This post needs a little bit of a rant warning, but I have an gripe that needs some air time.
All aboard the gluten free train!
Gluten intolerance/avoidance/celiac disease (which I’ll lump together and call ‘gluten intolerance’) seems to have gotten a bit of a bum rap of late. It’s an easy target. People purporting to have an allergy to they have a reason to avoid those white processed carbs, until they see something on the menu they really want and it’s all forgotten. Silly people getting onto a health bandwagon that requires silly foods. Right?
There’s gluten free rice which is charged at a premium. Gluten free breads which would be better off not having been dreamed into existence at all and cost you a handsome sum. Gluten free skin products. Truly! And which of these is necessary, and which is opportunism?
What is gluten, anyway?
I’ve discussed what gluten is at a basic level in my post Why I Prefer Coconut Flour, and why if you remove gluten from your diet you shouldn’t seek ‘replacement’ foods.
Basically, gluten is a protein found in some grains. It is part of a plant’s defence mechanism. Plants want to go on living like the rest of us, so the gluten is there to make predators feel ill when they eat that grain. Some of us are more able to digest gluten than others, depending on whether that person has the right concentration in their gut of the enzyme that breaks down gluten. When that enzyme is deficient the gut cops it and health suffers as a result. In coeliacs, the immune system recognises the gluten as a danger but attacks the gut wall as well.
Considering that gluten is a plant defence mechanism specifically designed to stop predator species from eating too much. It’s doing a pretty good job, don’t you think?
Some studies show that all of us have an immune response to gluten. Eliminating or reducing gluten might not be a cure all for everyone but may still be worthwhile if the individual concerned has a propensity for inflammation such as hayfever or other allergies. My husband for example finds that his hayfever is not as severe if he keeps gluten to a minimum. He does not have gluten intolerance and still occasionally eats bread.
The sciency-wiency stuff
So there is this study (click here) which says that self diagnosed gluten sensitive people don’t have any measurable response to gluten when submitted to a double blind placebo:
In a placebo-controlled, cross-over rechallenge study, we found no evidence of specific or dose-dependent effects of gluten in patients with NCGS placed diets low in FODMAPs.
Hardly the death of non-celiac gluten intolerance the media thinks.
Sounds conclusive? Nope. Not even. Why?
The sample size was 37 people, and it was conducted over two weeks. Hardly a sample size enough to call ‘end game’, particularly since the timeframe given for exclusion diets is six weeks because intestinal damage takes at least that long to heal. Two days to indicate a result in a two/three week study is not nearly enough time to eliminate all the nasties in the system and have the damage heal. Without full healing time, you can’t know for sure what it was that made you sick.
A window of two days was allowed for a reaction. Reaction times can be much slower than that. For me, two days is the short end of the range.
These 37 people had IBS. We don’t know if gluten was their sole issue because they had no other diagnosis than IBS, which is an umbrella term for ‘gut is a bit shit but we don’t know why’. The gluten free and FODMAP diet may not have excluded all triggers.
Tests were conducted for biomarkers associated with celiac disease. Just because this biomarker was not present does not mean there was not a systemic reaction of note and does not take into account that there may be another biomarker we do not yet know of at play here.
Fatigue was taken into account, but again the window was only two days. I certainly believe that ‘I feel like shit warmed up’ is something that SHOULD be taken into account. I have never tested positive for any marker associated with gluten, yet when I eat it I am violently ill and my skin erupts and my mood hits rock bottom. So thank you, scientists, for considering another indicator apart from intestinal upset. But giving a small window for a reaction doesn’t take into account how long this damage takes to dance its way through our systems.
This study was not peer reviewed. This is important!
Did you notice that there is one thing the media have missed about this study? GOING GLUTEN FREE STILL WORKED FOR THESE PEOPLE.
Did you also notice that this study was paid for by George Weston Foods who make… BREAD? Hmmm.
There are many bloggers that know far more than I do about gluten that have written responses to this study:
- Robb Wolf wrote an article called “Does Gluten Intolerance Exist?”
