Wheatless: Free Read: First Chapter

UNDERSTANDING THE
SNOBBISH PROTEIN

One of my most unusual case as a nutritionist was K. He was 12 when his mother brought him to Qua Nutrition in Bangalore in July 2018. He was enrolled in a sports nutrition
programme. During counselling, his mother told us that doctors at a city hospital had diagnosed K with alopecia areata and that his eyelashes and eyebrows were falling off. Alopecia is the medical term for baldness and alopecia areata occurs when the immune system attacks hair follicles (or roots). This patchy baldness can develop anywhere on the body, including the scalp and face, and the hair often falls out in clumps. This can also happen due to severe stress. This was a classic case where, had it been an old person with hair fall, especially a woman, one would have naturally blamed it on hormones and ageing. But this was a 12-year-old. I asked myself the following question: could his genes be sensitive to gluten?
We caution all patients with alopecia areata to avoid the consumption of wheat. However, asking a 12-year-old to give up pizza, cakes, pastries and noodles to only eat healthy food
would have been the very end of civilization for him. Moreover, K was a swimmer who burnt energy in the pool and consumed twice the average quantity of food to build his stamina. Since children do not consume food at fixed times, they end up snacking at odd times. This is why junk food becomes part of the staple diet of many endurance-based athletes globally.
I frequently give the example of Serbian tennis legend, Novak Djokovic, to my clients. In his book, Serve to Win, Djokovic speaks about his love and craving for bread, pasta and pizza
from his family restaurant. He then mentions that he found out his body could not process wheat. Eliminating gluten made him feel instantly better, clearer, lighter and quicker. His renewed physical health and mental focus enabled him to achieve his two childhood dreams: to win Wimbledon and to be ranked as the world’s number one tennis player.
For a 12-year-old, the connection between his eyelashes and eyebrows falling off and giving up his favourite margherita pizza was not all that clear. But since gluten sensitivity or severe
stress is often the cause in such cases, the first thing we ordered was a nutrition gene test. Some of the parameters tested in this test are the gluten and lactose sensitivity genes. The test results came in four weeks and confirmed our prognosis of gluten intolerance.

The next step was intensive counselling and we convinced K that the only way forward for him was to go on a threemonth diet without consuming wheat and wheat-based food items. I told him, ‘If you want to win gold at the next tournament, you have to give up gluten. It is slowing you down.’ I took a paper and drew an intestine along with a forest and miniature soldiers in it. With the help of the illustration, I explained how a thug called gluten had entered that intestine forest and how the little soldiers (his immune system) were
fighting the thug. It was a difficult journey for the boy, but he eventually understood the point and promised to give up wheat. Despite an occasional and perfectly understandable lapse, K seemed to have kept his promise because I later heard that he won gold medals in several swimming competitions. I met him again six months later and he said, ‘Sir, have you noticed?
My eyelashes have grown back.’ Whenever he cheated on his no-wheat promise, he noticed that his eyelashes began to fall again. So, he came to understand that the only way forward
for him was to go completely gluten-free. Curiously, while his blood tests for gluten had been negative, the DNA tests we conducted proved that he did have the genes that made
him sensitive to gluten. Today, K is still on a plan with us and very disciplined about his diet. He needed no further convincing that winning medals and gluten consumption did
not go well together. K’s case led me to some questions and got me thinking about whether we now have more gluten in our food than we can digest. It also got me thinking about whether the modern-day wheat we consume today does us more harm than good.

