Gander at Gluten
The following article was extracted from the research section of my book, The Meat and Potatoes of a healthy meal plan...no bun intended.
Gluten-free is considered by many to be the latest fad diet. Most diets are just for losing weight, but people on this diet are claiming more benefits than just weight loss. The number of people on medication for mood, memory, ADD, migraines, pain, thyroid issues, autoimmune diseases, diarrhea, constipation, Irritable Bowel Syndrome, Crohn’s, colitis, autism, arthritis, psoriasis, dermatitis, and schizophrenia has risen dramatically over the years. What about all the people being diagnosed with chronic fatigue? Why all the sudden are people of all ages having such issues? A magnifying glass is now being placed over food sensitivities as the key culprit or the accomplice to these conditions and many others. If gluten is the culprit, you should feel much better by simply taking gluten out of your diet. When I call gluten an accomplice, I am basically saying that there may be multiple factors affecting your current health condition. Gluten would be just one of these factors. There are four situations where you would need to remove gluten along with doing something else:
1. You may need to remove another food(s) you are sensitive to.
(E.g., dairy, soy, eggs, corn, yeast, etc.)
2. You may need to add additional foods that you are currently not eating.
(E.g., someone that doesn’t eat enough fruits and vegetables.)
3. You need to supplement with certain nutrients to bring back balance to your body.
(Speak to your healthcare provider to see what may be relevant for you.)
4. You need to make other lifestyle changes to bring back balance to your body.
(Most commonly, changes in sleep, exercise and stress.)
Is it possible that the “breadbasket of the world” could be producing wheat products that are bad for us? Research indicates that the way we process wheat in the United States (deamidation) actually triggers an immune response in the body that increases inflammation 169-172. For this reason some people tolerate wheat products abroad because they have been processed differently, but not in the USA. Other theories for the increase in gluten sensitivity include potential cases of leaky gut, which is associated with food sensitivities 173, particularly to gluten sensitivity 174-178. The following are other factors which may be causing the rise in cases of “leaky gut,” thus increasing gluten intolerance: integration of genetically modified food into our food supply 179-182, hybridization of grains over the years 183-184, aflatoxin exposure185-186 (commonly found in old grains, nuts, oilseeds, and dried fruit), stress 187-188, and poor nutrition.
Most people don’t believe they are gluten intolerant. I hear it all the time: “But I feel fine when I eat wheat.” People think if they don’t feel a reaction right away, they can tolerate the food and are not sensitive to it. Most reactions to food sensitivities do not occur this way! The majority of those who are intolerant are having an inflammatory response that they are unaware is connected to the food they are eating. Sometimes the body has found a way to adapt, so you don’t feel any major symptoms after consuming a food. However, it is still impacting inflammation in the body, and once you take it out of your body for a few months, then reintroduce it, your body will respond negatively and you will feel a difference.
Remember, inflammation is the root of most disease. If you are sensitive to a food, every time you consume that food your immune system will respond. This can cause chronic and systemic inflammation in the body. There seems to be a pattern showing that those with certain medical conditions have a much higher likelihood of also having a gluten sensitivity. In these cases, gluten may exacerbate symptoms of the condition, or may cause other symptoms associated with food intolerance. The research has connected the following conditions to gluten intolerance (GI) and/or celiac disease (CD): neurological illnesses 189, neurodegenerative diseases 190, autoimmune conditions 191-194, skin issues 195-200, Type 1 Diabetes 201-207, autism 208-209, headaches/migraines 210-212, ADD/ADHD 213-214, acid reflux/GERD 215-216, lower gastrointestinal digestive issues 217-221, Down Syndrome 222-226 and seizures 227. The problem is that most of the current research focuses only on celiac disease, not other types of gluten sensitivity. That is because those with Celiac disease were thought to be the only population known to be gluten intolerant. Gluten sensitivity, outside of celiac disease, is now just starting to be recognized by the mainstream population as a real issue. Thus, research is now looking into the connection between other digestive issues and gluten sensitivity 174-178.
Be careful with the media reporting absolutes about gluten based on “the newest research.” Have you ever turned on the news and heard, “Research shows that there is no such thing as gluten sensitivity” or, “Gluten-free is not healthy”? First of all, everyone is different and you can’t make a general statement that applies to absolutely everyone when it comes to most things involving nutrition. Also, some studies may be poorly designed, or poorly reported 228. Still, the media isn’t always wrong when bashing “gluten-free.” I do agree that not everyone has to be gluten-free, and that gluten-free products are not necessarily healthy. My book should help you navigate which are the healthiest options. It also goes over “reasonable treats” which are healthier alternatives to gluten and dairy products for those with known gluten and dairy sensitivities.