- Mark Sisson wrote an article called “Does Gluten Have Any Effects on Non-Celiacs?”
- Chris Kresser wrote an article called “Is Gluten Sensitivity Real?”
- Neely Quinn wrote an article called “Is Gluten Sensitivity Real?”
- Dr. David Perlmutter wrote an article called “Gluten Sensitivity May Involve the Gut”
- Gluten Free Girl article “Gluten Sensitivity is Real”
- Hashimoto 411 article “What about Gluten Sensitivity not really existing?
There is so much research in this area, check out this study which found that gluten elicits an immune response in all individuals upon exposure. Another study even found psychological effects to gluten exposure akin to opioids!
Apart from having to defend your dietary choices? Apparently the nutrition in bread/pasta is going to leave a big hole in your diet.
What nutrition can you possibly get from your food if your gut is moving to fast or is too damaged to absorb nutrition from your food?
If you replace gluten containing foods with poor substitutes, sure… your nutrition will suffer. So will your wallet! Replace with whole foods and heal your gut? Heaps better.
Why does a study like this matter?
Because its popular reception (not the findings of the study itself, mind you) seems to legitimise calling bullshit on the gluten free movement. I also find it interesting that the Paleo diet is so similar in some respects to going gluten free – both aim to reduce grains, but one is associated with really fit buffed people, and the other with those fooled by snake oil…
Is gluten free a fad, and does that matter?
A fad is an intense and widely shared craze that is short lived. Going gluten free is certainly intense, but I hope for the people that it could potentially help get well that it is not short lived. I hope the craziness and zealotry dies down, and I hope the unscrupulous marketers find their conscience (or, hell could freeze over!).
What give me the irrits about this discussion is that we are making people feel bad for taking charge of their health and avoiding that which makes them feel ill. And for me, that is not on. If someone is trying to improve their health by experimenting with what they eat, all power to them. If it’s cutting out gluten and processed foods, great. Don’t belittle or ridicule people for taking charge of their own health in the way they see as working for them. I for one would be sad for someone who gave up something that was working for them simply because they were singled out for it. If you do not feel ill effects from eating something, don’t underestimate the extent to which someone else feels pain or illness.
Being a wheatard is hard work. Asking every single eyeball-rolling waiter who serves you in every single restaurant or cafe is such a menu item is gluten free is as annoying for you as it is for them. Let alone trying to choose a vegetarian gluten free option. Most places have two choices: pumpkin soup or mushroom risotto. Mmmm. Then just wait to have that soup served to you with croutons. Can’t you just pick that out?
But in the same breath, increased awareness means that more options are becoming available all the time. And menus are being marked for everyone’s convenience. Choosing new places to eat can be really hard. I have a few trusted places that I know will offer me a few selections. I can’t have even a small piece of your very nice cake at morning tea. I can’t have that pastry, even though I’m sure it’s really tasty. Yes, it’s hard. But I’d rather miss out then spend the rest of the next week praying to the porcelain gods and living with pain.
On the other hand though, those who fade in and out of removing gluten from their diets do little to inspire compassion in their observers who then misunderstand the seriousness of the effects of gluten intolerance. Neither do they help their own bodies recover from the damage done – 100% commitment is needed when you remove gluten from your diet if you have an intolerance. Even a small amount in a gluten intolerant person can cause a relapse of symptoms.
The next time you engage in a discussion with someone abut gluten intolerance, if you are the suffer take the time to explain to your audience how this all makes you feel. Don’t proclaim from the rooftops the benefits of this and that, because how people manage their own bodies is their own choice. If you are listening to someone talk about their experiences with gluten, ask them how this has made them feel. You may find some resonance with how you are feeling, and want to cut down your gluten intake. Or, you might learn how your friend has overcome a personal hardship.
And at the end of the day, whatever the science says, if you feel like crap after eating something then don’t eat it again! Label or fad aside. Experiment complete.
**UPDATED 4 September 2014**
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