By Shannon Gierl
If you've been tuned in at all to health and wellness news over the last 10 years, chances are you've heard a thing (or 5,000) about gluten. And, chances are you're thoroughly confused and not looking for another reason to ban any more favorite foods from your diet, so you've kinda ignored the hype. I get it. I mean, it's in EVERYTHING, right?
Well, I'm going to sum it all up for you, right here and now: what is gluten, why it might be bad for you, how to tell if you have an allergy to it (and why it seems like everyone and their mom has a gluten allergy these days), and most importantly, what to do about it if you do.
Gluten is a protein molecule found in wheat, barley, rye, spelt, kamut, and most oats (due to cross-contamination). Gluten literally means “glue”. Gluten is what gives bread its elasticity and texture. (1)
Gluten Sensitivity vs. Celiacs
So there are two main camps that people fall into who have a problem with gluten exposure. The more severe is called Celiacs. It is estimated that about 3 million Americans, or 1 in 133 people has Celiacs. By definition, Celiac disease is an autoimmune digestive disease that damages the villi of the small intestine and interferes with absorption of nutrients from food, which can lead to malnourishment. Symptoms include bloating or gas, depression, headaches, problems with weight gain, infertility, fatigue, joint pain, and many more. It is estimated that only 5% of people suffering from Celiacs are ever diagnosed.
If someone does not have Celiacs but has any other kind of gluten intolerance or sees negative health impacts from gluten, this is known as gluten sensitivity. Research from the Center for Celiac Research and Treatment indicates that gluten sensitivities, or intolerances, affect much more of the population: about 18 million Americans, or 6%.
Gluten sensitivity, unlike Celiacs, is not an autoimmune disorder. However, it triggers an innate immune response that creates inflammation throughout the body, with wide-ranging effects across all organ systems. A sensitivity can cause subtle to severe symptoms depending on the patient, many of which mimic those of celiacs disease. Sensitivities often occur outside of the digestive system, such as, joints, skin and nervous system, including brain fog, headaches, and numbness in the legs, arms, and fingers. It can be the single cause behind many different "diseases." (2)
Why all the sudden hype?
It's pretty obvious that the attention that gluten has been getting has ramped up considerably in the last few years. Sales of gluten free food have grown an estimated 27% in the last few years, and is reported to be a $4.2 billion market in 2012. So why all the hype? Is 'gluten-free' just the latest fad diet in our never-ending quest to find that magical bullet that will melt the pounds?
Most likely not. Turns out there are a myriad of valid reasons why the gluten free diet has skyrocketed to stardom lately. The first is the drastic rise in incidence of gluten related diseases. A study (published in Gastroenterology. 2009 Jul;137(1):88-93) comparing the blood of 10,000 people from 50 years ago to 10,000 people today found that the incidences of full-blown celiac disease increased by 400 percent (elevated TTG antibodies) during that time period. (2) To date, research indicates that over 200 diseases are associated with gluten sensitivity. These can range from seizures to skin conditions, covering the full range of the body and organs. (1)
So the next question is why are we so sensitive to this staple of our diet? While it is true that we have been eating wheat for generations, we have NOT been eating the commercial wheat that is grown today.
Wheat was introduced into Europe during the Middle Ages, and 30 percent of people of European descent carry the gene for celiac disease which increases susceptibility to health problems from eating gluten. American strains of wheat have a much higher gluten content (which is needed to make light, fluffy Wonder Bread and giant bagels) than those traditionally found in Europe. This super-gluten was recently introduced into our agricultural food supply and now has "infected" nearly all wheat strains in America. (2) By modifying wheat to contain more gluten than it originally did, the agriculture industry has vastly increased our exposure.
Finally, the last reason that it seems our bodies have grown increasingly intolerant to wheat and gluten can be blamed on our cultural eating and lifestyle habits today. The Standard American Diet (SAD) has very little nutritional value and our society is much more stressful, which contributes to the breakdown of our immune tolerance for substances like gluten. Without proper nutrition, our bodies have a tendency to make less of the enzymes required to digest and break down gluten particles. Chronic exposure combined with diets that are compromised nutritionally has created the perfect storm for an explosion of gluten-related diseases. (1)
Great...so why is gluten so bad?
