This is the final version that was given at the Annual General Meeting of
the Calgary Chapter of the Canadian Celiac Association, March 15, 1997. 


             Gluten is a Dubious Luxury of Non-Celiacs
                                by
                            Ron Hoggan

Note: In this paper I use the term "gluten" and "cereals" generically, as we
 celiacs use it, to refer to all toxic proteins in wheat, rye, barley and oats.

One must wonder why, in spite of increasing life-spans in the advanced
industrialized nations, modern medicine has failed to clearly identify the
cause of many neurological, autoimmune and malignant disease. The
gluten-free diet is only recommended where there is a clear indication of
advanced, gluten-induced disease, but is this the best advice?

We may sometimes feel disadvantaged by the strict gluten-free diet we have to
follow. It is costly and inconvenient. But perhaps it is those who continue
to consume glutinous foods who should be concerned. Gluten, while dangerous to
celiacs, has never been investigated for deleterious effects on the general
population. Yet we have studies that show that hunter-gatherers following
traditional life-ways do not develop the neurological, auto-immune and
malignant diseases that people living in the industrialized world
experience, and these people rarely eat gluten-rich foods (1,2). There is
already compelling evidence connecting the advent of agriculture to bone
and joint disease (3), and humankind has only been cultivating cereal
grains for approximately 10,000 years (2,4), which is but a brief moment in
evolutionary terms. Remember too, it is only a small population located in
the Near East, that has had that length of exposure to cereal grains (4);
most of the world has had agriculture for an even shorter period of time.
Neurological and auto-immune diseases, as well as malignancies, are
over-represented among celiacs (5), suggesting that glutens/gliadins may be
a major environmental contributor to such diseases. Yet this area of
investigation appears to have been avoided in research on these health
problems. One must wonder at the cause of this neglect of such an
important possibility.

There is abundant evidence connecting the advent of agriculture with
retardation of long bone growth, dental enamel hypoplasia, iron deficiency
anemia (indicated by porotic hyperostosis), juvenile osteoporosis, and joint
disease (18). Do these conditions sound familiar? Many are the commonest
signs of celiac disease, and they were apparently the rule, not the
exception, in cultures adapting to agriculture.


We know, from palenotologists' study of human remains from the ancient past,
that when a culture begins to cultivate cereal grains they experience
substantial reductions in height, which is variously reported as 5" and
6"(2,4). Clearly, the reduction is substantial and significant. We know,
too, that these remains demonstrate weaker bone structure (through
reductions in peak bone-mass) and evidence of articular damage(3).
Additionally, ancient Egyptians, who consumed a diet that would be
considered very "heart-healthy" in our culture, have left behind mummies
which clearly demonstrate atherosclerosis (7). While the evidence from the
ancients is compelling, there can always be counter-arguments and debates
when we are reaching back as far as 10,000 years into the past. Yet a few
marginal pockets of scientific enquiry have explored a few elements of
modern implications of this issue.

W.J.Lutz (4) has offered an alternative perspective on the "French Paradox."
(The "French Paradox" is the unusually low rate of death by myocardial
infarction among the French despite quite high per-capita rates of fat
consumption.) Dr. Lutz has studied the spread of agriculture through
Europe. He presents a picture whereby the spread of agriculture, and thus
the period of time a culture has been exposed to cereal grains, is
inversely related to the incidence of cardiovascular disease. The
underlying assumption, of course, is that the longer the exposure, the
greater the likelihood that those who were intolerant to these grains were
trimmed from the gene pool of such cultures; it seems that the less time a
culture has been exposed to gluten, the greater the portion of the
population that continues to develop cancers and cardiovascular disease.
(Lutz also provides similarly compelling data on the rates of breast cancer
mortality.) 

This work is confirmed by Simmoon's observation that there is a negative
correlation between the frequency of antigen HLA-B8 and the length of time
wheat farming has been practised in various parts of Europe (19). 


Another interesting study done in China produced what the investigators
found to be rather surprising results(8). In this investigation, the
researchers plotted the diets of more than 3500 rural Chinese women, and
measured their levels of SHBG (sex-hormone binding globulins). They were
very surprised to find that wheat consumption, and perhaps, reduced fish
consumption, were the strongest predictors of levels of SHBG, which would
indicate an increased risk of cardiovascular disease.

Another study has connected gluten with neurological illness (9). This group
of researchers tested 53 patients with neurological illness of unknown
origin for antibodies against gliadin. More than half of them (30 people)
demonstrated these antibodies. Nine of those folks proved to have celiac
disease, but the other 21 only demonstrated an immune response to gluten, of
a type that is often dismissed as meaningless. This study has some
far-reaching implications for neurological research.

Yet another indication that celiacs are not the only segment of the
population to suffer from the adverse effects of gluten is a study that was
carried out on a very small group of siblings of celiacs(10). When subjected
to rectal gluten challenge, half of the siblings showed an immune response
to gluten, but these results did not correlate with the hereditary
predictors of celiac disease.

As for the connection between autoimmunity and cereal grains, it is clear
and compelling. The theoretical perspective of molecular mimicry suggests
that gliadin-derived peptides, may activate the immune system against
collagenous tissues, and since intestinal permeability (not celiac disease)
is all that is required to allow the passage of these peptides into the
bloodstream, a significant number of many types of autoimmune diseases seem
likely to benefit from a gluten-free diet (11 ).

In total, then, there are several studies which demonstrate (often
coincidentally) that a much larger group than those with celiac disease are
mounting an immune response against gluten, and that this response is
causing or contributing to serious illness. Phytic acid in whole cereal
grains binds to minerals, including calcium. This chemical bond is not
broken in the GI tract. The net result is the binding and wasting of
much-needed dietary  calcium, even among those whose immune systems can
tolerate gluten, and these grains may be implicated in osteoporosis (12). 


I would now like to draw your attention back to the issue of malignancy.
_Medical Hypotheses_ will soon publish, a paper I have written which
suggests (among other things) that gluten may be implicated in a great many
cases of lymphoma (14). Gluten has been demonstrated to interfere with the
celiac patient's ability to mount an immune response to malignancies
(15,16,17). In my paper, I have postulated a dynamic whereby gluten may have
a similar effect in others who are simply sensitive to gluten, or who have a
sub-clinical form of this disease.

Ray Audette, a populist writer, has said that Stanislaw Tanchou "....gave
the first formula for predicting cancer risk. It was based on grain
consumption and was found to accurately calculate cancer rates in major
European cities. The more grain consumed, the greater the rate of cancer."
Tanchou's paper was delivered to the Paris Medical Society in 1843(20). 

We hear all the time about pollution in the industrial world being the
source for modern man's high incidence of cancer. It is the chemical
additives, we are told, in the food we eat, that causes much of the
problem. Perhaps. 

I would like to suggest that the evidence from antiquity, the pattern of the
spread of agriculture in Europe coinciding with the patterns of civilizatory
illnesses, the levels of SBHG associated with wheat consumption, the high
incidence of gliadin antibodies among those with neurological illnesses of
unknown origin, the sensitivity to gluten among siblings of celiacs in spite
of the absence of genetic indicators associated with celiac disease, and my
own investigation of the literature regarding lymphoma, all point to the
strong possibility that gluten is a dangerous substance to many more people
than just celiacs.


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