Buzzword: GLUTEN. Everyone’s at least heard of it by now but may not know exactly what it is or why some people need to avoid it. Gluten is a protein found primarily in the grains: wheat, rye, and barley. It can also be found in malt, brewer’s yeast, triticale, and sometimes even oats. This means that several bread and cereal products, desserts, beer, and even some candies contain gluten.
People who have celiac disease, an auto-immune disease-causing gut inflammation in 1% of the population, must avoid gluten to avert damage to the bowel lining. Gluten-free diets for those with celiac disease is not a new therapy. Currently, however, a gluten-free diet is being employed by a larger percentage of the population who believe that they, though not to the celiac level, are also sensitive to the protein. Perceived symptoms of non-celiac gluten sensitivity include abdominal pain, gas, bloating, diarrhea, headache, brain fog, depression, fatigue, rash, and joint pain. Many who claim to be sensitive to gluten have reported alleviation of these symptoms and overall improved GI health when they go gluten-free. Some research has also shown links between gluten and autism, epilepsy, cancer, dementia, and schizophrenia, which might be enough of a claim to make even the toughest of critics avoid this protein!
So why do some feel better on a gluten-free diet? There are several controversial hypotheses being researched currently:
Theory #1: Gluten is not fully digested due to a body’s lack of appropriate enzymes. The undigested gluten in turn causes gut inflammation and hyper-permeability, which may then lead to toxins and bacteria from food being able to cross the blood-brain barrier. The result is what’s referred to as “leaky gut,” or a disruption of the gut lining, leading to the aforementioned GI symptoms.
Theory #2: Poorly absorbed carbohydrates called FODMAPS (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), which are present in gluten-containing grains, may be the culprits, which means that the actual gluten is not to blame. A low FODMAP diet has been touted for relief of GI symptoms similar to those associated with gluten insensitivity.
Theory #3: Lack of fiber is decreasing gut discomfort. Many people who avoid gluten are also unfortunately decreasing beneficial fiber in their diets. The absence of symptoms they feel may actually be the result of less fiber and not less gluten. A good number of gluten-free products on today’s store shelves are void of fiber.
Theory #4: People simply feel better when they replace a diet swimming in highly refined carbohydrates with a diet laden with nutritious fruits and vegetables. (This idea seems shaky, as not all who go gluten-free are increasing their fruit and vegetable intake!)
We all should go gluten-free, then, right? Well, that’s not proven to be the best choice, either. There are valid risks of embarking on a gluten-free diet because participants are excluding whole grains. As a result, several nutritional deficiencies may occur, the most concerning of which are iron, fiber, calcium, and B-vitamins. Risk of cardiovascular and other disease increases when these foods are eliminated. One can get adequate amounts of disease-fighting nutrients and still avoid gluten, but much diet education and preparation will be needed. Healthy substitutes like non-gluten containing grains, legumes, beans, fruits and vegetables will need to be consumed in greater quantities.
So, what is the answer for the non-celiac population… do we avoid or include gluten? The answer is that there is no answer. The research is new, and the evidence is inconclusive. From this dietitian’s perspective, give it a try if you think it may help you, but be smart about it. Remember to make substitutions in your diet that will fulfill your nutrition needs and not leave you deficient.
