Download Wheat and Gluten: We Hardly Know You

Survey
yes no Was this document useful for you?
   Thank you for your participation!

* Your assessment is very important for improving the work of artificial intelligence, which forms the content of this project

Document related concepts

DASH diet wikipedia, lookup

Freeganism wikipedia, lookup

Diet-induced obesity model wikipedia, lookup

Food studies wikipedia, lookup

Food politics wikipedia, lookup

Obesity and the environment wikipedia, lookup

Dieting wikipedia, lookup

Human nutrition wikipedia, lookup

Coeliac disease wikipedia, lookup

Food choice wikipedia, lookup

Nutrition wikipedia, lookup

Gluten-free diet wikipedia, lookup

Transcript
WheatandGluten:WeHardly
KnowYou
JulieMillerJones,PhD
ProfessorEmerita
St.CatherineUniversity
St.Paul,MN
Disclosures
•  ScienEficAdvisortotheInternaEonalLife
SciencesInsEtute,WheatFoodsCouncil,
HealthyGrainsInst.(Canada),HealthGrain
Forum(EU)
•  Givespeechesandreceivehonoriaforsuch
fromavarietyoffoodcompaniesand
commodityboards
WhatThisTalkWillCover
•  Alookatthecurrentenvironmentandpopulardiets
•  Alookattheclaimsthatwheathaschangedandis
makingusfatandsick.
•  Ifwheathasnotchanged,whathas?Linktheroleof
gutmicrofloraandgutdysbiosistohealthanddisease.
•  AddresslegiEmateandunfoundedclaimswithrespect
towheat,gluten,carbohydratesandhealth.
•  OutlinedietarystrategiesandEpsforthosewith
glutensensiEviEes,allergies,celiacdiseaseandother
digesEvedisorders.
TheLatestFadorHeretoStay?
… mega-sellers like Grain Brain and Wheat Belly suggest
that wheat may be the new asbestos
CLAIM:
HUMANSDIDNOT
EVOLVETOEAT
GRAINS
Claim:HumansDidNotEvolvetoEat
Grains
•  Humans-eaEnggrains>100,000yrs
•  Dentalrecordevidence
–  Hominidswereandareomnivores
–  CookedgrainDNAindentalcalculusofPaleolithic
humans
•  Caveandcookingevidence*
–  Grains(sorghum,wildmaize,others)foundincaves
•  GrainDNAonstonetoolsandincookingpotsindicate
processingandcookingofgrains.
*CavesinIraqandtheLowCountries;theAmericas
Henry,A.etal.EthologyandSociobiology15:219–35.;Unger,P.Theknown,theunknownandthe
unknowableDOI:10.1016/0162-3095(94)90015-9.
Claim:HumansDidNotEvolveto
EatGrains
•  Withtheadventofagriculturehumansevolved
tohave6copiesofamylase
–  otherprimates-2copies
•  Amylase&cookingofCHOenabledready
supplyofglucosetothebrainincreasingthe
brainsizeofhumans
http://news.sciencemag.org/
evolution/2012/10/raw-food-notenough-feed-big-brains
news.nationalgeographic.com/.../
121026-human-cooking-e…- A
surge in human brain size about
1.8 million years ago is linked to
the innovation of cooking
WhatWasLifeLikeinthePaleo
Period
•  Averagelifespan~35years
–  65-85%vegetarians;moremeatincolderclimates
–  Ourancestorsdideatgrainsandlegumes.
–  Earlyhumansateverymuchlikemodernpigsand
bear-gegngcaloriestosurvive
hhp://www.dailymail.co.uk/sciencetech/arEcle-2878166/ScienEsts-slam-cavemandiet-say-early-humans-just-ate-could.html#ixzz42Kv1U4Ur
