Gluten Free is Good! Fact or Fantasy?
With so many people going gluten free, a question I'm often asked is whether this is good for us, or whether it's a gimmick, enforced on us by a clever marketing industry. In a one-sentence answer, I do believe that a gluten free lifestyle can be beneficial for some (please note the word some) of us and not just for those with celiac disease.
What is celiac disease?
Celiac disease is an auto-immune disease generally diagnosed by looking for tTgA IgA antibodies in the blood and if they are present a biopsy of the small intestine is taken to see the damage to the villi.
Are there any other recognised gluten-related conditions?
Non-celiac gluten sensitivity (NCGS) is quite simply when someone feels better with the exclusion of gluten from their diet. The symptoms of a problem with gluten vary from digestive to migraines, to mental health issues, such as anxiety and depression. Having no digestive complaints does not mean you cannot have a problem with gluten and we are seeng this more and more. There is more and more research on NCGS. It can be determined by the Cyrex Array 3 test (www,cyrextests.com) which looks at many more different antibodies than just tTgA. This week I ran this test with a client who we discovered is reacting to numerous peptides in gluten as well as the classic celiac ones. She has been suffering for years and I think gluten exclusion will be a big part of her solution. You can, of course, also exclude gluten for a period of time without testing and note symptoms upon its reintroduction. Sometimes people feel so much better when gluten is excluded that they don't want to reintroduce it.
Many top level athletes are also on predominantly gluten free programmes from their nutritionists as gluten has been shown to increase inflammatory markers in the blood of many of us. Without it in their diets, recovery times are improving. This counts for a lot when you're at the very top of your game.
There is also research into gluten and auto-immune diseases besides celiac. This could potentially be due to the inflammatory cascade and also due to the fact that gluten damages the intestinal lining of sensitive individuals, causing increased immune activity in the bloodstream. I will write on this at greater length on a different post.
Why does gluten appear to be problematic for some people?
Gluten was hybridised in the 1980s to make it easier to grow. Roughly 5% of the proteins now in it are “foreign” to the body and so may create an immune response.
Gluten has also been deamidated to make it more water soluble. This causes problems for some.
Gluten grains can sit around for months in storage and can produce toxins in this time, causing more inflammation in the gut.
We eat more and more of it (cereals, toasts, pastas, cous cous, cakes, biscuits) and if it causes inflammation in the intestines of an individual, then the more gluten that person eats, the more inflammation there is, which can cause a variety of problems in the digestive tract or elsewhere in the body.
Gluten can increase levels of a molecule in the gut called zonulin. This causes the cells in your intestinal lining to separate allowing proteins through into the bloodstream that are bigger than is deemed normal by our clever immune systems and our immune cells go into attack. If you've heard of leaky gut, this is one of the ways it can occur.
Interestingly (to me!) Scots have a greater incidence of celiac disease than the English, presumed to be because gluten came into the diet later up here than in did in the tropics of England, where wheat crops were grown earlier in the agricultural evolution.
This does not mean to say everyone should avoid it and if you're someone with great digestion, a balanced mood and great energy with no inflammatory issues, then why would you? However, many people who come to see me aren't in this lucky group and many of them do have health issues where the exclusion of gluten for a period may be something we consider.
Which foods is gluten found in?
Wheat (bread, pasta, cous cous, egg noodles, cakes, biscuits), spelt, rye (bread, ryvita), barley, (beer, whisky) oats (cross-contamination with other grains) and many sauces, stocks (soya sauce, baked beans)
What are good alternatives?
Rice, quinoa, brown rice pasta, millet, corn cakes, GF oats and oat cakes. Use gluten free shop-bought alternatives with care. Ie. Breads are ok sometimes (Burgen is quite good) but they tend to be high on the glycemic index. Try my paleo bread recipe on my blog www.edinburghclinicofnutrition.com instead, or other good recipes. Sweet potatoes, potatoes and squashes are a healthy alternative to grains. Spiralizing carrots, courgettes, beetroot or butternut squash gives variety and nutrients too. Cauliflower rice is also useful. Just steam a cauliflower, throw it in the processor for 10 seconds and hey presto. Add olive oil and herbs to taste. Many supermarkets now sell all of these spiralized options and cauliflower "couscous."
I use ground almonds, coconut flour, chestnut flour or buckwheat flour in baking, along with tons of seeds.
PLEASE DON"T just go and buy mass produced gluten free options on a regular basis. These are often made with very high GI flours and plenty of sugar, neither of which is the recipe for a healthier digestive system.
Eating out is getting easier and easier. In fact it's easier to be gluten free than it is to be dairy free. Breakfasts can involve GF oats, ground seeds and berries. Lunches at this time of year could have different salads with good protein sources and cauliflower couscous or rice. And evenings, well this is when good old meat, fish and 2 veg comes into own.
.This is the account of a recent client who gluten is undoubtedly problematic for. She does not have celiac disease. Please note, even if we find that gluten is contributing to negative symptoms, it may not be the only avenue to explore and as wonderful as this result below is, it's not always so straightforward :)
Having suffered from digestive and sleep problems for my entire adult life, and trying everything I could think of to deal with them, I decided that I wanted to try to manage my health through diet and lifestyle rather than medication. At my first consultation Kate suggested that I could have a problem with certain foods and it would be worth running some tests. By my second consultation a few weeks later the results were in confirming that I have problems with certain foods, including gluten. Kate advised that the first step was to heal my intestines and recommended a couple of supplements to help. Within days of starting the plan my digestion improved enormously and my sleep quality has also improved. I no longer get the bloated, sluggish feelings that I became so used to and I can't wait to see how much better I feel over the next few months.
Lorraine B. Edinburgh.
To sign off, there may be benefits to following a gluten free way of eating for a significant number of us, but it should not be forgotten that there may be many other things contributing to poor digestive health, low mood or a lack of energy and these should be addressed too.
Wishing you the best of health!