I don't have a "re-exposure story", rather an avoidance story.

I used to have terrible cold weather, exercise induced asthma.  After nordic skiing I would be wheezing, coughing, sucking on albuterol and begging for low dose corticosteroids.  I also had terrible acid reflux.

Fast forward:Wheat free for over 6 months.  No more asthma, no reflux.  Period.  End of story.

Is it the wheat?  Can't say for sure, but it's awfully suspicious.

Reflux -- starts a day later and goes for up to a week.  And Bloat:2-5 inches on my waistline in a day, lasting up to three.  Miserable.  And why, having experienced this once, have I done it often enough to verify the connection with certainty?  I am working on that one.

Last year, I had a cookie after a few months' being wheat-free. It gave me a stomach ache, acid reflux for two days and sinus congestion for four. No more wheat for me.

Wheat increased hunger with even with only a small amount. Crackers in soup was enough to set it off.

Also, when I was trying to get off wheat, I noticed that 2eggs and 2bacon and I could go 5 hours before hunger, or 2eggs and 2bacon and toast was good for three hours before hunger. That was the final step to giving up wheat. Now three years and 59 Kg loss later, there is no doubt in my mind that wheat is evil, and I do not regard it as suitable for human food. I speculate that it increases ghrelin or cortisol.

For me, in the two years since I began eating Gluten-Free (Low Carb for 6 years), the few times I've had re-exposure to wheat, I've experienced fast onset and intense abdominal pain (known exposure during the daytime) and heartburn, indigestion, intense nausea, and disrupted sleep (exposures during evening meal not discovered until the next day).  

My husband wants to think he's fine with wheat (though I know that he has at least one gene that predisposes to celiac), but IMO, he isn't.  He eats no wheat at home because that's the default, and he's OK with that.  But if he goes out to dinner at a restaurant that serves "good" artisan bread, he  will indulge in a few bites (he does restrict his carb intake, so it's still a limited amount).  More often than not, he will sleep fitfully on those nights, snore more, and wake in the night with indigestion.  He wants to bury his head in the sand and will only acknowledge the discomfort being due to eating too many carbs, not the wheat itself.  I notice he sleeps fine if he eats a small amount of potato or rice.  Go figure.  

Our 12 yo son has been eating GF for two years also.  About 6 months into GF, he unknowingly ate wheat a number of times (licorice candy laces at a friend's house), which  resulted in outbreaks of canker sores in his mouth each time.   He also exhibits mood and behavior changes when he eats wheat, which is what prompted me to test him for gluten intolerance in the first place.

I need to be able to choose more than 1 option in the poll. The top 3 choices are me. If I just eat a little, I only get GI symptoms followed by sinus headache. If I eat more, then I get arthritis symptoms (first diagnosed when I was 13. Now that I avoid wheat, it's gone unless I re-expose myself).

I see now that I should have added two more choices: 1) More than one of the above, and 2) "other," i.e., effects not listed.

Anyway, we'll have to make do. I believe we can still get a useful non-scientific sense of what readers have experienced.

I eliminated wheat on your suggestion over a year ago. Occasional re-exposure (usually dining out) has no effect on me.

If I go for 3-4 days without wheat, grains or sugar and then go out and binge on a pizza and ice cream or something like that I become explosive within 20 minutes to an hour.  It's like a wheat and sugar rage.(I'm not saying this is an excuse for rage, I'm saying it has happened to me and I believe partly do to re-exposure)  It seems the combination of the wheat plus sugar can be the worst.  
I get red rashes around my neck sometimes right away and sometimes up to a day or later and sometimes get bad diarrhea.  
I think it can be almost dangerous to cut things like gluten and sugar suddenly out of the diet without being very serious about keeping them out. I have found it very hard to cut out wheat without binging on it later after 4 or 5 days. I don't believe that my symptoms are just psychological either.
I was also diagnosed with ADHD as a young kid and then rediagnosed with adult ADHD by 3 different doctors.  I also have bouts of mania at times too.  I am considering trying to go completely gluten/refined carbohydrate free to see if it helps with the symptoms and gives me some relief.
I have never been tested for celiac or gluten intolerance but I would like to be. I think it would help explain to my girlfriend, family and friends why I can't go out and eat pizza or have a beer or ice cream.  Right now they all think I'm a hypochondriac.

