
cases, the problem may be entirely different proteins—or even some
carbohydrates. “We're so used to dealing with gluten as the enemy, but it might
actually be something else,” says David Sanders, who teaches gastroenterology
at the University of Sheffield in England. Joseph Murray, a
gastroenterologist at the Mayo Clinic in Rochester, Minn., agrees: “I'm starting to feel more
uncomfortable calling it nonceliac gluten sensitivity. I think it might be
better to call it nonceliac wheat sensitivity.”
Against the Grain
If the culprits behind certain instances of gluten sensitivity are, in fact,
wheat constituents other than gluten, finding the right ones will be difficult.
Wheat has six sets of chromosomes and a whopping 95,000 or so genes. In
comparison, we humans have just two sets of chromosomes and about 20,000 genes.
Genes code the instructions to build proteins, so more genes mean more proteins
to sift through. Some initial experiments have spotlighted a few potential
offenders, however.
In laboratory tests, wheat
proteins known as amylase-trypsin inhibitors have stimulated immune cells in
plastic wells to release inflammatory molecules called cytokines that can
overexcite the immune system. Further tests showed that these wheat proteins
provoked the same inflammatory response in mice. Likewise, in an Italian study,
small concentrations of wheat germ agglutinin, a protein distinct from gluten,
roused cytokines from human intestinal cells growing in a plastic well. Preliminary research
suggests that, in other cases, by-products of gluten digestion may be the
problem. Breaking down gliadin and glutenin produces even shorter chains of
amino acids—the building blocks of proteins—some of which may behave like
morphine and other soporific opiates. Perhaps these molecules explain some of
the lethargy exhibited by people who do not have celiac disease but are
nonetheless sensitive to wheat, suggests Aristo Vojdani, chief executive
officer of Immunosciences Lab in Los Angeles. In a small study by Vojdani and
his colleagues, the blood of people classified as gluten-sensitive had higher levels
of antibodies that recognize these gluten by-products than blood taken from
healthy volunteers.
A final group of potential
culprits belongs to a diverse family of carbohydrates such as fructans that are
notorious for being difficult to digest. A failure to absorb these compounds
into the blood may draw excess water into the digestive tract and agitate its
resident bacteria. Because these resilient carbohydrates occur in all kinds of
food—not just grains—a gluten-free or wheat-free diet will not necessarily
solve anything if these molecules truly are to blame.
No Piece of Cake
Despite the recent evidence that wheat sensitivities are more numerous and
varied than previously realized, research has also revealed that many people
who think they have such reactions do not. In a 2010 study, only 12 of 32
individuals who said they felt better on a diet that excluded gluten or other
wheat proteins actually had an adverse reaction to those molecules. “Thus,
about 60 percent of the patients underwent an elimination diet without any real
reason,” notes study author Antonio Carroccio of the University of Palermo in Italy.
Nevertheless, uncovering
nongluten agitators of illness will give doctors a more precise way to diagnose
grain sensitivities and help people avoid certain foods. Researchers could, for
example, design blood tests to look for antibodies that bind to various short
chains of amino acids or proteins such as wheat germ agglutinin, explains
Umberto Volta, a gastroenterologist at the University of Bologna in Italy. And some scientists think ongoing
research will eventually yield new therapies. “If we know what triggers the
immune system, we hope we can switch the system off and cure the disease,” says
Roberto Chignola of the University of Verona in Italy.
Personally, I suspect that
something besides gluten might trigger my own symptoms. On occasion, I have
tried gluten-free grain-based products such as beer made from barley from which
the gluten has been extracted. Every time my headaches came roaring back with a
vengeance (far sooner than any hangover might have struck), making me all the
more suspicious that gluten is not the root of my troubles.
If that is true, and there
is even the remote possibility of safely reinstating gluten in my diet, I would
really like to know. As a New Yorker, it is hard for me to forgo pizza. If
gluten was vindicated in my case, perhaps I could add it to nongrain flours or
otherwise cook up experimental pizza at home and get those gooey, stretchy
slices out of my dreams and onto my plate.
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Wayne Coghlan, B.Sc., M.A., D.C. Ontario Chiropractor locum tenens www.drwaynecoghlan.weebly.com drwaynecoghlan@gmail.com 705 447-7003 Wayne Coghlan: Chiropractor - Available for locums Doctor of Chiropractic Residing in Mississauga, Ontario. Available to serve the chiropractic profession as chiropractor locum tenens 30 years clinical experience, sole practitioner, Collingwood Chiropractic & Sports Injury Clinic, Collingwood, Ontario. Sole practitioner Diversified, sports injuries and rehabilitation, soft tissue therapy, custom foot orthotics, injury prevention, posture correction, lifestyle modification and coach, ultrasound, interferential, combine MSK with nerve pressure model, low intensity laser, x-rays, shockwave therapy, WSIB, MVA, PMP, Universal. Registered and in good standing with CCO OCA CCA CCPA Available to travel throughout Ontario. Locations outside of an hour or so radius may require accommodatio...