If you have celiac disease or a diagnosed allergy to wheat, this post is not for you. If you don’t have celiac disease, but you follow a gluten-free diet and feel like it’s changed your life, more power to you. I’m not here to change your mind or convince you one way or the other. This post IS for those out there that have no idea what the heck is up with gluten.
What is gluten?
Gluten is a protein found in certain grains, especially wheat. For those with celiac disease, exposure to gluten causes an autoimmune reaction where the body’s immune system sees gluten as a problem and tries to attack, however it ends up attacking healthy cells in the body, too. They often experience severe symptoms of digestive distress and malnutrition. The only treatment is to eliminate gluten from the diet.
The discovery of celiac disease and its villainous trigger gluten occurred over 60 years ago (wars and famines have a way of prompting nutritional discoveries). A few decades ago as the disease was becoming better understood, a couple of scientists started studying its presence in the U.S. and discovered some interesting findings based on studying test tubes of donated blood… as many as 1/130 people may have celiac disease, many of them potentially undiagnosed.
It just so happened this was being hashed out as our country was diving head first into a low-carb craze, demonizing anything with toast potential. So at the same time we were learning “carbs are bad,” a disease gaining more attention was telling us thousands of people may actually have an allergy to an ingredient prevalent in many high carb foods. The link seemed so obvious.
As it often happens in medicine and research, some major wires got crossed and before you know it, gluten is bad. Really bad. Not only is gluten bad, but gluten-free is VERY GOOD. It’s curing everything from autism to arthritis. The term gluten-free has essentially become a synonym for “healthy.”
This study in 2013 showed that 30 percent of Americans were trying to cut down on gluten. 30 percent! For a disease that affects less than 1% of the population! These numbers certainly suggest a significant number of people are going gluten-free because it’s trendy, or they think it’s healthier.
What’s wrong with gluten-free?
The problem is, gluten-free isn’t necessarily healthier or better. People who don’t eat gluten don’t eat whole grains and lose out on some nutritional protections associated with them. Eating gluten-free can be very expensive. And because the market loves to take advantage of us, there’s now a gluten-free version of all our classic favorites, but instead of gluten other not so good ingredients and fillers are added As it turns out, a gluten-free diet can be healthy or unhealthy depending on how you eat, similar to how a vegetarian diet can be healthy or unhealthy.
So why would someone chose to eliminate something as prevalent as gluten (it’s in SO MANY THINGS you would never think) if they didn’t have an allergy?
When thousands of people start following a diet trend, many of them will tout its benefits. These benefits may be a placebo effect, or they may be real. But it doesn’t really matter when thousands of people THINK this diet has helped them. So many, that a new term emerges. Gluten “sensitivity.” That is to say, there is no serologic evidence of an allergy or disease, but it’s felt there is an intolerance that can’t be measured. If you go gluten-free and suddenly feel like the best version of yourself, you have a gluten sensitivity. But good luck getting a doctor to get on board with that.
Is gluten-sensitivity a real thing?
Are thousands of people eating gluten-free for no reason? Is it all in their heads?
Gluten sensitivity is something highly debated in the medical community. There are many, many anecdotal accounts of people having long-standing GI symptoms that resolve on a gluten-free diet. Is it a placebo effect? Or have we just not found the markers that would indicate there’s some sort of reaction going on?
In an interview on Freakonomics Radio, gastroenterologist and celiac expert Dr. Benjamin Lebwohl was quoted as saying:
It’s really counterproductive to question whether non-celiac gluten sensitivity is real. Clearly, the symptoms are real. The suffering is real. I don’t have to tell you how many patients I’ve seen. I promise they’re real. What we don’t know is what exactly is driving their symptoms. What’s the biological basis? Many of them are coming to celiac-disease specialists because they really don’t have elsewhere to go in the area of so-called conventional medicine because there isn’t a well-defined pathway for these patients.
We need to better understand them, listen to them, try to understand what’s driving your symptoms. I’ve certainly seen patients where it really appears to be gluten that’s driving symptoms, even though we can’t for the life of us find a marker in the blood or the intestine. We need to study these patients. We need to take care of them. I certainly wouldn’t doubt that it’s real, though. We just need better science.
So there you have it. The gluten debate. Clear as mud, right?
My thoughts on the subject, and understand this is my opinion and not referenced by specific research, are that
- People have been eating gluten for thousands of years without problems for the majority of the population. I don’t think that has suddenly changed in the last few decades.
- To add to #1, for those who believe they have a food intolerance I would first recommend eating a healthy diet consisting of a variety of healthy whole foods like fruits, vegetables, healthy fats and proteins instead of strictly gluten-free, to see if your symptoms improve.
- Our diet has become increasingly processed and overloaded with refined grains (see this post if you don’t know what I’m referring to with enriched grains) that aren’t good for us. When you eliminate gluten, you eliminate a lot of these unhealthy foods. I think it’s very possible people associate feeling better on a diet low in processed foods and refined grains with removing gluten, which is merely a correlation and not a causation.
- If the leading experts on celiac disease think there’s potential for a non-celiac gluten sensitivity to exist, who am I to say there isn’t? The overwhelming increase diagnosis of irritable bowel syndrome and non-specific GI disturbances is undeniable. I hope their research continues to evolve and we find answers for these people.
- I suspect most of these experts would agree, gluten is not the cause of most of the physical complaints and diseases it has come to be associated with and thousands of people have unnecessarily eliminated gluten from their diet.
What do you do with this information?
If you truly think you have a gluten sensitivity, first, just be aware there isn’t a way to test for this. And there’s a good chance conventional medicine won’t be on board with your self-diagnosis. But if you chose to follow a gluten-free diet, and your symptoms resolve, then go for it. Make sure you’re eating lots of fruits and vegetables to get the recommended fiber you need since you are limiting many whole grains. Watch out for “gluten-free junk food” and try to eat well-balanced, just as everyone should.
What do I do personally?
I get cauliflower crust pizza at our local pizza shop because it tastes good, gives me more servings of vegetables and limits my intake of refined white flour. That’s by choice. I also eat gluten. Lots of it. One of my favorite foods is my husband’s homemade whole wheat bread with everything seasoning. I count my blessings I don’t have to avoid foods like that for the sake of my health.