IMC PRACTITIONER ARTICLES

Wheat Product Reactivity: It’s not all about Gluten

by Bob Dozor, MD

The markets I shop at have growing sections full of gluten free products. Clearly they are getting more popular!

Do you need to buy only gluten free products if you feel better eliminating wheat from your diet? Usually not!  Mainly we are talking about bread and pasta. Many people feel better when they eliminate bread and pasta from their diets. The major protein in wheat is gluten. Wheat has been bred (pun?) over the millennia for more gluten, because gluten makes better bread. But wheat also contains other things including carbohydrate and fiber. There are also some vitamins and minerals. Often the carbohydrates are the culprit, not the gluten.

Gluten sensitivity manifests from very mild  abdominal discomfort to severe diarrhea, pain, bloating, weight loss and even blood in the stool. The more severe form of gluten sensitivity is called Celiac disease (or Sprue). Celiac patients really must eliminate gluten from their diets, and they are well served by gluten free products. There are reliable blood tests to detect this condition. There are also people with milder illness who may not have the same blood markers as Celiacs who also benefit from Gluten elimination.

There are many more patients with sensitivity to wheat who in fact don’t benefit from gluten elimination.  The issue for them is really the carbohydrates. Carbohydrates cause trouble in two ways. First, white bread will often cause severe swings in blood sugar, which make people feel like they been through the ringer. Carbohydrates can also ferment in the gut causing disturbances in the bacterial populations of the intestines which in turn can cause bloating and gas. Gluten free products won’t help these people! Usually they don’t have to eliminate wheat, but they feel better if they reduce wheat in their diets

If you are unsure where you stand, your physician may be able to help you sort this out.

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