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Should You Cut out Gluten?

Is Gluten-Free is an Overblown Fad?

Ok, so what’s the big deal with gluten? Isn’t this just another annoying diet fad? We’ve been eating gluten for thousands of years, what is it with all this not-adapted-yet mumbo-jumbo? Celiac is real, but uncommon; self-diagnosing gluten sensitives are just hypochondriacs, right? I’ve been eating sandwiches, pasta, and pancakes my whole life and now you’re telling me I “may not tolerate it” as well as I think I do?! How is that even possible?

This is what went through my head at my first exposure to an anti-gluten preacher. I spent a number of years as a waitress in a nice restaurant where the chef’s get pretty bent out of shape when you don’t want to eat their food as-crafted. I admit to being judgemental of people who asked for gluten free but were not celiac (you have to ask so that you don’t make anyone really sick). I wrote them off as misinformed fad followers. My judgement of them as misinformed was pretty ironic, seeing as I had never really bothered to look into it myself. This ironic condition is something I recognize in many of the gluten-free haters out there today.

Define “Healthy”

Fast forward to a few years later, and on my quest to identify the “healthiest way to eat”, I stumbled upon Paleo. I’ve noticed that people may have more of a knee-jerk reaction to the concept of caveman dieting than they do to gluten free, it’s a coin toss. But if you can get past the aversion to re-enactment scenarios and understand that the main point of the pitch and concept is EVOLUTION, it becomes the most logical diet ever conceived. It’s the single most obvious and intelligent way to go about evaluating answers to the question: what should humans be eating?

If you compare the answers and size them up to the evolutionary model, some of these answers fall out immediately. For example, you can’t get away with claims that meat eating and cooking food are unhealthy as they are the reigning concepts in what made us human. Countless civilizations have never lost their health to them, and yet they have lost their health to over-consumption of grain.

History of Grain Consumption and Where it All Changes

If you like history, the story of the human diet is remarkable. And it is the only context in which you can come to understand why grains became a staple. It also becomes clear that it was not a choice for health and even had many dire health consequences. Archaeologists can date when intensive agriculture took over in a given area by noting the shrunken stature and skeletal deformities that were caused by abandoning the nutrient dense hunted and gathered food items for the nutrient poor grains. Over-consumption of grains caused serious health problems until they discovered it was due to malnutrition and began to fortify grains. But yes, grains made their lives easier from a logistics standpoint. It was a trade off. They could settle and support higher populations and eventually devote time to specialization which allowed for the invention of all-things-cool.

Knowing this simple historic truth completely changed my perception of grains. They are not the ADA heart-healthy, colon healthy foods as they are marketed to us. They are cheap fillers, with sketchy potential. They are num-nums that people obsess over and defend like Golem and his precious.

Intensive monocrop agriculture wipes out diversity in an ecosystem and depletes the soil. There are whole swaths of earth that have been unethically farmed to death. It’s unsustainable to farm this way long term. Wheat/Corn/Soy is a corporate conspiracy that the government is in on. A few huge companies make loads of money on grains and beans. The massive grain/bean corporations have ex-execs controlling the USDA and FDA. This sounds like legit tin-hattery, but unfortunately it all checks out. Trust me, they love the feed-the-world-with-grains cults.

What is Gluten?

Gluten is a protein found in wheat, rye, barley, and wheat relatives (spelt, kamut, emmer, einkorn and triticale). Without getting too technical, it is part of the survival strategy of some grains. Gluten is essentially designed to protect the plant and be detrimental to the predator. All life forms have evolved defense strategies to ensure that they stay alive and reproduce. The more successful the strategy, the more likely it is that these organisms are still around. Generally, running has been a sufficient strategy for four and two legged animals, in addition some have horns and or claws while some hide in trees and others have learned kung-fu or figured out how to make swords, automatic weapons, and EMPs. Plants have none of these at their disposal, thanks to being immobile, so they have evolved systems of chemical warfare.

Modern humans seem to prefer to ignore this reality of the plant world, assuming that they are all benign, bestowed upon us as little gifts from nature’s kitchen to be happily munched ad libitum. While this concept may sound comforting, it’s simply not true. Don’t forget about cyanide in wild almonds or the potentially fatal compounds produced by some mushrooms. The specific mechanisms that grains have evolved produce chemicals that damage the lining of our guts, bind to essential minerals making them unavailable to the body, inhibit digestion and absorption of other essential nutrients including protein.

Celiac Disease, an Autoimmune Condition with Wide-Ranging Symptoms

Celiac disease is an autoimmune disease caused by exposure to gluten. It is the only autoimmune disease whose environmental trigger has been identified. The clinical presentation of CD can vary from a classical gastrointestinal form: abdominal cramping, vomiting, diarrhea, anemia, and weight loss, to a more systemic form presenting with osteoporosis, autoimmune disease, neurologic problems, thyroid disorders, T1 diabetes, joint pain, eczema, depression, gluten encephalopathy or gluten atoxia (dementia from wheat), and low fertility.

