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    Being Gluten-Free 'Is Determined By Evolution', Says Gastroenterologist
    By News Staff | June 28th 2012 02:57 PM | 29 comments | Print | E-mail | Track Comments

    The evolutionarily recent over-reliance on wheat-based products could be a reason behind the current increases in dietary problems related to gluten, according to an expert in digestive disorders. 

     Professor David Sanders, Consultant Gastroenterologist at the Royal Hallamshire Hospital and University of Sheffield, says, "Only for the past ten thousand years have we had wheat-based foods in our diets, which in evolutionary terms makes wheat almost a novel food. If you put that in context to the 2.5 millions years that mankind has been on earth, it makes sense that our bodies are still adapting to this food, and more specifically, the gluten that it contains." 

    So eat trees, like Australopithecus Sediba did. And wouldn't this gluten issue have happened hundreds or thousands of years ago?  The West has the most balanced diet in world history, with the least dependence on one food type, so why would evolution occur in the new millennium so that wheat was going to be bad for middle-class white people?

     Sanders' comments were prompted following the recent claim that potentially up to 6% of the population[1] could be suffering from gluten sensitivity, making it by far the most common gluten-related disorder[2] after celiac disease. Celiac disease currently affects around 1% of the population, which is an 80-fold increase in reported cases since the 1950s, when only 1 in 8000 were susceptible[3], compared with 1 in 100, today.[4] 

     A recent survey commissioned by the Dr Schär Institute identified that GPs and dietitians frequently see patients with what they believe to be gluten sensitivity but they are uncertain how to manage the condition. Its gastrointestinal symptoms are general and include abdominal pain and bloating, diarrhea, constipation and generic malaise. Headache, fatigue, limb numbness and anemia make for diagnostic difficulties too. The survey found that 90% of dietitians and 86% of GPs claim to be aware of gluten sensitivity but more than half have a limited or average understanding of it. 

     Speaking on behalf of the Dr Schär Institute, dietitian Melissa Wilson, said, "The comments from Professor Sanders and the survey results demonstrate that serious confusion exists when experts try to diagnose or manage gluten sensitivity. GPs and dietitians are telling us that they do not feel there is enough information available, despite reporting a large number of patients displaying symptoms associated with the condition." 

     NOTES:

     [1] Clinic data from Prof A Fasano, Baltimore Clinic, US 

     [2] S. Anna et al. Spectrum of gluten-related disorders: consensus on new nomenclature and classification.BMC journal 7 February 2012 

     [3] Davidson LSP, Fountain JR. Incidence of the sprue syndrome. BMJ 1950;1:1157-61) 

     [4] Sanders DS, Patel D, Stephenson TJ, Milford-Ward A, McCloskey EV, Hadjivassiliou M, Lobo AJ. A primary care cross-sectional study of undiagnosed adult coeliac disease. Eur J Gastroenterol Hepatol 2003;4:407-13. 


    Comments

    Actually "most humans" haven't even been eating wheat for 10 thousand years. In most parts of the world, it was introduced 100 or 200 years ago, after the wheat combine and steamships got invented. Wheat is a hard crop to grow or to ship, and that was more true in the past. My grandparents, in Germany, actually didn't eat wheat much until after WW1. Wheat was considered "rich people food" back then. In Roman times, wheat cost twice as much as barley, so the slaves mostly got barley.

    Another big factor that, that gets mostly ignored, is that in the US, most wheat products have added iron. That added iron is irritating to the digestive tract, and adding an irritant to a food that doesn't digest well, is a great way to induce an immune reaction. That's how vaccines work. The added iron starts out with infant formula, which likely sets the stage for cow milk allergies too.

    Did anyone read this article to see if it made sense? especially the paragraph beginning "so eat trees" and "sanders comments" I've read those several times and am still scratching my head.

    I think the third paragraph was a comment by the "News Staff", about Sander's comments which were quoted in the 2nd paragraph. It was rhetorical I assume, because clearly we aren't adapted for eating trees either (though some of our ancient relatives might have been).

    As for the West having "the most balanced diet in world history" ... hah! Pretty much our entire diet is based on corn, wheat, soy, sugar, dairy. Beef, chicken and pork for meats. And a lot of people eat few or any fruits and vegies. The more traditional diets used a large variety of vegetables and fruits, plus a wide variety of animals (including insects, fish, reptiles, bats, snails, rodents) and some staple starches (yams, grains, legumes). Check out the book "What I eat" for a great snapshot of what other people are eating.

