Wheat Benefits and Wheat-related Allergies 

Consuming wheat has commonly been highlighted in social media and news that it can badly impact the body resulting in weight gain, vomiting, unwell, poor brain function. In this article we would like to highlight on the positive nutritional aspect of eating wheat and increase awareness on some of the negative health conditions associated with wheat that can be seen in susceptible individuals.

Health Benefits of Wheat

Wheat has been our main staple diet for more than 10000 years. The wheat proteins are packed with amino acids that helps the body generating cells and metabolism. It provides us fiber, macro- and micro-nutrients and serves as energy fuel for our daily life. Wheat grains have various vitamins including vitamin B complex, vitamin E, folic acid, phenolic acid antioxidants and also have minerals such as calcium, phosphate, potassium, magnesium, zinc, iron, selenium, copper and etc.

The wheat comprises of an outer layer of bran and germ, and an inner core full of flours. 

Wheat grains are free of cholesterol, has low sugar, fat, sodium, saturated fatty acid and suitable for maintaining a good cardiovascular profile. Most of the healthy nutrients are concentrated on the outer layer, hence full grain is encouraged in modern healthy diet.

Wheat-Related Disorders

Over the years, there are increasing prevalence of wheat-related disorders reported. This is mostly due to adverse reactions following consumption of wheat resulting in an immune inflammatory response in affected individuals. Wheat-related disorders are an umbrella group of medical conditions secondary to wheat hypersensitivities including celiac disease, wheat food allergy, wheat-dependent exercise- induced anaphylaxis, irritable bowel syndrome and etc.

Celiac Disease

Celiac disease is a lifelong autoimmune condition of abnormal absorption of the small intestine triggered by consumption of gluten in susceptible persons. The symptoms of celiac disease can be triggered by gluten that is found in wheat, rye or barley. 

Those who are genetically susceptible to celiac disease experience failure to thrive following consumption of gluten. This is resultant of gut malabsorption of the main micronutrients from the diet. Young children and adolescent may even have difficulty in putting on weight or delayed puberty.

Other common symptoms are summarised here:

	Symptoms
Gastrointestinal System	BloatednessIndigestionDiarrheaAbdominal painNausea and vomitingOily stool (difficult to flush)
General System	Lethargy/ Low energy levelDizzinessNight blindnessSkin rashAnemic/PaleBrittle bonesLow body mass index

Food Allergy to Wheat

Wheat is a common food allergy following milk and egg allergy. Wheat allergy occurs following

1. Sensitisation of wheat protein allergen after exposure to wheat via inhalation, direct skin contact or oral consumption. The body immune system develops an initial inflammatory response and memory cells that are able to recognise similar wheat protein in the future.
2. Upon repeated exposure to similar wheat protein, the memory cells are activated and this triggers a cascade of chemical cells causing inflammation and clinical presentations of allergic symptoms.

The allergic symptoms of wheat allergy can be confusing as it may present as very mild and non-specific overlapping with common gastro-intestinal disorders.

Areas	Allergic Symptoms of Wheat
Respiratory System	Snuffly, watery nose and eyesShortness of breathThroat constrictingBreathing difficultyCoughWheezing/ Asthma
Gastro-intestinal System	BloatednessIndigestionNausea and vomitingDiarrhea
Dermatological Area	Itchy SkinHives, Eczema rashFacial swellingLip/Eye swelling or rash

Rarely, in a catastrophic allergic reaction, one may develop anaphylaxis following exposure to wheat, leading to seconds to minutes of severe allergic reactions such as facial swelling, airway constriction, breathing difficulty, circulatory collapse with drop in blood pressure. One can feel extremely unwell, experiencing fainting spell, unable to breath, rash, and will require immediate medical allergy treatment as this can result in death if left unattended.

Respiratory Wheat Allergy (Baker’s Asthma)

This type of wheat allergy is an occupation-related allergy seen in those who have contact with wheat such as bakers, millers, flour handlers or confectioners. Exposure to wheat allergen protein can occur through inhalation or direct skin contact of wheat particle during work. Wheat proteins such as flour, rye, barley oats can trigger such allergy.

Following repeated exposure to these allergens, the immune system recognizes the wheat allergens and start to mount an allergic response. The symptoms tend to become worse overtime with repeated exposure as this increases the sensitization against the allergen over time. One can present with breathing difficulties, repeated cough, and asthma.

Wheat-Dependent Exercise-Induced Anaphylaxis (WDEIA)

This is a rare form of wheat allergy where one does not have allergy reaction from consuming wheat on its own. However, severe disastrous allergic reaction can be triggered by provoking factors such as exercise, medications (NSAIDS, Aspirin), alcohol or even stress when concurrently taking wheat. While the underlying cause remains unknown, it is postulated that these triggering causes increase gut absorption of wheat protein allergens into the blood circulation resulting in immune allergic response.

One who is experiencing WDEIA can present with a wide range of symptoms from mild hives, facial and lip swelling to even severe symptoms of anaphylaxis.

Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal condition affecting 5-20% of adults. It is a diagnosis of exclusion with non-specific gastro symptoms such as flatulence, bloatedness, abdominal pain, discomfort, diarrhea, constipation, lactose intolerance and etc. IBS symptoms can be aggravated by certain food such as wheat or carbohydrates. 

The underlying cause of IBS is poorly understood. It is considered a ‘functional’ diagnosis as patients tend to undergo a battery of investigation tests that come back as normal. Research over the years postulated that there is a psychosocial element in the cause of IBS where there is communication of the brain-gut axis, changes in the gut microbiome, increase in permeability of the intestinal linings which result in its effect on the gut immune system and IBS symptoms.

What should I do if I am concern of wheat-related disorders?

If you are suspecting of experiencing adverse symptoms following consumption or exposure to wheat, you are advised to discuss with your healthcare provider on this matter.

A good succinct history with reproducible symptoms repeatedly following exposure to wheat is vital in diagnosing wheat-related disorders. In cases that are more ambiguous, one can consider 

• blood serology tests (to screen for celiac disease antibodies- anti-tissue transglutaminase antibodies),
• allergy tests (skin prick tests, RAST blood tests, oral food challenge)
• endoscopy (gastroscopy) 

to delineate the causes of wheat-related health symptoms.

Baseline micro-nutritional blood tests may be considered to understand the extend of nutritional deficiency in the wake of long term wheat-related symptoms.

What is the treatment for wheat-related health conditions?

• As wheat is the culprit in wheat-related health conditions, omitting and avoiding wheat is key in management. Products that have flour, flour dust, rye, barley oats should be avoided as well.
• In Celiac Disease, lifelong avoidance of gluten diet is key in management of Celiac’s symptoms.
• Antihistamines and corticosteroids may be used to manage allergic symptoms that stems from wheat.
• Those who develop wheat allergy due to occupational exposure should consider wearing protective gloves, facial mask/goggles when dealing with wheat. 
• Known allergy-trigger factors such as simultaneous exercise, painkillers (NSAIDS), alcohol, stress should be mitigated when consuming wheat in susceptible person.
• Gut probiotics may be beneficial in irritable bowel syndrome.
• Substituting wheat with other nutritious proteins such as corn, rice, millet, buckwheat, quinoa is important in ensuring one receives sufficient nutrients from their daily diet.

Whether you’re exploring the health benefits of wheat or suspect you may have an allergy, professional guidance can make all the difference. Dr Ben Medical Clinic offers comprehensive evaluations to help you find clarity and confidence in your food choices. Book your consultation with us and take charge of your health.

References:

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