People living in cultures that rely too heavily on whole grains can end up with high rates of mineral deficiency symptoms, even with otherwise adequate dietary intake. Grains contain a high amount of phytic acid, which binds to the minerals and pulls them through the body. So wheat causes us to blow through our vitamin D and has the potential to lead to mineral deficiency. Rickets would be one example, associated with poor vitamin D status or mineral deficiency. The incidence of rickets rose sharply in Dublin during the 1940’s when refined wheat flour was swapped in for whole wheat flour. Think about when you consume wheat. We don’t usually eat our wheat alone, we wrap whole meals in it, prime our stomachs with several pieces of it before eating, finish off a meal with something cradled in it...

Clinical studies have also noted marked improvement in schizophrenia and autism spectrum disorder on a gluten free diet.

But wait, there’s more!!

A recent JAMA study (Journal of the American Medical Association) showed increased risk of death, mostly from heart disease and cancer, in people with diagnosed, undiagnosed, and “latent” celiac disease or gluten sensitivity. This is major research that proves gluten is affecting, even increasing risk of death, in people other than celiacs.

Non-Celiac Gluten Sensitivity- Isn’t it all Due to FODMAPS?

No. 😊

People that don’t like to accept the condition termed Non-Celiac Gluten Sensitivity often cite this one study https://www.ncbi.nlm.nih.gov/pubmed/23648697. The study does not prove that the condition does not exist, as the media and everybody sharing the articles like to suggest. And it’s one study against a dozen studies demonstrating that NCGS is a thing. This study demonstrates that people with IBS (as they were the only people tested in the study) did well on a wheat free, FODMAP free diet but did not demonstrate any significant difference in treatment with isolated gluten. So they reacted to wheat but not gluten. This study suggests that patients with IBS were reacting to something other than the gluten in the wheat. It’s odd though that they gave all of these people whey protein. People that are sensitive to dairy can react to this. It kind of messes up the results of the study. It also illustrates that there are more compounds specific to wheat they can bother people. It does not prove that there is no such thing as NCGS.

Genetics

Gluten sensitivity and celiac are determined in large part by genetics. 50% of the genes involved with CD have been identified, which is far better than most diseases. Genes for CD have shown to be under positive selection, meaning that they are becoming more and more prevalent. There are a few studies proving this, but one I find interesting compared the blood of 10,000 people from 50 years ago to 10,000 people today and found that the incidences of full-blown celiac disease increased by 400 percent during that time period. If we saw a 400 percent increase in heart disease or cancer, this would be headline news. But we hear almost nothing about this.

Even so, not everyone who is genetically susceptible will end up developing health problems due to gluten, but it's impossible to estimate how many of the problems we attribute to other causes are in fact caused or exacerbated by gluten and the damage it enacts on the gut barrier.

Pub med article explaining CD may be a misfire in our adaptation to protect against bacterial infection  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032060/

Gut Permeability and Why I Think Everyone Should Say Goodbye to Gluten

Gluten has been recently shown in a study to increase gut permeability and inflammation in everyone, not just celiacs. They tested three groups; celiac, non-celiac sensitive, and normal and found that all three groups experienced increased inflammatory markers and increased markers of leaky gut. The reactions were worse among the celiacs, but still present for the normal controls. https://www.ncbi.nlm.nih.gov/pubmed/25734566

Gut permeability is an interesting topic that started off in the lunatic fringe, as do many new discoveries in science. If you brought it up to your doctor just a decade ago, he would suspect you had fallen prey to the internet. Up until the 80‘s, scientists believed that the gut barrier was impermeable until a group of Japanese scientists proved otherwise. Some doctors remain clueless, but it won’t be for long, since gut permeability is now the subject of heavy research as it’s been connected to so many ills. For example, every autoimmune disease that has been tested for the presence of “leaky gut” has come back positive. They haven’t tested them all, but this news is rather alarming. Gut health is now strongly linked to depression and mood disorders.
So maybe you don’t seem to react at all to gluten. But according to science, it is causing you some degree of enhanced gut permeability. You can also fall prey to the 10 or so other known factors that increase gut permeability. I would assume that if we know that too much gut permeability sucks, then we would be making the best decisions for our health to eliminate as many of these causes as possible. Lest we done-go and screw ourselves. Therefore, it seems reasonable to view it as a health time bomb for all individuals. https://drruscio.com/leaky-gut/

Grains are Not Nutrient Dense

Aside from the potential that you carry genes that predispose you to react negatively to gluten exposure, especially the repeated exposures recommended by the great American food pyramid, the reality that gluten breaks down the gut barrier of everyone- not just celiacs, and that a compromised gut barrier leads to chronic inflammation and autoimmune disease, they’re addictive, they spike your insulin levels, the fact that grains contain high amounts of phytic acid that bind to minerals and effectively rob your body of the nutrients you consume along with wheat, and cause you to rapidly burn through crucial vitamin D stores… (sigh) there’s really not that much nutritional value left to them once they have been processed and cooked in order to be considered edible. Was that a run-on sentence or what?

