A fire-roasted veggie sandwich produced with gluten-rich wheat. Image: wEnDy/Flickr/CC BY-NC-ND 2.0
In recent decades, fat, sodium, carbohydrates, sugar and protein have all been targeted as ‘bad’ dietary factors. Right now the focus seems to have shifted to gluten: a protein found in cereal grains, especially wheat but also rye and barley. For a small proportion of consumers, such as those diagnosed with coeliac disease or wheat allergy, the avoidance of wheat and other gluten-containing foods is essential. Symptoms for sufferers can include nausea, vomiting, cramping, bloating, abdominal pain, fatigue and even very serious conditions such as liver disease.
The prevalence in the population of coeliac disease and wheat allergy, while significant, sits between 1-2%.
But the growing number of consumer foods labelled as either gluten or lactose free, and the popularity of restrictive diets like the paleo diet, would suggest more people are making the choice to go gluten or wheat-free – above what the coeliac and wheat allergy statistics would suggest.
To understand more about this trend, we conducted a nationwide survey of nearly 1200 people selected at random from the Australian electoral roll. The aim of the research was not only to quantify the prevalence of wheat avoidance in Australia but also to pioneer understanding of the drivers underpinning this decision.
Wheat avoidance in Australia
The data collected revealed that as many as 1 in 10 Australian adults, or approximately 1.8 million people, were currently avoiding or limiting their consumption of wheat-based products. Women were more likely to be avoiding wheat than men.
The survey also revealed that over half (53%) of those who were avoiding wheat were also avoiding dairy-based foods.
Why is this an issue? According to current Australian Dietary Guidelines, both grain and dairy-based foods are an important component of a balanced diet. They contribute significantly to the daily dietary fibre and calcium intake of both adults and children. They also deliver other important nutrients such as protein, vitamins and minerals, and – if eating whole grain – resistant starch.
So why are people choosing to avoid wheat?
The reasons behind this decision are complex. Some respondents reported that they were avoiding wheat due to a diagnosis of coeliac disease (1.1%), or because a family member has been diagnosed with coeliac disease. Others stated they were avoiding wheat for weight-control or taste preferences.
However, the vast majority of the survey’s wheat-avoiding respondents – which equates to 7% of (non-coeliac) Australians – were avoiding wheat-containing foods to manage a range of adverse symptoms they attributed to the consumption of these products. Symptoms were mostly gastrointestinal in nature (bloating, wind and abdominal cramps) but also included fatigue/tiredness.
When asked if they had any formal diagnosis including that of an intolerance, allergy, or coeliac disease which required them to avoid wheat, most (84%) of these symptomatic individuals said no.
So what sources are people relying on when it comes to making decisions such as avoiding wheat? There is a great deal of information which links the consumption of specific foods to adverse symptoms. According to our data, those who decide to eliminate wheat tend to do so based on advice from sources such as complementary practitioners (for example, naturopaths) family, friends, the media, and to a lesser extent their GP or a medical specialist.
Is wheat really so bad?
Up until recently it was thought that gluten was only really a problem for individuals with coeliac disease. Our findings, plus the extraordinary rise in popularity of the gluten-free diet in Australia and elsewhere, suggest that, apart from coeliac disease and wheat allergy, other conditions associated with the ingestion of wheat are emerging as health care concerns. Currently, the driver of most of the research activity in this area is the concept of non-coeliac gluten sensitivity (NCGS).
NCGS is defined as adverse reactions to the consumption of gluten, where both allergic and autoimmune mechanisms have been ruled out and where gastrointestinal symptoms improve on a gluten-free diet. Many aspects of NCGS remain unclear, including prevalence, clinical spectrum, physiological mechanism and treatment. There is also considerable debate as to whether it is in fact gluten or some other component of wheat that triggers the reported symptoms.
Fructans, for example, are short-chain carbohydrates which are found in wheat-based products, as well as other foods. For a proportion of the general population fructans, along with other short-chain carbohydrates (collectively called FODMAPS), can trigger symptoms like bloating, wind or cramps – by holding water in the gut or through the rapid production of gas by intestinal bacteria.
Our finding that people may be avoiding more than one dietary component at a time has the potential to complicate being able to know exactly which dietary components, and in what doses, are to blame for their symptoms. Further research is needed.