CLAIM:GRAINS/GLUTEN-CONTAINING
CARBOHYDRATESTAPLESAREBADFOR
THEHUMANDIET
RecommendaEonsforCarbohydrates
(CHO)andCHOStaples
DietaryrecommendaEons-mostcountries/healthpromoEonorgs
Foodguidelinesrecommendgrainsasafoodgroup
CHO/grainstaples-Baseofpyramid/diet
45-65%ofE(upto75%ofE)
• 
• 
• 
• 
– 
– 
– 
– 
– 
– 
– 
Australia/NewZealandDietaryGuidelines
EuropeanFoodSafetyAuthority
UKScienEficadvisoryCommiheeonNutriEon
USDietaryGuidelines/USInsEtuteofMedicine
SingaporeHealthPromoEonBoard
IndianHealth
HealthpromoEonbodiessuchasheart,canceranddiabetesassociaEons
WorldHealthOrganizaEon/Food&AgricultureOrganizaEon(WHO/FAO)
• 
“themacronutrientthathumansneedinthelargestquan3ty.”
MontagneseCetalNutriEon.2015;31:908-915.RadhikaG,etalPublicHealthNutr.2011;14:591-8
hhp://www.hpb.gov.sg/HOPPortal/health-arEcle/2638
CLAIM:MODERNWHEATHASBEEN
BRED(TRADITIONALANDGENETICALLY)TO
BECOMETOXICANDFATTENING
BreedingChangesEverythingEdible
http://cdn.foodbeast.com.s3.amazonaws.com/content/wp-content/uploads/2013/09/
V8XnPeQ.jpg
Claim:WheatChangesCreatedShort
Straw“Frankenwheat”
“Wheatweeatthesedaysisn'tthewheat
yourgrandmahad…It’san18-inchtallplant
createdbygene3cresearchinthe’60sand
’70s.”WilliamDavis
•  Nosignificantchanges
Kasarda,USDAAlbany2013;Chibbar2015,HealthGrainEU
So Jack, were these some seeds
Norman Borlaug sold you?
13
FACT:Tri3cumaes3vumanditsparentsare12”-60”tall.
–  Heightgenesdonotcodeforglutensandgliadins
37 ancestral and modern varieties of wheat - From Red Fife dating (1860) to
newest variety tested 2007;grown in 2013 and in 2014
Photo Credit: U Sask- Hucl et al
14
GlutenLevelsUnchanged
©Chibbar et al. 2015 over 150 yrs “Analysis of a variety of heritage and modern wheat starch shows very
little difference ….varied from 56 % (Apex 1937) to 69% (Superb 2001)
Claim:Gliadin–AnewproteinthatisaddicEve
1700-1893studies,namedanddescribedchemically
Osborne&Voorhees
TheProteidsoftheWheatKernelAm.Chem.J,392-471(1893)
2012–new,toxicproteinWilliamDavis
“everybodyelseissuscep3bletothegliadinproteinthatisan
opiate.Thisthingbindsintotheopiatereceptorsinyourbrain
andinmostpeoples3mulatesappe3te,suchthatweconsume
440morecaloriesperday,365daysperyear.”
Opioid receptor
46lbs/yr
Hemmings WA, Antigen Absorption by the Gut. Springer Science & Business Media, 2012
16
Claim:OlderWheatsAreSuperior
Emmer,einkorn,other‘ancient’vsotherwheats-sameregion
“Thedatadonotsupportanoverallsuperiorityofprimi2veforms,
butevidencedinteres3ng,poten3allyexploitable,between-and
within-speciesvariability.”
Einkorn/Emmervscommonwheat
Higher-protein,riboflavinandB6,carotenoids
Fructans(+prebioEcand–FODMAP)
Lowerdietaryfiber8.7-9.1g/100gvs10.7-12.7g/100g
Loweryield,Poorerbreadquality
HidalgoA,BrandoliniA.JSciFoodAgric.2014;94:601-12;BenincasaP,etal.JSciFoodAgric.2015;95:1795-803;
GiambanelliE,etal..JSciFoodAgric.2013;93:3490-501.GebruersK,etal.JAgricFoodChem.2008;56:9740-9.
1917
Claim:Ancientwheatglutenisless
immunogenicandallergenic
