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Gluten Intolerance

Is Wheat Gluten Bad for Everyone? Adjusting the Paleo Diet if you don’t have celiac

If you are enjoying Sean Croxton’s Paleo Summit and compelled by dramatic stories of  health improvements from eliminating wheat, but are not looking forward to giving up your bread, pizza, beer, and sourdough forever, then I’ve got good news for you.

In the days before celiac disease, everyone’s bread was made with sprouted grain. Sprouting makes wheat more nutritious and lower in carb (12 gm versus 15gm per 1 oz slice of flour breads)

Who can and who cannot eat wheat

Becuase the Paleo diet is wheat free, many people with celiac disease find it an easy way to recover from their symptoms while enjoying great meals. People with celiac disease have antibodies to their own tissues that have developed after their bodies confuse wheat gluten with pathogenic bacteria. Until their immune system can recognize and correct the error, eating wheat triggers intestinal and joint inflammation and fatigue. I describe how processed food promote celiac disease and how to prevent or even reverse celiac symptoms in the video at this post.

If you have not been formally diagnosed with Celiac but had digestive troubles for which you tried eliminating wheat and now you find yourself feeling better, you may wonder if you need to make avoiding wheat a permanent change. To decide, you should assess to what degree you have also eliminated processed foods (including vegetable oils) and reduced your total intake of carbs. These factors alone will generate significant health gains and in the absence of a firm diagnosis of celiac you may try sticking with the low carb, vegetable oil free diet and adding back wheat that has been prepared in a traditional manner.


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If you don’t have celiac symptoms and are following the Paleo diet for other reasons, but are now missing your favorite foods, there’s absolutely no reason not to add them back.

But…

Everyone adding back wheat should be aware that by adding back wheat you can easily consume too much carb and don’t want to exceed 30-100 gm total carb per day–the wide variation depends on your activity level.

Why I do not advise everyone avoid wheat

Wheat gluten may have been prematurely blamed for the current emerging epidemic of celiac disease in the same way that, back in the 1960s, choleseterol was prematurely blamed for the then emerging epidemic of heart attacks. I am confident that, upon further scientific study, we will find celiac can actually arise from other factors that have less to do with the native (existing in the form in which nature made it) wheat gluten molecule and more to do with the molecular changes to gluten that result from the processing of wheat gluten, and not the wheat gluten per se.

And this brings up an important issue. People are using the Paleo diet to accomplish different health goals. Some, to alleviate food allergies, others for weight loss, and still others for body building. This is one reason why we find different variations of the Paleo diet. Another has to do with the fact that we have is limited evidence to inform us on the details of a true Paleolithic-era diet, and so for the most part we’re using our imaginations and different people make different educated guesses.

I see all versions of the Paleo diet as a great way to make first steps towards a truly traditional diet. These days anyone can easily find many healthy and delicious recipes in Paleo cookbooks and blogs to make the transition from a SAD diet to a better one as tasty and as easy as possible.

Still, because the Paleo diet is not directly informed by existing traditions, there are some important missing pieces and even potential pitfalls I think everyone should be advise of.

Adapting Paleo to Your Life: The Good, the Bad, and the Silly

The Good:

Paleo programs value grass fed, pasture-raised, humanely treated animal products: meats, eggs, and dairy. These are far superior to products from animals raised on monoculture grains in filthy conditions and are healthier for us for innumerable reasons. Paleo diets also steer us clear of hydrogenated and otherwise processed vegetable oils containing toxic trans and Megatrans fats that promote inflammation and DNA damage in every tissue of the body.

Other elements of the Paleo diet that will introduce you to important principles of all successful traditional diets include the use of:

  • Fat-rich tropical fruits including coconut and avocado and their oils: medium chain saturated fatty acids
  • Fresh nuts and seeds: fiber, insoluble and soluble, and minerals
  • Fresh vegetables and seasonal berries: vitamins, especially heat sensitive vitamins, and insoluble fiber
  • Nut flours: when fresh ground at the time of use these make for great low-carb baking

Because the Paleo diet provides far more protein than the standard American diet (SAD), it is a particularly powerful tool for recovering from emotional disturbances (most brain neurotransmitters are derived from amino-acids) and for rebuilding weakened muscle and bone.

The Bad:

As a diet based on pre-history, by definition the Paleo diet is not informed by any living tradition and sometimes suffers from lack of attention to traditional cooking methods. While the concept of avoiding industrial foods makes sense, it seems unnecessary to go so far back in time that we have little idea of what life was like, especial if it means ignoring traditional culinary techniques with thousands of years of successful use, for example fermenting and sprouting grains.