Braing fogm clogged nose and slower bowel movement.

Why i dont get diarrhea when eating wheat?

Would like to add at times I have experienced an intense fatigue the next day like I can't wake up and also sharp pains in my body and headaches.

I ditched wheat a year ago after my wife was diagnosed celiac. I immediately experienced a number of health improvements (blood lipids, sleep, allergies, etc.).

Fast forward: We all suffered some inadvertent wheat exposure yesterday via some chocolate covered Brazil nuts (of all things). This accidental A-B-A experimental design resulted in the following:

1. My celiac wife experienced what she calls "the flip" within an hour of exposure(i.e., intense GI distress).
2. My five-year-old son went to bed with some wicked reflux.
3. I woke up with some twinges in my lower back and an ache in my football-weary left shoulder. I was also complaining to my wife about fuzzy-headedness that refused to respond to caffeine or hydration. I could only describe it as "carb  flu"...

And then I read your post!

Depression, agitation and brain fog if I get glutened. Some times this comes with abdominal pain and a rash on my back - I think it is dose dependent. Cross contamination with wheat is a big issue when eating out. Needless to say, I eat out infrequently and then try to stick with the restaurants that are the most aware of gluten issues.

Several weeks ago, I started Robb Wolf's 30 day challenge.

The first two weeks were brutal - calling it a withdrawal flu was a massive understatement. So, I thought I would try some wheat and see what happened (could not be worse, I thought). Well, it was.

I still felt extremely crappy, but I was now MASSIVELY GASSY - AMAZINGLY GASSY, for about 48 hours - flatulence on wheels, in spades.  I did not go out at all in those 48 hours - when the gas came on, it went out, LONG, and QUICKLY and LOUDLY.

I am easing back into wheat and grain free. I am gluten free today and tomorrow (Sunday and Monday). I expect to try a small amount of wheat on Thursday, then maybe a little more the following Thursday.

After being wheat-free for almost a year, I have intestinal pain and inflammation after re-exposure to wheat. And higher blood glucose for a day or two (type 2 diabetic).

reading this makes me wonder- how many people with re-exposure symptoms actually have a problem with gluten versus just wheat?

It would be interesting to see if some of you are still symptom free if you ingest say barley, or rye, while remaining wheat free.  
Just a thought...I do agree with all Dr D says about wheat, but it does beg the question as to how many are truly GLUTEN intolerant.

I have limited wheat consumption severely over the last 8 months. I have lost 120 pounds, no longer have bouts of illness, asthma, depression, or low energy. I also take vitamin D and other supplements that have helped (many are from your blog recommendations).

Last week I ate a small piece of cake and dessert pizza. Shortly thereafter I started sneezing, had a scratchy throat, and runny nose. I called off sick the next day for fear of being contagious. My symptoms subsided quickly and I am now attributing them to the processed flour eaten at my work luncheon. I think it was an allergic reaction since I recall having much more severe symptoms fairly regularly in my wheat eating days. Those were attributed to an "allergy" of unknown origin back then.

The comments to this blog post and poll are incredible!

I should re-post them in a blog post to highlight all the varied versions of wheat re-exposure.

The range of benefits with wheat elimination and the effects of wheat re-exposure are truly incredible. Look at what commenter Donald Kjellberg had to say: 120 lbs lost!

Not everybody, of course, loses 120 lbs. But what other food, when eliminated, has the power to do this in select individuals? Then makes them sick on re-exposure?

I suffered from Ankylosing Spondylitis, Iritis, Plantar Fasciits, etc for a number of years. I restricted carbs, especially wheat and I've been symptom free for the past two years now.

