What’s the best diet for a pregnant woman and her unborn child? Are there foods that should be avoided? The Nutrition Society, in the manner of many other organisations and authorities, warns about soft cheeses, raw eggs, fish like swordfish and marlin high in heavy metals, and even vitamin supplements containing vitamin A.

But like most establishment bodies, they don’t hint at any risks linked to the consumption of gluten or grains. Many bodies positively recommend consuming wholegrains as part of a so-called ‘healthy diet’. What’s going to happen now there’s a major study out, published in the British Medical Journal, that says women who eat the most gluten run a two-fold greater risk of giving birth to a child who develops type 1 diabetes compared with those who consume the least.

The study isn’t conclusive because it’s based on a 360 item food frequency questionnaire answered between 1996 and 2002 by over 90,000 Danish women in week 25 of pregnancy. Follow-up was about 15 years. But the proportionate increase in type 1 diabetes incidence in children born to mother’s consuming more than 20 grams of gluten a day, compared with those consuming less than 7 grams per day, was inescapable. This comes at a time when there’s a push to try and cement and increase whole grain consumption internationally, including in Asia where gluten-containing grain consumption has traditionally been “very low”. In trying to explain this robust trend, the authors of the Danish study, led by Julie Antvorskov and Knud Josefsen from the Bartholin Institute in Copenhagen, consider the complex interplay of factors that might be responsible. It includes the pro-inflammatory effects of gluten and its potential to increase gut permeability and elicit autoimmune reactions. They also reference a lot of the published science, both in animal studies and humans, that points to inflammatory, immune and autoimmune effects of gluten in the diet.

The emerging evidence of risks associated with gluten, including on unborn children, is the very reason the ANH Food4Health guide, unlike guidance from governments or most other authorities, avoids all gluten-containing foods. We sometimes find ourselves getting a little impatient about complaints being made by the pro-gluten brigade which so often expresses concern about the risks of key food groups being left out. These same critics are somewhat mute about vegetarians and vegans – despite whole categories, namely meat or dairy – being omitted from the diet. It’s important to get some perspective on the scientific facts, and surely we owe it to the next generation to give them the best start in life?

So, we think it’s the right time to add gluten-free pregnancy and gluten-free weaning, to more established benefits that give babies a flying start, including vaginal delivery, breastfeeding for at least 6 months and circulating vitamin D in the optimal range (100-150 nmol/L [40-60 ng/ml]).

That’s why as part of September’s #ThrowbackThursday we’re sharing two of our previous articles on the problems that can be caused by gluten to give you the information needed to make a decision about whether or not you should go ‘gluten-free’.


What’s the big deal about gluten?

Up until recently, most people, whether members of the public or health professionals, thought a gluten free diet was only for the 1% or so of people diagnosed with coeliac disease. As research progresses and results from clinical practice emerge, we now know that gluten (a protein found in some grains) and associated proteins (gliadins and glutenins) can contribute to health issues in a much wider part of the population. The spectrum of gluten-related disorders broadly spans three categories: auto-immune, allergic and non-autoimmune/non-allergic conditions.

Gluten-related disorders

Widely acknowledged as the world’s leading expert on gluten-related disorders, Dr Alessio Fasano MD, along with his former team at the University of Maryland School of Medicine, Baltimore, proposed the following classification of the disorders (Figure 1), which may even be too simplistic.

Included among those affected by gluten are therefore not only coeliacs, but also people who suffer from wheat allergy (Ig-E and non-Ig-E-mediated) and those who have, what is now referred to, as Non-Coeliac Gluten Sensitivity (NCGS). First referred to in the 1980s, NCGS is the term used to describe individuals suffering a range of symptoms, not linked to auto-immune disease, that quickly improve after gluten is removed from the diet, and in which both coeliac disease and wheat allergy were properly ruled out. If gluten exposure is maintained, there is a risk that very serious conditions, such as autoimmune thyroiditis, may occur in around 1% of the NCGS population, itself difficult to estimate given the low rates of reporting and medical diagnosis.

Making matters even more complicated is the scale of under-reporting linked to gluten-mediated type 1 diabetes and cancer, both of which are triggered via autoimmune reactions (Figure 1). These conditions are frequently undiagnosed as being gluten-mediated and being forms of ‘silent coeliac disease’, they result from years, or decades, of chronic exposure to gluten.

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Are you courting autoimmune disease with your daily staple?

In case you hadn’t noticed, as a society, we are now dying slowly (mostly uncomfortably and painfully) from chronic inflammatory and metabolic diseases, not fast from acute infections as our ancestors used to. Interestingly nothing much has changed in 40 years as far as genes and environmental triggers go, yet acute chronic disease rates continue to rise. Would it surprise you to know that we’re not born with the destiny to develop chronic inflammatory diseases (CIDs)? The stark fact is that our current health crisis is not down to genetic changes or pathogens (infections), it’s down to something we are doing to ourselves and the planet.

I’ve just had the extreme pleasure of sitting in 3-days of back to back presentations on all aspects of autoimmune disease (AID) at the Institute for Functional Medicine’s 2018 Annual International Conference. I know this might not seem like everyone’s idea of a good time, but we practitioners are a strange lot! The conference focused on the interplay of the gut, genes and the environment in an attempt to stitch together the ‘puzzle of autoimmunity’. Given that more than 100 autoimmune diseases have been identified, there was a lot of ground to cover. Yet, despite multiple diseases and multiple symptoms the causes and treatment approaches are often much the same.

Among the most important, known stimulators of autoimmune and chronic inflammatory diseases are gluten (the protein in wheat, barley, rye, spelt and triticale) and gut dysbiosis, aka unhappy gut bugs! Add obesity into the mix and you have the components in place for the perfect autoimmune storm.

This is a subject close to my heart as I developed Graves’ disease (an autoimmune disease) at the age of 17. Back then no one knew anything about the connection between gluten and autoimmune thyroid disease, so I underwent 2 years of extreme drug therapy. It didn’t work, and culminated in surgical removal of my entire thyroid gland (full thyroidectomy) at the age of 20. My passion for what I do in the natural health space was spawned the day I walked away from the surgeon’s office – young, vulnerable and still sick, but out of medical options. They washed their hands of me, job done. It took me 25 years to find what worked, but only 3 months to regain my health. No one has to suffer the same fate now we know how to prevent and treat gluten-related autoimmune disease.

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