Particularly problematic is the fact that some Paleo programs I’ve encountered emphasize lean meats, fruits and tubers, and store bought nut flours. Lean meats combined with foods that raise blood sugar may block your fat-burning enzymes. In addition, abrupt increase in protein intake without increase in fat intake can increase your uric acid level and trigger joint and muscle paina or kidney stones. Finally, nut flours can undergo rapid oxidation and are going to be far less nourishing than the intact nuts, unless you grind your own.

I advise caution with the following Paleo-compatible recipes

  • Fruit smoothies
  • Dishes based on sweet potatoes or store-bought nut flours
  • Skinless, boneless meats

The Silly:

Paleo Pizza. It might be tasty as a salad, but won’t satisfy my craving for melty cheezy goodness.

Any recipe that generates odd adaptations of familiar foods might be fun, but some get carried away. The silliest Paleo recipe I’ve seen is “pizza” lacking cheese or crust and made out of ground beef shaped into triangular piles. Another unnecessary complication is the use of flours for reasons other than better flavor or reducing carbohydrate intake. If you like spelt or coconut or almond flour, by all means enjoy them. But if you don’t, or you like wheat flour better for certain recipes, then use wheat flour.

Finally, Paleo is on-again-off-again with dairy. Some practitioners exclude it altogether based on the idea that animal domestication only occurred after the Paleolithic era. (I discussed my take on the importance of dairy to early human health previously). Others exclude it based on a misunderstanding of the cause and implications of lactose intolerance (I will focus on lactose intolerance in a future post.) Still others include ghee but exclude butter and cream. Ghee is butter that has been heated to coagulate the proteins which then get separated and discarded. Not only does this waste perfectly good protein, heat destroys the heat senstive omega-3 and conjugated linoleic fats and is less nourishing than fresh butter.

Traditional use of wheat

When people first began eating wheat thousands of years ago there were no such thing as flour mills. That means whole wheat flour was non-existent. What did people do to make their daily bread? They first germinated the grains and used the softened seeds to form a dough that could be further transformed by yeasts and other micro-organisms and eventually baked into loaves. Sprouted and fermented foods are one of the Four Pillars of World Cuisine, and we explain why sprouting and fermenting grains makes them healthier in Chapter 7 of the 2009 edition of Deep Nutrition, and Chapter 10 of the 2017 edition.

Dr. Cate

With over two decades of clinical experience and expertise in genetic and biochemical research, Dr. Cate can help you to reverse metabolic disease and reshape your body.

This Post Has 43 Comments

  1. Hi, Dr. Cate:

    I recently purchased the audible version of Deep Nutrition. I have been through chapter 7 twice but have not heard anything about sprouted and fermented foods. Could you please provide the timestamps of the audible copy that speak to sprouted foods if you can find the time?

    “Sprouted and fermented foods are one of the Four Pillars of World Cuisine, and we explain why sprouting and fermenting grains makes them healthier in Chapter 7 of Deep Nutrition.”

    Thanks,
    GFS

    1. I don’t have access to timestamps, believe it or not! But I have a solution to the issue. This article was written before the re-release of DN and the new chapter is 10. Actually, now I’m going to update the language here so thank you for pointing that out.

  2. ove - Paleo Diet, recipes, articles, news, videos | Paleo Diet, recipes, articles, news, videos says:

    […] I love it when intelligent people take a broad view of the paleo approach, and avoid getting bogged down in dogma.  Here, Dr Cate looks at why (and how) wheat can be incorporated into a paleo diet (for some people) […]

  3. This article is a nice change from the general hysteria regarding gluten in the paleo community. My question, Dr Cate, is that I have mild IBS and many paleo advocates are adamant gluten must go but a 30-day gluten-free challenge made no difference, if anything I felt worse without my small slice of butter-laden sourdough in the morning. Should I try harder to eliminate all grains, or instead concentrate on adding in more sauerkraut/probiotics etc? Many thanks for a voice of reason.

    1. 30 days is a good trial and if it made no difference I think your saurkraut/probiotic idea is a very good, safe next step.

  4. HI Dr. cate,

    I’m following the Paleo Diet mostly to leave out all refined sugar and white anything. The NO grains part of the diet bothers me. I eat Ezekiel 4:9 toast in the morning. What is your take on
    this bread?

  5. Nice post! I eliminated wheat from my diet about 2 years ago. Since we really don’t know whether paleolithic people where eating wheat or not, I think it is clear that we do not need it. Some people argue for B vitamins. But really? No way is wheat going to be a better source of B vitamins than good grass fed (and sometimes raw) liver! Fiber? Vegetables are a better source! Anyhow, since the evidence is blurry and wheat is not the best food to begin with, I prefer to avoid it. What do you think?

