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Unless you’ve been hiding under a rock you’ve likely seen a burgeoning number of gluten-free products showing up on store shelves, heard a friend espouse the virtues of a gluten-free diet, or maybe even given up gluten yourself. Gluten-free is all the rage these days. But for its popularity, confusion about gluten abounds—even among some of those following a gluten-free diet. If you’ve found yourself wondering, “What’s the deal with gluten?” Or ever had to mumble your way through a confused explanation about why you’re eating gluten-free, read on, this one’s for you.
Gluten refers to a family of proteins that naturally occur in the cereal grains wheat (and its relatives spelt, emmer, einkorn, kamut), rye, barley, and triticale. Gluten proteins are sticky and strong, and give bread and other baked goods structure, elasticity, and chewiness; it acts as a sort of glue that holds certain foods together. Without gluten, breads are dense and crumbly. Gluten is largely what makes bread, well… bread. But gluten also prompts an abnormal immune response in some people, and if it isn’t eliminated, can lead to major health problems.
Ideally, during digestion, proteins such as gluten should be broken down into individual amino acids and then absorbed through the small intestine, but gluten proteins are difficult for the human digestive tract to break down, which can cause serious problems for some people. One in every 133 people in the United States has celiac disease—an autoimmune disease in which gluten triggers the immune system to attack the lining of the digestive tract—and another 30 percent of Americans may have gluten sensitivity, aka, “non-celiac gluten sensitivity.” 1 In either case, malabsorption of nutrients and inflammation can occur. Gluten also opens up the tight junctions that bind intestinal cells together, leading to “leaky gut” which allows proteins that are not fully digested (like gluten) to enter the bloodstream, triggering an immune response. Malabsorption, inflammation, and leaky gut create a vicious cycle, with inflammation leading to leaky gut, and leaky gut leading to inflammation, and both leading to more malabsorption. This is why individuals who are intolerant to gluten can experience such a wide variety of symptoms. As the damage progresses, the immune system may become hyper-vigilant and begin to attack other parts of the body, leading to autoimmune diseases.
Not long ago it was hallmark digestive symptoms like gas, bloating, and diarrhea that may have been the first clues that gluten was a problem. But today we know digestive symptoms are just the tip of the iceberg and many people with celiac disease and gluten sensitivity experience no digestive symptoms whatsoever. In these people, symptoms like joint pain, skin conditions, brain fog, autoimmune diseases, migraines, mood issues, infertility, osteoporosis, and fatigue are some of the clues that point to gluten intolerance. Because celiac disease and gluten-sensitivity can manifest as so many different symptoms, in different parts of the body, it can be incredibly difficult to get an accurate diagnosis. The standard tests used by most doctors only test for one specific type of gluten: gliadin, which is believed to be responsible for the damage that occurs in celiac disease. But there are numerous gluten proteins that one can react to, so a negative test result only means there is no immune reactivity to gliadin, and therefore no celiac disease, but it doesn’t necessarily mean there isn’t a sensitivity to one of the other gluten proteins. More extensive testing for non-celiac gluten sensitivity to other gluten proteins does exist through Cyrex labs, but these tests are not standard practice. A simple way to determine if you are sensitive to gluten is to completely remove it from your diet for three weeks and see how you feel. Improvements in symptoms likely indicate that gluten is problematic for you. Note that in some chronic cases, like autoimmunity, it may take up to six months to notice improvements.
There’s no question that celiac disease and gluten sensitivity are on the rise. Using modern testing procedures on preserved blood samples from the 1950s, researchers at the Mayo Clinic were able to determine that celiac disease is four times more common today than it was back then. Why are we seeing this increase? No doubt increased awareness and diagnostic tools have helped to diagnose people with celiac disease that may have otherwise been missed, but the increase goes far beyond better diagnostic tools. First, we eat a lot of gluten. Most people consume it at breakfast, lunch, dinner, and snacks. Second, today’s modern wheat—most people’s main source of gluten—is not what it used to be. Wheat has been hybridized to increase yields and to improve baking characteristics. Modern wheat has new gluten proteins and more genes for producing gluten proteins that are associated with celiac disease than the wheat of 100 years ago. While this is good news for food manufacturers and bakers, it has been disastrous for our bodies. Combine this increased gluten intake with our increasingly poor gut health, caused by stress, antibiotics, poor diet, and increased toxin exposure, and we’ve created the perfect storm for triggering celiac disease and gluten sensitivity.
The first step to a healthy gluten-free diet is to eliminate all gluten. This includes the obvious sources like wheat, rye, barley, and triticale and any product made from these grains such as bread, pasta, cookies, crackers, tortillas, etc. But gluten hides in many less obvious places like oats (unless specified gluten-free), sauces, soups, gravies, beer, imitation bacon and crab, some cheeses, and numerous other prepared food items, supplements, and medications. It is important to educate yourself on all the ways gluten might be slipping into your diet and work to get them all out.
Otherwise, a healthy gluten-free diet should look a lot like any other healthy diet. It should be built around foods like brightly colored fruits and vegetables, organic and naturally-raised meats, wild fish, cold-pressed virgin olive oil and coconut oil, nuts and seeds, and full-fat, pastured dairy products as tolerated (about 50 percent of those with celiac disease also experience an inflammatory response to dairy). For those that choose to include grains and legumes in their diet, stick with whole gluten-free grains like quinoa and brown rice, ideally soaked and/or fermented, and beans that have been properly prepared by soaking and slow cooking. While gluten-free options abound for everything from pasta and bread to cookies and donuts, these products tend to be loaded with other types of refined gluten-free flours and sugar and are better saved for the occasional treat.
Once you know the basics of gluten it is pretty easy to see why it’s such a big deal and, more importantly, why it might be worth pursuing a gluten-free diet yourself. After all, the solution to a myriad of health problems might be as simple as hopping on the gluten-free bandwagon.
Gluten is everywhere and may hide in some pretty unsuspecting places…
 Bronski P, MacLean Jory M. The Gluten-Free Edge. New York, NY: The Experiment, LLC; 2012.
 Lieberman S, Segall L. The Gluten Connection. New York, NY: Rodale; 2007.
 n.a. Celiac Disease: On the Rise. Discovery’s Edge. Mayo Clinic Online. July 2010. Available at: http://www.mayo.edu/research/discoverys-edge/celiac-disease-rise
 Davis W. Wheat Belly. New York, NY: Rodale; 2011.
 Kristjánsson G, Venge P, Hällgren R. Mucosal reactivity to cow’s milk protein in celiac disease. Clin Exp Immunol. 2007;147(3):449-455.
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