Ok ok so you are probably wondering if the whole gluten craze is real or a fad. And mind you, without digging it the research, I’d probably be wondering the same thing. With many celebrities advertising gluten free diets, nearly 30% of the population has followed suit. What’s real and what’s not? Why are so many people suddenly senstive? So lets unravel the mystery of gluten…..
What is gluten?
Gluten is a protein that has been around for thousands of years. Its found in many grains like:
- Contaminated oats
- Wheat germ
- Natural Flavors
- Modified Food Starch
So you might be asking, if its been around so long, why are so many people just now reacting, or sensitive? Part of the issue is that conventional medical doctors do not believe in a gluten “sensitivity.” They believe only in Celiac disease, a condition where the body starts making antibodies against gluten. Eating gluten can ilicit terrible pain and bloating for these patients. However, most doctors do not understand that there are varying degrees of gluten intolerances that lab tests are not sensitive or specific enough to detect.
How Can Gluten Affect You?
- You can have a wheat or gluten allergy. Trust me, this one sucks. You’d know it. It is sometimes dangerous and produce anaphylactic symptoms at its worst, or abdominal pain/nausea/vomiting at its best.
- You can have Celiac disease. Celiac disease patients not only have antibodies against the protein in their blood, but they also often have duodenal lesions or irritation/inflammation in the small intestines. There are three different types of Celiac disease depending on which transglutamate antibodies you produce in response to gluten exposure. This can determine whether your gluten allergy affects the gut more, the brain more or the skin more. These different types present differently.
- You can have Non-Celiac Gluten Sensitivity (NCGS). This disorder was classified in 2012 and is thought to be more prevalent than Celiac or a wheat allergy. It is difficult to track due to a lack of serum biomarkers and poor investigation by practitioners. However, it is defined by symptoms that usually occur after gluten ingestion, disappear with gluten withdrawal from diet and relapse following gluten challenge.
The Stats on Non Celiac Gluten Sensitivity
Today, lets focus on NCGS since this group of patients seems to be dismissed the most. For starters, most people who are gluten sensitive or allergic have a certain genotype that is prevalent-HLA DQ8 and HLA DQ2 and their ancestry is Northern European.
Classic symptoms can vary widely and range from headaches, abdominal pain, chronic fatigue, brain fog, joint aches, unexplained inflammation, and even disturbances in attention and depression. Some patients may even be misdiagnosed as having IBS, due to increased bloating, distenion, nausea, diarrhea or constipation. NCGS has even had some interesting ties to schizophrenia and autism spectrum disorders.
Its hard to determine how many people actually have just a gluten sensitivity versus a fad diet. Dr. Fasano, director of the University of Maryland Center for Celiac Research, helped conduct research that showed it could be one in 133 people or close to 6-7% of the population. However, Dr. Ford, a pediatrician in Christchurch, New Zealand and author of The Gluten Syndrome, says he believes the percentage of people who are gluten-sensitive actually could be much higher — potentially between 30% and 50%. It is estimated that up to 10% to 15% of the population has antibodies to gluten, indicating their immune system is reacting to the protein.
It looks like the mystery remains for the time being…however, here are some facts about the wheat industry to consider before you discount the sharp rise in gluten free diets.
- Genetic manipulation of grains: no long term research has been done on safety, yet we assume these foods are safe to eat and trust our superiors to protect us. Selective breeding has modified wheat has been going on for nearly 100 years in order to produce higher crop yields, improve disease resistance and create better bread. The strength of gluten has even been increased. Wheat flour is preferred over flours from other grains because approximately 80% of its proteins consist of gliadins and glutenins. When these gliadin proteins cross link with water, that forms dough and its gooey consistency that is ideal for baking. Science has used hybridization and genetic selection to breed for wheat with stronger gluten and gliadin proteins. One hypothesis is that this is what is setting off so many immune systems. Although wheat has been used to feed the world, at what cost?
- The pervasive use of grains in the food supply: Almost all packaged foods or boxed snacks contains grains either as a main ingredient or an additive. Never before in history have we had so many processed carbs and grain products as the main ingredient on our plates. More grain exposure = more reactions
- The use of herbicides and pesticides has increased: Much like genetically modified foods, these chemicals used have never been fully studied and no long term safety standards have been set. Glyphosate is sprayed on wheat two weeks prior to harvest and we already know what glyphosate can do to the amino acid composition of plants via disruption of the Shikimate pathway. Where do you think we get our amino acids? PLANTS. Therefore, the use of herbicides may be drastically affecting the food chain supply and level of nutrition we get from our food.
- Over use of antibiotics: Although life saving if one has a bacterial infection, the over utilization of these drugs contributes to a change in the normal healthy gut flora thus weakening the immune system. Additionally, we feed them to chickens, pigs, cows, and fish that are being raised for human food consumption.
- Aspirin, ibuprofen and other Non steroidal anti inflammatory medications: These pain relievers eat away at the intestinal and stomach linings leading to intestinal permeabiity or leaky gut, which lowers immunity.
- Anti-acid medications like Nexium, Prilosec, Protonix or Pepcid suppress acid in the stomach, which is needed for proper digestiona and absorption of minerals. Its supposed to be acidic in the stomach, just not in the esophagus, so if you have acid reflux, you are being asked to change your diet…not take a pill to suppress symptoms.
- Grain is cheap food and easy to produce: The government subsidizes grain making it much cheaper to use as a staple food. It has been used to “cure” blindness caused by vitamin A deficiency, however cheap does not equal nutritious or a high quality food.
- Poor education on nutrition and corporate marketing: I got three hours of nutrition training in residency. The general public may even get less. The focus is on passing standardized tests, not free thought. Therefore even the authorities left to teach nutrition to the masses may not know what is truly heatlhy. In fact, commercials, the government based food pyramid, billboards, and goverment guidelines back whole grains as “healthy,” which further confuses the general public.
The bottom line is that whole, unadulterated grains without modification or herbicides and used in a balanced manner with whole foods may actually be pretty healthy. My consensus? I tell most of my patients, who are full of inflammation, to avoid grains and stick to brown rice or quinoa until we can sort out what is being done to wheat and grains.
But by all means, listen to your own body….be your own best doctor.
- Czaja-Bulsa G. Non Coeliac Gluten Sensitivity – A New Disease With Gluten Intolerance. Clinical Nutrition (Edinburgh, Scotland). 2015 Apr;34(2):189-94.
- Fasano A. et. al. Spectrum of Gluten-Related Disorders: Consensus on New Nomenclature and Classification. BMC Medicine. BMC Medicine 2012, 10:13 doi:10.1186/1741-7015-10-13. Published: 7 February 2012