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Will Eating a Gluten Free Diet Be Good if I Have Diabetes, Graves', or Heart Disease?

What is the difference between a gluten free diet and a wheat free diet, and is avoiding wheat-based foods a good way to improve thyroid disease or cardiovascular health?

No matter what ails you, your health may improve when you replace wheat (and foods that contain gluten) with less processed grains, fruits, vegetables and heart-healthy types of protein.

Three years ago, Felice Caldarella, MD, an endocrinologist from Clinton, NJ, was suffering from frequent digestive distress. Despite being healthy, he alternated between having diarrhea and constipation, often feeling bloated, and struggling to stay focused. His symptoms were most pronounced on the weekends when he would typically have a couple of beers. Wondering if it might be something in his diet, he decided to try eliminating wheat to see whether it might make a difference.  

You can be gluten free and still enjoy sourdough or sprouted wheat breads.

Going Wheat-Free and Avoiding Gluten Can Restore a Sense of Wellbeing

Beer, which contains wheat, was first to go. Dr. Caldarella also stopped eating anything else that contained wheat or gluten (a protein found in many grains, including wheat, rye, and barley), including salad dressings and soy sauce. Within two weeks, his gastrointestinal symptoms disappeared.  “I am back to feeling normal and I am symptom-free,” he says.

Millions of Americans like Dr. Caldarella have made the decision to eliminate gluten-containing foods from their diet even though they do not have celiac disease. In fact, the number of people in the US without celiac disease who appear to suffer from a wheat-based intolerance have eliminated gluten-based foods from their diet has grown to the millions. 1

These individuals often experience symptoms such as abdominal pain, bloating, diarrhea, and a “foggy mind” but they don’t test positive a digestive disorder. When eliminating wheat-based foods from the diet resolves their symptoms, these people may assume (or be told) they have either non-celiac gluten sensitivity (NCGS) or non-celiac wheat sensitivity (NSWS).

However, scientists are divided over the true diagnosis in so many individuals who have decided on their own to swear off wheat, says Jane Varney, PhD, a research dietitian in the Department of Gastroenterology, Central Clinical School, at Monash University in Melbourne, Australia.

Modern Wheat Has Evolved from the Wheat Grown 50 Years Ago

“While some scientists think that many of these individuals are experiencing a reaction to gluten, others question the diagnosis of NCGS/NCWS and think that other components in wheat (namely, the FODMAPs, which is the acronym for Fermentable Oligo-, Di-, and Monosaccharides and Polyols, may be triggering GI symptoms and that often times this group of individuals is suffering from irritable bowel syndrome (IBS),” Dr. Varney says.

A sensitivity to wheat or foods that have gluten may develop, but wheat contains more than one potential culprit that can bring on bothersome gastrointestinal symptoms, says Amy Hess-Fischl, a program coordinator for the Teen and Adolescent Diabetes Transition Program at the University of Chicago’s Kovler Diabetes Center. In addition to gluten, wheat contains other proteins and carbohydrates that may play a role in triggering GI distress in susceptible individuals. “It does seem that experts cannot pinpoint the one reason for this influx of symptoms,” says Ms. Hess-Fischl.

Wheat is being bred differently today than it was years ago, says Victoria Maizes, MD, executive director of the University of Arizona Center for Integrative Medicine in Tucson, Arizona, and it’s much higher in gluten than it once was. “Also, we used to ferment bread dough very slowly, which breaks down gluten,” she says. “but now it’s common to use a rapid rising yeast, and so the dough is not fermented overnight.”

Some research shows that modern forms of gluten are more difficult for the body to digest than the grains raised four to seven decades ago, says Melanie Boehmer, RD, of Lenox Hill Hospital in New York City. “In essence, what has happened is that modern processing techniques isolate the wheat proteins (gluten) and add them to products like semolina pasta without the enzymes that naturally occur with them that are needed to help our bodies break them down during digestion,” she says.

Consider Using FODMAPs as a Guide to Better GI Health

Wheat products tend to be high in certain FODMAPs, Dr. Varney explains. In particular, the FODMAPs known as fructans and GOS (galactooligosaccharides found in legumes and dried beans, soy milk, and nuts) can cause digestive issues in people with IBS. “These small carbohydrates move slowly through the small intestine, attracting water along the way,” she says. “Some pass undigested into the large intestine, where they are fermented by gut bacteria, producing gas. The increased water and gas in the intestine can cause the intestinal wall to stretch and expand, causing pain," she says.

A low FODMAP diet may be prescribed for individuals who have irritable bowel syndrome, Varney says.  Reducing FODMAPs in the diet can help in two ways, she explains. Choosing diet reduces water movement into the small intestine and reduces gas production from the bacterial fermentation of FODMAPs, she says. And this helps reduce IBS symptoms like abdominal pain, bloating and distention, diarrhea, and possibly constipation, according to Dr. Varney.

Evaluating the low FODMAP diet has also been trialed in women with endometriosis, athletes who have GI symptoms during strenuous exercise, nursing mothers of infants who have colic, and people with have other functional gastrointestinal disorders. Initial research suggests it may also be helpful to consider avoiding FODMAPs to lessen IBS-type symptoms, says Dr. Varney.

For those who want to try to eliminate wheat or gluten from the diet, start by talking to a doctor, she says. There is a range of conditions that may be contributing to gastrointestinal symptoms and it is important that these are ruled out and a diagnosis is made before dietary modifications are commenced, she says.

Going gluten-free is more than just cutting out gluten, Boehmer says. “It’s a lifestyle change and involves more than just buying gluten-free products at the supermarket,” she says. She recommends working with a registered dietitian who will help you create a plan that replaces sources of gluten with other healthy carbohydrates and high-fiber goods. “If going gluten-free helps you to eat more whole, single-ingredient foods like fruits, non-starchy vegetables, and lean protein sources, then you are doing it right,” says Dr. Varney.

Also, gluten-free foods are not necessarily healthy, Dr. Maizes says. Flours that are made with white rice and tapioca may be gluten-free, for instance, but they can cause a rapid rise in blood sugar and are not a good source of nutrients. “There is a huge food industry now producing gluten-free foods,” she explains. “Some are probably healthy but most of them are not.”

What're the Differences Between Wheat and Gluten?

Gluten is a protein found in wheat as well as rye and barley. Wheat-free doesn’t necessarily mean gluten-free. Commercially-brewed beer is a good example because it is often made from barley. However, barley may be present, or hidden, in foods because it used as a sweetener or malt flavoring, so an oat cookie—oats do not contain gluten—that have barley malt would be wheat-free but not gluten-free. Spelt, a form of wheat that is considered to have less gluten than wheat but isn’t completely gluten-free.

Most of our flour, specifically wheat flour, has been milled, processed and bleached to remove any valued nutrients most especially dietary fiber. And then it’s used as the base for prepared goods like cookies, cake, brownies, and candy. What else do all of these baked goods have in common: sugar, another reason to avoid wheat-based foods and those containing gluten.

The question becomes one of physical response: do you need to avoid gluten or are you just better off avoiding wheat and flour-based foods to improve your overall diet, benefit from easier weight loss, and establish a much healthier way of eating. This is particularly relevant if you have diabetes (even prediabetes or gestational diabetes), seek cardiovascular health, have polycystic ovary syndrome (PCOS), or thyroid disease.

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