A review paper in The New England Journal of Medicine found no less than 55 diseases that can be caused by consuming gluten. These include osteoporosis, irritable bowel disease, anemia, fatigue, canker sores, cancer, and lupus, rheumatoid arthritis, multiple sclerosis, and almost all other autoimmune diseases. (2) I have fibromyalgia, and it is oftentimes recommended that those suffering from this chronic illness avoid gluten. Since I gave up gluten 2 years ago, my fibromyalgia symptoms have significantly and measurably reduced.
Gluten has also been linked to many psychiatric and neurological disorders including depression, anxiety, schizophrenia, migraines, dementia, and epilepsy.
A recent large study in the Journal of the American Medical Association found that people with Celiacs disease or gluten sensitivity (diagnosed or undiagnosed) had up to a 79% increased risk of death, mostly from heart disease and cancer. (2)
Ok, s&*^ just got real.
So what should you do about it?
The first step is to know if you have a gluten sensitivity, or even Celiacs. Get Tested! (Do I sound vaguely like your 6th grade sex ed teacher? ha.)
There are several ways of testing for Celiacs. The most simple involve testing for a range of specific antibodies. Others include genotyping for celiac disease, and an intestinal biopsy to examine the state of the intestinal villi and tract.
Gluten Sensitivity Testing:
Gluten sensitivity can often be challenging for an untrained practitioner to identify as its symptoms mimic those of a wide range of diseases on a range of organs in the body. The symptoms may also be delayed (30 minutes – 4 days), making it challenging for one to recognize gluten as the offending agent. (1)
While testing can help identify gluten sensitivity (blood and saliva tests which look at 12 different peptides of gluten) the only way you will know if this is really a problem for you is to eliminate all gluten for a short period of time (2 to 4 weeks) and see how you feel. For this test to work you must eliminate 100 percent of the gluten from your diet, with no exceptions, cheat days, nor accidental slip-ups.
Then eat it again and see how you feel. If you feel bad or different at all, you should stay off gluten permanently. This will teach you better than any blood or saliva test about the impact gluten has on your body. (2) It was through this method (albeit accidentally) that I discovered my allergy. I went on the Paleo diet for 6 weeks, and when I came off of it and started eating bread again, I felt like crap. No joke. Through research and process of elimination, I found out the culprit was gluten.
By failing to identify gluten sensitivity and celiac disease, we create needless suffering and death for millions of Americans. It is estimated that 99 percent of people who have a problem with gluten don't realize it. These people are suffering needlessly, going to the doctor, and costing the healthcare system millions of dollars. They attribute their poor health and symptoms to something else--not gluten sensitivity, which is 100 percent curable. (2)
Columbia University studied all 10 million subscribers to CIGNA and found those who were correctly diagnosed with celiac disease used fewer medical services and reduced their healthcare costs by more than 30%. Health problems caused by gluten sensitivity cannot be treated with medication. They can only be overcome by eliminating 100 percent of the gluten from your diet. (2)
I promise, there are perks!
So, that's pretty rough right? There's no magical pill you can take, no surgery to fix this one. Just. sheer. will. And at first it's difficult, I won't lie. When I initially went gluten free, I felt like a freak at restaurants: "Um, is there gluten in that? Do you use regular soy sauce? Can I have that burger without the bun?"
However, it gets better. And in the past two years I have noticed a HUGE shift in most restaurants and food stores in terms of the availability of gluten free products, menu items, and even education of the staff. At most nice restaurants the servers know what gluten is, they know where it is usually found, and they are mostly educated about their menu (or at least willing to go ask the chef if they aren't).
But gluten free isn't all fuss and frustration. There are HUGE perks to being gluten free! Like, um weight loss? Yes, please! No bloating? Sign me up! Stable energy throughout the day (no need for that 3pm cappuccino)? I'll take back that $5.25, thanks, Starbucks.
The list goes on! Have more questions about a gluten free lifestyle? Email me at firstname.lastname@example.org. And stay tuned - I have dubbed May "Gluten Free is Glorious Month" and I will be posting gluten free recipes, and more blog posts about how to adopt a gluten free lifestyle that is painless, delicious, and oh-so-good for your radiance.