Gluten Free Choice Consulting

The Mayo Clinic, Dr. Tom O'Bryan, and others have stated that celiac disease is primarily a neurological disease, and that classic celiac symptoms - primarily gastrointestinal - are like the tip of the iceberg, while other physiological effects are far more common. These effects include significant neurological and mental health disorders, learning disabilities, and problems with cognitive and motor skills.

In 2008 I wrote an article called “Gluten, Celiac Disease, and the Brain”. Below is a follow-up article that makes a strong argument for more widespread consideration of the effect of food sensitivities in the treatment of neurological and mental health disorders. This area is a special interest of mine. If, after reading the article below, you have a story you wish to share, I'd love to hear it (choosehealth@glutenfreechoice.com). I am always trying to learn more, and sharing your experience might also help someone else some day in the future.

“No illness which can be treated by diet should be treated in any other manner.”

Food For Thought: A Gluten-Free Brain for Better Neurological & Mental Health

More than 57 million Americans have been diagnosed with a mental health disorder, an estimated one in four-to-five adults. A recent study in the United Kingdom revealed that 6% of the population suffers from neurological disorders that run the gamut from numbness in the hands and feet to complete immobility. Learning disorders, developmental delay, and attention disorders also have a neurological component. While environmental contamination certainly is thought to play a role, is part of the problem what we are eating?

One food substance has increasingly been associated with neurological symptoms - Gluten: a protein found in the cereal grains wheat, rye, barley, and related species. Gluten sensitivity has been studied extensively in relation to the hereditary autoimmune disorder celiac disease, which is estimated to affect at least one per cent of the population; but gluten sensitivity can also be present in the form of gluten intolerance—difficulty digesting and processing these sticky grain proteins—which may affect a much larger percentage of the population. Gluten sensitivity can lead to neurological and mental health effects in various ways, including: Triggering inflammatory autoimmune responses throughout the nervous system; Producing narcotizing effects on the brain; Inducing changes in brain perfusion, or blood flow; And, through celiac disease, causing the malabsorption of key nutrients necessary for optimum neurological and mental health.

To undertake a comprehensive study of the more than forty neurological and mental disorders linked to celiac disease and gluten intolerance would require several volumes and a lifetime of study. Consider the table below listing neurological and mental health disorders that may be related to celiac disease.

Those who study celiac disease, such as Dr. Thomas O’Bryan, have often stated that the gastrointestinal symptoms commonly grouped together as “classic celiac disease symptoms”, are like the tip of the iceberg, and that neurological illness related to consuming gluten is really far more prevalent in the population at large. In recent years, this seems to have become the consensus.

We know that certain foods, including gluten, can trigger neurological and behavioral symptoms; we also know that people who exhibit learning disabilities, mood instability, mental illness, and even criminal behavior, can change their diets and overcome previous behavioral patterns to live healthy, productive lives. A review of Barbara Reed Stitt’s work with probationers reveals how prevalent mental health conditions and accompanying medical conditions such as reactive hypoglycemia, are among those who are incarcerated. Treating prisoners with a dietary approach is a potentially huge source of health care savings, especially considering that the US has the highest documented incidence of incarceration in the world—3.2% of all US adults. (There are also nearly 100,000 juveniles held in correction facilities.) On average, states spend 7% of their annual budgets on corrections.

Daily headlines tell us that our entire health care system is in crisis. We need to be looking for a way out. Caring for mental and neurological illnesses takes an enormous bite out of our health care budget. Consider this: Health care consumes 16% of GDP (Gross Domestic Product) and is expected to increase to 19.5% of GDP by 2017. Mental illness, as a subset of health care, affects at least 20% of all Americans, and it is the second leading cause of disability. Sadly, less than half of those who suffer mental illness may be receiving treatment, at least in part due to lack of health care access.

We still have a long way to go to understand all the pathological mechanisms behind neurological and mental health disorders, and what role foods and food-related substances play in triggering symptoms. However, the clinical evidence, gathered from well-respected, peer-reviewed journals, is significant. The hundreds of millions of people who suffer daily from neurological and mental health disorders linked to substances found in common, everyday foods, can make dietary choices that will have a positive impact on their health, ease the difficulty with which they live their lives, and, in some cases, help them to achieve complete recovery. It is time for the public to be made more aware of this important connection--that what we eat has such a powerful effect on simply who we are as individuals. We are what we eat, and it is vitally important to include diet as an integral part of any treatment plan, and to avoid jumping immediately and exclusively to pharmaceuticals when considering treatment of chronic neurological and mental illness.

One of the most critical questions we must now face as a society is why haven't we begun to implement, on a wider scale, the dietary changes necessary to begin to turn things around? And, significantly, why are institutional diets—those found in schools, hospitals, and prisons—still full of problematic foods? Do our institutional diets allow for the choices necessary to accommodate individual reactions to foods, including food sensitivities, allergies, and intolerance? It is time for every physician, teacher, school system, hospital, and correctional institution to increase its awareness and begin to implement system-wide changes. In providing for those with gluten intolerance, this means going beyond offering salads without croutons and sandwiches without bread! It means offering attractively-prepared naturally gluten-free foods like safe whole grains, seasonal vegetables, and humanely-raised animal proteins. Does it cost more to provide this type of diet for our growing children, for our medically and psychologically fragile population? Sure, it does. But food production costs must be weighed against the heavy burden of our out-of-control health care system, and the suffering of those with treatable, even preventable, mental and neurological health disorders.

Some scientists have suggested that environment plays a role in the well-documented increase in neurological and mental health disorders, but, I think we also need to ask ourselves as a society – what are we feeding ourselves and those who depend on us, and can we do better? We already know the answer. We also know that good nutrition begins at home, so, above all, I hope that every parent learns to pay attention to the subtle and not-so-subtle signs of food sensitivities in their own children, and then chooses to feed their children appropriately. We know now that “eating everything on the plate set in front of you” is not always the best advice. As a nation, we face an epidemic of childhood obesity, rising rates of childhood allergies, skyrocketing Autism diagnoses, and one-in-five children that struggle with a learning disability. As a mother and health care professional, this reality is quite frightening to me. Continuing on the path we are following can only lead to a worsening of our nation's health care crisis and hardly bodes well for our childrens' future.

Copyright Wendy L Cohan, RN, November, 2010 - Gluten Free Choice Consulting