‘Ancient’vsmodern
wheats“…presentresultscannot
Total gliadin and α-gliadin determination by
indirect ELISA shows more in ancient.2
confirmthatancientdurumwheats
wouldbelessCD-toxic.Inconclusion,
westronglyadviseagainstceliac
pa3entsfromconsumingancient
wheatsincluding…”1
–  notlessallergenicbyblot
andpinpricktests3
‘Ancient’
2ŠuligojT,etal.EvaluaEonofthesafetyofancient
strainsofwheatincoeliacdiseasereveals
heterogeneoussmallintesEnalTcellresponses
suggesEveofcoeliactoxicity.ClinNutr.2013;
32:1043-9;.
3SimonatoB.etal.AllergenicpotenEalofKamutwheat.
Allergy.2002;57:653-4
1Colomba
MS, Gregorini A. Are ancient durum wheats less toxic to
celiac patients? A study of α-gliadin from Graziella Ra and Kamut.
ScientificWorldJournal. 2012;2012:837416
CLAIM:WHEAT,GRAINSANDCARBS
CAUSEOBESITYANDCHRONICDISEASE
Obesity, CHO/Grains Alleged as Culprits
20
AvailableCaloriesHaveIncreased
~ 600 Kcal more overall, ~200 calories more each from fat and
CHO; 50 cal more from sweeteners
GrainIntakeIsFlatorDecreasingas
ObesityClimbs
http://www.fao.org/docrep/005/ac911e/ac911e05.htm
23
MixofWholeandRefinedGrains
LowestVisceralAbdominalFat
McKeown et al. Am J Clin Nutr 2010; 92:1165-71
Framingham Heart
Study (n=2834)
24
O
FTHE MICROBIOME,DIET,
INFLAMMATION,DRUGSALLERGY
ANDAUTOIMMUNEDISEASES
DISEASES
DigesEonandGutHealth:
TheFirstPointofWellness
"Diges3on,ofallthe
bodilyfunc3ons,isthe
onewhichexercisesthe
greatestinfluenceon
thementalstateofan
individual.”
Jean-AnthelmeBrillat-Savarin
(1755-1826)
FoodAllergies,Intolerances,and
SensiEviEesDefined
•  FoodAllergy*:anIgEmediated
reacEontoafoodproteincausing
histaminerelease
•  FoodAutoimmune:reacEoncaused
bytheacEvaEonofagene(celiac)
•  FoodIntolerance:reacEontoa
metaboliteoringredientsuchas
lactose,caffeine,ortyramine(aged
cheesesandAsianfermented
sauces)
•  FoodSensi^vity:reacEontofood
componentthatisnotanallergic,
chemicalorautoimmuneresponse
*Celiacdiseaseisanautoimmunediseasenotanallergy
Allergy
•  IgEImmunoglobulinresponsetoaprotein
•  Eczema&hives,swelling
•  Asthma&hayfever-likesymptoms,cough
•  Tiredness
•  GIsymptoms
•  Rare:anaphylacEcshock –  Neurological
–  Joint/musclepainsèarthriEs
–  IBS,other
Hollowayetal.PracEEoner.2011;255(1741):19-22
28
PerceivedandActualPrevalenceof
FoodAllergy
•  Upto35%believethey
havefoodallergy
•  ~3.5%confirmedbyoral
foodchallenge
Mastcellsrelease
histamineazer
proteinbindswithIgE
•  10-foldlowerprevalence
www.foodallergy.org/document.doc 2014
hhp://www.jacionline.org/arEcle/S0091-6749(07)00991-8/abstract; Rona RJ et al. Journal
of Allergy and Clinical Immunology 2007, 120:638-646
IncidenceofFoodAllergy-US
90%ofAllergiesdueto8FoodGroups
Children%
• 
• 
• 
• 
• 
• 
• 
Milk Eggs Peanuts1.4/Nuts
Wheat Soy Fish0.1&Shellfish
Sesame 2.5*
1.5*
1.1
0.4*
0.4*
0.1
0.1
*80%outgrowbyteenyears
• 
• 
• 
• 
• 
• 
• 
• 
Adults%
Allseafood 2.8
Peanut 0.6
Treenuts 0.5
Wheat 0.5
Fish 0.4
Milk 0.3
Sesame 0.1
Wheatallergyinen^re