    Gerhard Adam
    As for the West having "the most balanced diet in world history" ... hah! Pretty much our entire diet is based on corn, wheat, soy, sugar, dairy. Beef, chicken and pork for meats. And a lot of people eat few or any fruits and vegies.
    I think the point is that the West has "the most balanced diet in world history" available to them.  Whether they choose to partake or not is a different matter.  If someone fulfills their nutritional needs from McDonald's it isn't a fault in the availability of food.
    Mundus vult decipi
    Hank
    Sure, our ancestors ate trees, as A. Sediba shows. Shrubs too.

    That assertion someone else made that wheat is only in the last 200 years is silly. The Romans lived on wheat and Europe had it as the paramount crop since 1200 AD. There were zero seasons in America since its founding that Americans did not eat grains.  
    Wheat has *existed* as a crop since the times of the Mesopotamians. But if you look at the whole of the world, and whole of the population, only a small percentage of humans actually ate it much. No one in south Africa did, or south Asia, or Australia, or the Pacific islands, or both Americas. Most of Northern Europe had very little wheat also. It was a major crop in the Middle East and Mediterranean area, but barley was probably more common (and cheaper). Northern China grew wheat, but it was a low-gluten wheat.

    America and Canada turned out to be really good places to grow wheat, and that was when "Winter Wheat" came into being. The hard wheat has a higher gluten content, and became prized. In the 1800's, when some farm automation came about and steamships got invented, it was exported all over the world. In the 1900's better farm techniques and breeds gave us a LOT of very high gluten wheat, and bigger yields.

    Anyway, I know for a fact that my personal ancestors didn't eat wheat much, though they prized it when they could afford it. This is also generally true for people that grew up in Ireland or Scotland 100 years ago. Oats were common, but not wheat. It's interesting reading one encyclopedia from the early 1900's. They state that Americans are "more energetic" because they have a superior grain, wheat, which the rest of the world doesn't have much.

    So ... if your ancestors were from the Middle East, France, or Italy, you probably have long-term-wheat-eating genes. Everyone else: not so much.

    Hank
    So ... if your ancestors were from the Middle East, France, or Italy, you probably have long-term-wheat-eating genes. Everyone else: not so much.
    Not trying to be mean, but beliefs like this are just silly. 
    Silly? Please elaborate or consider your remark disregarded.

    Hank
    I want everyone who refuses to accept science to disregard my remarks but contending there is a special gene that affects middle class, Western white people is incredibly stupid.
    "So ... if your ancestors were from the Middle East, France, or Italy, you probably have long-term-wheat-eating genes. Everyone else: not so much.

    You said this was "silly." Do you realize that the genes for celiac disease (HLA DQ2 and HLA DQ8) are far more prominent in people of Western European ancestry? Why do you think that is? Do you reject that premise that Europeans may be more sensitive to wheat than, say, people from India?

    Hank
    If it was genetic it should be the opposite.  Far more Asians are lactose intolerant than northern Europeans, for example.  That is what I mean about the assertion being silly.
    There are a couple of reasons it's primarily in white middle class people right now. Mainly because they are the ones looking to get tested for it. And THAT is very recent. Africans and Asians probably don't get affected as much because they are still mostly eating their traditional diets, but there have been some horrible cases where American food aid was shipped to other countries, even where high-gluten wheat was shipped to villages that had traditionally eaten low-gluten wheat. American bread also often has added gluten, plus added TTG as a "flour enhancer", and TTG is involved in the celiac reaction, and ferrous sulphate, and bromine, all of which might be additional triggers.

    Still, the reaction itself is very much genetically based and the research on it is pretty clear. Like most genetically based issues, it's a combination of genes and gene triggers, and in this case, the triggers seem to be food.

    Gerhard Adam
    ...you probably have long-term-wheat-eating genes...
    What is a "wheat-eating" gene?  More to the point, what makes you think that you harbor specific genes for specific foods?
    Mundus vult decipi
    He should have said a genetic makeup that allows one to eat wheat, to be more clear. Genes that cause celiac disease have been identified, as have the antibodies. Non-celiac gluten intolerance affects 6 times as many as does celiac disease. In these individuals, there is an innate immune response so antibodies haven't been isolated and genes haven't been identified, but a clear immune response has been documented. http://www.celiaccentral.org/non-celiac-gluten-sensitivity/introduction-...

    In most cases, celiac disease usually does not kill or become debilitating until later in life. From an evolutionary perspective, the amount of selection pressure to remove celiac genes from the pool would be minimal (at least in comparison to some other genetic disorders). Evolution only cares that the individual be fit enough to reproduce and do a reasonable job raising the child.

