Are You Gluten Sensitive?

The other day I got a good laugh from a Facebook post which stated, “This just in: The dinosaurs were wiped out by GLUTEN!”

Going gluten-free has become somewhat passé to many people who aren’t directly affected by this omnipresent grain protein. It might be a different story if gluten was found in calves liver, lima beans or spinach. But, alas, wheat is the primary source of gluten, and wheat-containing foods and products are often delicious and difficult to avoid. 

Besides baked goods, wheat is commonly used as a binding agent (think meatballs), a topping (breadcrumbs on baked oysters or fried chicken), and even as a thickener in sauces and soups. The truth is you have to make a concerted effort to nudge gluten out of your diet. It’s possible, but requires some degree of conviction and dedication. 

It's long been known that a very small percentage of the population has celiac disease (CD), a serious form of gluten intolerance which can cause anemia, bone loss, fatigue, gastrointestinal symptoms, malabsorption, joint and muscle pain, and psychological disorders, including anxiety and depression. CD can only be definitively diagnosed after undergoing specific blood tests that look for gluten autoantibodies. 

Occasionally, a bowel biopsy may be taken to determine the degree of intestinal damage that can result from repeated exposure to gluten. However, some people who test negative for CD still believe they suffer adverse reactions to glutenous grains such as barley, oat, rye and various types of wheat (bulgur, einkorn, faro, freekah, Kamut, spelt, triticale, etc.). Some of these individuals may in fact have a related condition known as non-celiac gluten sensitivity or NCGS. 

In recent years, coverage of NCGS has increased significantly in the medical literature. Essentially, it has been determined that NCGS is an “independent disease outside of celiac disease.” Another important finding is that a high percentage of those with non-celiac gluten sensitivity develop other types of autoimmunity, bowel diseases and psychiatric disorders as well. But, perhaps the most intriguing developments in the field of gluten research come courtesy of several interventional trials. The first found improvements in body weight and digestive symptoms in patients (with or without celiac disease) when gluten was removed from their diets. 

In another instance, adding even small amounts of gluten to the diets of NCGS patients for just one week resulted in numerous side effects, including abdominal bloating and pain, depression and “foggy mind.” A third study, appearing in the June 2015 issue of the J ournal of Nutrition, goes on to reveal that gluten consumption inflammation in otherwise healthy young adults. Finally, emerging data now suggests that Irritable Bowel Syndrome (IBS), a prevalent digestive disorder, may be largely influenced by a reaction to gluten. If this is substantiated by further studies, this would be a turning point in the understanding and management of IBS and other similar conditions. 

The above trials offer an important insight into how one can test for gluten intolerance in the comfort of their own home. Simply put, a cost-effective, reliable way to assess gluten sensitivity is to avoid gluten altogether. 

I suggest a minimum two-week, gluten-free challenge. The easiest way to accomplish this is to eat a whole food diet that minimizes processed foods that often contain hidden sources of gluten. Next, be sure to read medication and supplement labels carefully, as these pills and tablets may contribute trace amounts of gluten. 

Keep in mind that this challenge can be preceded or followed up by additional testing available from doctors or nutritionists. 

Another Reason to Go Gluten-Free 

Sensitivity issues aside, I frequently recommend gluten-free diets because of their nutrient density. For example, you’ll get much more nutrition from eating a scrambled egg and some sliced avocado for breakfast instead of cereal and milk or toast with jam. For lunch, a Caesar salad (hold the croutons!) with chicken breast or wild salmon contains a broader array of healthy fats, minerals and vitamins than a hamburger or BLT with fries on the side. And, instead of semolina pasta for dinner, how about a vegetable-based alternative like spaghetti squash? This is a delicious, gluten-free staple in our household. 

Lastly, there are more gluten-free foods available in health food stores and markets than ever before. Many of these products are quite nutritious and tasty. You can find everything from cereal made from coconuts to pizza crust made from ground almonds and flax seeds. The convenience of such foods can make a big difference in the long-term maintenance of a gluten-free lifestyle. 

Digestive Enzymes and Healthy Bacteria 

A final issue to consider is dietary supplements. There are quite a few gluten-digesting supplements on the market. If you know or suspect that you are gluten intolerant, I urge you not to depend on these as a way to “have your cake and eat it out”. The research on the efficacy of gluten digesting supplements is mixed. Therefore, until there’s more certainty on this topic, I don’t think they should be relied upon. On the other hand, I do believe that probiotic foods and supplements show real promise in improving the health of those with CD and NCGS. Those living with these conditions often exhibit an imbalance in gut bacteria. 

The key to addressing a mixed-up gut is to restore order by taking probiotic supplements and/or eating a variety of cultured and fermented foods such as kefir, kimchi, and yogurt, which contain healthy bacteria in the form of probiotics. For those who don’t react well to dairy, alternative sources of kefir and yogurt using almond, cashew or coconut milk are available. 

Always bear in mind that supplements are intended to "supplement" an already healthy diet. In the case of gluten sensitivity, that means avoiding gluten as the first and primary step in the healing process. 

John Paul Fanton, based in Los Angeles, California, is a consultant, researcher and writer with over 20 years of experience in the field of natural medicine. He designs unique nutritional plans, mind-body (meditation, mindfulness, etc.) and vitamin/supplement programs for individual clients who are interested in improving overall health, weight and wellness. You can find his weekly column on the Healthy Fellow.

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