popula^on~0.5%
hhp://www.foodallergy.org/document.doc2014.
WasermanS&WatsonW.AllergyAsthmaClinImmunol.2011;7Suppl1:S7;Sicherer&
Sampson,2010;Chafenetal,JAMA.2010;303:1848-56.
30
WheatAllergy–IgEResponseto
WheatProtein
•  27wheatproteins
–  documentedasallergens
•  Gliadins:mostsevere
–  γ-gliadin
–  ω-5gliadin-Wheatdependent
exerciseinducedanaphylaxis
(WDEIA)
•  Glutenins
•  Wheatglutelin:mostfrequent
allergens
•  Albumins
•  Someglobulins/enzymes
α-amylase/trypsininhibitor
non-specificlipidtransferprotein
EllietalWorldJGastroenterol.2015;21:7110-9;Millsetal
PlantFoodAllergens2007Blackwell
Eaten any wheat
lately?
31
MicrobiomeandHealth
•  Body - 10 trillion cells
Microbes outnumber human cells 10:1
~1 - 3 % of body
200 lb. adult 2- 6 lbs bacteria
“Weshouldstartthinkingaboutdiets
notonlyfromtheperspec3veof
whatweshouldeat,butwhatwe
shouldbefeedingouren2regut
microbialsystems….
“thereisnotjustonewaytobehealthy,
theredoesn’thavetobeoneortwo
‘justright’gutcommuni2es,but
ratherarangeof‘justfine’
communi2es
~JeffLeach,founderoftheHumanFood
Projectandco-founderofAmericanGut.
MicrobiomeDiversity/Balance
•  Micorbiomeassoc.withtheImmuneSystemanddisorders
–  Allergies&Asthma
–  Crohn’sdisease&ColiEs
–  Obesity&Diabetes
–  Cancerrisk
–  Heartdisease
•  Pooptransplantsbychangingmicrobes
–  RatschangedsuscepEbilitytoheartahacks
–  Leanratsbecameobeseandviseversa
•  Assoc.withStress,PersonalityGerm-freemice&ratsaremore
vulnerabletostress
–  Mice:Warmandfriendlyvs.aggressiveandstand-offishstrains
•  Assoc.withCogniEonandBehavior
–  Highfat/highproteindietsreducememoryacuity;
execuEvefuncEoning
–  MarkersofinflammaEonèaffectenErebodyincl.brain
GutBacteriaThroughtheLifecycle
Source:Ohmanetal.FronEersCellularInfecEonMicro.2012;2:1-10
IntesEnalMicrobesandAllergy
Clostridia,
Enterobacteriaceae,
Staphylococci
Decreased
risk
prone
Food allergy-
Lactobacillus
Bifidobacterium
mice
Increased
Risk
Source:NovalRivasMetal.JAllergyClinImmunol.2013Jan;131:201-12
LowAcid,BacterialOvergrowth
DietaryDysbiosis&Disease
Lowstomachacidallows:
1.  Pathogenicbacteriato
surviveandpopulate
thegutèdysbiosis
2.  Contributestoweak
EghtjuncEonsèleaky
gut
3.  Proteinscrossthegut
ètriggerimmune
reacEons
Dysbiosis: microbial
imbalance in the GI tract
AcidSuppression&Allergy
AntacidsandanE-ulcerdrugs:
•  êstomachacid èêproteindigesEonèpotenEal
allergicreacEonorinflammatorypotenEal
•  PromoteIgEformaEonbydietaryproteinfragments
Ø  Milk,potato, celery,carrots,apple,orange,wheat,
rye
Ø  SensiEviEeslingered>3+mo.azerantaciduse
Ø  Alcohol,NSAIDs(aspirinetc),beta-blockersor
antacidsmayaggravatetheseverityofafood
allergicreacEon.
Ballmer-WeberB.TherUmsch.2012;69:225-9.Untersmayretal.FASEBJ.2005;
19:656-8;DehlinkE,etal.ClinExpAllergy.2009;39:246-53;DiesneretalWienMed
Wochenschr.2012;162:513-8;McCarthyDMCurrOpinGastroenterol.
2010;26:624-31
AcidSuppression&Allergy
•  AcidsuppressionwhileInuteroassociatedin
offspring(Swedishcohort>29,000)
