I Don’t Know Everything (Part Two of Two)

Question:

“You’re generally good about paying attention to peer-reviewed literature and scientific evidence, which is why I was surprised at your suggestion that people should limit their wheat intake and that ‘eating too much gluten might actually trigger celiac disease.’ What is this based on?”

Answer:

There have been mentions of large amounts of gluten triggering celiac in articles I’ve read over the years. As far as I know, it was all theoretical or anecdotal. The website I linked to in my post, from the National Digestive Diseases Information Clearinghouse, also implied this possibility:

“The length of time a person was breastfed, the age a person started eating gluten-containing foods, and the amount of gluten-containing foods one eats are three factors thought to play a role in when and how celiac disease appears.”

It make sense that the more someone is exposed to something that can trigger an autoimmune reaction, the more likely that reaction is to be triggered. But to reiterate what I said in my original post, this can only happen if someone is genetically predisposed to celiac disease.

It is true that I try to limit my recommendations to peer-reviewed literature, but in many cases it isn’t possible; there are too many things that have not been studied rigorously. In these cases, I have to go with what I believe to be true in giving recommendations, though I should point out when I’m not aware of research verifying what I recommend.

I did not mean to imply that this is a well-established fact, and that is why I said it “might” trigger rather than it “can” trigger. However, when I re-read that sentence, I can see that it might be taken to mean that it definitely triggers celiac in some cases but might not in other cases. So, to be clear — eating large amounts of gluten might never trigger celiac disease, but I tend to think there is a greater possibility that it can.

Finally, I would feel negligent not to let vegetarians know of this possibility given that they could easily eat very large amounts of gluten if they think there is no reason not to do so.

9 Responses to “I Don’t Know Everything (Part Two of Two)”

  1. Melissa Says:

    Thank you so much for raising awareness about gluten sensitivity. This is a crucial but little known dietary issue, especially for vegetarians and vegans. I was a vegetarian for 14 years, but became very sick with digestive problems and an autoimmune disease. My diet at the time was based on whole grains and contained a lot of sietan, soy sauce, and foods with hidden gluten– overall healthy choices, but it turns out not healthy for me. Through research and persistence I learned about gluten intolerance, which matched many of my symptoms. A genetic test revealed that I am predisposed to gluten sensitivity, and a strict gluten free diet has has opened a whole new world to me. I’ve been gluten free for over a year and feel better than I ever have before. It’s a striking difference.

    When people say that they tried being vegetarian but didn’t feel good (and they are being sincere) I now wonder if an increase in their gluten intake may be a factor. Begin a gluten free vegan takes more planning and creativity, but the rewards are worth it. I’d love to read more about your suggestions for gluten free vegan living. And thank you for this great blog!

  2. Johanna Says:

    This is worrisome to me because my brother developed gluten intolerance as an adult, and while he’s doing all right with it, I do not want the same thing to happen to me. And it’s only because of checking ingredients for him that I realized that Tofurky, despite the name, is mostly gluten. I don’t eat a lot of Tofurky, or a lot of seitan, or a lot of any other single gluten-based food, but when you add it all up, I might very well be eating too much.

  3. Jack Norris RD Says:

    If you have been eating this way for a long time, then you’re probably fine. I know I eat a decent amount of gluten. My main concern is for people to consider not eating a wheat-gluten based veggie meat at every single meal. Mix in non-gluten foods when you can to create a balance. But I wouldn’t worry about it so much that the prevention is worse than the disease.

  4. Hugo Pottisch Says:

    Jack – you are doing such a great job reviewing all the research that is coming out in such a genuine manner. Please keep it all coming!

    I have a most burning question regarding one of the, in my opinion, most underrated studies of 2006: Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review by the British Medical Journal.

    It seems to be the most comprehensive systematic reviews ever and the conclusion was, as also reported by the BBC, that: “the British Medical Journal review of 89 earlier studies looking at heart disease, cancer or strokes found no evidence the fats offered protection.”

    What does that mean? Any implications for vegans?

  5. Jack Norris RD Says:

    Thanks for pointing that review out. To my surprise, I did not come across it when recently updating my omega-3 recommendations here. I did come across these two analyses, which are more favorable to omega-3s:


    http://www.ncbi.nlm.nih.gov/pubmed/16825676

    http://www.issfal.org.uk/lipid-matters/issfal-policy-statements/statement-3-pufa-in-adults-7.html

    I plan to read the one you point out as soon as I am able.

    My main concern for vegans is not getting enough DHA for the brain and nervous tissue, and not so much for the cardiovascular benefits.

  6. Hugo Pottisch Says:

    I would be very interested in learning more about the DHA and brain connection. The paper that I have cited does explore all omega 3 acids (also DHA) and has not, as far as I can tell, pointed to any neurological aspects beside the following paragraph:

    “Toxic compounds, such as fat soluble methylmercury, dioxins, and polychlorinated biphenyls, are also found in oily fish and fish oils, but any harm from these compounds would be seen only after long term supplementation.7 8 Animal intervention studies and studies of adults after severe inadvertent exposure indicate that dioxins and polychlorinated biphenyls increase the risk of cancer.9 10 Methylmercury may increase the risk of myocardial infarction and cause neurological damage.”

    What papers would you recommend concerning DHA and the nervous system? (I will also try to find your citations on Veganhealth.org). Have I mentioned what great work you do and that you should keep it coming 😉

  7. Jack Norris RD Says:

    I haven’t done much research into the DHA and nervous system connection. I have scanned PubMed at the abstracts of papers, but haven’t done much more than that.

  8. Hugo Pottisch Says:

    PS: How do other apes get their DHA? I know that some chimps can fish – but most apes do not. Chimps consume the most animal products – 2-4% of calories from insects and 0-2% from animals. The rest is plant based. Where do bonobos, chimps, gorillas and orangutans get their DHA from?

    Personally – I would rather follow their diet than any “cultural” recommendations. After all – what we have evolved to eat over millions of years can count more than the adjustments over merely thousands of years – at least from an anatomy and genetic point of view? An Indian elephant eats slightly different than an African one, a bonobo eats slightly different than a chimp, a house cat different than a tiger… but…

  9. Jack Norris RD Says:

    Hugo,

    There is information on BeyondVeg.com about the diets of non-human primates. It’s been awhile since I’ve read it and it’s on multiple pages and I don’t know that it addresses DHA. My personal opinion is that the evolution of apes and humans diverged long enough ago that significant differences in optimal nutrition have manifested themselves, and the value of looking at the diets of apes, in comparison to the nutrition research that has been performed on humans, is very minimal. And that’s assuming that the most natural diet of humans (if that can even be defined or determined) is the optimal diet for humans, which is probably not the best assumption; diets can be tweaked and improved in unnatural ways.

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