Do You Really Need to Follow a Gluten-Free Diet?

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You can scarcely go a day without hearing about gluten-free diets and foods. There are entire sections of grocery stores dedicated to gluten-free foods. Most major restaurant chain menus now label specific dishes as gluten-free or “gluten-friendly.” You probably know at least one friend or family member on a gluten-free diet. It’s easy to think “being gluten-free” is a fad and one to roll your eyes at, but did you ever stop and wonder if there is any merit to this way of eating? What do you really know about gluten and its effects on the body?

What is Gluten?

Gluten is a family of proteins found in wheat, rye, barley, and non-gluten-free oats (due to cross-contamination). It acts like a glue or binding agent that holds food together and is responsible for giving shape, rise, and elastic texture to things like bread and cookies. The two main proteins in gluten are glutenin and gliadin.

Potential Problems with Gluten

Celiac Disease

For those with celiac disease, consumption of gluten causes the immune system to attack the gluten, as well as the lining of the intestines. Celiac disease is an autoimmune condition and one that causes severe digestive symptoms like bloating, constipation, nausea, abdominal cramping and pain, weight loss, tiredness, and even anemia. It’s estimated that about 1% of the population has a diagnosis of celiac disease.

Gluten Sensitivity

On the other hand, gluten sensitivity is a more common condition. Dr. Alessio Fasano, a world-renowned physician and chief of Pediatric Gastroenterology and Nutrition at MassGeneral Hospital for Children, estimates that about 6-7% of the population may be gluten-intolerant. This means that some 20 million people in the United States alone could have the condition, and many may not be fully aware.

However, other researchers like Dr. Rodney Ford, a pediatrician in Christchurch, New Zealand and author of The Gluten Syndrome and Dr. Kenneth Fine, a gastroenterologist who founded and directs the gluten sensitivity testing service Enterolab, believe the percentage of people who are gluten-sensitive actually could be much higher — potentially between 30% and 50%.

Symptoms of gluten intolerance or sensitivity can affect other areas of the body in addition to the intestines, and this is partly why it can go undiscovered. These symptoms may include skin rashes, psoriasis, alopecia, depression, anxiety, achy joints, headaches, and — the biggest one of all — autoimmune conditions.

Problematic Proteins

Zonulin is a protein that was discovered in 2000 by Dr. Alessio Fasano and his team. Zonulin modulates the permeability of tight junctions between cells of the wall of the digestive tract. (Essentially the intestines should be primarily closed off, but an increase in zonulin allows them to open up.)

These researchers found that the two most powerful triggers to open the zonulin door are gluten and gut bacteria in the small intestine.  Gliadin (one of the gluten’s proteins) causes zonulin levels to increase both in those people who have celiac disease and those who do not. This leads to a condition known as “leaky gut.”

When someone has leaky gut, bacteria, food particles, and microbes can pass from the intestines into the blood stream where they do not belong. The immune system thinks they are foreign invaders and will mount an immune response leading to food sensitivities. This can also lead to autoimmune responses and autoimmune disease.

Autoimmune Conditions

Gluten has been associated with an increase in autoimmune conditions due to the aforementioned mechanisms (leaky gut). The following is a list of some autoimmune conditions:

  • Rheumatoid arthritis

  • Lupus

  • Crohn’s disease

  • Ulcerative colitis

  • IBD

  • Multiple sclerosis

  • Type 1 diabetes

  • Guillain-Barre

  • Psoriasis

  • Hashimotos thyroiditis

  • Grave’s disease

  • Myasthenia gravis

  • Vasculitis

  • Celiac disease

You can find a more exhaustive list here. Suffice it to say, if you have one of these conditions or are wanting to avoid them, you want to stop the immune system from attacking your body. This means that closing the tight junctions in your intestines and stopping leaky gut is of utmost importance.

Is There a Definitive Yes or No to Gluten Consumption?

Dr. Alessio Fasano

Even the gluten researchers don’t totally agree on this. Dr. Fasano, the leading researcher in all things gluten, believes that gluten can be one of the culprits in the development of autoimmune conditions and food sensitivities. However, on his appearance on the Doctor’s Farmacy podcast with Dr. Mark Hyman, he clearly states that food intolerances are caused by various mechanisms. He says that gluten intolerance is a combination of genetic predisposition, environmental factors, one’s overall gut microbiome (how healthy your good gut bacteria is), if one has leaky gut, how reactive or hyperactive one’s immune system is, and whether or not one suffers from chronic inflammation.