Research shows that there are parts of the gluten protein that affect the immune system which are not being tested for in standard gluten antibody panels 229-230. For this reason you may have your lab tests come up normal and still have gluten intolerance. However, there is a very comprehensive test for gluten done by Cyrex labs. If you have any of the symptoms or conditions listed in the Conditions Benefiting from Gluten-free/Dairy-free section, the cheapest way to see if you are gluten intolerant is to try going gluten-free. Unfortunately, the only way you will know for sure is to be strict with the diet in order to feel results and see if it helps. Plan on doing it very strictly for three months to test it out. If you are serious about getting better, you may also need to eliminate dairy, and most soy products since many people seem to do better off of all three of these foods. Some people show sensitivity to other foods as well. In order to get results, all food sensitivities need to be eliminated. The top foods sensitivities include: shellfish, nuts, corn, soy, wheat, gluten, yeast, dairy, and eggs. People always ask me, “Shouldn’t I eliminate just one first to see if it helps?” “Do I have to eliminate both gluten and dairy together?” The answer is, yes, you should eliminate both at the same time. What if you are sensitive to both gluten and dairy, but you only eliminate gluten from the diet? If you are not feeling better going gluten free, it maybe cause you are still eating dairy or another food you are sensitive to. After a 90 day elimination you can slowly reintroduce one at a time to see if you can go back on gluten, dairy, or both.
Now let’s take a deeper look at the research connecting gluten intolerance to various medical conditions. In 2002, a published study revealed that most people with diagnosed neurological symptoms caused by gluten sensitivity had no digestive issues at all 231. This is just one example to show you that you don’t have to have digestive issues to be sensitive to gluten. Today a lot of people are on anti-anxiety medications, use caffeine to concentrate, and take other medications to relax. While gluten-free may not be the “cure all” for these conditions, it can be a significant contributing factor in some individuals. I had a patient that didn't even realize the change until I asked her in a follow up consult. I said, "how is the brain doing since you have been off of gluten?" There was a pause. Then she said, "oh my gosh, I haven't had to take a xanax!"
Current statistics estimate that 5-10% of Americans are gluten intolerant. Some people claim that this number is likely much higher. Research has shown significantly higher rates of gluten sensitivity among those with various medical conditions. For example, 44% of subjects (23 out of 52) with Huntington’s disease had elevated antigliadin antibodies, a marker for gluten sensitivity 190. Similarly, a study published in 1995 showed elevated antigliadin antibodies in 37% of all rheumatoid arthritis patients 232. That is huge! What is even more alarming is that the gliadin antibodies are just one group of many different parts of gluten that can be tested. For example, one person might test negative for gliadin antibodies, but may test positive for antibodies against glutenin, transglutaminase, or any of the other byproducts of gluten digestion. So the number of people with rheumatoid arthritis and Huntington’s disease who are sensitive to gluten is likely much higher. At the end of the day, if you have an autoimmune response to any part of gluten, you need to stay away from it strictly.
It has been found that 9.71% of those with Type I Diabetes (autoimmune disease) had celiac disease 233, which is significantly higher than rates of celiac disease in the general population. Again, celiac disease is just one manifestation on gluten sensitivity. There are very good odds that a Type I diabetic will test positive for other antibodies associated with gluten. Thus the number of Type I diabetics with an actual gluten sensitivity is likely much higher. A documentary called Simply Raw: Reversing Diabetes in 30 days put a group of diabetic individuals on a raw vegan diet (which happens to also be gluten and dairy-free). This was under the supervision of a medical team. At the end of the documentary, one of the Type I diabetics went from 75 units of insulin a day, down to four units a day, and the newly diagnosed Type I diabetic was able to totally get off of insulin. This is unheard of in the medical field! This documentary was made in 2005. In a 2011 interview 234, six years after the documentary was filmed, the Type I diabetic is still off of insulin. He admits that the only exception to his non-dependence occurs if he gets sick (his blood sugars spike for 2-3 weeks). This documentary and others (e.g., Fat, Sick and Nearly Dead, Crazy Sexy Cancer) show the power of food in reversing disease. While these documentaries may inspire you to eat healthier and change your lifestyle, it is very important that any changes in medication always be done under the supervision of your doctor.
I highly recommend those who are interested in learning more to watch the new documentary, What's with Wheat, which interviews some of the leaders on this topic! https://whatswithwheat.com/
To view the abstract to the studies below, simply copy and paste the reference into the search box at www.pubmed.com (or google if pubmed doesn't go through). If you have pulled up the abstract in pubmed you can access the full research study by clicking on rectangle box link at the top right of the webpage (sometimes free).
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