Updated: Dec 10, 2019
Gluten free diet is the dietary trend of the century. Can you think of anyone following a gluten free diet? I bet you can! Many of us hear ''gluten-free'' and assume it means healthy... Word of the wise (meaning myself) : Inaccurate! Don't get me wrong, some individuals should definitely avoid all gluten containing foods. However, this is NOT a "one size fits all" diet. Let me reveal to you what the latest science says.
Let's start by defining gluten. Gluten is a protein found in grains such as wheat, barley and rye. Gluten is useful in many baked goods because it allows the dough to create bonds to help it rise and to create moistures. There are 3 types of gluten intolerances: celiac disease, wheat allergy and non celiac gluten sensitivity. Let me quickly explain the difference.
Celiac Disease (CD) is an auto immune dysfunction that reacts to gluten ingestion and can cause many unpleasant symptoms(1). Ingestion of gluten in an individual with CD, will results in the atrophy of the villi in the small intestine.(2) This causes an increase in intestinal permeability and a reduction in absorption of nutrients.(3) Ok so what does this mean? Well first off, you need to understand that the intestinal villi are little projections that absorbs nutrients and transport them to the bloodstream so our bodies use them. Someone who suffers from CD will have significantly smaller villi compared to a normal individual which leads to malabsorption of nutrients(4,5) (check picture below!). This means that the body is not getting the nutrition it needs (#BIGPROBLEM).
Common symptoms include: diarrhea, constipation, bloating, gas, inflammation, weight loss, iron deficiency, arthritis, lack of energy and depression (6). Fortunately CD is easy to diagnose and to treat. Since it's an autoimmune reaction, a blood test will let you know. If you do have CD, you need to follow a gluten free diet.
(WARNING: if you do take a blood test you need to have gluten in your system for at least 6 weeks. If not you might get a false negative.)
Wheat allergy (WA) is an overreaction of the immune system to the ingestion of wheat. Symptoms include, but are not limited to, rashes, hives, itching, swelling, trouble breathing, wheezing, anaphylactic shock(7) (Basically a whole range of symptoms from mild to fatal). Like other allergies you can take an allergy test to figure out if you are allergic to wheat or not. If this is the case, you should avoid all wheat containing food (NOT GLUTEN).
Wheat free: amaranth, barley, corn, oat, quinoa, rice, rye, and tapioca
Gluten free: buckwheat, corn, non contaminated oats, quinoa, rice
NON CELIAC GLUTEN SENSITIVITY
Now what if you react to gluten but have tested negative on CD & wheat allergy test? There is still a chance you might have non celiac gluten sensitivity (NCGS). This sensitivity is hard to diagnose and is mainly subjective. Unlike CD or wheat allergies, no biomarkers can identify this sensitivity. It is self-perceived. But it does exist. In 2011 Jessica R. Biesiekierki et al. conducted a double blind, randomized, placebo-controlled study (AKA a very strong evidence based study) that concluded the existence of intolerance symptoms with gluten ingestion non related to IBS or celiac disease. (This is a HUGE step!). However, (yes, it gets more complicated...) new research now suggest that it might not be the gluten in the food but particular sugars such as fructans and galactans (=simple sugars found in many wheat containing foods)(9). According to Gibson and Shephard, (10) some individuals lack the enzyme to digest fructans which mean they are malabsorbed in the small intestine. These fructans are then fermented by the gut bacteria which can lead to bloating, gas, pain reflux and altered bowel movement (which are the same symptoms as NCGS..)(11) Conclusion: More studies are needed!! Is it the gluten that causes the negative symptoms or is it the fructans? Or a combination?
SO...WHO SHOULD BE GLUTEN FREE?
Now the question: WHO should remove gluten from their diet? ONLY individuals who suffer from CD, WA or NCGS. If you do not have any form of digestive problems, there are no reason to avoid gluten. The removal of gluten may lead to deficiencies in vit B12, folate. Therefore removing it from your diet ''just because'' may actually be detrimental to your health. If you suffer from any type of gas, bloating, pain, reflux, and altered bowel movements after eating wheat or gluten you should talk to a registered dietitian about getting tested for CD and WA. If both come out negative, try removing gluten from your diet and notice the changes. Reintroduce gluten after a few weeks to see if the inflammation reappears. (** Need help identifying your sensitivity? contact me ) I will say it again so it is clear for everybody: you should avoid gluten ONLY if you have celiac, a wheat allergy or an intolerance to gluten.
Gluten- free to lose weight?
I often hear people say ''I am on a gluten free diet to lose weight'' or ''The daughter of my friend's friend tried a gluten free diet and lost 50lbs, it must really work!!''. Gluten is found in a lot of processed foods. So some people will lose weight being on a gluten free diet, but in the end it's not about the gluten at all.. its about all the processed crap in your diet. GLUTEN DOES NOT MAKE YOU FAT. Therefore removing it from your diet will not shed pounds off your body. If weight loss is your goal start off by looking at your diet (#checkyoself!) and get help from a Registered Dietitian (get accurate information personalized for you!). Please remember : gluten-free DOES NOT equal healthy. Gluten-free cookies are no better than regular cookies, actually they can be worst for your health (Higher in sugar and in fat). The best tip I can give you: Focus on a good relationship with real, unprocessed food.
Nowadays, industries will label raspberries as gluten free in order to make more money. This marketing strategy is an insult to our intelligence. Let's not be fooled by it. Educate yourself, look at your diet and make the right decision for YOU!
I hope this helped clear up the buzz about gluten.
If you have more question, want to know more, contact me :)
Have a great day & enjoy your gluten-filled amazing food!!!
1- Di Sabatino A, Corazza GR.(2009)Coeliac disease. Lancet. 373:1480-93
2- Beyond celiac disease. (2017). website: https://www.beyondceliac.org/celiac-disease/facts-and-figures/
3-Ciaccio, E.J., Lewis, S.K. & Green, P.H. (2013). Detection of villous atrophy using endoscopic images for the diagnosis of celiac disease. Dig Dis Sci. 58:1167-9
4-Dietitians of Canada. Celiac Disease Practice Question: Does having celiac disease increase the risk of iron deficiency? If so, should people with iron deficiency be screened for celiac disease and vice versa? In: Practice‐based Evidence in Nutrition [PEN]. October 18, 2006
5-Dietitians of Canada. Celiac Disease practice question: Are people with celiac disease at higher risk of developing bone disease / osteoporosis? In: Practice‐based Evidence in Nutrition [PEN]. Feb. 8, 2007
6- Celiac Disease Foundation. (2007-2017) Celiac Disease Symptoms. website: https://celiac.org/celiac-disease/understanding-celiac-disease-2/celiacdiseasesymptoms/
7- Food allergy research &education (2017) website:https://www.foodallergy.org/allergens/wheat-allergy
8- Biesiekierski JR. et al. (2011) Gluten Causes Gastrointestinal Symptoms in Subjects without celiac disease: a double-blind randomized placebo-controlled trial. American Journal of Gastroenterology. 106:508-516.
9-Biesiekierski JR, Peters SL, Newnham ED, Rosella O, Muir JG, Gibson PR. No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Gastroenterology. 2013;145:320–8. e32
10- Gibson, P. R. and Shepherd, S. J. (2010), Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach. Journal of Gastroenterology and Hepatology, 25: 252–258. doi:10.1111/j.1440-1746.2009.06149.x
11- Muir. J et al. (2007).Fuctan and Free Fructose contente in common vegetable and fruits. Agric. Food Chem. 55 (16), pp 6619–6627