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Should Your Diet Be Gluten-Free?

Salad with feta, tomatoes and avocado.

The recent interest in a gluten-free diet came about for many reasons. They include weight loss, decreased waist measurements, improvement in bowel function and decreased abdominal bloating. Yet many people are unsure what “gluten-free” means or if they should eat this type of diet.

Dr. William Davis, a preventive cardiologist in Milwaukee, Wisconsin, examines the issue in his New York Times Bestseller, Wheat Belly. In his book, Dr. Davis discusses wheat’s contribution to the American obesity epidemic. The wheat we eat today has been modified and is different than what was available 200 years ago. Wheat produced today has a higher glycemic index and less protein than wheat produced in ancient times.

Wheat’s effect on the body

The relationship between wheat consumption and heart health is based on obesity and waist circumference. Fat in the abdomen is metabolically active and produces more hormones, particularly estrogen. Men and women with abdominal fat are not only at increased risk for metabolic syndrome and diabetes, but also certain types of cancer, such as prostate, breast and uterine cancer. Waistlines expand when we consume more calories and produce more stress hormones (cortisol), and our genetics are also an influence.

Types of wheat

Whole wheat and processed wheat products are the most commonly consumed gluten products. Other products containing gluten are rye, barley, spelt and bulgar. Whole grains are those that contain the entire grain – the bran, germ and endosperm. Refined grains have been ground into flour, which often results in the bran and germ being removed and, with it, the B vitamins, iron and dietary fiber. Whole grains cannot be identified by the color of the bread, which usually has added molasses or food coloring.

Read the food labels

To have an American Heart Association whole grain label, a food must have more than 51% whole grains. The USDA currently recommends 5-7 servings (oz. equivalents) of whole grains daily. One serving equals 1 slice of bread, 1 cup of ready-to-eat cereal or 1/2 cup of cooked rice, cooked pasta or cooked cereal. These recommendations are for the entire population and not based on individual needs. Consult with a registered dietitian and your doctor to determine the appropriate number of servings for you.

Since 1970, wheat consumption has increased 32%, according to the U.S. Department of Agriculture Economic Research Service. We’ve also seen a similar increase in the development of high-fructose corn syrup. Our levels of physical activity have declined, and our average calorie intake went up by 300 calories between 1985 and 2000. These combined factors have contributed to an escalation of the obesity epidemic.

About the glycemic index

It’s a good idea to avoid foods with elevated glycemic indexes. The glycemic index is a measure of how quickly blood sugar increases after eating a food. More precisely, it estimates the blood glucose response of 50 grams of available carbohydrate in a food compared to 50 grams of pure glucose. Foods with lower glycemic indexes may be better for your health.

We might expect our blood sugar to increase more slowly after eating wheat than after eating refined sugar. However, the way we have changed wheat production has increased its glycemic index. Whole wheat bread has a higher glycemic index (72) than table sugar (59).

It is not beneficial to replace wheat products with highly processed gluten-free products. The glycemic index of some of these substituted foods may be higher than it is for whole wheat products. Starches used most often in gluten-free cooking come from rice, potato and tapioca.

The bottom line

Avoid eating too many carbohydrates and foods with high glycemic indexes. Both contribute to abdominal obesity. Also avoid the belief that highly processed gluten-free foods are good for you. Instead, we recommend eating foods that look like they did when they were growing in the ground, on a tree or in the field. Try to eat plenty of vegetables, fish, olive oil and other heart-healthy fats, nuts/seeds and protein-rich foods that help stabilize blood sugar. Limit your grain intake to no more than the USDA recommends. And remember that whole grains are not in the brown “wheat” breads we see in the supermarket – instead, target the full grains for more protein and B vitamins.

If you have a suspected intolerance to wheat products or abdominal upset after wheat intake, talk to your physician about testing for celiac disease.

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