His parents were stunned when the doctor suggested he go off bread and avoid all foods with flour. What was going on, they wondered? Isn't bread the staff of life? Isn't it an integral part of what we should be eating for optimum health?

We're told the Mediterranean diet is good for us, for what it does for our cardiovascular systems. We don't hear that it is tough on our guts, and that the Mediterranean countries have high levels of coeliac disease (severe gluten sensitivity). The Italians are foremost in researching the subject.

A lot of new research indicates that a diet high in grains - even whole-grains - may not be so good for some people. These are people with a genetic problem with gluten. They often come from families with digestive problems. Various grains contain gluten proteins. They put elasticity into the cooked product. Wheat has the highest gluten content of any of the grains. Did you know that there is an addictive element in wheat protein? We have bread two or three times a day at least - not to mention biscuits, pastries and cake. It is hard to give up.

Gluten is found also in rye, oats and barley. Most processed foods contain gluten to some extent or other. It takes only a few molecules of gluten to upset the tissues of the small intestine in gluten-sensitive people. Other food sensitivities may develop. Parasitical and fungal infections, also. Nutrients are absorbed through the membranes of the small intestine into the bloodstream and ultimately to every cell in the body. So it stands to reason that when the membranes are damaged and the villi atrophied, nutrient absorption is reduced. The lack of nutrients can affect every portion of the body - depending on the degree of damage. People used to be unwell for years, never suspecting that a food they eat might have been causing their problems.

A recent article in TIME magazine reported research showing that gluten can cause inflammation in the brain. www.time.com/magazines/printout/0,8816,99825,00.html) M.E./CFS researchers are now looking at its effects on the entire central nervous system.

Gluten sensitivity used to be hard to diagnose. Not now - just a simple blood test for antibodies to gluten gives a good indication.

Gluten sensitivity and chronic disease
The symptoms of gluten sensitivity seem to be widening and changing -perhaps because we eat so much bread, and perhaps because we know more than we used to.

Problems recognised today as associated with gluten sensitivity include:

• peripheral neuropathy
• shaky gait
• loss of brain power
• bone demineralisation.

There is an increased association between gluten and autoimmune illnesses. Consider gluten-sensitivity as a possible background factor in:

• arthritis
• thyroid diseases
• insulin-dependent diabetes
• Sjogren's syndrome
• Addison's Disease
• M.E./CFS
• dental defects
• hair loss
• skin rashes.

Gluten and mental disorders
Gluten is also associated with mental disorders. Prof Klaus Lorenz wrote extensively on the subject in Cereals and Schizophrenia, 1990. Dr Chris Reading, an orthomolecular psychiatrist practising in Sydney, advises its avoidance to all his patients with mental disorders. He firmly believes that gluten can damage the stomach cells which produce Intrinsic Factor necessary for vitamin B12 uptake. Over time, it can thus create vitamin B12 deficiency with its accompanying neurological disturbances. Dr Reading therefore also prescribes B12 injections for these patients.

Coeliac disease
In New Zealand about 1 in 1,000 people are known to have coeliac disease, but the figure is increasing.

"The disease is being recognised much more frequently than it was 25 years ago," according to Dr Bramwell Cook, clinical director of gastroenterology at the Christchurch Public Hospital. "In Canterbury possibly as many as 1 in 300 people born today will be recognised in later life to have coeliac disease. However, there are many people with unrecognised coeliac disease in our community. A recent study suggests that between 1 in 100 and 1 in 200 people have it. While many of these people will be only mildly affected and may never need treatment, some have significant symptoms which can only be helped by a diet."

Professor Michael Marsh of the University of Manchester is one of the world's foremost coeliac researchers. Addressing the N.Z. Gastroenterological Society last October, he said that for a person to develop coeliac disease, they need to have the genetic predisposition PLUS some triggering factor - viruses or bacteria in the gut PLUS nutrient deficiency, metabolic stress or malignancy.

The spectrum of patients with gluten sensitivity includes:

1. those with classical coeliac disease symptoms
2. those with atypical symptoms
3. those with a single unexplained symptom (.e.g peripheral neuropathy or joint pain)
4. those with dermatitis herpetiformis
5. those with asymptomatic latent coeliac disease.

If you have health problems which fit into these categories, you can do so much to help yourself by avoiding foods containing gluten. Enjoy a wider choice of foods. Buy a gluten-free cookbook. Look for Gluten-free labels.

You may notice an immediate improvement when you avoid gluten. On the other hand, it may take months before your body starts to heal.

Foods containing gluten
Cakes, breads, biscuits, pastries, batters made from wheat
Bran and wheat germ
Rye
Millet, barley and oats (low levels)
Soups, salad dressings and sauces thickened with flour
Root beer
Prepared mustard
Most soy and tamari sauces

Healthy carbohydrates - for you
Rice, potato, corn, arrowroot, tapioca, kumara, pumpkin, amaranth, quinoa, etc. Small amounts, as tolerated, of oats, millet and barley; of breads etc made from Dinkel or Spelt wheat.

Jacqueline Steincamp is author of "Overload: Beating M.E./CFS". She has been associated with research into ME for fifteen years and has written numerous health articles, including one on endometriosis. www.nzine.co.nz/views/endometriosis_natural.html

For more information about her go to
www.nzine.co.nz/features/guinz25-50_part7.html
At the end of that article there is a list of her contributions to NZine.