    Now my celiac disease comes from the Connemara side of my family. I'm pretty certain that the villages of Connemara did not have wheat on a regular basis until probably the turn of the century.

    I think it may also be possible that Western diets heavy in grains could result in earlier onset of more serious symptoms. I had only minor symptoms of celiac disease as a child, but when I went to college and my diet became much heavier in grains, my symptoms worsened. It was another 4-5 years until I was diagnosed.

    Of course, all my evidence here is anecdotal with a sample size of 1. Makes it kind of hard to construct a confidence interval.

    In the past, "celiac" was considered to be an illness of babies and very young children, that the kids would "grow out of" if they survived long enough. It was described pretty clearly even before it had a name, and was treated with diets such as "nothing but cream and raw liver", or later "the banana diet". My thoughts are that the vast majority of celiacs at the time died as young children, as those "weakly kids who never thrived". They started surviving childhood ... as did myself ... after antibiotics got invented, and those kept me alive. After I grew up, it seems to go into remission and suddenly I seemed ok. Til I got pregnant, and it all came back again.

    No one really can tell how many celiacs there are, unless someone does random blood tests. Which was the genius of the University of Maryland study. Mostly, it is asymptomatic. But by testing the blood of supposedly healthy people, turns out it's pretty common. The IgA antibodies that indicate "gluten intolerance" (as opposed to celiac) are similarly rather common in random blood studies, even though most people don't believe they have a problem.

    Beer was made of wheat by the egyptians, along with other cultures in the times of the Akkadians, sumerians, babylonians. Wheat isnt the only thing they made beer out of in those days. Unfortunately, our "ancient knowledge" of "modern man" only goes back roughly 6000 years, but id be willing to bet cultures before them used wheat for beer since its abundance would have been a bit more plentyfull under pre-ice-age climate conditions 12,000 to 18,000 years ago, Regardless of who created beer out of what, we can state that allergies to such things as wheat do occur in our modern day world, mainly propagated by the lack of "good germs and bacteria" that keep being removed from food by agencies like the FDA. The more we try to protect individuals from comon bacteria consumption the harder it becomes for our bodies to grow strong and healthy internally. A simple and golden rule i personally follow is: "if the bugs wont eat the food your about to consume, odds are you shouldnt eat it either." If you think the statement is false, leave a double quarter pounder of mcdonalds sitting out over night.... for a month, i promise you the bugs will leave it alone.

    Hank
    I know California bugs will eat that hamburger.  Not sure about the 'we only eat organic food' bugs in your hometown.

    Otherwise, I agree with your comment.  The goofy assertion that people only ate wheat in the last 10 years and caused this 'gluten' allergy, or whatever some of these crackpots are claiming, has no basis in the literature. Grains have been a staple for millenia.
    Hank,
    Your refusal to admit the facts stated above or to see local and cultural differences makes me wonder about your own tolerance to gluten. It is well known to those who have chosen not to eat gluten that one effect of refraining from doing so is much greater tolerance of others opinions. So feel free to think that this is silly (not a very good place to stand for discussion purposes, but whatever) and may you always have no digestive trouble.

    Hank
    This is completely silly, whether you think for 'discussion purpose' it is wrong to say so is irrelevant. You have a completely unsupported bit of speculation with no grounding in evidence or science and draw a conclusion from it - and then make it epigenetic or whatever you are claiming.  

    My belief that genetic gluten allergies are a gene only in middle class western white people has a more solid foundation than your idea that being gluten free makes people more 'tolerant'.
    Did the bread that Jesus Christ broke at the last supper consist of wheat? gluten? Barley? How about the "loaves" and the fishes fed to 1000's that was referenced in the Bible???
    It would be advantageous to know this........if it contained a substance that was harmful I don't think His Father in heaven would have put here on earth for His Son or Us to eat, right?
    Anyone?

    Hank
    The people who believe in this gluten voodoo surely don't believe in any religion...well, maybe Gaia.
    New to the gluten "voodoo" and trying to research as much as I can to form an opinion or at least make an educated guess about what 's good for the body and whats not. Every-d-a-y there seems to be something we 're doing or not doing that's right. The latest in SC this week" sweet tea makes us fat". My grandmother died at 92 and drank sweet tea at least 2 x per day and oh yeah she never weighed over 105 lbs in her lifetime. Resented the comment...insinuating Southerners are uneducated and fat!
    So in your opinion is gluten to be avoided at all times, in moderation, oe is this another scare tactic from manufacturers to make money.

