Low- or Gluten-free Diets Linked to Type 2 Diabetes

Gluten is a protein that is commonly found in wheat, rye and barley, which gives bread and other baked goods elasticity and a chewy texture. It is avoided in a small percentage of the population that cannot tolerate gluten due to Celiac disease or gluten sensitivity. Gluten-free foods often contain less dietary fiber and other micronutrients, such as, vitamins and minerals, thus making them less nutritious and they also tend to cost more. However, recent popularity of gluten-free diets has been trending even among people without any health problems.

A ‘Gluten-free’ diet has been interchangeably used to represent a ‘healthy diet.’ On the contrary, researchers have shown concern that it may actually lead to the development of type 2 diabetes (T2D) over a period of few decades. Although there is no scientific evidence that low-gluten will contribute to diabetes, the scientists are concerned about the long-term health benefits with the reduction in gluten consumption. An analysis of a large study of U.S. health professionals observed the effects of food on health in nearly 200,000 subjects. The study suggested that gluten intake might not exert significant adverse effects on the incidence of T2D or excess weight gain. Thus, limiting gluten from the diet is unlikely to facilitate T2D prevention and may lead to reduced consumption of cereal fiber or whole grains that help reduce diabetes risk. The purpose of the study was to determine if gluten consumption would affect health in people with no apparent medical reasons to avoid gluten.

A long-term observational study looked at the data from three big previously held studies that started 40 years ago with the Nurses’ Health Study (NHS) and continued with Nurses’ Health Study II (NHS II) and the Health Professionals Follow Up Study (HPFS) to observe the effect of nutrition on long-term health. The studies, NHS (n=69,276), NHSII (n=88,610), and the HPFS (n=41,908), estimated the gluten intake using a validated food-frequency questionnaire collected every 2 to 4 years and the T2D incident was defined as physician-diagnosed and confirmed diabetes with supplementary information. The major dietary sources were pastas, cereals, pizza, muffins, pretzels, and bread. The average daily gluten intake was 5.8 grams per day for NHS, 6.8 grams per day for NHSII, and 7.1 grams per day for HPFS.

The researchers found that most subjects consumed less than 12 grams gluten per day and surprisingly, within this range, the subjects who ate the most gluten had lower risk of T2D during 30 years of follow-up. However, subjects who ate less gluten consumed less cereal fiber that is a protective factor from progression of T2D. Moreover, participants in the highest 20% of gluten consumption had a 13% lower risk of developing T2D versus subjects with the lowest daily gluten consumption less than or equal to 4 grams per day. The mean gluten intake (± standard deviation) was 5.83±2.23, 6.77±2.50, and 7.06±2.76 grams/day in NHS, NHSII, and HPFS respectively, and strongly correlated with intakes of carbohydrate sources, especially refined grains, starch, and cereal fiber (Spearman correlation coefficients greater than 0.6).

During the prolonged 4.24 million years of follow-up from 1984-1990 to 2010-2013, 15,947 T2D cases were confirmed. An inverse association between gluten intake and T2D risk was observed in all three cohorts after multivariate adjustment and hazard ratio (HR) comparing extreme quintiles was 0.80 (0.76, 0.84; P less than 0.001). Further adjusting for cereal fiber resulted in slight attenuation in the association (HR [95%CI]= 0.87[0.81, 0.93]), but not other carbohydrate components. There was no significant association with weight gain in participants without major chronic diseases and aged less than 65 years with changes in gluten intake in multivariate adjusted model: 4-year weight change (95%CI, lb) was 0.08 (-0.06, 0.22; P=0.25) in NHS, -0.05(-0.18, 0.08; P=0.43) in NHSII, and 0.36 (-0.24, 0.96; P=0.24) HPFS for each 5-gram increase in gluten intake.

In conclusion, the study suggested that gluten intake might not exert significant adverse effects on the incidence of T2D or excess weight gain. In the conference media release, the author acknowledged that the study does not conclude the effects of gluten in the prevention of T2D, but limiting gluten from the diet may lead to reduced consumption of cereal fiber or whole grains that help reduce diabetes risk. The study suggested that if avoiding gluten is not clinically deemed necessary, then avoiding foods that have other benefits could be harmful unless replaced with healthy, naturally gluten-free grains, such as quinoa or buckwheat. Overall, although gluten-free diets have grown in popularity, evidence is lacking regarding gluten intake and long-term health, thus it is crucial to have a comprehensive understanding of diet and nutrition prior to making dramatic changes in the diet.

Our Second March Meeting

On March 18, Brenda called our second meeting to order and said Allison would have the presentation. This time everyone was present plus one guest that A.J introduced.