Making a nutritionally poor food a dietary staple is a fast and secure way to make oneself nutritionally deficient and sick. If you have been programmed to believe that grains = carbs, and are the only source of dietary carbs, you can now take a moment to rejoice that this outlook is wrong and you are now free from this state of mis-information.  Optimal sources of dietary carbohydrate are roots and tubers such as sweet potatoes, white potatoes, beets, yucca, taro, carrots, parsnips, turnips, etc. Fruits are also a source of carbohydrate.

If you are starting to fear that you will be missing out on the awesome heart-healthy fiber you’ve been getting from Cheerios and whole wheat toast, fear not. Starchy and non-starchy vegetables provide a much better source of insoluble dietary fiber than grains ever will.

As far as micronutrients are concerned, meat is loaded with vitamins and nutrients, especially liver, and contains none of the potentially harmful defense substances found in plants, grains, and legumes. Liver, while it may be disgusting to 95% of the population, is nature’s perfect vitamin supplement for omnivores. You should woman-up/man-up and eat some weekly.

Blood Sugar

From cardiologist and author of the book, “Wheat Belly”, Dr. William Davis

“I learned just how bad wheat was when I asked patients in my cardiac practice to remove it from their diet. I did this because 80% of people I’d meet for the first time were diabetic or pre-diabetic, situations that double or triple heart disease risk. In an effort to minimize this situation, I applied a very simple fact: Two slices of whole wheat bread raise blood sugar higher than 6 teaspoons of sugar, higher than a Snickers bar. (Most people are unaware that the glycemic index of whole wheat bread is among the highest of all foods.) Whole wheat bread has a GI of 72, white bread a GI of 69, Shredded Wheat cereal 67, Table sugar has a GI of 59, Mars bar 68, Snickers bar 41.

So I asked everyone to remove wheat to observe the blood sugar effects. People would come back after a 3-6 months and, indeed, their blood sugars and HbA1c (a measure of prior 60 days blood sugar) would be much lower, even to the point at which some diabetics were no longer diabetic. But people told me plenty more: They lost 30 pounds, lost 4 inches from their waist, felt better than they had in 20 years with more energy, less moodiness and deeper sleep. They told me how they experienced complete relief from acid reflux, irritable bowel syndrome, migraine headaches, hand and finger arthritis and joint pain, sinus congestion and chronic sinus infections. They told me about how their asthma improved so much that they threw away three inhalers, their rheumatoid arthritis was so much better they were in the process of reducing medication, their ulcerative colitis and Crohn’s had improved so much that no medication was required any longer, their leg edema had disappeared and rashes were gone.

At first, I dismissed it as pure coincidence. But the effects became so frequent and consistent that the conclusion became unavoidable: Wheat was the underlying cause for an incredible array of health problems and weight gain, and that eliminating was key to astounding health.

And note that this was not gluten avoidance for the gluten-sensitive; this was wheat avoidance for everybody, as it was a rare person who didn’t experience at least some measurable improvement in health, if not outright transformation. I now recommend complete wheat avoidance for all my patients, as well as anyone else interested in regaining control over health and weight.”

Testing

Unfortunately, the vast majority of people affected by gluten are undiagnosed and even unaware that there is something funky going on under the hood. Many of us have non gut-related symptoms and so don’t consider that something we are eating could be a contributor. Some of us have been tested for food allergies and the results have come back negative. This may come as a surprise, but a negative blood antibody test does not rule out gluten sensitivity! In fact, only about 12% of Americans can be diagnosed as gluten sensitive using blood antibody tests as opposed to 29% using stool tests, which still isn’t much. The problem with the blood tests is they aren't very sensitive. The most common blood tests for celiac disease look for a class of antibody called IgA. IgA is produced by the mucosa in the gut. Unless gut damage is already extensive, the majority of IgA stays in the gut. This may cause many cases of gluten sensitivity to go overlooked.

In Closing (For the Haters)

I have had multiple clients that knew they reacted to gluten come back from standard testing and seem sad and confused that the tests came back negative. Some decided to load up on gluten and suffer the consequences for two weeks to go back in and be retested to get their positive result. This is mostly just to get the haters off their back and be able to justify their dietary choices to others who give them a hard time about their condition not being real.

If we know that something makes us feel like shit, do we need to torture ourselves to get medical confirmation? Do we need to get medical confirmation to wave in front of uninformed friends and colleagues that tell us there’s no such thing as gluten sensitivity?

And to all of you out there still trying to deny this condition, do you not understand how truly inconvenient it is to not eat gluten in this world we live in? It’s a pain in the ass, especially for people that don’t like to think too much about their food. Why someone would make this up is beyond me. And with the volumes of research linking poor gut barrier function to autoimmunity, mood disorders, and so much more- combined with the research showing that gluten induces gut permeability in EVERYONE, not just celiacs and NCGS folks… Then please tell me, haters- why are you so pro-gluten?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2653457/

https://www.ncbi.nlm.nih.gov/pubmed/21917438

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https://www.ncbi.nlm.nih.gov/pubmed/12694579

https://www.ncbi.nlm.nih.gov/pubmed/22224779

https://chriskresser.com/50-shades-of-gluten-intolerance/

https://chriskresser.com/3-reasons-gluten-intolerance-may-be-more-serious-than-celiac-disease/