The whole story on the KickAS forums here: http://www.kickas.org/ubbthreads/ubbthreads.php?ubb=showflat&Number=427748#Post427748

Lot's of confounders to consider. Lest I be thought of as a wheat apologist troll my wheat and grain consumption is limited (rice less so).

Any food item we omit will shift our gut bacteria away from those that thrived on that food. Others will then pre-dominate;  and so, to re-expose after (say) 3 days some of us won't have the same % protein degrading bacteria to handle the wheat protein fragments and more gaseous fermentative bacteria.

Wheat preparation is another thing and ingredients consumed at the same time can also make a difference. I think of yogurt/kefir and white/brown sugar as modulators; rather than meats/vegetables, which can interact with digestion in their own way and alter the synergy. This is not to contradict individual testimonials of their reactions; nor contest an experiment where wheat all alone is eaten and neither to ignore genetic factors .

Then there is the doseage factor regarding how much at one time is ingested. Some are prone to inflammatory reactions; their threshold may be linked to excessively stimulating co-existant fungii colonizing their intestine.

The breeding of wheat is something this blog has helped me understand. Cutting it out entirely for health reasons is for many a simple strategy I hadn't seen clinicaly used. It won't make sense to third world poor however; largely since the "hygenic" hypothesis implicates our immune systems as part of the problem.


.

My nemesis is processed grains.  Have always tended toward obesity and have only been able to control my weight by minimizing processed foods and by doing a lot of exercise.  Low carb didn't work for me.

My other nemesis is my 92 yr-old mother's sweet tooth.  Don't have the will power to resist all the junk food she demands, yet I'm her caregiver, and don't have the heart to deny her her sweets.  Have gained about 25# since moving in with her.  She may outlive me.

Am now experimenting with substituting chia seed for my usual oat/barley porridge.

I found wheat to be one of the worst things for giving me gas bloating and acid reflux, and I'd had sinus and nasal congestion my whole life. When I ate that cookie, it just re-introduced old problems. I can occasionally eat a gluten-free, grainy goody at my party place without any side effects. I also have a little sprouted rice protein powder every day.

Another odd thing about wheat: it was hard for me to stop eating it once I started. I could go through a whole box of cookies in one sitting, even though I wasn't a binge eater. But I can have a couple of gluten-free cookies and stop.

Except for one slip up this recently past holiday season, I've been sugar-grain-starch free since July 2008.  Mental fog was the most noticable re-exposure symptom I had.

My mom has had the worst acid-reflux for 40-plus years.  It had become so bad that she was on three medications just to deal with the symptoms. After much training and coaxing, I finally got across to her how to totally get off wheat.  Not at all to my surprise, after being wheat free for a few weeks, she lost weight and her acid reflux was GONE!

But she had been addicted to wheat for so long, she relapsed, and the reflux fire soon returned.  Wheat must be akin to heroin with some people.  Even though they know it's very bad for them, they can't help themselves.

Re-exposure often leads to diarrhea for me, or such a heavy feeling of tiredness that all I can do is lay down and pass out. A local pizzeria makes a darn good pie, but since I started practicing wheat-avoidance, I can't keep my eyes open after eating there. I can't say for sure that it's the wheat causing it, but definitely something in the crust. Diarrhea, on the other hand, is definitely triggered by the wheat for me.

My mom complained of gastric reflux for years, but never filled the prescriptions that her doctors would give her. I suggested wheat-avoidance- gastric reflux disappeared within 3 days and hasn't returned (has been 6 months now). I've already commented elsewhere on this blog about how much weight and bloating she has lost...

Some readers have suggested that changes in gut bacteria play a role here, and I tend to agree. When my mother stopped eating wheat, her years of gastric reflux symptoms ceased. Yet, her blood test for H. Pylori, taken one month after stopping wheat and cessation of symptoms, was positive for antibodies (indicating past or present infection) and her subsequent breath test was positive for current infection.

So, for my mother, H. Pylori + wheat = gastric reflux symptoms, and H. Pylori without wheat = no symptoms. It would be interesting to know if the H. Pylori would have disappeared after a longer period without wheat as her intestinal bacteria changed...