–  Allergy(OR1.43)
–  Childhoodasthma(OR1.51)
Source:DehlinkEetal.ClinExpAllergy.2009;39:246-53;Diesneretal.WienMed
Wochenschr.2012;162:513-8
C
ELIAC,GLUTENSENSITIVITY,LEAKY
GUTANDDYSBIOSIS
CausalFactorsforCeliacSymptoms
1.  Gluten
2.  GeneEcs(>97%)
–  HLA-DQ-2
–  HLA-DQ-8
3.  Trigger-stress,trauma
–  Surgeries,pregnancy,etc.
–  InfecEons,childhooddiseases
4.  IntesEnalPermeability
–  EmergingFactor
–  “LeakyGut”
Scientific American
• 
CeliacIncidence
USAverage(healthypeople):1in133;only1:4700
diagnosed
–  HigherifScandinavian,Irish,partsofMiddleEast:1in50-60
–  Est.African,Hispanic-andAsian-Americans:1in236
•  Inpeoplewithrelatedgutsymptoms:1in56
–  1st-degreerelaEves:1in22
–  2nd-degreerelaEves(aunt,cousin):1in39
•  Incidenceisincreasing:2to5xhigher
–  BasedonthepresenceofEssuetrans-glutaminaseanEbodies
– NoconEnuousdatarelaEngtotheincidenceofceliacdiseasein
theU.S.populaEononayear-by-yearbasis
Sources:Fasano,www.uchospitals.edu/pdf/uch_007937.pdf
AlbertoRubio-Tapia,AmerJGastro,2012;DOI:10.1038/ajg.2012.219;RiddleetalAmJ
Gastroenterol.2012Aug;107(8):1248-55
•  Abdominalpain
(IBS) 68%
•  Eczema,rash 40%
•  Headache 35%
•  “Foggymind” 34%
FaEgue Diarrhea Depression
Numbnessin
extremiEes
•  Jointpains
• 
• 
• 
• 
33%
33%
22%
20%
11%
4%haveglutensensiEvityEllietalWorldJGastroenterol.2015;21:7110-9
Novalidatedoragreedupontestfornon-celiacglutensensiEvity.
42
TopReasonsCitedforSeeking
Gluten-FreeProducts
1. 
2. 
3. 
4. 
5. 
6. 
DigesEveHealth(39%)
NutriEonalValue(33%)
HelpLoseWeight(25%)
Other(21%)*
HealthierSkin(20%)
JointPain(18%)
7.  ImproveConcentraEon(13%)
8.  AlleviateStress(12%)
9.  CleansingRegimen(10%)
10.  AlleviateDepression(9%)
11.  AlleviateAsthma(6%)
12.  TreatCeliacDisease(5%)
Source:HartmanGroupSurvey,1700USAdults,July2009
TheoriesaboutIncreasing
PrevalenceofCeliac
1. 
2. 
3. 
4. 
Increased awareness, better diagnostics
Gluten sensitivity
Bacterial overgrowth - medications, age, diet
High Salt intake1 - modest increase
increases proinflammatory molecules
5.  Clean theory or hygiene hypothesis2
1Wu
et al., Nature, doi:10.1038/nature11984, 2013; Kleinewietfeld M. Nature,
doi:10.1038/nature11868, 2013; Yosef N et al., Nature, doi:10.1038/
nature11981, 2013. 2Fumagalli et al. J Exp Med. 2009;206(6):1395-408;
Brooks et al Curr Opin Allergy Clin Immunol. 2013 Feb;13(1):70-7; Frei et
al Allergy.2012;67(4):451-61;LaciandPenagos.NestleNutrWorkshopSer
PediatrProgram.2011;68:169-83.
TheoriesaboutIncreasing
PrevalenceofCeliac
6.  Infant&EarlyPracEces
• 
• 
• 
• 
33%ofbabiesintheUSAbornbyCaesarian
Breastvs.bohlefeeding
NoeffectofEmingforglutenintroducEon
Wasaneffectofglutenintroazer6mo.Inanotherstudy
7.  FoodborneinfecEonsandviruses:trigger
autoimmunediseases
hhp://www.cdc.gov/nchs/fastats/delivery.htm2015AronssonetalPediatrics. 2015;135:
239-45; ( US Germany Sweden Finland) Stordal et al Pediatrics. 2013 Nov;
132(5):e1202-9 – Norway;Silvaetal.ActaMédicaPortuguesa,2011December;24Suppl
