Woe is Wheat

(Shirt available at Cafe Press)

I don't eat wheat as a general rule, and the reasons I don't are circumstantial, to be sure.  The most compelling reasons to me are all those healthy non-wheat eating cultures.  Read enough of Food and Western Disease: Health and nutrition from an evolutionary perspective, or The Primal Blueprint: Reprogram your genes for effortless weight loss, vibrant health, and boundless energy, or Dangerous Grains: Why Gluten Cereal Grains May Be Hazardous To Your Health, and wheat just doesn't seem tasty anymore.  If it ever did.  Well, maybe in a pizza.

However, the beautiful Ms. Minger has used the (admittedly fairly useless) China Study data to make the smokey fire around wheat flare up again.  The handsome Dr. Guyenet has a reasonable overview at his site.  (Hmmm... there seems to be a strong correlation between non-wheat eating blogging and good health and good looks.)

And, very recently, Dr. Rodney Ford published a paper where he makes an argument that there should be a medical condition labeled "The Gluten Syndrome,"  and that everyone with many common neurological and psychiatric conditions (such as ataxia, hypotonia, developmental delay, migraine, depression, anxiety, etc.) be tested for gluten sensitivity via the IgG anti-gliadin antibody.  His reasoning being that IgG antigliadin positive people can have negative intestinal biopsies (if they have latent disease or patchy involvement of the intestine), and they can also have negative IgA tTG testing (another pretty specific celiac antibody test) and still have improvement in symptoms on a gluten free diet.

While looking into the matter, I stumbled upon a very good paper called Neurological complications of coeliac disease: what is the evidence?  If you have institutional access, I highly recommend checking this one out.  It has some nice suggestions for teasing out biases and inaccuracies in research papers, and it has a good review of the pathophysiology of celiac disease.   Neurologists are one of my favorite species of doctor, as they tend to be brilliant and cranky*, and these authors point out very fairly that the evidence linking gluten exposure to ataxias, certain types of epilepsy, and peripheral neuropathy is often poor and contradictory.  Bless their clinical hearts, though, they end up recommending a trial of gluten-free diet for anyone who's game, educated about the type of data there is, and who has a positive celiac biopsy or positive celiac or gliadin antibody testing for those with certain neurologic conditions, recognizing that the harm of a gluten-free diet is minimal, and there are some case reports where going gluten-free improved ataxias, peripheral neuropathy, and seizures.


I have the same take with schizophrenia - the indirect evidence is damning, the direct not as much, but enough case studies and small studies to suggest that at least some (especially new onset) schizophrenics could really benefit from a gluten-free diet.  And seeing as how we are dealing with a progressive, devastating brain illness with no cure, it seems fair to give patients and families the option and explaining the data.  For most it won't make a difference, but for a few... I wouldn't hold off medication for a new onset psychosis to try a gluten-free diet, though. 

I'm not sure about testing everyone with depression and anxiety (or schizophrenia) for IgG or IgA ani-gliadin, or even IgA tTG.  I'd probably just recommend the gluten-free diet trial idea to anyone interested.  Mostly it's the schizophrenia data that puts me in this mindset.  All sorts of anti-wheat antibodies were found in the serum and urine of schizophrenics, after all, but most of them were entirely different than the celiac antibodies.  Until we know more about what to test for, I think you risk giving someone with a negative test a false sense of security about gluten.

No classical music link this week.  Nope.  It's a holiday weekend and there's a hurricane coming, and that calls for something a little more modern.

I'll still be blogging over the weekend, though.  Did you know that in a study of 52 patients with Huntington's disease (invariably fatal genetic autosomal dominant ataxia condition), 44% had a positive IgA or IgG (or both) anti-gliadin antibodies?  The general population is about 4.8% positive.  Wild, huh?  (No, don't jump on that and say OMG WHEAT causes HUNTINGTON's because that might not be what it means at all.  But still, pretty wild). This means a post on evolution, Iceland, genetics, anthropology, and even a mention of poor Dr. T. Colin Campbell. In the mean time, keep eating meat, fish, veggies, and a bit of fruit and nuts.

*Neurologists are almost always right handed.  The field of psychiatry has more left handers (I have no source for this and it may be an urban medical myth).  There was a Nova episode last year about Oliver Sachs (famous neurologist) and music.  In it he admitted to preferring Bach to Beethoven.  I think that is the very definition of a neurologist.