Tuesday, January 01, 2013

Gliadin and "Wheat Belly" calmly considered.

I got curious about wheat as a nutrition problem when my father-in-law was (voluntarily) on a no wheat diet, due to a suggestion from a friend of his who had done so, and who subsequently experienced good results. My father-in-law had been having severe itching, but the doctors could not identify any cause for it. So he thought he would give it a try. During the Thanksgiving holiday they visited us, and it was challenging to fix meals that had no wheat.

Since wheat, particularly "whole wheat" is regularly touted as a very healthy grain, I was wondering if my father-in-law had received good-intentioned, but quack advice. Then I happened to run across [this] video, by a Wisconsin cardiologist, Dr. William Davis, who argues that modern wheat is a "perfect, chronic poison." Here's his position:
[T]he wheat we eat these days isn't the wheat your grandma had: "It's an 18-inch tall plant created by genetic research in the '60s and '70s," he said on "CBS This Morning." "This thing has many new features nobody told you about, such as there's a new protein in this thing called gliadin.... [Everybody] is susceptible to the gliadin protein that is an opiate. This thing binds into the opiate receptors in your brain and in most people stimulates appetite, such that we consume 440 more calories per day, 365 days per year."[1]
On his view many people, perhaps the majority of people, are sensitive to this opiate. He claims that upon giving up wheat many people have surprising recoveries from commonly known ailments: "Diabetics become no longer diabetic; people with arthritis having dramatic relief. People losing leg swelling, acid reflux, irritable bowel syndrome, depression, and on and on every day."[1]

His overall advice is "(1) avoid all products made from high-yield, semi-dwarf wheat that wreak health destruction, and (2) create a diet that is otherwise healthy and appropriate for all members of the family." Unfortunately, it turns out that a lot of products are wheat-based: all breads, all breakfast cereals, noodles, pasta, bagels, muffins, pancakes, waffles, donuts, pretzels, crackers. And there are some surprises too: processed foods containing wheat, such as soy sauce, Twizzlers, Campbells Tomato Soup, salad dressings, taco seasoning.[2]

Is this all faddish quackery by a doctor who seeks to make lots of money on his book, or is there really something here?

I first checked-out the blogsite of Dr. Thomas L Halton. He holds a Doctor of Science in Nutrition from Harvard University as well as Masters Degrees in both Exercise Science and Human Nutrition. He is a Certified Nutrition Specialist, a Licensed Dietitian/Nutritionist in the State of Massachusetts and an ACE Certified Personal Trainer. So, this guy certainly gets the nod for being a qualified reviewer. He finds that the books is well researched, and recommends it, mostly on the grounds that Davis's views agrees with his own foundational view of nutritional recommendations -- blood sugar stability. He writes, "A major concept in this book is that swings in blood sugar have a negative impact on weight control and health in general. I couldn't agree more."[3] He notes that Davis did a test on himself that seems to bear-out his claims:
"The author found a woman who grows the old fashion wheat and bought some flour from her. After eating 2 slices of bread made with this flour, his blood sugar rose to 110. He repeated the test with modern flour. His blood sugar after eating 2 pieces of bread made with modern wheat rose to 167! It is quite plausible that wheat used to be a healthy, lower glycemic grain years ago, but is now high glycemic due to genetic manipulation."[3]
Of course this is one guy, doing one test on himself. But I suspect its illustrative, and it's probably reasonable to assume that other tests, and on other people, have shown the same thing. Otherwise, Dr. Halton would have complained. Dr. Halton thinks Dr. Davis gets a lot right in the book, though he has some disagreement with what ratios and what selections Dr. Davis allows. It seems they both agree that too many and the wrong types of carbohydrates are the real basis for health problems in the American diet.

Granted, I am friendly to the view that carbohydrates are difficult to manage, and indeed at the basis of many nutrition problems, but Davis' claims are specifically that something about the genetic make-up of modern "dwarf" wheat, gliadin, is what's specifically causing many health problems. Not surprisingly, the Grain Foods Foundation is unimpressed by Dr. Davi's claim and nutritional advice:
"Omitting wheat entirely removes the essential (and disease-fighting!) nutrients it provides including fiber, antioxidants, iron and B vitamins. [...] Besides this, the advice dished out by Dr. Davis is completely counter to the Dietary Guidelines for Americans, the gold standard of scientifically-sound nutrition advice. The Guidelines call for the average healthy American to consume six one-ounce servings of grain foods daily, half of which should come from whole grains and the other half from enriched grains. Wheat is the basis for a number of healthful whole and enriched grain foods including breads, cereal, pasta and wheat berries that provide valuable nutrients to the American diet and have been shown to help with weight maintenance."[4]
They further maintain that this is yet another fad diet, and contrast Dr. Davis with the "real experts". This strikes me as odd, since if a certified, practicing cardiologist does not count as an expert, I'm not sure just who would.

One study I noted in Dr. Davis favor shows that even people without a special sensitivity to gliadin (celiac disease (CD) patients) develop problems in the face of eating it. (Celiac disease is a chronic reaction to gluten proteins that results in the poor absorption of nutrients in the small intestine.) Admittedly, the study was small, using three celiac patients and three patients without the disease. Their conclusion was, "The data obtained in this pilot study support the hypothesis that gluten elicits its harmful effect, throughout an IL15 innate immune response, on all the individuals. This innate response is found in both patients with and without CD, although the triggering of an adaptive response is CD specific." [5] Another study from the Univ. of Maryland showed that "based on our results, we concluded that gliadin activates zonulin signaling irrespective of the genetic expression of autoimmunity, leading to increased intestinal permeability to macromolecules."[6]  As I quickly searched-out studies that appeared in professional journals from academic labs, there is indeed clear evidence that gliadin does have noted, but limited effects on otherwise healthy people.

What can be said, then, overall?  The evidence leads me to this conclusion: some individuals could indeed be sensitive to gliadin, even without having celiac disease; since, the immune and system does not operate on a discrete have-it, don't have-it system when it comes to having troubles with absorption of nutrients. My current belief is that Dr. Davis has overstated his claim -- namely, that gliadin is toxic to all (or almost all) who eat genetically modified wheat.  Yet he does have scientific evidence on his side that gliadin can have measurable intestinal effects on some large portion of the population. Just how large and how significant these effects are is up in the air, but I currently do not see the call for alarm that he seems to be raising.



[image] www.goldenprairieoats.com/gluten-free-assurance.html

[1] "'Modern wheat a "perfect, chronic poison,' doctor says" CBS This Morning, September 3, 2012 (Accessed Jan 1, 2013)

[2] "Wheat Belly: Quick and Dirty 2" Wheat Belly Blog December 5, 2012. (Accessed Jan 1, 2013)

[3] "Book Review: Wheat Belly" Dr. Thomas L. Halton website August 14, 2012. (Accessed Jan 1, 2013)

[4] "Our Perspective on 'Wheat Belly". Six Servings (Official Blog of the Grain Foods Foundation). Aug. 30, 2011. (Accessed Jan 1, 2013)

[5] "Is gliadin really safe for non‐coeliac individuals? Production of interleukin 15 in biopsy culture from non‐coeliac individuals challenged with gliadin peptides" GUT: An International Journal of Gastroenterology and Hepatology June, 2007, 56(6)889-890. (Accessed Jan 1, 2013)

[6] "Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines." Scandinavian journal of gastroenterology - PubMed.gov April 2006; 41(4):408-19. (Accessed Jan 1, 2013)