The Gluten-Free Diet is Born: Thank You Dr. Dicke!

The Gluten-Free Diet is Born: Thank You Dr. Dicke!

In Honor of Celiac Disease Awareness Month, Gluten Free Watchdog is writing a series of articles (the goal is one per day during the month of May) related to the gluten-free diet–currently the ONLY treatment for celiac disease. 

Post #3…

“We have learnt in the course of many years’ experience in the treatment of celiac disease that it makes a great difference to the patient what kind of starch-containing foodstuffs are included in the diet; in particular whether or not wheat is used.”–Willem-Karel Dicke, Dutch pediatrician and early advocate of the gluten-free diet for the treatment of celiac disease, 1953

Prior to Dr. Dicke’s feeding trials some physicians believed that people with celiac disease could not eat carbohydrates or “starch” (with the exception of bananas). Dr. Dicke’s feeding trails demonstrated that it was not all “starch” but a particular “starch” that was problematic.

Dicke’s Classic Feeding Trials (Excerpted from The Gluten Free Nutrition Guide by Tricia Thompson, McGraw-Hill, 2008)

“Beginning in the late 1930s, a Dutch pediatrician named Willem-Karel Dicke observed that his patients with celiac disease improved when they did not eat products containing wheat. In the late 1940s, he and his colleagues conducted feeding experiments designed to find out if wheat was the specific starch that caused problems for people with celiac disease. Patients participating in these feeding experiments were placed on diets that were similar except for the type of starch. Every few weeks, the specific starches provided to each patient were changed. Starches that caused a decrease in fat absorption and consequent increase in fat excretions were considered harmful to people with celiac disease.”

Findings from the paper “Coeliac Disease II. The Presence in Wheat of a Factor Having a Deleterious Effect in Cases of Coeliac Disease” (Acta Paediatrica. 1953;42:34-42).

Dicke and colleagues conclude from the feeding trails presented in this paper that wheat starch, corn flour, maize starch, rice flour, and peeled, boiled potatoes are harmless while wheat flour, rye flour, and oats are harmful. In their summary statement, they write: “A factor exists in wheat, which is the cause of anorexia, vomiting, diarrhea and a large proportion of the fat elimination is patients with coeliac disease. However, this factor is not the wheat starch.”

Tomorrow’s post: “Remembering the Children, especially Mechie who helped doctors identify gluten as the factor in wheat responsible for the deleterious effects of Celiac Disease”

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Comments (3)

  • Bonnie
    Reply

    Hi Tricia, Can you further comment on the very last sentence of Dr. Dicke’s paper? Do you know how he came to the conclusion that “wheat starch” is not the factor”? Does or can today’s scientific community support this evidence on any level? GFWD’s product report on wheat starch from 10/14/15 suggests otherwise. Thank you.

    May 3, 2017 at 6:14 pm
    • Tricia Thompson Reply

      Ahhh. Guess what? Wheat starch is the topic of upcoming posts. Keep in mind that Dicke’s feeding trials and subsequent conclusions are based on fat absorption—starches that lead to a decrease in fat absorption and consequent increase in fat excretion (based on fecal fat measurements) were considered harmful. Although there may have been less fat excretion when wheat starch was eaten–remember gluten is in the protein fraction of wheat–over time concern grew about the amount of gluten protein remaining in the starch (in other words can the protein and starch components of wheat be separately completely? This will be discussed in far more detail soon.

      May 3, 2017 at 6:58 pm
      • Bonnie Reply

        My intuition and knowing your attention to detail told me you weren’t letting that just “slip by”. However, I had to ask. And I was wondering how Dr. Dicke was separating the wheat starch from the protein. And as you said, he was using fat excretion as measurement. Looking forward to future postings.

        May 3, 2017 at 7:31 pm

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