COMMENTARY

Beans, Greens, and the Best Foods for the Brain

Bret S. Stetka, MD

Disclosures

July 07, 2015

In This Article

And (Of Course) What About Gluten?

Dr Deans took the stage to discuss one of today's trendiest health issues: gluten.

"There are some real issues," she began, "but I think most people can tolerate whole grains and gluten quite well." About 2% of Americans have celiac disease and are allergic to gluten, even in microamounts. Gluten sensitively is a bit more controversial; it's reportedly found in up to 6% of adults, yet 11% of adults now purchase gluten-free foods.[10]

One related area that may deserve particular attention is the possible relationship between gluten and psychosis. The CATIE trial[11] demonstrated that patients with schizophrenia have significantly elevated antigliadin antibodies (gliadin is a component of gluten); over 23% of schizophrenic patients had moderate to high antigliadin antibodies compared with just 3.1% of controls. "Maybe we should be checking our psychotic patients for celiac disease," commented Dr Deans, before walking the audience through an anecdotal case.

A very skinny, 37-year-old woman with no psychiatric history had become increasingly paranoid and psychotic within 1 year. She had lost her job, become homeless, and alienated family and friends. She underwent numerous drug treatment trials to no avail. Eventually she arrived at the hospital, and because of her weight, an endocrinologist suggested celiac disease. Though initially skeptical, the patient agreed to go to the state hospital where she was kept on a gluten-free diet for 3 months. She stabilized.

Subsequently she consumed a gluten-heavy meal and her antigliadin antibodies skyrocketed again; she ended up back in hospital. "They called and asked me about meds," recounted Dr Deans, "but I said, 'No meds; just keep her gluten free.'" Once again, the patient quickly remitted.

"I just think that if we're going to start recommending things like MRI for first-episode psychosis, screening for celiac disease is a lot cheaper and might be good to think about," said Dr Deans. But for most people, she commented, going gluten free probably won't have much of an effect. "All of these gluten-free options are great for people with celiac disease, but otherwise I don't think that a gluten-free muffin is particularly healthier than your white flour muffin in terms of brain health."

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