Allison said she had wanted to have this last meeting, but with all the flu, she felt that should be covered instead. Now she felt that gluten-free foods needed to be covered. She asked how many knew about gluten-free foods. Of the 26 present, only three hands were not raised. Next, she asked if anyone had celiac disease. No hands were raised and she commented that was understandable. Next, she asked if anyone had not read Bob's blog on February 19 about arsenic and mercury poisoning. Five hands were raised and Allison said that she was happy there were so few.

She said she had found the same article from many sources from many countries. She felt this indicated that the study was important and people around the world were concerned about the possibility of arsenic and mercury poisoning.

She then had Brenda bring up a slide with this paragraph - The way I see it, this research doesn’t mean that going gluten-free will automatically increase your intake of the heavy metals. However it's an important reminder that how you eat gluten-free matters, both in terms of arsenic and mercury, and your overall nutrient intake. Here are three key ways you can optimize your health if you eat gluten-free.

Next she asked if anyone was gluten sensitive and trying to eat gluten-free. Two hands were raised and one of the two asked how serious this could be and she felt she was gluten sensitive and was eating more gluten-free foods. Allison asked her to remember her question and asked for the next slide.

The next paragraph said - You can find gluten-free versions of nearly any food these days, including bagels, bread, wraps, baked goods, and crackers. Many are made with rice flour, but what they also have in common is that they’re all highly processed. If you need to follow a gluten-free diet, yes, it’s nice to be able to eat pizza or a cookie if you really want it. But these foods should be occasional treats, not daily staples. And it’s important to note that simply being gluten-free does not make a product healthy. Many processed gluten-free foods are made with refined flour (stripped of fiber, nutrients, and antioxidants), as well as added sugar, sodium, or other unwanted additives. Make whole, fresh, and minimally-processed foods your go-tos, not gluten-free versions of packaged, multi-ingredient products.

Then Allison said she had several more slides and would read them before discussion. Brenda started the slides, which are here:

Rice is just one of many gluten-free grains. Others include quinoa, buckwheat, millet, oats, sorghum, teff, corn, and amaranth. Pulses (the umbrella term for beans, lentils, peas, and chickpeas) are also gluten-free, as are starchy vegetables, including sweet potato, yams, fingerling potatoes, and squash. When planning meals, include a wide variety of these whole foods that are naturally gluten-free.

For example, instead of whole wheat toast at breakfast with your veggie and avocado omelet, opt for sweet potato toast, or a side of black beans. In place of a sandwich or wrap for lunch, make a salad and add a small scoop of quinoa or lentils for a healthy source of carbs. At dinner, replace pasta with spaghetti squash. And snack on roasted chickpeas or hummus with veggies rather than chips, pretzels, or crackers.

Consume low-mercury seafood. We don’t know the precise source of the mercury that caused the elevated levels detected in this study, but seafood can be a significant contributor in people's diets. One resource to help you figure out which seafood to avoid is the Environmental Working Group’s Consumer Guide to Seafood.

Generally, low-mercury options include wild Alaskan salmon, Atlantic mackerel, rainbow trout, shrimp, and clams. Varieties with moderate mercury levels include cod, crab, canned tuna, lobster, mahi mahi, and sea bass. High levels of mercury are found in shark, swordfish, king mackerel, and grouper.

As with any eating plan, this simple motto can help you strike a healthy balance: Keep it real, mix it up, and don’t overdo it.

After reading each slide, Allison went back to the question. She stated that most gluten-free foods in grocery stores have many added ingredients and are often loaded with sugar.

Then she opened it up for more questions and several people asked for a repeat of the slides, which Brenda did with discussion on each paragraph. Another 40 minutes were spent in discussion and many good questions were raised and when the last question was answered, a round of applause happened and the woman that had asked the first question said she was happy with the discussion. Several others also said thank you and felt that this was near the top of the discussions presented to the group. Several of the members that had been with the group since the early days, agreed but said there were a couple of meetings that had been more valuable.

Gluten-Free May Mean Arsenic or Mercury Poisoning

Allison called Wednesday and asked if I had read this about gluten-free foods. I told her that I had and would have a blog about it in the coming week. She said she had several other articles and would be asking Brenda to have a program if we were having a meeting this or next weekend. She said she is aware of the flu among the members and that three were in the hospital. I said that only two were still in the hospital and that now I may be coming down with it.

To my blog – a new study suggests that a gluten-free diet may pose serious health risks, after finding that the eating pattern may raise the risk of exposure to arsenic and mercury.

Study co-author Maria Argos, assistant professor of epidemiology at the University of Illinois at Chicago (UIC), and colleagues recently reported their findings in the journal Epidemiology.

A gluten-free diet excludes foods that contain gluten - a protein found in wheat, barley, and rye, as well as the byproducts of these grains.

For people with celiac disease - an autoimmune condition whereby gluten intake leads to intestinal damage - a gluten-free diet is the only treatment for the condition.