Until then, there is a risk that a significant proportion of Australians may be undertaking diets that are unnecessarily restrictive, with the potential danger of associated nutritional imbalances. Also of concern is the finding that the majority of symptomatic respondents appear to be bypassing conventional medical advice in their decision to go wheat-free. We would be remiss not to draw attention to the potential risk here of a serious clinical condition going undetected.
To find out more about our research into diet and lifestyle, visit our website.
2nd December 2015 at 12:31 pm
I think a major problem is that to prove your coeliac you have to go on a gluten diet for 6 weeks which, for true coeliac’s, is impossible. Therefore there are probably more coeliacs in society than the statistics can show – but showing people on a gluten free diet is much easier. So its possible that the statistics are not giving the whole story.
23rd November 2015 at 5:37 pm
Fascinating article.
My wife has issues with wheat, her reaction is dramatic with bloating and cramps. She went on an exclusion diet and then reintroduced foods until she worked out which food caused the problem. This was done on the advice and under the guidance of our GP at the time and it was quite easy to identify the problem in her case as the reaction was fairly instantaneous and obvious. There has been no medical reason for this that has been identified. The FODMAP stuff was really totally off the mark with her and the FODMAP diets suggested by medical professionals made her feel awful.
What is interesting is that because she is gluten free I am now on a low gluten diet and I feel much better for it. I am not sure of the mechanism but I feel much worse when I revert to a “normal” diet. I feel that this particular issue is not fully understood and I believe that the reason people are going gluten free is because it makes a lot (not all) of people feel better. I think that if we could understand diet better then we could dramatically improve peoples health, or at least be able to explain to them why they are in such a bad way.
Keep up the good work
Chris
23rd November 2015 at 3:34 pm
So what are you all saying; we should go back to the pre-1970s varieties of wheat and take a more controlled and directed genetic modification path to achieve the desired attributes from production and nutritional points of view? Probably a worthy endeavor and build in some drought and saline resistance at the same time.
Another change also happened a little before this the regulatory brakes were taken of dictating the acceptable rates of milling extraction, so instead of enforcing a percentage extraction rate to maximize the yield of flour, millers were able to sacrifice yield for a whiter flour minus nutritionally valuable components from the testa. In part it was a trade-off for removing bromide from bread formulation as a dough improver and bleaching agent.
What a tangled world we live in!
8th November 2015 at 2:26 pm
If I eat wheat or any gluten containing grains , but particularly wheat , I start to ache all over and I get stomach problems . I have tested this many times by eliminating all food except vegetables and fruit for a few days and then eat wheat in the form of bread with nothing else on it . Within a short time the aches and stomach troubles return . I am not coeliac , just intolerant to gluten .
If I eat any dairy products then my sinuses , nose and throat clog up with mucus in a very short time . I tested this also many times in the same manner as above with the same result . I am lactose intolerant .
Stay away from these products and I am fine .
6th November 2015 at 4:31 pm
Have you considered that there might be something wrong with modern wheat?
Dr Norman Borlaug won the 1970 Nobel Peace Prize for inventing the high-yield thick-stemmed semi-dwarf wheat that kicked off the “green revolution”. Borlaug was brilliant, but is still widely criticised for his methods, which involved bombarding plant embryos with highly toxic chemicals and gamma radiation to induce multiple gene mutations.
Borlaug dismissed his critics as elitists who had never felt hunger, the implication being that mass food has unavoidable costs to both health and landscape. This tacit trade-off became universally accepted.
Since then, 1980s Borlaug’s dwarf wheat has become globally dominant, now providing some 20 per cent of all human calories. It also has three times as many chromosomes as primitive wheat and many medics blame it for an enormous range of both environmental destruction (irrigation, monoculture, erosion, chemical intervention) and human disease.
Cardiologist William Davis’ best-selling book, Wheat Belly, documents multiple cases where quitting wheat ends pre-diabetes, hypertension, irritable bowel, psoriasis, joint pain, asthmas, high cholesterol, acne, depression, obesity and various forms of chronic pain.
Davis’ explanation is twofold. He argues (a) that human health deteriorated markedly even when, 10,000 years ago, we first started eating primitive “einkorn” wheat, because our guts are not designed for grass seed. But also (b) that current epidemics of obesity, diabetes, mental ailments including depression, ADHD, bipolar and paranoid schizophrenia and a range of autoimmune diseases including Crohn’s, thyroid, lupus, endometriosis, vasculitis, coeliac disease, ulcerative colitis, peripheral neuropathy are linked to the deliberate but uncontrolled mutagenesis – essentially a primitive form of genetic modification – that Borlaug induced.