Interesting that I should sit down, turn on my computer and find your poll. Having gone several weeks, maybe months, avoiding gluten, I took my daughter and her boyfriend out to eat because my wife has been working late at the office lately. Although I was thinking I would just eat my steak and chicken, I succumbed to the temptation of eating about a dozen greasy, breaded shrimp that my daughter and her boyfriend ordered. It's 1:39am and I still do not feel sleepy. My left nostril is completely blocked, my stomach feels bloated, really, really full and I've been burping. In your poll I checked sinus problems but could have chose gastrointestinal or nervous problems just as well. A few weeks ago my daughter brought home a pizza and, once again, despite my knowing that I shouldn't, I ate a couple of pieces. I was sick for two days. The pain in what I think was my transverse colon was so bad I thought I might have to go to ther emergency room. Before I ate the pizza I had never gone grain-free that long before. I did this after reading Robb Wolf's book. I AM CONVINCED. No more wheat for me! Please, Lord, give me strength.

It is very interesting to read the comments here.  I have been LC for almost 4 years but have cheated sometimes (at restaurants).  I have had intestinal distress but never considered that it was from the wheat...

RE: Pizza - Just don't eat the crust.  We still get pizza and eat the toppings with a fork!

"Still others say there is no such thing."

Really?  I hadn't noticed anyone saying that.  I, like a few others, reported that I, myself, did not experience symptoms from very occasional wheat re-exposure.

When I eat wheat, I often have diarrhea the next day. And I am hungrier, I believe.

Again, 90% of this is pure mental.

Interesting the vote results are mostly on GI distress.

I'd suggest a couple additional matrixes:

1:  How long have you gone without wheat
2:  How much wheat did you consume?
3:  How neutrotic are you?

I went without wheat for 2-3 days last week.  Had a bad day on Thursday -- stuck at home with little food to eat, so had some WASA whole wheat crackers. Yuck.  Noticed some gassiness but nothing rising to the level of pain.

I do suspect it mostly is internal flora, but that shouldn't change in 2-3 days.  If you are cramping and shitting after eating some breadcrumps, you either have celiac or some severe mental problems.

Remains a good idea to advise people to give up wheat -- so prevalent is US diet and easy way to lose weight.  Hard to see it being a long term problem if not abused.

I remember stories of Indians during 1940's famine being unable to eat wheat while starving. Extreme example -- people who didn't eat wheat for 6000+ years being forced into it.  However, 50 years later common diet item.  Obesity is out of control but that is as much from 10x as many caloric units being available as in the 1930 (i.e. people don't starve to death like they used to)

"Effects not listed" for me.  I am OK on minimal wheat but when I cross a certain threshold, my eczema flares a week or two later, and my asthma sometimes returns.

On January 31, 2011, Charlie said... "Again, 90% of this is pure mental."

Your psychic ability or your plain old unfounded, indeed unfoundable, presumptuousness would be really funny - if you were trying to be funny.

But, I think you really mean "Again, 90% of this is pure mental."  Even though you do not have a clue as to whether or not anything described by others on this or any other blog really is, "90% of this is pure mental."

I think the main question you should ask yourself is, "3: How neutrotic are you?" Charlie, can you figure out how to use a spell checker? "neutrotic". HAH.

Charlie, you actually made the statement, "Again, 90% of this is pure mental." You know NOTHING about most, if not ALL, of the people who comment here. Yet, that you actually think you know what goes on in their minds! Do you use a crystal ball to make your divinations, Charlie?  

You even made the more ridiculous statement that, “you either have celiac or some severe mental problems.” Your POMPOUS, SELF-RIGHTEOUS PRETENTIOUSNESS is risible, Charlie, RISIBLE!  If anyone on this post has “severe mental problems” Charlie, it is you, and only YOU.  

I expect you are the same “Charlie” who made a complete fool out of himself on Stephan Guyenet’s blog by spewing similar complete and utter nonsense about “honesty”.