However, according to a 2012 survey, around 28-30 percent of us restrict our gluten intake or avoid consuming the protein completely, even in the absence of gluten sensitivities.

Rice flour is a common substitute for gluten in many gluten-free products. Argos and colleagues point out that rice can bioaccumulate arsenic, mercury, and other potentially harmful toxic metals from water, soil, or fertilizers. Exposure to these metals has been associated with increased risk of cardiovascular disease, cancer, and other diseases.

"Despite such a dramatic shift in the diet of many Americans, little is known about how gluten-free diets might affect exposure to toxic metals found in certain foods," note the authors.

With the aim of investigating the link between gluten-free diets and toxic metal exposure, Argos and team analyzed the data of 7,471 individuals who were a part of the National Health and Nutrition Examination Survey between 2009 and 2014.

The researchers identified 73 participants aged between 6 and 80 who reported following a gluten-free diet. Blood and urine samples were taken from all participants and assessed for levels of arsenic and mercury.

The researchers found that levels of each toxic metal were much higher among subjects who followed a gluten-free diet than those who did not eat gluten-free products; mercury levels were 70 percent higher in the blood of gluten-free subjects, while arsenic levels in urine were almost twice as high.

According to Argos, these findings suggest that there may be "unintended consequences of eating a gluten-free diet," though further studies are needed to confirm whether this is the case.

The researchers add that:

1. "With the increasing popularity of gluten-free diets, these findings may have important health implications since the health effects of low-level arsenic and mercury exposure from food sources are uncertain but may increase the risk for cancer and other chronic diseases.
2. Although we can only speculate, rice may be contributing to the observed higher concentrations of metal biomarkers among those on a gluten-free diet as the primary substitute grain in gluten-free products."

Argos points out that there are regulations in Europe that limit arsenic levels in food products, and he suggests that the United States might benefit from similar regulations.

"We regulate levels of arsenic in water, but if rice flour consumption increases the risk for exposure to arsenic, it would make sense to regulate the metal in foods as well," he adds.

Our February '16 Meeting

Tim talked to me several times and I said he had the right to use whatever he needed from my blogs. When the meeting started on February 20, Tim took time to thank Sue, Brenda, and me for the discussion we had about a few of Sue and Bob's friends that were promoting gluten-free foods. He asked for a show of hands of people that did not know what gluten was. Seven hands were raised and Tim said not to be afraid to admit this, as most people may not know about gluten.

This caused three more people to raise their hands. Tim said that most of the longer term members knew about gluten and those that had been in the group from the start definitely knew about gluten, as this had been a topic of discussion many times. Gluten is the tough, viscid, nitrogenous substance remaining when the flour of wheat or other grains is washed to remove the starch. Tim said the wheat and other grains are the important words and they contain the gluten.

Since celiac disease is an autoimmune disease, it is generally the people with type 1 diabetes that develop celiac disease. There are a few other people that can develop celiac disease, but this would be a very small number and even smaller number that have type 2 diabetes, but it is possible.

Tim said some people with type 2 diabetes do develop an intolerance for gluten, and when this happens, not eating wheat or grain products can really help. As he was talking, Tim was rotating some slides and pausing when people were asking questions. Among the newer members, there were quite a few questions and Tim was taking time to answer every one. When he put the slide up with these statements, (Celiac disease is one of the most commonly misdiagnosed diseases by doctors. A doctor should monitor the diet in order to prevent complications. The diet will also help people with non-celiac gluten sensitivity.), this raised several questions.

Tim explained that many doctors don't think about autoimmune diseases and don't see celiac disease that often and many doctors never see a person with celiac disease.

Tim then started on gluten-free foods and that several people are presently promoting gluten-free as a weight loss diet. Yes, they're heavily promoting gluten-free and hoping to make a sale of their products. Tim called on Sue to explain what she had seen in products.

Sue said they had several cereals, pasta, and other products that were labeled gluten-free. Most of the other products could be found much cheaper in the grocery stores and wouldn't have the sugar added that their products included. All products were over-priced and had more sugar or fructose than comparable products. And they say this is a weight loss diet – right.

Tim stated this is what they are promoting and even some of the foods in the grocery store that claim to be gluten-free also have added sugar and high fructose corn syrup and this is why we don't recommend these products for people that have diabetes.

Then Tim showed his last slide, which said “LCHF.” He turned to me and asked what this meant. I said that it meant we did not eat high carb foods that included any grains and other foods heavy in starch. By doing this most of us would never have any problems with gluten and even is we were gluten sensitive, we did not need to worry, as we would be eating foods that did not contain any gluten. I finished by saying that the low carb, high fat way of eating was better than eating gluten-free foods.

