G is for Gluten Part Two

Oh the gluten issue...my wheat belly post is now the most popular page on this site. So popular, in fact, that it shows up in the number two spot after the wheat belly blog during a Google search. Point...and counter point. 


Gluten is on everyone's lips in some shape or form, this issue is no longer just a "health food thing". We are awash in a sea of processed gluten-containing foods and not surprisingly, massively suffering its effects. 


( For a brief discussion of what gluten is, check out part one if you haven't already. )


Onto the million dollar question: should you avoid gluten? The answer is simple... 


Maybe. Darn dietitian...always confusing us with the subtleties of truly personalized nutrition!


According to new work from the pioneering team at the University of Maryland, there is now a clear spectrum of wheat and gluten intolerance. Here is a look at who should be avoiding gluten and/or wheat:


1. Those with Celiac Disease. No surprise there. Celiac Disease is not an allergy but an auto-immune disease mediated by gluten exposure. If you suspect that gluten is making you ill, ruling out Celiac Disease immediately (go to your doctor and get a blood test tomorrow! It is that simple.) is critical as this diagnosis will ensure that you get the lifelong medical care you require to avoid complications and get gluten free right. A proper diagnosis will also provide you with strong motivation to stay strictly gluten free for life. If you cannot (or your doctor will not) do a blood test, you can actually screen yourself at home and take the results to your doctor.


2. The gluten sensitive. These are people who have ruled out Celiac Disease but through elimination and challenge have demonstrated that their symptoms are directly attributable to gluten and not just wheat. Symptoms include mental fog, fatigue and abdominal discomfort. It is not clear exactly how this sensitivity is mediated, according to study authors.The diagnostic process should be performed with a health professional's guidance to ensure that no other complicating factors could be missed.


3. The wheat intolerant. This classification is not laid out in the study but I added it because I have a personal interest in it. These are people who do not react to other gluten-containing grains such as rye or barley but do react to wheat. I personally became wheat intolerant after having my son and I have ruled out Celiac Disease and wheat allergy with my physician. Without a doubt, when I eat wheat I have increased bloating, a sick/nauseous feeling in my stomach, reflux (which I have never had before - not even when pregnant!), fatigue and if I eat enough of it...bathroom issues. Let's stop there.


4. The wheat allergic. This is a classic allergic response that has to do with histamine release when wheat is consumed. It is mediated by IgE immune cells and can have a spectrum of symptoms from anaphylaxis to hives.




Now what about the rest of us? 


Let me say this: I stand by my earlier statement that, for those of us who don't react to wheat or gluten, it isn't the wheat but how we process it. It is true that much of the wheat we consume has greater levels of more strongly reactive gluten and that those of us who react can become very sick but here is the catch - gluten is one of those rare proteins that none of us digest properly. So a little or a lot...wouldn't we all be pretty sick if it was really that toxic? We don't digest fibre either...and that contributes to its healthfulness. Now, I am not going to claim that gluten is a healthy bonus but I am just trying to illustrate a point.


We consume highly processed gluten-containing wheat 3 - 6 times a day. What other food do we consume so monotonously? Well, maybe dairy. Certainly not steak or blueberries or almonds. Our bodies were not meant to handle such an over consumption of a single food. Especially one that is usually so nutrient poor. Our bodies are designed to glean optimal nutrition from the greatest variety of foods that nature has to offer. In addition, eating such high-glycemic, low nutrient, un-filling food makes overeating almost a certainty, leading to weight gain. Mainlining wheat flour is a sure path to dis-ease. That is your wheat belly. 


So, for better health and vitality, we all need to explore new grains. And eat them as unprocessed as possible. Try rye crackers and spelt bread. Have buckwheat pasta and barley risottos. Eat wheat berries every once in a while. Toss quinoa in salads. Oh, and every once in a while, have a meal with absolutely no grains. See how it feels. Give your body a break from our wheat carbo-loaded normal.


What do you think about all of this? Does gluten and/or wheat affect you? Start the discussion below.

Nutrition ABCs...G is for Gluten (Part One)

On our way through the nutrition alphabet, it's time for G...how could it not be gluten? You can hardly have a conversation (here on the diet-conscious West Coast at least!) without the word popping up. 


You know, in my education, I actually didn't learn a lot about Celiac Disease and gluten. It was only when I started my career that I became immersed in the world of the gluten free and nowadays, gluten free advocates are multiplying like rabbits. As a dietitian, it is impossible to ignore...and for the public, an important topic on which to set a few things straight. So let's start with a simple definition.


What is gluten? 


Gluten refers to a family of storage proteins, also called prolamins, that are found in wheat, barley and rye and all grains related to (and commonly contaminated with) them. Spelt and Kamut contain gluten. Most commercial oats are cross-contaminated with gluten. For this reason, wheat free and gluten free do not mean the same thing. This is an important fact to remember because many I see are confused by this. Since gluten is a protein found in wheat AND other grains, all gluten free foods will be also free of wheat but since gluten is found in other grains, a wheat free food might still have gluten. 


Is gluten bad for me? 


It depends on who you ask. Us darned health professionals have differing views on this question, based on our interpretation of the research available. In conventional medical thinking, only those of us with Celiac Disease or non-Celiac gluten sensitivity need to avoid gluten. According to best estimates, 1% of us in North America have Celiac Disease, an auto-immune disease that causes the body to attack itself when gluten is ingested. Celiac Disease is NOT an allergy to gluten. Gluten is the trigger that activates the disease process in those who have it. 

Dr Alessio Fasano, of the Cleveland Clinic, also estimates that a further 6% of us have non-Celiac gluten sensitivity, which is non-immune mediated yet still causes health concerns when gluten is consumed. Doing the quick math, that should leave 93% of us who can safely and healthfully consume gluten. However, advocates of many popular diets including the Wheat Belly Diet and the Paleo Diet, believe that all of us should stop consuming gluten. There, the research becomes a little more fuzzy. 


We'll get further into the question of whether we should avoid gluten in the next instalment...