What you are doing here, as on SG’s site, is called “projection”. What you do not like about yourself, but are afraid to acknowledge in yourself, you project onto others, and claim it is they who have  â€œsevere mental problems” and that “90% of this is pure mental”. So, Charlie; it is YOU who should deal with YOUR mental state, and stop projecting it onto other people, whom you know NOTHING about!

Just like Might-o'chondri-al (what a mouthful!) mentioned, it's hard to tease out the confounders. I don't sit down and munch on some wheat stalks on my off days. These are the occasions when I allow myself to indulge in delicious croissants, scrumptious shortbread tarts and traditional Australian carrot cake (if you do something bad, you might as well be good at it). These very occasional indulgences, apart from containing wheat, also have other NADs, to use Dr Kurt's phrase, that I routinely avoid: sugar, maybe HFCS, maybe some trans fats, maybe some other additives/chemicals I'm not aware of. I know the fall-out: pimples within 24 hrs, flatulence, ankle oedema and headache. I would be hesitant to blame just one ingredient as tempting as it is to indict wheat. But I am not prepared to run an experiment involving me, wheat husks and gluten-free cookies

I'll submit "other".

No overt symptoms, but since limiting
carbs generally, wheat specifically,
my A1C stays in the low 5s, and my
insulin requirement is half what it was...

Suits me.

Jack

What if you have multiple symptoms? Grains are a disaster for a lot of people I know: http://www.cutthecarb.com/your-daily-bread-pasta-and-pizza-are-killing-you/

For those worried about their blood sugar levels, may I recommend this: chana dal

And here is an interesting article on this food:

http://www.mendosa.com/chanadal.html

From: http://www.mendosa.com/chanadal.html

"Tim writes, "While I was in Tesco ( Britain's largest supermarket) I checked on the nutritional information panel on the back of a packet of Chana Dal. It was:

        "100g = 1404kj or 332kcal
        protein 23.1g
        carbo 48.2g
        fat 6.5g
        fibre 10.0g""

But the Chana Dal currently on sale states the nutritional composition as:

Energy kCal 298kCal
Energy kJ 1,264kJ
Protein 24.0g
Carbohydrate 59.7g
of which sugars 2.2g
Fat 3.1g
of which saturates 0.3g
Fibre 16.1g
Sodium Trace


http://www.mysupermarket.co.uk/tesco-price-comparison/Rice_Pulses_And_Grain/Natco_Chana_Dal_2Kg.html

What don't I experience!  I typically avoid wheat (and gluten for that matter) as I'm pretty sure it makes me sick, but when I slip (or someone else slips me some) I end up with massive amounts of joint swelling and tenderness, diarhea, cramping, gas, bloating and brain fog.  I'm absolutely miserable.  Just that alone is enough to keep me off gluten. I have RA, so if I have repeated exposures I'll have a flare which SUCKS!

Like clockwork, I get massive pain in one or both hips with certain movements when I deviate from a low-wheat regimen. I also get heartburn, and difficulty sleeping as well. All are very good reasons to stay off the grain, for me.

depends if it is a fleeting re exposure of prolonged. no symptoms in former and in latter i get weight gain and a crackling but not painful back but im young so that explains the the painlessness. 26 yo.quiv

The varied responses to wheat re-exposure could literally fill a book.

What is amazing is that this is just a "food"--it's not a poison, medication, or some foreign chemical like a pesticide. It's just wheat.

I know that someone like Charlie would come on and say something like "it's all in your head." I hear this all the time.