He goes on to say that it is actually okay to have some level of gut permeability because that’s how we build up our immune systems to foreign invaders. However, inundating the body over and over again with attacks is not healthy.

My Verdict

1) It’s not a necessary food group.

I’m not a medical advisor or doctor, but I do have a gluten sensitivity and have done boat loads of research on the topic myself. I find that there is an overall consensus that gluten and wheat products are NOT a necessary part of one’s diet. You don’t need to eat it to live. In fact, grains in general have been implicated in inflammation, even those healthy ones like brown rice and quinoa.

The wheat of today is not the same as the wheat of yesterday. Ancient wheat was approximately 4% gluten. Today, the dwarf wheat we eat is around 12% gluten, meaning that there is more of the harmful stuff than in the past. This may contribute to the upswing in leaky gut and resultant illnesses.

2) I believe that if you don’t need to eat gluten, you shouldn’t.

There are plenty of gluten-free options available to make an easy switch over to a gluten-free lifestyle. I’m NOT advocating buying and eating a bunch of gluten-free junk food. Not at all. JUNK IS JUNK. Gluten-free packaged foods are probably no better than those with gluten in the sense that they may be high in sugars, carbs, and damaged oils that create inflammation in our bodies. But when you need a piece of bread or a cracker, reaching for a product made with rice or almond flour is probably better for your digestive tract. Why eat something that may potentially harm you now or down the road if you don’t need to?

2) Try an elimination diet.

If you’re not sure what to do or aren’t convinced gluten is harming you, try to remove it from your diet for a month to 6 weeks. Keep track of how you feel during the time you’re off gluten. Do you notice changes with energy? How are your bowel movements? How does your stomach feel? Are you less bloated? Are you experiencing fewer headaches? How does your skin look? How do your joints feel? If any of these improve during those 6 weeks, it may be indicative that gluten was, in fact, harming you.

After the 6 weeks are over, reintroduce gluten and notice if anything changes for you. Do you have a recurrence of any symptoms or negative reactions? If not, gluten may be fine for you to eat in moderation. If you feel badly, you have your answer.

Which Foods Have Gluten?

The following is a list of foods containing gluten. (See the Celiac Foundation’s List for a more thorough itemization.) There may hidden gluten in processed foods, so be sure to always read labels before eating these products. And when dining out, be wary of sauces and soups that often may contain gluten or flour for thickening purposes.

  • Grains: wheat, rye, barley, oats (unless specified as gluten-free), spelt, farro, graham, durum, semolina, malt (and malt vinegar), brewer’s yeast

  • Pasta and noodles

  • Breads and pastries

  • Crackers

  • Baked goods

  • Cereal and granola

  • Breakfast foods: pancakes, waffles, french toast, crepes

  • Croutons and bread crumbs

  • Breaded foods and many fried or battered foods

  • Sauces and gravies

  • Tortillas

  • Beer

  • Soy sauce

  • Salad dressing

  • Candy and candy bars

  • Pre-seasoned meats

Final Thoughts

So there you have it. Ultimately, you need to decide which diet is best for you and for your health. It never hurts to eliminate a food for a time just to see if you notice any differences. Elimination protocols are the key standard in determining whether or not you have a reaction or sensitivity towards a specific food, even above and beyond blood tests.

I’ve taken food sensitivity tests via blood work and have found them to be inconsistent. I do react to gluten and dairy. I was told that eggs were highly reactive for me, so I eliminated them for a time, but once I reintroduced them, I don’t find that they bother me at all. On the other hand, foods that did NOT come up as reactive for me like spinach, bananas, and almonds cause my rosacea to flare immensely. The point is … each one of us is different. Only YOU can know what is best for your body, but you have to LISTEN to it. Plain and simple. Keep track of any physical ailments you experience and keep a dietary journal in which you can track your food choices each day. This may help you discover which foods are best for you and which foods you should avoid. Food is medicine, but you need to use it wisely.