What is wheat?

Wheat is a highly nutritious and useful grain. It is one of the top three most produced crops in the world, along with corn and rice. Wheat is a major source of many nutrients, including dietary fiber, several B vitamins (thiamin, riboflavin, niacin, and folate), and minerals (iron, magnesium, and selenium).

Although wheat, is rich in fiber, minerals, vitamins and nutrients, guess what? You can get too much of a good thing! We need about 20 to 30 grams of fiber per day for good health. If you want to introduce texture to your formerly limited/no fiber diet, add it gradually to avoid any adverse outcomes such as abdominal pain and increased flatulence (gas). Moreover, 50 or more grams of dietary fiber eaten in a day counters its benefits, it may decrease the number of minerals your body absorbs, especially zinc, and iron, magnesium, and calcium.
Furthermore, the elderly or those who have had gastrointestinal surgery should proceed at a slow pace when adding fiber to the diet. They are especially vulnerable to gas, bloating, diarrhea, constipation and poor absorption of nutrients.

One more thing – wheat is not for every body!

Who should not eat wheat?
People with gluten intolerance/gluten sensitivity or wheat allergy have good reason to avoid wheat.

What is gluten?
Gluten is a binding protein in wheat that helps glue carbohydrates together. It gives the dough the glue-like, elastic and smooth property that some of us love in bread. Gluten makes pizza stretchy. Glute is found in wheat, rye, barley, durum, emmer, spelt, farina, faro and certain other grains.

Several grains are naturally gluten-free e.g. rice, corn and popcorn, quinoa, amaranth, buckwheat, millet, sorghum, teff, and oats (as long as they haven’t been contaminated with wheat during processing). Rice, millet, sorgum (aka guinea corn) are locally grown in different parts of Nigeria and they are good wheat/gluten-free alternatives.

What is gluten intolerance?
Gluten intolerance occurs in some people if they eat products containing gluten and they experience improvement when following a gluten-free diet. Gluten sensitivity is different from celiac disease; though it can cause symptoms similar to celiac disease.
Food sensitivities and intolerances do not involve the immune system. Either food triggers an intolerance in your digestive tract, where your body is unable to break it properly, or the body reacts to food you are sensitive to such as wheat in this case or lactose in some other cases.

Causes of food sensitivity or intolerance may be due to a variety of reasons, such as:
• Not having the right enzymes needed to digest a particular type of food
• Reacting to food additives such as sulfites or artificial colors
• Recurring stress or psychological factors – sometimes the mere thought of food may make you sick. The reason is not entirely understood.
• Pharmacological factors, like sensitivity to caffeine or other chemicals
• Sensitivity to the toxins, naturally found in certain raw legumes like lima beans
• Irritable bowel syndrome – this chronic condition causes cramping, constipation, and diarrhea.
• Food poisoning caused by toxins from bacteria in spoiled food can cause severe digestive symptoms.

The symptoms of intolerance are all digestive-related and can include: gas and bloating, diarrhea, constipation, cramping, or nausea. But symptoms of food sensitivity vary. Unlike celiac disease, gluten sensitivity is not an autoimmune disorder, neither does it cause damage to the small intestine or elevate antibody levels in the blood. Gluten sensitivity is also not an allergic reaction.

How is gluten sensitivity/intolerance diagnosed?
Presently, there is no objective test for diagnosing gluten sensitivity, so a diagnosis of exclusion is often used, and other disorders are also ruled out. An elimination diet is used, followed by the reintroduction of gluten-containing foods to assess if health improves with the absence of gluten from the diet.

Symptoms of gluten sensitivity/intolerance
Symptoms of gluten intolerance include but not limited to which causes symptoms such as diarrhea, bloating, cramps, weight loss, fatigue and more. Apart from this, there doesn’t seem to be any particular reason to take wheat out of our diet. Eating in moderation, and variety again is key, choose healthier whole wheat products that are minimally refined or unrefined, and don’t go overboard.

Treatment of gluten sensitivity
Previously, a gluten-free diet had many benefits because it required increasing fruit and vegetable intake—therefore people felt better eating gluten-free: no more unhealthy bread products, no more fast food restaurants. Now, there is just as much gluten-free junk out there.

What is a wheat allergy?
An allergic reaction is an immune response to a normally harmless substance. Thus a wheat allergy is an allergic response to foods containing wheat. When an individual with a wheat allergy ingests wheat, their body produces an antibody which attacks the material. Usually, the severity of these allergic reactions may range from life-threatening anaphylactic shock and difficulty breathing to itching, swelling, rash, nasal congestion, diarrhea, and abdominal cramping. Treatment is avoiding of wheat generally, but medications may also be used if wheat is ingested by mistake.