4:1035-40.“DiversificaEoninthefirstyearoffoodlife.”;LaciandPenagos.NestleNutr
WorkshopSerPediatrProgram.2011;68:169-83
45
TheoriesaboutIncreasing
PrevalenceofCeliac
7.  ShortfermentaEonsforbreadvssourdough:
breakdowntheoffendingpepEdes,useofgluten
8.  AgronomicpracEces:ferElizers,growing
condiEons,specificvarieEes
9.  Poordietsoverall:lowfiber,folate,vitamins,
toomanycalories
10.  Changeinthegutmicrobiome:mayincrease
autoimmunediseases
Sources:Millionetal.Int J Obes (Lond). 2013 Mar 5; SungetalNeurogastroenterol
Motil. 2013 Mar 22. Ceseviciene2012;Grove2009;Katz2011,Rizzello2007;Belz2012
46
T
HEMICROBIOME,FIBER,
WHEAT,OBESITYANDCHRONIC
DISEASE
The US “Dietary Fiber Gap”
US Intakes vs. Recommendations
14
25
AverageDailyIntake
18
38
Men
15
25
The filled in color
for each category
represents the
actual intake,
whereas the
empty portion of
the bar is what is
lacking to reach
the daily
recommendations
Women
0
5
10
15
20
25
Grams Dietary Fiber
Clemens R et al. J Nutr. 2012; 142:1390S-401S.
30
35
40
* Data from the
USDA and
NHANES
48
Under 5% Meet Dietary Fiber Intake
•  US NHANES gender / age categories
•  < 4% meet the requirement
•  <<<<1% males 14-50 yrs
•  13-15% women 51+yrs
Marriott, et al. Crit Rev Food Sci Nutr. 2010;50:228-58.
49
FiberandFlatus
•  Flatusemissions:men,fiber28g+/-13g
–  mean –  range 12.7
2-53
•  Flatusemissions:women,fiber24g+/-3g
–  mean –  range
7.1
1-32
•  Correlatedwithfiberintake
Source:BolinandStanton,EurJSurgSuppl1998582:115
GasMaybeDuetoFODMAP
•  "Fermentable,Oligo-,Di-,Mono-saccharidesand
Polyols”DatafromMonaschUniversity,Australia
•  EliminaEondietpossiblyhelpswithIBS
BarrehJS,GibsonPR.TherapAdvGastroenterol.20125:261-8.
Gluten Avoidance
“the reigning dietary restriction of our time”
•  30% - decreasing / avoiding gluten completely
•  >100 million trying to cut down on gluten
–  40% avoiding it because of gas/ bloating
•  >10 million households GF 2014
•  Sales $973 million, 2014 è $2.3 billion by 2019
PkgFdFacts2/2014;SloanFdTech12/2014;*
Gallupsurvey
U.S.ConsumersIncreasinglysaytheyare,
orwanttobe,Gluten-Free
•  ~One-thirdofU.S.adultssaytheywanttocutdownorbefree
ofglutenin2013
Source:NPDGroup,hhps://www.npd.com/perspecEves/food-for-thought/gluten-free-2012.html
SorEngOutWhoShouldBeGlutenFree
•  AskQuesEons
–  Whatistheirdiet&lifestylelikeNOW?Whyarethey(or
dotheywanttogo)gluten-free?
•  EncouragetesEngFIRSTtoruleoutCeliac
disease
•  MUSTBEINGESTINGGLUTEN:HavetheanEbodytests
èthenproceedtoagutbiopsyandcheckforthe
genes,ifwarranted
•  GlutenSensiEvity:notestavailable
•  GeneralGutHealthIssues(IBS,Crohns,etc):
–  LowFODMAPmaybewarranted
IngredientstoAvoid
•  Wheatandits
relaEves
•Malt/beer
•MaltExtract/vinegar
–  Wheatgerm,bran,
•MaltFlavoring
starch,bulgur,durum,
•  Soysauce
semolina,pastas,
farro,farina,cous
•  Hydrolyzedvegetable
cous,triEcale,spelt,
protein
dinkel,einkorn,
•  Manyflavors
emmer,Kamut®
•  Manyotherfoods
•  Rye,Barley
