Gluten- Friend or Foe?

You would be hard pressed these days to find an ingredient that receives more hype than gluten. Between gluten sensitivity, gluten intolerance, wheat allergy, and celiac disease the whole topic can be more than confusing! Rather than going into the nitty gritty detail about what differentiates each of these entities, I am going to provide a brief overview of gluten and gluten sensitivity. While I might delve into more detail down the road, I want to keep this post simple yet informative.

Gluten itself is a type of protein that is found in certain grains; mainly wheat, barley, and rye. In addition to being present in these grains, gluten is used to make many chemical additives that are found in packaged and processed foods. This means that we are exposed to gluten even when consuming things that grain-free- ie. deli meats and condiments.

You may wonder why gluten has been made out to be the “bad guy” of the nutritional world. In people with celiac disease (which is an actual allergy to gluten), gluten truly does earn that title. Not only does it cause everything from malnutrition to severe digestive and neurologic symptoms in these patients, it increases their risk of developing certain gastrointestinal cancers. It used to be very black and white- you either had celiac disease and had to avoid gluten entirely or you did not have celiac disease and could consume gluten without any ill effects. We now know that there is a lot of “grey” surrounding the whole issue of gluten.

Many people find that they react to gluten, despite not having celiac disease, and fall into a category called “non-celiac gluten sensitivity” (or NCGS). The symptoms of NCGS can impact every part of the body and include gastrointestinal issues (diarrhea, constipation, pain, bloating, etc.), fatigue, headaches, mental “fogginess,” joint and muscle pains, rashes, depression, and anxiety- to name a few (1). Unfortunately, there is much that remains unknown surrounding the diagnosis and actual science of NCGS, but it is an area of focus in current medical research.

So what exactly causes the symptoms of gluten sensitivity? As I mentioned, it is not entirely clear. But it seems to stem primarily from the effect that gluten has on the digestive system. Gluten is known to be an “anti-nutrient,” which means that it can be difficult to digest for people both with and without gluten sensitivity (2). Anti-nutrients are built-in defense mechanisms that plants have in order to protect themselves against infections. While that’s great for the plants themselves, it can cause issues for us humans when we consume them. Not only can they bind to and interfere with the absorption of certain vitamins and minerals, they can damage the lining of the intestine- remember “leaky gut” from our Gut Health series? This allows the movement of everything from undigested food particles to bacteria through the intestinal wall and into the blood stream (3). Your immune system sees these undigested food particles as “foreign invaders” and mounts a response against them, causing inflammation throughout the body (2, 3). Gluten is especially good at provoking this series of events and helps to explain why it can trigger symptoms in some people.

The big question you may have is “Should I avoid gluten?” That is a loaded question! If you have celiac disease you have to avoid gluten-100%. But keep in mind that celiac disease affects only 1% of the population (1). Assuming you do not have celiac disease (which needs to be ruled out by your health care provider), the only way of knowing if gluten is an issue for you is to do an elimination diet. This involves entirely eliminating gluten from your diet for a period of at least 30 days (preferably 2-3 months) then re-introducing it and monitoring your body’s response. It is best to follow a structured elimination diet plan when attempting this so you don’t inadvertently consume something with gluten. We especially like the Whole 30 as it has a clear-cut set of dietary guidelines and comes with a plethora of supportive resources. I personally recommend that any patient who suffers from an auto-immune or gastrointestinal condition try a gluten-free elimination diet. That being said, please check with your own health care provider before embarking on one of these, as every patient is different and needs individualized care.

If it turns out that you are sensitive to gluten, do not despair! There are plenty of delicious food options out there that are gluten-free. Besides unprocessed animal products, fruits, vegetables, nuts, and seeds, grains such as quinoa, brown rice, and oats (look for the gluten free variety to avoid cross-contamination) are all great alternatives to gluten containing products. Almond flour, coconut flour, and non-GMO corn flour are naturally gluten-free flours that can be used in place of wheat flour in baked goods. Now that more and more people are going gluten-free, there are multiple cookbooks and websites that offer delicious recipes and a variety of gluten-free foods on the grocery store shelves.

One word of advice- gluten free does not necessarily mean healthy. There are plenty of gluten-free foods that offer minimal nutritional value and are full of sugar and other additives. To avoid inadvertently increasing your consumption of processed foods when transitioning to gluten-free eating, try and eat mostly unprocessed, whole foods like I mentioned above.

Here is a list of websites and books that offer great guidance and recipe options:

–Beyond Celiac –GlutenFreeGirl –PaleoRunningMomma –Grain Brain by Dr David Perlmutter –Wheat Belly by Dr. William Davis

I will close by re-emphasizing the importance of figuring out what works for YOU and YOUR body. Bio-individuality is incredibly important when discussing different styles of eating and gluten is not an issue for everyone. Assuming you don’t have celiac disease, occasionally eating gluten-containing foods is not likely to cause any serious health problems. Yes, you may have some digestive discomfort for a day or two following, but you will likely bounce back without any issues. You also have to consider that other foods can potentially trigger the same type of symptoms that gluten can. Dairy products, eggs, legumes, and even gluten-free grains can be problematic for some people. Approach your diet with an attitude of curiosity and try out different styles of eating. Make note of what does and does not work for you and if you are struggling to figure it all out, talk to your health care provider, health coach, or nutritionist to have them help you out along the way.

Continue to follow your gut,

Erin