    1. Our general philosophy is that the Paleo diet is a kind of traditional diet, and one about which we have much less info than more modern traditional diets. Exploring traditional diet commonalities is the central theme of Deep Nutrition and helps us to establish support or lack of support for many modern-day speculations about nutrition, including your other question about food combining. On that topic, the main issue is one of facilitating digestive enzyme function, encapsulated by the rule in our book Food Rules entitled “Use Fat and Salt on Veggies.”

  6. Hi Cate,
    I wonder if the real wheat issue is gluten or wheat germ agglutinin. Each time I eat wheat (essentially white flour), my eczema/psoriasis get back, if the quantity is enough I’m tired after the lunch. But when I read celiac disease symptoms (or symptoms often cited by gluten intolerant guys), I still don’t share all of these symptoms, so, isn’t Wheat Germ Agglutinin the real culprit ?
    I should try to eat seitan (100% gluten !)and compare with wheat germ with little or no gluten.

    1. Wheat germ agglutinin is a plant lectin. Plant lectins are designed for a variety of purposes to bind to glycoproteins and glycolipids. Collagen is a glycoprotein, and if wheat germ agglutinin binds to collagen certainly it could cause it’s own set of problems, though I don’t think it would be the underlying cause of gluten intolerance.

      Our digestive acids and enzymes are supposed to be able to neutralize this sort of plant lectin, however, along with the numerous other compounds plants manufacture to protect themselves.

  7. Wow, your response time is outstanding! Just ordered your food rules book, can’t wait!
    Now if you could just eliminate those CAPTCHA things one has to figure out before posting…I never get them right!

  8. Dr Cate,
    Thank you for suggesting probiotics to me a couple of weeks ago for my incredible gas problem….it went away in a couple of days PLUS eliminated my 25 yr struggle with constipation! You are my hero!

  9. Dear dr. Cate,
    I just read your book Deep Nutrition and want to thank you for writing this book. I learned so much, now I am even more restricted about what to eat…can you answer a quick question, pls…is canola oil in mayo (trader joes)also a no no? I know mayo has no nutritional value, but a tiny bit on a turkey sandwich….you get the picture. I have totally cleaned out my pantry and given away all the crackers and stuff, but would you have a list of good things to snack on?

    1. We use mayo on BLT and in pea salad b/c we can’t seem to get the nack for homemade. We just don’t use recipes that call for cups of it. Click under the recipes tab and poke around there for some quick food ideas.

  10. I keep bouncing between my favorite sources of dietary information, but I still can’t seem to get a grip on the grey areas. I guess continuous learning is the name of the game though.

    As far as wheat, I’ve never had any issues, but reading Wheat Belly somewhat convinced me to stay away from it. It seems that modern wheat is further from the original plant than factory-farmed skim milk is from pasture-raised raw milk.

    Lots of other interesting stuff here too. 300 characters isn’t enough :(((((

    1. I like to always try to put books like Wheat Belly in perspective. Wheat is far from the only plant that’s been selectively bred for several thousand years and its only a matter of time till the next book comes about corn, then soy, then tomatoes, potatoes, broccoli…and, well you get the idea.

      What do you do? It’s more important than ever eat meals that are as nutrient dense as possible, make sure that any vitamins you buy are naturally sourced, and when you can, grow your own!

    1. I’m not a ghee-making expert but since the butter must be heated high enough so that the proteins coagulate I would not consider it raw anymore.

  11. Hi Dr. Cate,
    I saw your comment about the impact of protein/amino acids and emotional disorders, wondering if you could say more about the relationship between nutrition and mood/anxiety disorders. I’m a psychotherapist and have generalized anxiety and some depression. I’ve been on an SSRI for 5 years and like the idea of not having to take them. My clients also often ask me about nutrition and mental health disorders, but I never have any good info for them!
    Thanks,
    Jen

  12. “… no such thing as flour mills.”

    Sure, but there were saddle querns, then rotary querns.

    But as you say, a cereal grain can be processed whole. In fact, one assumes that porridges (or meat/veg pottages with grain in) made from unground grain must have been used extensively in the past. “Creed” wheat was known in England as frumenty (c.f. Hardy: Mayor of Casterbridge). Interesting that bread has largely ousted porridges/gruels. I guess people like the texture of bread – plus it’s portable.

  13. Hi Dr. Cate,

    I’m confused… you say

    “…heat destroys the heat senstive omega-3 and conjugated linoleic fats and is less nourishing than fresh butter.”

    and then go on to say

    “Heat also destroys the omega-3 and CLA in butter, so raw butter is superior and cooking it at HIGH heat (sizzling) starts to damage these special nutrients.”

    but isn’t ghee an ancient ‘traditional’ food prepared at a very low temperature? I don’t believe it’s heated to “sizzling” is it?

    Thanks,

    Annie

    1. Comparing Ghee to butter, butter has protein, Ghee doesn’t. Ghee has been heated and unless you make yourself you can’t be sure how it was made, could have been overheated.
      The function of ghee was preservation in a tropical climate without refrigeration. Any process that preserves may reduce nutrients (except of course fermentation).

