Sunday, July 22, 2012

Since when did GLUTEN become the enemy?

     Cases of Coeliac [see-li-yac] Disease have been recorded as early as the 2nd Century AD but only in WWII did a Dutch pediatrician tracking children with the condition notice that they seemed to be doing better during that time when wheat, barley and rye were restricted in war rations. He noted they took a turn for the worse after the war when supplies of these grains resumed. He proved the relationship between the protein present in these 3 grains – GLUTEN and the disease. This clinician, Willem Dicke, was the first to propound and frame guidelines for the gluten-free diet.

     While there have been numerous cases in the West, the incidence of a milder form of the condition, Gluten Intolerance as well as the full blown disorder in India have become a household discussion topic with many people now thinking that going gluten-free is the healthiest option.

     As a nutritionist facing questions about this topic from the people I counsel, I observe these trends with alarm – how is this information overload landing on the general public? The question in fact is - are the people reading these materials now educated about the condition? Are people recognizing their previously inexplicable symptoms and getting themselves and family members screened for the condition?

     I hope, at least, the latter is being accomplished because this is a serious disorder with serious health consequences if it remains undiagnosed. Research is now examining coeliac disease as a possible cause for osteoporosis, liver problems apart from anaemia and other nutrient deficiencies and their impacts.

      It is evident that, like Diabetes and Heart Disease initially in India, cases of coeliac disease and gluten intolerance largely go undiagnosed because of lack of awareness and unavailability of inexpensive large scale screening processes. Coeliac disease and Gluten intolerance cannot occur without genetic predisposition. We must develop simple, cost effective DNA tests to determine this tendency.

     Having said this, delving into research on the subject is dissatisfying for someone who’s interested in prevention. Not enough research is being done to answer several basic questions:

  • -          If a person is genetically predisposed, are there aggravating dietary factors which result in onset of symptoms? A possible avenue for deeper research could be the dependence on refined wheat (maida) – eating maida based junk food and maybe an unhealthy diet, especially low in whole grains, fruits and vegetables in general.
  • -          Continuing with this train of thought, is it a coincidence that the rise in prevalence of this condition through the ages is proportional to the extent which refined wheat flour based foods and unhealthy eating habits have become predominant globally?
  • -          If there are such aggravating factors, in the same genetically predisposed person - what are the effects of a multiple whole grain, healthy, balanced diet implemented as early as possible?
  • -          If a newborn is diagnosed with genetic predisposition, can it be symptom - free if breast fed exclusively for 6 months and introduced to wheat only after a year of life? Also, could life-long adherence to a multiple whole grain, largely natural, unprocessed, high fiber, balanced diet where wheat is an occasional inclusion be the answer to prevent symptoms from ever occurring?
     Ask people who follow a multiple whole grain diet (including wheat, whole rice, oats and millets) ingesting plenty of vegetables, fruits, legumes and whole pulses, nuts and dry fruits, etc with minimal junk food intake (such people do exist – including yours truly and extended family) whether they suffer from any digestive disruptions and the answer would be a resounding NO.

     For those of you who are pregnant or have young children, you need to know that research has proved that exclusive breast feeding for the first 6 months of life and continuing to breast feed in the weaning period while introducing wheat among other whole grain cereals not only decreases risk of gluten related disorders in later life, it also provides protection against other auto-immune conditions such as Down’s Syndrome, Insulin Dependent Diabetes, Systemic Lupus and Multiple Sclerosis. This is one of the reasons why in India, where extended breastfeeding is the norm, symptoms of sufferers start later in life and are generally much less severe than any Western nation.

     For a disease condition which only has a simple dietary solution (exclusion of gluten and gliadin containing foods - wheat, rye, barley and a few others), an entire industry has been built around it. From healthcare to publishing, from food manufacturing to media – millions, if not billions of dollars are made annually worldwide. So it is profitable to many to keep Coeliac Disease and Gluten Intolerance fresh in the minds and conversations of the public. If people, who have no business going gluten-free, want to do so, this industry welcomes them with open arms and tries to fan that flame as well with books and endorsements made by people who profit financially from doing so.

     Let’s be clear – going gluten-free or eliminating wheat completely from the diet has absolutely no benefits for a family or an individual having normal digestive health. Go ahead and include chapathis, whole wheat bread, daliya, etc in your diet. Just make sure you include the other whole grains mentioned above as well (you can also eliminate white rice and switch to red or brown). While you’re at it, limit consumption of maida and it’s products to an absolute minimum. Cereal grains are important in the Indian diet but aren’t the only components – eat a well balanced diet.

     One of the reasons that people (with average digestion) who go gluten-free report dramatic improvements is because they probably evaluate and healthily modify their eating habits, cut out maida products (which translates into most junk food) and include more varieties of whole grain cereals apart from other healthy practices. Anyone would show results if he/she did this.

     Switch off those alarm bells that have been ringing for some time – ignore this hype completely! Everyone just take a deep breath and relax. Don’t allow this topic to create any more stress or doubt for you than it already has. However, this is a great time to start to educate yourself with hard facts about what you can do to improve your family’s nutrition, health and fitness.

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