If someone comes to my clinic and asks, ‘What is gluten?’, I attempt to break it down in a language that even a 12-year-old can fathom. As mentioned earlier, gluten is a protein. But what is a protein? A protein is a block made up of different amino acids. Amino acids are the building blocks of human life. They all have names such as glutamine, arginine, lysine, leucine, valine, histidine, tryptophan, threonine, etc. All these amino acids combine in different permutations and combinations to make up proteins. Gluten happens to be one such protein. However, gluten is present in such small quantities in wheat that it adds no nutritional value and comes nowhere near an egg or a piece of chicken, in terms of protein content. Wheat and other related grains (including barley and rye) contain a mixture of two proteins—glutenin and gliadin. When flour made from grinding these grains is mixed with water, the two proteins combine and form gluten. Without water, it would be near impossible to create gluten. So, by adding or withholding water, one can encourage or deter gluten formation. To maximize gluten formation, a moderate amount of water is ideal. When baking bread, the more the dough is kneaded, the more gluten is formed. This gluten formation causes the dough to become elastic and stretchy, as is the case with bread dough. Kneading causes the gluten strands to get stronger and longer. However, if too much gluten is formed, the dough stops stretching easily and becomes tough and chewy. Relaxing or resting the dough reduces its elasticity, making it easier to roll out. Unlike bread dough, pastry dough is only mixed until all the ingredients are combined, resulting in less gluten development. However, if there is too little gluten in the pastry dough, it will quickly disintegrate. This is also why while making crumbly cookies, the cookie dough is not kneaded at all. The problem with gluten is that it is a snob that thinks it is royalty—it does not believe it should be broken down.
Gluten thinks it is mother nature’s gift to other ingredients. The trouble starts when gluten enters your gut believing that the acids in the stomach cannot subjugate it. Normally, digestive enzymes break down the long strands of protein, as is the case with proteins from eggs, meat or milk. The enzymes cleave or break off into groups of amino acids called
peptides. Gluten, however, refuses to be broken down into smaller parts. It continues on its journey from the stomach, relatively unaffected, into the intestine, where it meets the
gut microflora or microbiota (the microorganisms including bacteria, archaea and fungi that live in the digestive tracts of humans, other animals and insects).