I'm wondering your views on wheat products contained in cooking flavorings such as soy-sauce etc.
I've cut out wheat from bread and flour however going through all my condiments there is a small amount (~4-8% ) of wheat in these.  The physical amounts are obviously quite small in cooking so for example 8% wheat in soy-sauce would translate to about 1.5 grams out of a 20ml tablespoon serving.
It would be very hard to go the extra step and cut out my cooking condiments.
I’m not wheat intolerant, obviously.  Your thoughts?
Thanks

I have severe joint pain, especially in my knees and hips, when reexposed to gluten.  I also had GI issues in the form of slowing things down.  I went gluten free last April 2010 and had 1 exposure in September and that was enough for me to cut it out for good.  All my tests show no reaction to gluten (blood/stool), but I know there is something there my body does not like!

ps:  I agree with others who wrote about gastrointestinal flora.  I believe we need to address these issues in a broader way.   A person could have a bacterial or parasitic overgrowth (or yeast for that matter) that are "carb" feeding, causing GI distress when wheat is consumed.

Dr. Davis,

Your blog has been educational and inspirational to me as a medical professional.  I have been lurking for several months, perusing old blogs and waiting for new ones.  The conversations in the comments are interesting, sometimes heartbreaking with the illness that people have suffered before the true cause has been found.

I write now because the improvements in health the removal of wheat, and various reactions with the re-introduction of it is something that has been known in the field of Environmental Medicine for over 40 years.  

Foods other than wheat, as well as environmental chemicals, can cause similar problems with ill health.  An older, but still useful, book on the subject is 'Alternative Approach to Allergies' by Theron Randolph, MD.  In it, Dr. Randolph describes his work with food and chemically sensitive patients, his theories on why this happens, and his observations on treatment.  Because these sensitivities are highly individual, the gold standard multi-centered double-blinded placebo-controlled studies are impossible to do.

As with many doctors who practice outside the 'normal' medical paradigm, I have family and personal experience with food and chemical sensitivities.

My father had had cluster headaches since he was a young man.  He saw Dr. Randolph in the early 1980's, when I was a freshman in medical school.  Dr. Randolph diagnosed sensitivity to wheat and corn (not sure of the technique).  My father also found orange juice triggered headaches.  

When he removed these foods from his diet and went on a strict four day rotation diet, his headaches quit.  That is not the natural history of cluster headaches.  When I mentioned this to anyone at school, I was told that it was the wrong diagnosis, or it was a coincidence.  It is best to not rock the boat, so I kept quiet after a while.  

The next year, as a sophomore, I had a chemical exposure from new carpet in my apartment.  Whether it was the glue or the finish, it made me very ill.  I became confused, developed nasal allergies, couldn't do simple drug dose computations, and depressed.  My mother had to come and help me move.  Very embarrassing for a 20-something to need mommy, but I did.  

I eventually recovered almost back to normal, but even now my memory and ability to concentrate on technical materials is not what is used to be.  

My dad went back on a conventional diet after 4 years, and his headaches did not return.  He has developed diabetes, arthritis, and balance problems.  I suggested his diet might have something to do with all of this, but he is unwilling to change.  It is hard to convince an 87 year old man that he shouldn't eat his wheaties!

Extrinsic Asthma is triggered by pollen, chemicals or some other external agent; Intrinsic Asthma is triggered by boggy membranes, congested tissues, or other native causes… even adrenalin stress or exertion.

I really wish that I had tangible reasons to avoid wheat, but after a fast-food experiment at the end of last year, I had no problems to report whatsoever. So I have to rely on the theoretical information I have to motivate my avoidance of wheat.

My goodness, I didn't even know wheat can cause these. I just found ways to cure arthritis. Anyway, prevention is better than cure.

Dr. Davis,

My name is Barbara and I have been going to you for several years.  I have been using benecol light on my husbands sweet and white potatoes.  After seeing your blog on plant sterols I am worried that I am giving him something thats not in his best interests.  Would you please comment.

My son and I both have asthma, and we manage with a combination of conventional medicine and some alternative treatments like respitrol for asthma.

Nin Jiom Pei Pa Koa (http://ninjiom-hk.cwahi.net/) may be another choice. i know alot of people use it, its also non alcoholic, though it's effectiveness is not as good as alcohol based cough medicine, but it's still good to use on not so serious scratchy throat.

I started gluten/wheat free 5 days ago. But two days in and I started having terrible flatulence and loose stools. Are they connected?? Patellofemoral arthritis in both knees feeling great tho.