    For ME there is no question: eat gluten and I get very, very ill. At first I thought it was hysteric, a psychiatric thing, foisted on me by my unconscious. But turns out it's real, and the symptoms are real, and that there is an empirical test for it.
    Now, if you have a food that affects 6% of the population ... and it's been shown that it will make at least 1% of the population die earlier ... is that still a good food? Would the FDA approve such a food, if some food company invented it? Would you feed it to your kid? I think the FDA would ban it, actually. Wheat has probably killed more people that tobacco and pot put together.

    But since wheat has been "grandfathered in", I suspect humans will either have the problematic genes die off (people like me don't live so long, and tend to be sterile to boot), or someone will modify wheat genes to be less problematic. I don't think anyone knows if the people with the "right" genes do better on wheat though, or not. I have not found a truly healthy group of people that relies on wheat as the main staple, although people seem to do fine on millet, oats or even rye.

    What I've been doing is going through the book "What I Eat" and look for the peoples who tend to be healthy, all over the world, and look at what they eat (along with other studies about what people eat). And looking at the diets of the people around me, esp. older people who are healthy. There are some trends for sure. Sweet tea does not seem to be one of the things that is problematic, or sugar for that matter. Lots of long-lived healthy people eating white rice too! And eggs ... egg-eaters tend to be healthier. The people who have more weight problems seem to be the countries with higher iron levels ... not just beef, but also iron-enriched starches, and esp. if swigged down with juice or pop (which encourage iron absorption) and without tea.

    Hank
    When did you discover this gluten illness?  Were you ill your entire life?
    I don't ave the illness just the symptoms as a result of intestinal surgery, so I try to follow a diet that does nottrigger the symptoms .

    You are wonderful and I respect and thank you kindly for your comments. Beef roast, white rice on the stove and yep, Sweet Tea for dinner way down South in Charleston SC where we are much like the Chinese.....worship our ancestors and eat rice every day LOLOLOLOL

    What happened for me was that someone was saying that going GF would help with my thinking ... I had had issues, including major depression, for 30 years or so. I thought she was full of it, and went on the diet to prove her WRONG. I balanced the carbs, eating rice instead of wheat, and drinking wine rather than beer. And I felt like I got kicked by a horse. I simply could not function, my brain turned off. This convinced me that for ME, gluten is a drug. Later, a bunch of health issues cleared up too, but still, my major symptoms are in my ability to think. It took like a month to regain a sense of "who I am" but I felt a lot better. Then I ate some pizza to test it out. And went into this weird anxiety mode that was very scary and not fair to my family.

    That was like 12 years ago. My ongoing depression of 30 years just went away, as well as a lot of anxiety, and I suddenly became a lot easier to live with. My gastro eventually decided that yes, I'm celiac. My family isn't, but in their own experiments, they feel better without gluten. I'm not going to put myself through trying to bake with it in any case (it's hard to handle it without breathing it in, and then I get sick) so if they want some "real" bread they have to get it somewhere else. My husband though, says that anything that can make you sick if you eat it, isn't fit to be food. He can eat some, but when he gets a lot of it his stomach complains.

    And yeah, I am struck by how much the traditional southern cooking looks like Chinese. My Mom cooks southern, and she is big on okra! And chicken feet, tripe, gizzards, big piles of greens ... all Chinese delicacies. I go to the Asian store to get stuff for her. Mostly I cook Asian style these days, lots of Tom Yum and rice noodles, and I have to say, I am loving it. We had a family get-together for Mom's birthday and I made a big pile of fried gizzards ... surprisingly, the grandkids gorged on them. I made a big chocolate cake too, with fudge frosting, and no one could tell the difference, except that since it was homemade, it was way tastier than those insipid store-bought ones.

    I should also say that on our diet, my husband (57) has perfect cholesterol and blood pressure, no grey hair, fits into his high school clothes, and a full head of hair. Looks 15 years younger than his classmates at the reunion, and is doing better than his younger brothers. My kids are similarly in way better shape than their peers, and rarely get ill. I don't think this is JUST the lack of wheat, but the entire diet seems to be working very well.

    I've been pondering for some time whether this and some other autoimmune conditions (and conditions based in inflammatory responses) may be a reaction to agricultural monocultures. If so, it would be expected that greater diversity in agricultural crops and diet might reduce incidence. The challenge is that this also defeats the economies of scale that created the monocultures in the first place, and would require a drastic overhaul of how we think about agriculture and food in order to come up with a sustainable approach that doesn't undermine our overall infrastructure.