The gut microbiota provide essential capacities for the fermentation of non-digestible food bases such as dietary fibres and endogenous intestinal mucus. A significant function of the
intestinal mucus layer is to form a barrier for the intestinal epithelium (single-cell layer that forms the lining of both the small and large intestine [colon] of the gastrointestinal tract).
It protects the intestines from pathogenic invasion. The great diversity of the human gut microbiota implies a vast catalogue of metabolic pathways and raises questions concerning the involvement of microorganisms in the metabolism of different nutrients. It is like a library, in which one can catalogue many subjects (microorganisms). Each subject has its books (individual species, for example, lactobacillus) and then each book has its own chapters (the metabolism of these species where each microorganism has its own biochemistry circuits). They are all working either synergistically or antagonistically
in the gut.
For many people, the gut microbiota contains bacteria that produces enzymes to break down the gluten molecule. However, this is not the case with everyone. For many, their
gut may not have the capability to break down the molecule. As a result, the gluten does not pass out of the body very quickly. It stays in the intestine and starts knocking on its
doors to make its way to the bloodstream. The intestines are like an immigration office and gluten is like a VIP passenger that wants to bypass all rules and regulations.
In these cases, since the gluten does not want to be disintegrated, it starts to throw its weight around, pushing against the intestine walls and sending signals to zonulin, a receptor found in the blood. The zonulin, in turn, expands the gaps in the intestine. Most amino acids are broken into tiny molecules, so the intestine does not need to expand its doors. However, gluten causes it to expand repeatedly over the years, tearing and enlargening the gaps in the intestine. It bypasses the normal process (followed by other amino acid molecules) and enters the bloodstream. Now, guess what? The immune system in the body cells issues a red alert against gluten. The immune system sees gluten as an invader, and now, begins the battle. We have a protein entering the blood and the immune system views proteins as viruses, bacteria, fungus and larger molecules. Therefore, an autoimmune attack is triggered even though gluten is not bacteria or fungus. As a result of this, inflammation develops. Our bodies have many healing mechanisms to deal with this daily trauma occurring inside us. But, as we get older, our healing mechanisms begin to weaken, and then the symptoms of inflammation can show up aggressively. At this stage, the
gluten in our blood breaks down into a morphine-like substance called gluten exorphins. These are bioactive, which means that they activate receptors in our bodies—in this case, the opioid receptors.
Simultaneously, in our brain, the exorphins (also called gluteomorphine) reduces the body’s pain and emotional pathways via these opioid receptors. The feel-good factor is so high that you feel like eating more of these foods. Just think of the cravings and comfort eating associated with carbohydrates. Constant activation of our opioid receptors causes them to
‘down-regulate’ (or shut down), which means we require more quantities each time to activate them. Gluten, working just like a drug in the body, kickstarts the spiral of overeating of carbohydrates and upon refraining, a sense of ‘withdrawal’ from carbohydrates ensues.
Certain findings show that those who crave carbohydrates, such as biscuits, cakes and pastries, are pointedly less depressed after snacking, whereas those who do not crave carbohydrates experienced fatigue and drowsiness post consumption.This also means that carbohydrates can restore some energy for someone who craves them, much like a coffee drinker who becomes more active after another cup. The theory of dietary influences on mood is based on the suggestion that the balance of protein and carbohydrate consumed in a meal can affect the neurotransmission of serotonin. One assumption of this theory is that meals high in protein increase alertness. A second assumption is that carbohydrate-rich snacks and meals will alleviate depressed mood, especially ones occurring due to carbohydrate-craving obesity, premenstrual syndrome and seasonal affective disorder. It is argued that these syndromes are predominantly characterized by a depressed mood and a craving for highcarbohydrate foods. Gluten can ‘mask’ its own toxicity through exorphins that are produced through the digestion process. The process of documenting the client’s clinical symptoms through a simple interview, by observing their history of bowel
movements and moods and by noticing inflammation markers in their blood test, allows me to ask them to take a DNA gluten and food intolerance test.There are two types of people who come to me—those addicted to and affected by gluten consumption, and those
addicted but not affected. The first type come to me with issues like eczema, psoriasis, severe migraines and acne, allergic rhinitis (continuous sneezing), etc. I believe many health issues such as thyroid problems, diabetes (which is autoimmune in children) or even joint pains occur because of gluten. So, when I meet these people, I get enough data from them to first convince them to do a gluten sensitivity test. If their test comes back gluten-sensitive, I use those tests to persuade them to stop gluten consumption. Even if they are not allergic, gluten can still have ramifications on the brain and the intestinal systems. People
often feel there is no truth to such a correlation, but there have been times in the past as well, when people have been incredulous of activities causing health damage. Smoking is
the perfect example of this. As little as 30 or 40 years ago, even doctors said smoking a few cigarettes would not do any harm. But today, in India, the desire to stop smoking is so
intense that smoking in public places is banned. Why? We have evolved our belief with the availability of more scientific data on smoking. I am a passionate believer that in the next decade or so, there will be substantial data on gluten sensitivity and that it will become part of mainstream health awareness and monitoring programmes. Hence, my intense focus on the subject—to make people in pain listen.

This is where the second type of clients come in—those I like to call ‘lifestyle people’, who are vain. They come for weight loss and anti-ageing tips, to play better sports, etc., without any signs of gluten allergy. For them, externally, the symptoms of gluten allergy are often non-existent. We conduct genetic tests, which, besides gluten, can also analyse other parameters such as the vitamin profile, type of cooking oil or coffee you consume,
and so on. Are you caffeine sensitive? Are you lactose sensitive? Are you gluten sensitive? There are nearly 60 parameters that we consider for this category of people. This segment of the population does not see any reason to give up gluten, since there is no pain. People in this category usually say things like: ‘I do not want to do gluten testing’, or, ‘I will take a gluten test, but even if it is positive, I will not stop taking gluten. I want to cheat.’ To deal with clients like this, I ask them to limit wheat intake to once a week or to take an enzyme that helps in breaking down gluten. This enzyme does not guarantee complete protection,
but it is better than having a headache or loose motion. Most clients find that their body feels better and they have more energy in the absence of gluten and they agree to go ahead
with my nutrition plan in the end.