•  Oats–non-purity
Gluten Free (GF) Does Not Help
with Weight Loss
•  Many GF products are
higher in carbs and calories
“The increase in weight of already
overweight patients after dietary
gluten exclusion is a potential
cause of morbidity, and the
gluten-free diet as conventionally
prescribed needs to be modified
accordingly.”
Source: Marcason W. J Am Diet Assoc. 2011, 111:1786; Dickey W, Kearney
Am J Gastroenterol. 2006;101:2356-9.
56
NutriEonalImpactofaGFDiet
•  Highinfat,caloriesandmeat
–  Manygainweightonthisdiet
•  SomeincreaseBMI56%
–  Highglycemicindex:alternaEvegrainfoodshigherinstarch,
sugarandfat
•  Ricecerealand/orrice-tapiocabread,muffins,chips,doughnuts,
cookies
•  Fewergrainsandwholegrains,
•  Nearlyallrefinedlowfiber
–  Uselowerproteingrains
Jenkins et al 1987 AJCN 45: 946-951; Berti 2004 EJN 43: 198-204
NutrientsinGluten-FreeProducts
–  Manygluten-freefoodsnotenrichedorforEfied
–  LowinBvitamins,nofolate=highhomocysteine
–  Lowiniron
INGREDIENTS: White Rice Flour,
Filtered Water, Honey, Safflower Oil,
Vegetable Gum (xanthan, cellulose),
Fresh Yeast, Sea Salt
Kupper et al Gastroenterol 2005 128: S121-7; Thompson et al J Hum
Nutr 18:163-169; JADA 2000 100: 1389-96
CostandEaEngQualityof
Gluten-Free(GF)Foods
•  Ave 242% more
–  range 5-1000%
•  GF quality tends to be less than non-GFF
“results to date have been notoriously off-putting.”
Gluten-free bakery formulations have tended to be dry,
bland, powdery, crumbly and/or oddly-textured, often
with a reduced shelf life.”
Case, S. All Things Baking. Chi, 2011; Zannini E. et al.
AnnuRevFoodSciTechnol.2012;3:227-45.
GutHealth:Much,MuchMore
ThanJustGluten-Free
•  Guthealthhelpers:
–  PrebioEcs(inulin,oligosaccharides)
–  ProbioEcs(yogurt,kombucha,supplements)
–  AnEoxidant/anE-inflammatoryfoods(fruits,
vegetables,wholewheatandotherwholegrains,
nuts,fahyfishorfishoil,etc)
–  Smallermeals
–  Healthylifestyle:lowalcohol,notsmoking,
exercise
CONCLUSIONS
•  Paleo-anotherlowcarbdiet
–  Wedidevolvetoeatgrains
•  fewadvantages,manydisadvantages
•  Ancientwheatsarenotbeher;Wheat
proteinshavenotchanged
•  GliadinisneithernewnoraddicEve
•  Ourmicrobiomeanddietshavechanged
•  1%haveceliac;~6%neednogluten/wheat
–  Celiac/autoimmunediseasesareincreasing
–  Gluten-free-costlyandnonutriEonalbargain
ResourcesforClientsWhoNeedto
FollowGluten-FreeDiets
•  CenterforCeliacResearch&Treatmenthhp://www.celiaccenter.org/
•  ShelleyCase,CanadiandieEEan:glutenfreediet.caverywell-informedRD
aboutceliacdiseaseandnon-celiacglutensensiEvity
–  Twiher:@ShelleyCase
•  NaEonalFoundaEonForCeliacAwarenesshhp://www.celiaccentral.org/
•  GlutenIntoleranceGroupofNorthAmerica:www.gluten.netTofind
restaurantsthatofferglutenfree,campsandsupportgroups.
•  FoodAllergyNetwork-www.foodallergy.orgGeneralAllergyInformaEon
andespeciallygoodforkidswithmulEplefoodissues.
AddiEonalResources
www.WheatFoods.org
QuesEons?
www.whea…oods.org
Facebook.com/WheatFoods
@Whea…oods