As an alternative health care provider (chiropractor), I’ve been studying and practicing clinical nutrition for the better part of 30 years.  Given the dietary recommendations over the years, food products/supplements offered and fads — the information can seem contradictory, confusing and frustrating.

First of all, we can simplify clinical nutrition significantly.  We are descended from hunter-gatherers and have inherited their gastrointestinal, immune and neurologic systems.  They had highly varied diets of roots, tubers, nuts, fruit, fish, fowl and meat from animals … and perhaps, occasionally eggs.  They had no access to wheat, dairy or refined sugar.  What it seems to have come down to is; eat like they did.  How come?  … Well, we’re looking at the tip of the iceberg, but here we go.

Let’s stick with wheat and leave dairy and refined sugar alone for now.  Through active selection and hybridization, in the US, over the decades we have developed wheat with higher and higher gluten content — which moved us from the flat breads we ate a centuries ago to the thick, chewy, gooey wheat based products we all love.  In order to make processing faster and cheaper, the gliaden portion of gluten was deamidated (removal of an amino acid).  This hybridization and deamidation has produced a wheat that has turned out to be inflammatory to humans. (1,2,3)

Much of this processing accelerated in the mid to late ’90’s so it took a while for the impact to develop, be recognized (by some) and for some health care providers to begin to respond.  Unfortunately, although the effects of gluten/gliaden and the presence of celiac and non-celiac gluten sensitivity is well represented in the literature, many providers are not reflecting this in their practices.  This includes my field, the nutritionists, naturopaths, osteopaths and MD’s.

Anyway, systemic inflammation has essentially been linked to diseases (cardiac, diabetes, hypertension, hypercholesterolemia, cancer, obesity, skin diseases, phychiatric problems etc.).  I did a PubMed search to pull up a reference on this connection.  Under “inflammation and disease” there were 177,571 references:http://www.ncbi.nlm.nih.gov/pubmed/?term=inflammation+and+disease.  I tried to dial it down and entered “inflammation and illness” and 17,701 references came up.  Of course, not all will agree, but this connection is well established.  Since the gluten/gliaden (especially deamidated), have been shown to cause systemic inflammation, it is now recognized that by that pathway, it is causing disease. (4)

Additionally, there are individuals with gastrointestinal symptoms, who identify the connection with gluten.  Unfortunately, only a third of people with gluten sensitivities suffer from gastrointestinal problem.  Many others suffer from “extra-intestinal manifestations” that effect the brain, nervous system and other organs. (5, 6)

Not all articles/authors will agree, but this is a topic being rigorously explored, both in the literature and in the field.

Shawn Phelan, DC, FICCWake Forest Chiropractic

1.  Yuan Z, Liu D, Zhang L, et al.  Mitotic illegitimate recombination is a mechanism for novel changes in high-molecular weight glutenin subunits in     wheat-rye hybrids.  PLoS One. 2011:6(8):e235112.  Molnar-Lang M, Kruppa K, Cseh A. et al.  Identification and phenotypic description of new wheat: six-rowed winter barley disomic additions.  Genome. 2012 Apr;55(4):302-113.  Szakacs E, Molinar-Lang.  Identification of new winter wheat — winter barley addition lines (6HS and 7H) using fluorescence in situ hybridization and the stability of the whole ‘Martonvasri 9 kr1’ — ‘Igri’ addition set.  Genome.  2010 Jan;53(1):35-444.  Vojdani A, O’Bryan T, Kellerman GH, et al.  The immunology of immediate and delayed hypersensitivity reaction to gluten.  European Journal of Inflammation 2008;6(1):1-105. Admou B, Essadouni I, Krati K, et al.  Atypical celiac disease: from recognizing to managing.  Gastroenterol Res Pract.  2012; 2012:637187, EPub 2012 Jul 3.6.  Grossman G.  Neurological complications of coeliac disease: what is the evidence?  Pract Neurol.  2008 April;8(2):77-89

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