Grainy Issues
For some people, wheat may do more harm than good

By Melissa Diane Smith

Americans love their bagels and pasta, which may explain why U.S. consumption of grains has increased more than 60 pounds per person per year since the late 1970s. The USDA-recommended six to 11 daily servings of grains has long been accepted as standard. But because all this starchy eating parallels an increase in obesity and Type II diabetes rates, a growing number of researchers and health professionals are advising against the standard amount. To top it off, additional health concerns have been linked to wheat, including allergies and intestinal disorders. Because of these factors, many people are steering away from wheat and replacing it with vegetables or nonwheat grain substitutes.

If you're considering reducing or eliminating wheat from your diet, the following information may help you make an informed decision. Be sure to consult your health care practitioner when making any major dietary change, or if you notice persistent health problems.

Weighing Wheat
There's a chance wheat may be the culprit if you're overweight and have trouble taking off the pounds. Products such as pasta and bread pack on weight because they have four to 40 times more carbohydrates and calories per cup than nonstarchy vegetables, such as salad greens, broccoli, asparagus, and mushrooms. Wheat products are also high-glycemic foods: They quickly raise blood sugar levels, which increases production of the fat-storage hormone insulin. Researchers believe that a diet heavy in high-glycemic grains actually increases hunger, prompting you to eat more calories throughout the day (Pediatrics, 1999, vol. 103, no. 3).

Limiting wheat products may also reduce your risk of more serious diseases, according to David S. Ludwig, MD, PhD, assistant professor of pediatrics at Harvard Medical School and director of the Optimal Weight for Life program at Children's Hospital in Boston. Because wheat and other grain products are high in carbohydrates and rate high to moderate on the glycemic index, they set off a cascade of events that can increase the risk of Type II diabetes and cardiovascular disease (Journal of the American Medical Association, 2002, vol. 287, no. 18). Eating low-glycemic vegetables, fruits, and legumes may help slow the rising incidence of diabetes among Americans, a condition that has increased an alarming 33 percent between 1990 and 1998 (Diabetes Care, 2000, vol. 23, no. 10).

Allergy Alert
Wheat is a common allergen and contains more than 80 different components that can cause a negative reaction (Rapid Communications in Mass Spectrometry, 2000, vol. 14, no. 10). Some people have a classic food-allergy reaction to wheat—for example, a rash appears quickly after eating it—but most wheat-sensitive people have more subtle, delayed-onset reactions, such as postnasal drip, sinus congestion, or joint aches one to three days after eating wheat. To determine if wheat sensitivity is the cause of persistent symptoms, eliminate wheat from your diet and track improvements. You can also ask your doctor to perform a blood test for immunoglobulin (IgG) antibodies to wheat.

Ironically, some wheat-sensitive individuals crave wheat products and have trouble not overeating them. Wheat products contain opioids, substances with amino-acid sequences very similar to those in narcoticlike drugs. These substances can set the stage for addictions, overeating, and binge eating in people with undetected wheat sensitivity, says James Braly, MD, author of Food Allergy Relief (Keats, 2000).

Perhaps you've noticed adverse reactions when you eat not only wheat but all grains containing gluten, a collection of proteins also found in spelt, kamut, rye, triticale, barley, and possibly oats. Any negative reaction to gluten is classified as a sensitivity, whereas a severe reaction to gluten—called celiac disease—leads to intestinal damage and poor nutrient absorption. It's estimated that one in 111 American adults has celiac disease (Journal of Pediatric Gastroenterology and Nutrition, 2000, vol. 31, suppl. 3). And one in every two Americans may have gluten sensitivity, according to Kenneth D. Fine, MD, director of the Intestinal Health Institute in Dallas, Texas. Common symptoms of either condition include gastrointestinal bloating and upset, persistent diarrhea or constipation, autoimmune diseases, and nutrient deficiencies. If you fit the profile for either of these conditions, ask your health care provider for blood tests or stool tests that measure gluten antibody levels.

Making The Choice
People who stop eating wheat often worry that they won't get enough essential nutrients. Yet if you watch your diet, this should not be a problem. "One of the great dietary myths in the Western world is that we need whole grains for health," says Loren Cordain, PhD, author of The Paleo Diet (John Wiley & Sons, 2001). Many nutritionists assert that even without any grains, it's easy to consume a nutritionally balanced diet from vegetables, fruits, fish, meats, and nuts (Journal of the American Nutraceutical Association, 2002, vol. 5).

If you're hoping to control your weight, simply reducing your intake of wheat may suffice. But if you have wheat allergies or sensitivities, strong wheat cravings, celiac disease, or gluten sensitivity, it's important to avoid all traces of wheat, including those hidden in foods such as soy sauce, cream sauces, and soups. Even small amounts of wheat can cause adverse symptoms and prevent the body from healing.

Continuing to eat wheat may be the right choice for you, but if you decide to be wheat-free, try replacing wheat products in your diet with nongluten options, including amaranth, buckwheat, corn, quinoa, and teff; or with rice and rice products, such as wild rice, brown rice bread, and brown rice pasta. But make sure to follow the age-old advice: Eat your fruits and vegetables. That's a surefire strategy for getting the nutrients you need and optimizing good health.

Melissa Diane Smith is a Tucson, Arizona-based nutritionist and author of Going Against the Grain</=I> (Contemporary Books, 2002).