The other issue that would be worth looking at is industrial processing of wheat, high impact, high temperature and what that is doing to the food value and structure of the wheat.
kind regards
6th November 2015 at 4:32 pm
Sorry, should have included a reference
http://www.smh.com.au/comment/bring-out-the-pigness-of-the-pig-the-chickenness-of-the-chicken-20150225-13o7jl.html
8th November 2015 at 8:57 am
Well said.
8th November 2015 at 10:14 am
http://www.cbc.ca/news/wheat-belly-arguments-are-based-on-shaky-science-critics-say-1.2974214
6th November 2015 at 8:13 pm
I must say that at first I was skeptical especially about the exorphin endorphin opiate hypothesis of Dr Wm. Davis about an actual wheat addiction.
I had no doubt that wheat especially the double triple quqdruple chromosome wheat of Dr Borlaug with altered and increased starch as well as gluten in the new dwarf wheat varieties is to a large extent responsible for the world wide obesity metabolic syndrome epidemic. Altered milk as well as HFCS and of course all sugars are also implicated.
But I had doubts about the Grain Brain of Dr David Perlmutter and lately Dr Dale Bredesen who implicate nearly all mental illness from autism to Alzheimer as wheat starch gluten related.
But addiction? Too much.
So my dear wife took to giving me weekly instead of pasta even if durum zucchini squash spaghetti which is just that squash. With meat balls and tomato sauce. I ate it not enthusiastically but willingly as I was the one who prompted her to alter our diet.
Then one day after a year or so she sprung a surprise on me. She served macaroni which I always despised as poverty food. Same meatball and tomato sauce. As I was eating this wheat macaroni and meatball and
tomato sauce meal I began to sing and hum and wave my arms around which are all very atypical behaviours as I am usually morose unhappy depressed in a foul mood. I even began to shout this is so good I will have more later tonight and from now on I will have this every night.
Then it hit me that I was actually high. I was getting exorphin high from the white wheat flour macaroni!!!
I had to face the fact that indeed I was a severe drug addict all my life eating several slices of bread with each meal even if rye or whole grain which is mostly wheat as well.
And it wasn’t because I was a glutton that I became fat over the decades of my middle age from 220 to 330 and with great effort back to 270 lbs but I had been a wheat addict all my life consuming enormous amounts of pasta bread rolls and at times donuts and bagels and crackers rarely pancakes pita pies pizza as well.
All wheat of course. Over a weekend I could eat an extra large pizza and I thought it was because of the
tomato sauce or cheese or toppings. No dummy it was the dough!
Then just last week I saw my first patient who did not lose or gain a balanced amount of fat from belly and hip but who actually lost 10cm or 4″ waist girth but no hip diameter.
I took to measuring not just weight BP P but waist and hip diameter in all my patients about three years ago
whenever their weight changed..
Only 1% of males or females have the required 80cm or 90 cm girth. The other 99% have metabolic syndrome if this be one criterion. .
I have copied out all the formulae of endorphin enkephalin dynorphin the AA amino acid structure trying to see the similarity to morphine thebaine opium codeine apomorpgine etc. What I fault Drs Davis Perlmutter and Bredesen with is that they do not include even one chemical organic structural formula in their books. How can you discuss starches glucose lactose gluten gliadin glutenin without giving their structural formula?
Their theories would leave the suspicion of quackery and the odour of cult and enter the world of science if one could see the molecular basis of their theories. Giving the number of haploid diploid tetraploid chromosomes was a good start.
Similarly I discounted the notion of AGEs until I looked it up and found Lys-Glu-Arg as one of these compounds. Then it made sense.
Similarly I had no opinion of cannabis until I found endocannabinoids such as anandamine and diagrams of receptors whereby medical marihuana became the fraud I always suspected it to be.
There really are such things as electrons protons atoms molecules and polymers of fat sugar and amino acids.
So after forty years medicine begins to make some sense.
Believe it or not a hundred years ago most serious scientists doubted the existence of atoms!
Not disconnected bunch of myriad suppositions but a grand scheme of real facts through organic and biochemistry.
I always say that in thirty years we will have all the answers. Actually I think that not even in three hundred.
In the meantime we have to go with what sounds rational based on at least a modicum of science.