Tim said this is correct and concludes my presentation. We will take time to answer more questions, but the meeting is over. Questions consumed the next thirty minutes and the members started leaving. When we finished cleaning, Tim stated that he could not believe people would try to promote gluten-free foods to people with type 2 diabetes. Sue said this is what her husband said and that is why they told them about LCHF way of eating which costs less and results in easier weight loss.

Gluten-Free Foods – Watch Nutritional Value

This was not what I had expected from WebMD. I do feel the writer may have it right. “Move over fat, salt, and sugar. There’s a new dietary villain in town and its name is gluten.” This is not to belittle those with celiac disease, as they do need to avoid any gluten. What the food industry is doing to gluten-free foods is not a good thing and is harming people more than helping them or serving peoples' best interests.

Best estimates say that approximately 18 million Americans have some degree of gluten sensitivity. About 3 million people are estimated to have celiac disease. Gluten-free foods are the latest food industry crime. They have little concern for the health and welfare of these consumers. Yes, the foods are gluten free, but it is all the junk that is added to these foods that creates additional problems for people trying to loose weight or even maintain a balanced nutritional diet.

According to Dr. William Davis, “Eliminating all things wheat from the diet is one of the most powerful health strategies I have ever witnessed. But replacing lost wheat with manufactured gluten-free foods is little better than replacing your poppy seed muffin with a bowl of jelly beans.” Dr. Davis is a strong advocate for a wheat free life.

Reading the Nutrient Facts panels and Ingredients panels on packaged foods is a good idea to help prevent nutritional vacuum in your daily food intake on a gluten-free diet. Consider purchasing gluten free products that have added vitamins and minerals.

Refined carbohydrates dominate most commercial gluten-free foods and it takes more gluten-free ingredients to produce a tasty product. Therefore, produced baked gluten-free foods are much higher in calories and total carbohydrates than the regular foods containing gluten.

Are there dangers from a gluten-free diet? Yes, even doctors that specialize in Celiac Disease are concerned about the nutritional dangers involved in eating gluten-free diets. They urge people to get nutritional counseling and follow the advice of a dietitian specializing in Celiac Disease. These doctors are also concerned about the levels (too high) of fat and too little of fiber. They state that people that need to be gluten-free and are closely monitored can receive tremendous benefits. Until you know that you have actual gluten sensitivity, be very careful about doing this on your own. There are many pitfalls that can damage your health unless you are under doctors orders and have assistance from people specializing in gluten-free diets.

Gluten-free should not be a fad because of the dangers. This is the concern of the medical community and rightly so as this is a dangerous fad. More can be read about gluten-free here. A gluten-free diet is not a plan for weight loss and can make weight management problematic for many.   Read this on WebMd as well and this article about gluten-free.

Gluten-free Foods Will Accelerate Onset of Diabetes

Yes, you are reading this correctly! Why should you not expect this from the US Food Industries? Because they are trying to make America fatter, and they are doing an excellent job of this! Don't blame those who have developed celiac disease as they cannot help it as it is an autoimmune disease like Type 1 diabetes.

When we have called on the US food industries to supply a solution for a problem, they manage to make us pay with more junk food and junk carbohydrates. Per Dr. William Davis in his blog here, saturated fat was replaced with hydrogenated fat and polyunsaturates, sucrose was replaced with high-fructose corn syrup, and now they are replacing wheat gluten-containing foods with junk carbohydrates.

If you don't think so, almost all gluten-free foods now use brown rice flour, cornstarch, tapioca starch, and potato starch. Sometimes they do use amaranth flour, teff flour, or quinoa flour and other less popular, but still gluten-free grains.

The foods prepared with these gluten-free ingredients, which are free of gliadin and gluten, will add weight to you and probably make you diabetic. They do increase visceral fat, cause your blood glucose levels to head for the stratosphere higher and faster than most foods – even wheat, which is notorious by itself. In addition to diabetes, your chances of cardiovascular disease also increases because of the lipoprotein distortions.

As Dr. Davis says, “eliminating all things wheat from the diet is one of the most powerful health strategies I have ever witnessed. But replacing lost wheat with manufactured gluten-free foods is little better than replacing your poppy seed muffin with a bowl of jelly beans”.

What even bothers me is that gluten-free is becoming a fad and therefore the increase of manufactured gluten-free foods that are harmful to your health are proliferating in the market place. They are more expensive and have a higher profit margin thereby exciting the food industry into more production.

When people like Oprah Winfrey promote gluten-free, you know people will try it. There are many pitfalls and health problems that can result from going gluten-free without guidance from a doctor and dietitian.

An article in USA Today dot com from August 17, 2008 about gluten-free is very interesting and surprisingly gives some excellent warnings about doing this yourself. It explains some of the health problems of do-it-yourselfers. Please take time to read it.