Friday, October 10, 2014

Go Gluten Free or Not?

Lots of people are going gluten free. In this post Fiona Willer argues that many people, especially young women, are doing so unnecessarily. In particular, she (and just about everyone else, like this guy) refer to a really neat study that experimentally isolated gluten and other components of grain, and determined that gluten was not responsible for intestinal symptoms. Instead, the culprits appear to be a group of short chain carbohydrates collectively known as "Fermentable, Oligo-, Di-, Mono-saccharides And Polyols.", or FODMAPs, that are poorly absorbed in the small intestine. However, it turns out that FODMAPs are found in things that also contain gluten (wheat, barley etc. as well as some fruits and vegetables). So if you avoid gluten ... In addition, restricting gluten containing foods will reduce your carbohydrate load, which helps with blood glucose control.

I found it interesting that Dr. Willer's argument for NOT avoiding gluten is that avoiding gluten might lead one to eat less wheat flour fortified with folate. Wait. You want me to eat wheat flour not for itself, but because it has something else added? I can take a multivitamin for that ... or you know, eat all sorts of real foods that naturally contain folate.

In 2012 I shifted my diet to reduce carbohydrates in response to being diagnosed as a Type 2 diabetic. Although this eliminated bread and beer, my 2 main sources of gluten containing carbohydrate, it did not eliminate gluten altogether. As a vegetarian, I was very keen on finding protein sources with relatively low carbohydrate, and many of those include wheat gluten as an ingredient. So, I reduced my consumption of lentils and chickpeas in favor of tofu and seitan, and processed foods containing soy and wheat protein. I lost ~25 pounds and brought my blood sugar back under control as a result.

Fast forward to spring 2014, and I finally got around to reading David Perlmutter's book "Grain Brain". Now that's a scary read. And although critics like Fiona Willer diss the book as "Alternative Medicine", I found the references to the scientific literature more compelling than that. As a result, I took a hard look at what I was eating, and went one step further, purging products containing wheat gluten from my diet. So, N=1 remember, and the plural of anecdote is not data! But here's my anecdote anyway. To borrow a phrase from the video linked above, my "satisfaction with stool consistency" dramatically improved, and more significantly, I felt better emotionally than I had in years. 

I had taken antidepressants for about 5 years, and I would occasionally forget to take my tablets in the morning. Typically I would start to feel withdrawal symptoms within a few hours of forgetting ("brain zaps"). A couple of months after I removed gluten from my diet I realized I was forgetting to take my antidepressant, and not experiencing any symptoms at all! With the support of my doctor, I began reducing the dosage of antidepressant, and 6 months later I've stopped altogether. And I feel great. 

So, I eliminated gluten, and coincidentally FODMAPs, and I feel good. Was there a cause and effect? I don't know. I'm not going to put gluten/FODMAPs back in my diet though. Your mileage may vary!

And here's a little (NSFW) light humor on Gluten courtesy of Southpark. It's not that bad. Really. It won't fly off. 

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