The difference between wheat allergy and celiac disease:
1. Children can outgrow wheat allergy but not celiac disease
2. In celiac disease one particular protein in wheat, i.e., gluten causes an abnormal immune response with leads to damage of the small intestine.

What is celiac disease?
Celiac disease is an autoimmune disease, not a food allergy nor sensitivity. It is also known as gluten-sensitive enteropathy or non-tropical sprue.
The cause of celiac disease is unknown. It tends to occur more prominently in individuals from Europe, North and South America, Australia, North Africa, the Middle East and South Asia. It is found rarely in other parts of Asia or sub-Saharan Africa thus in the past was called Western disease.

Symptoms of celiac disease
In people with this genetic disorder, gluten provokes an autoimmune response that damages the small intestine causing symptoms such as diarrhea, bloating, cramps, abdominal pain, weight loss, fatigue and loss of appetite. Additionally, recent research has also shown a plausible link between gluten sensitivity and infertility. So, if you have celiac disease, then you have one good reason to avoid wheat. Although celiac disease is not common in Nigeria, we are beginning to see conditions with similar symptoms and these have been attributed to our newly adopted Western lifestyle, the over-use of antibiotics, antacids and certain painkillers. The overuse of these medications are suspects in damage to the gastrointestinal tract and beneficial gut flora, especially when combined with our low-fiber, high-sugar diets. This damage could lead to the development of celiac disease and gluten intolerance or sensitivity and the resultant inflammation.

Celiac disease can begin at any age and occurs more often in people of European descent and women. Many people with it go undiagnosed or are misdiagnosed, however, because there may be no gastrointestinal symptoms—and when there are symptoms, they’re often nonspecific (that is, they could be caused by many disorders). Celiac disease causes malabsorption of key nutrients, notably calcium and iron, so it can lead to osteoporosis, anemia and other serious health problems. People with it are also more likely to have other autoimmune disorders, such as psoriasis, lupus, Crohn’s disease and certain types of thyroid condition.

What other conditions present like this?
Some people who continue to have symptoms even after changing their diet may have other conditions or disorders that are more common in people with celiac disease. These conditions may include:
• Small intestinal bacterial overgrowth, which happens when too many bacteria grow in the small intestine as a result of antibiotics misuse or abuse
• Pancreatic exocrine insufficiency, in which the pancreas does not produce enough digestive juice
• Microscopic colitis, an inflammation of the colon
• Irritable Bowel Syndrome
• Lactose intolerance, a condition in which people have symptoms after consuming milk or milk products
• Other food intolerances, which may occur because of continued damage to the intestine
• Neuromuscular disorder like gastroparesis a complication of long standing type 2 diabetes
• Pelvic floor dysfunction

How is celiac disease diagnosed?
To make a diagnosis, a formal evaluation currently involves blood tests and a small intestinal biopsy. If the evaluation is positive, then a gluten-free diet is necessary. If it’s negative, it’s best to try a healthier diet with more fruits, vegetables, whole grains, and beans while avoiding processed junk.
Few people are properly diagnosed for gluten problems, however, many are undoubtedly going on highly restrictive diets unnecessarily. It’s best to consult an experienced registered dietitian if you have or think you have celiac disease. If a healthy diet doesn’t help, then the next step is to try ruling out other causes of chronic gastrointestinal distress.
In some cases, people continue to have difficulty absorbing nutrients despite following a strict gluten-free diet. People with this condition, known as refractory celiac disease, have severely damaged intestines that cannot heal. Their intestines are not absorbing enough nutrients, so they may need to receive nutrients intravenously.

Conclusion
Whole wheat helps in preventing both heart diseases and cancer. It helps improve insulin sensitivity thus preventing diabetes. Although the adverse effects of wheat on some individuals should not be ignored, the consumption of whole grains, generally exerts positive effects on health. However, individuals who have a genetic predisposition for developing celiac disease or who are sensitive to gluten and/or allergic to wheat will benefit from avoiding wheat and other cereals containing related proteins.

If you feel wheat is causing you some problems, try eliminating it from your diet for a month or two. No current data suggests that that general population should maintain a gluten-free lifestyle, but for those with celiac disease, a wheat allergy, or a sensitivity diagnosis, gluten-free diets can be a lifesaver.

Thank you for reading this article. What was your take home?

Wishing you good health and happiness,

Dr Nse Onyebuchi

Author: Dr. Nse