      1. I’ve observed that it does resist burning better than butter when sauteing however. I only use it for cooking and baking, which it seems well suited to.

        I don’t make ghee myself, but I do purchase it from a Pennsylvania Amish Farm Cooperative, and I’ve got to say… I’ve never seen butter so orange in my life! It smells wonderful has a more elegant flavor than the butter I buy from them. It makes me wonder if there isn’t more to the tradition than simple preservation.

        A.

        1. Cooking can change the flavor. If they offer it raw, that would be more nutrient rich but it sounds like the ghee is still a great product.

  14. I am so glad to have found you and your Deep Nutrition book. My son and I eat sprouted wheat breads and tortillas. What about the sprouted wheat/grain breads like Ezekiel and brands like that that are made entirely from sprouted grains? Theoretically, they should be free of gluten, right?

    You are the best!

  15. When you say “heat destroys the heat senstive omega-3 and conjugated linoleic fats” is that also true in the case of grass-fed butter or is it more stable for some reason?

    Do you approve of products like Ezekiel or only homemade sprouted bread? Thanks.

    1. Heat also destroys the omega-3 and CLA in butter, so raw butter is superior and cooking it at HIGH heat (sizzling) starts to damage these special nutrients.

      On bread: We take what few shortcuts are available when we can. I enjoy Ezekiel and am aware that others advise against it b/c of added gluten but this relates to my newer post on gluten here: https://drcate.com/is-wheat-gluten-bad-for-everyone/

  16. Hello Dr. Cate: I just heard your interview on Underground Wellness and was very impressed. I just ordered both of your books on Amazon and am looking forward to reading them.

    My wife and I have been on the Weston Price diet for the last 4 years and love it. Hopefully, Sally will invite you to speak at the next conference.

    Thanks and looking forward to learning from you.
    Jack

  17. If my daughter gets itchy (Candida), do you recommend avoiding wheat, yeast and sugar? She’s 7.

    1. A poor diet sets someone up for these types of symptoms and it is likely that getting her diet in order will control them. I’m taking appointments to be able to work closely with anyone hoping to alleviate problems like this with diet changes. More info under the “Make an Appointment” tab.

  18. Thank you for this post and for recognizing the changing landscape of “Paleo”. I appreciate your thorough investigation of nutrition. There is no real “one size fits all” way to eat. To couple your insights with scientific backup make you (in my opinion) one of the most reliable sources. I believe Cordain to be a thorough investigator/scientist, and though we can never be absolutely certain, we do know that our ancestors ate zero processed foods. A good place to start!

  19. Hi Dr Cate,
    Just listened to you on the Paleo Summit and it was great! Do you know any physicians down in the Orange County area that you recommend?

  20. Hi Dr. Cate,
    I loved reading your book Deep Nutrition. I am currently reading Wheat Belly by William Davis MD. and what he writes about is very disturbing to me.The beginning of the book focuses on the fact that now a days we don’t consume the same wheat that our ancestors used for their meals. The wheat now available is made for mass consumption and of course high yield and low price. They have “developed” a seed that withstands a whole lot of droughts, pests you name it. What to do!! thanks!!

    1. It’s important to recognize that what Dr Davis says about wheat can also be said about most fruits and vegetables, as well as other grains. That’s the bad news. The good news is that for the past several millennia all drought tolerant and higher-starch/sugar strains have not been “developed” by man but by nature, and we simply selected the hardiest in an extension of the process of natural selection. The same still applies for all modern non-GMO crops. By sprouting and fermenting we can enhance the nutritional value of all foods.

  21. Hi, Dr. Cate. You write:

    “Still, because the Paleo diet is not directly informed by existing traditions, there are some important missing pieces and even potential pitfalls I think everyone should be advised of.”

    Loren Cordain, S. Boyd Eaton, and Melvin Konner have published estimated composition of Paleolithic diets based on extensive investigation of existing hunter-gatherer cultures. I have to think that Cordain took that into account in his latest book on the paleo diet.

    -Steve

    1. That’s a good point and I am sure the book is fascinating. However, our food chain is not as vital as that which existing hunter-gatherers access. So if a person can’t mimic the diversity of wild game or the diversity of wild plants there are things we can do to make up for that somewhat, which gets back to traditional food prep/cooking practices.

  22. Hi Catey,

    I’ve been sprouting and fermenting for years and you reinforced the importance. I do one or the other with virtually all grains. As for Essene bread – definitely. I make it frequently, but not with wheat; I use rye berries I sprout. After 2 days or so, just put them in the food grinder attachment of the stand mixer, make loaves with wet hands, and bake about two hours on low temp. So yummy.

    Aloha,

    Jeff

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