Diet is an important measure in preventing the diabetes. Look around you: People gain weight, they become pre-diabetic and diabetic. Lipids and lipoprotein patterns emerge: increased triglycerides and VLDL, reduced HDL, small LDL. Blood sugar goes up, inflammatory responses are ignited. You feel crumby, cancer risk is increased.

Speaking of wheat in the diet, I'd strongly urge anyone suspicious of gluten enteropathy, or "celiac disease," to get the Enterolab blood test, which has replaced endoscopy as the "gold standard" for diagnosis (don't let the gastroenterologist tell you otherwise). Quality of life is profoundly preserved through early diagnosis, and the medical community is largely clueless on this issue. -Keith.

No.   I eat a lot of whole grains (as part of vegan diet).  What is the health-upshot?  I have a little over 5% body fat, a resting heart rate of about 50, and a cholesterol level a little over 100.  And the diet is easily digested and I'm very active.  And I am more concerned about getting hit by a meteorite than getting diabetes or having heart problems. You can read a good relevant write-up here
www.drmcdougall.com/stars/peter_rogers_md.html

Perhaps there are some people with a specific allergy problem with a given grain (such as wheat), but the comments above are way off.

The diet I'm describing has profoundly helpful affects on both the heart and diabetes front as someone like McDougall's work makes clear.

I'm afraid that you are the occasional exception. These comments do not apply to everybody. Just the majority.

I'd appreciate a little clarity around what is meant by "grains" Whole grains cover a wide range of
different types ... wheat, rye, oats, etc. Are they all "bad"? You have mentioned flax (a grain)
for example as being "good". So which is which?
I ran across a grain called Salba promoted by a health food store as a healthy alternative for
those allergic to wheat ... but it's still "grain".

It depends on what you are trying to accomplish.

Some people who are exquisitely sensitive to any grain can do well by restricting themselves to ground flaxseed, barley, and some of the more obscure wheat "alternatives" in small quantities like quinoa, sorghum, and bulghur.

However, some people just need dramatically reduce wheat only and can do quite well.

Some people, e.g., those at true ideal weight with Lp(a) and no small LDL, don't benefit by a grain restriction at all.

I'd estimate that 70% of people would fall into the first or second category.

I can't argue with your results, but as a physician with a very strong interest in nutrition I have to disagree with your conclusions. In most cases it isn't the wheat that is harmful but the processing that strips it of its nutritional value, or the other junk like partially hygdrogenated fats found in the wheat containing products. Your simplified message works well for those that lack nutritional sophistication but is an unnecessary limitation for those with more nutrititional knowledge and the discipline to use it(such as the vegan commenter, Keith).

A breakfast of kamut (an ancient form of whole wheat), barley, and oat grains soaked overnight and rinsed, ground flax seed, and rice milk is low glycemic, high in protein, B vitamins, minerals, and both soluble and nonsoluble fibers. Soluble fibers improve lipid abnormalites and the insoluble fiber promotes proper digestion and colon health. It will also provide satiety easily until noon. I incorporate grains in this manner into my vegan diet. At 49 I have low blood pressure and pulse and low lipid levels and am proof that those with the nutritional knowledge and the discipline to use it need not avoid grains.

Yes, wonderful point.

I'm guilty of over-simplifying to make a point, though I believe a very important one.

I don't recall if I have read here on this site about the JAMA study from Stanford reviewing the 4 low carb diets and finding that the most effective in pre-meno women was the Atkins in reducing LDL (they presume, small hard atherogenic), lowering TGs 30% and promoting permanent 1-yr wt loss goals.

