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Bressan, Paola, and Peter Kramer. Bread and other edible agents of mental disease. Frontiers in human neuroscience 10 (2016): 130.
https://doi.org/10.3389/fnhum.2016.00130
>We present the implications for the psychological sciences of the findings that, in all of us, bread (1) makes the gut more permeable and can thus encourage the migration of food particles to sites where they are not expected, prompting the immune system to attack both these particles and brain-relevant substances that resemble them, and (2) releases opioid-like compounds, capable of causing mental derangement if they make it to the brain. A grain-free diet, although difficult to maintain (especially for those that need it the most), could improve the mental health of many and be a complete cure for others.
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>Unfortunately, gluten has proven to be toxic for a proportion of people that in the last few decades has been constantly rising (Rubio-Tapia et al., 2009). Indeed, the wheat varieties that contain the most detrimental type of gluten have become more common (van den Broeck et al., 2010). […] Yet gluten triggers some action as soon as it turns up in the gut—not only in a few sensitive people, but in all of us.
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>A post-mortem study of 82 schizophrenia patients found rates of stomach, small intestine, and large intestine inflammation as impressive as respectively 50%, 88%, and 92% (Buscaino, 1953; cited in Buscaino, 1978). The association between gastrointestinal pathologies and psychiatric disorders had already been noticed at least 2,000 years ago and has been confirmed repeatedly (for a brief review see Severance et al., 2015).
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>Most people with celiac disease do not know they have it. In a sample of over 5,000 Italian students, for example, the ratio of diagnosed to undiagnosed cases was 1 to 6 (Catassi et al., 1995). In the elderly, celiac disease often goes unrecognized as well, with a mean delay of 17 years from the onset of symptoms to diagnosis (Gasbarrini et al., 2001). Alarmingly, blood markers of the disease have quadrupled in the United States in the last 50 years (Rubio-Tapia et al., 2009) and doubled in Finland in the last 20 (Lohi et al., 2007).
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>Some people do better on a gluten-free diet and worsen upon a gluten challenge (even under double-blind, randomized, placebo-controlled conditions: Biesiekierski et al., 2011) although they do not meet the criteria of either wheat allergy or celiac disease. This non-celiac gluten sensitivity is diagnosed by exclusion, because there are currently no laboratory tests for it. The gut permeability of these people is normal, unlike that of celiacs—but gluten makes it soar just as much as that of celiacs (Hollon et al., 2015).
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>In vitro, antibodies against gluten removed from human blood attack cerebellar proteins and components of the myelin sheath that insulates nerves (Vojdani et al., 2014). They also attack an enzyme involved in the production of GABA—our prime inhibitory neurotransmitter, whose dysregulation is implicated in both anxiety and depression.
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>Changes in gut microbiota due to a sudden, massive exposure to wheat products have also been hypothesized to mediate the well-known relationship between immigrant status and schizophrenia (Severance et al., 2014). This might be, for example, the case of people moving to Europe from sub-Saharan Africa, where staple grains do not include wheat and are traditionally broken down via fermentation before being eaten.
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>Not all individuals handle these substances the same way. For example, abnormally high levels of milk and/or wheat exorphins have been found in the urine (Hole et al., 1979) and blood (Drysdale et al., 1982) of schizophrenia patients and in the urine (e.g., Sokolov et al., 2014; but see Cass et al., 2008) of autistic children. When purified and injected in the brain of rats, these substances made the rats behave in strikingly odd ways—very restless at first and then inactive and hyperdefensive. Among other things, the rats paid no attention to a ringing bell, in suggestive similarity to the apparent deafness often observed in children with autism (Sun and Cade, 1999; Cade et al., 2000).
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>The effects of food exorphins on behavior (for a comprehensive review, see Lister et al., 2015) and on the brain (Sun et al., 1999) are reversed by treating the rats with opioid antagonists. Naloxone has also been shown to temporarily erase psychotic symptoms, especially hallucinations, in schizophrenia patients (Emrich et al., 1977; Jørgensen and Cappelen, 1982). Naltrexone benefits some children with autism (Roy et al., 2015), arguably by blocking a brain opioid activity that might be abnormally high in these children (Sahley and Panksepp, 1987).
Coffee has opioid antagonist(s?) which work similarly to naloxone, btw.
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>Evidence that a diet devoid of wheat (and possibly of dairy as well, given the similarity between gluten and casein) can cure some patients with mental illness has been available for nearly 50 years.