CONCLUSIONS:  In this study, premenopausal overweight and obese women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight and experienced more favorable overall metabolic effects at 12 months than women assigned to follow the Zone, Ornish, or LEARN diets. While questions remain about long-term effects and mechanisms, a low-carbohydrate, high-protein, high-fat diet may be considered a feasible alternative recommendation for weight loss.

http://jama.ama-assn.org/cgi/content/full/297/9/969

Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women
The A TO Z Weight Loss Study: A Randomized Trial

Christopher D. Gardner, PhD; Alexandre Kiazand, MD; Sofiya Alhassan, PhD; Soowon Kim, PhD; Randall S. Stafford, MD, PhD; Raymond R. Balise, PhD; Helena C. Kraemer, PhD; Abby C. King, PhD


JAMA. 2007;297:969-977.

ABSTRACT  

Context  Popular diets, particularly those low in carbohydrates, have challenged current recommendations advising a low-fat, high-carbohydrate diet for weight loss. Potential benefits and risks have not been tested adequately.

Objective  To compare 4 weight-loss diets representing a spectrum of low to high carbohydrate intake for effects on weight loss and related metabolic variables.

Design, Setting, and Participants  Twelve-month randomized trial conducted in the United States from February 2003 to October 2005 among 311 free-living, overweight/obese (body mass index, 27-40) nondiabetic, premenopausal women.

Intervention  Participants were randomly assigned to follow the Atkins (n = 77), Zone (n = 79), LEARN (n = 79), or Ornish (n = 76) diets and received weekly instruction for 2 months, then an additional 10-month follow-up.

Main Outcome Measures  Weight loss at 12 months was the primary outcome. Secondary outcomes included lipid profile (low-density lipoprotein, high-density lipoprotein, and non–high-density lipoprotein cholesterol, and triglyceride levels), percentage of body fat, waist-hip ratio, fasting insulin and glucose levels, and blood pressure. Outcomes were assessed at months 0, 2, 6, and 12. The Tukey studentized range test was used to adjust for multiple testing.

Results  Weight loss was greater for women in the Atkins diet group compared with the other diet groups at 12 months, and mean 12-month weight loss was significantly different between the Atkins and Zone diets (P<.05). Mean 12-month weight loss was as follows: Atkins, –4.7 kg (95% confidence interval [CI], –6.3 to –3.1 kg), Zone, –1.6 kg (95% CI, –2.8 to –0.4 kg), LEARN, –2.6 kg (–3.8 to –1.3 kg), and Ornish, –2.2 kg (–3.6 to –0.8 kg). Weight loss was not statistically different among the Zone, LEARN, and Ornish groups. At 12 months, secondary outcomes for the Atkins group were comparable with or more favorable than the other diet groups.



Trial Registration  clinicaltrials.gov Identifier: NCT00079573

Is the recommendation to go wheat free entirely an effort to reduce carbohydrate intake or is the claim that gluten has an impact on blood lipids in and of itself?

Stephen_B

Eliminating wheat reduces the carbohydrate load. But it also has the curious exaggerated effect of diminishing appetite considerably. I won't pretend to understand this phenomenon, but the appetite-stimulating property of wheat can be substantial. Removing it returns control to appetite.

So Dr. D, is whole grains actually 'whole cr*p'...*pardon ze french*?  I know that personally (and I'm very physically active) that I would gain 10 lbs per year if I followed the Am Diabetes Assoc pyramid diet eating 11 servings of whole grains and 4-5 servings fruit daily (and insufficient protein and good oils like nuts/seeds, fish oil). And I did gain wt prior to going low carb!
Have a great Thanksgiving!!  We have so much to be thankful for... including this great souce of info and commentary.

The world has clearly gone way overboard on the whole grain kick. 6-8 servings per day of grains according to the USDA food pyramid and the ADA's diet you cite would make the majority of people gain enormous amounts of weight. I see these people every day who come to me frustrated. They're eating "right," following the standard advice and can't understand why they've gained 50 lbs over the past four years and have disastrous lipid/lipoprotein numbers, along with pre-diabetes or diabetes.

Drop the wheat specifically and weight, as you read above, drops like a stone in the majority.

Not everybody needs to do this. If you eat like this and are already at ideal weight with no small LDL, etc., then it may not be necessary. But I find it necessary in at least 70% of people I see.