THE TRUTH ABOUT GLUTEN
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It’s now 2023 and its become trendy to be gluten-free. Have you ever wondered WHY this matters? or if it applies across the board?
The short answer:not everyone needs to be gluten-free.
The long answer: it depends on a lot.
Lets break it down.
In some bodies gluten can be extremely inflammatory, but it depends on a myriad of factors including family history, gut health, mental health, inflammation, predisposition and various other symptoms.
Celiac Disease VS Gluten Sensitivity
Celiac disease is a genetically predisposed autoimmune disorder. If those who have true celiac disease consume gluten, or more specifically gliadin, their body literally attacks the small intestine and destroys the villi, leading to poor absorption, malnutrition, increased intestinal permeability and diarrhea, bloating, and a myriad of other symptoms.
Gliadin is the protein found in wheat that makes it rise (which I will go into more detail about later) but those with celiacs disease dont have the enzyme needed to break it down. The body releases inflammatory cytokines, prostaglandins, and leukotrienes (no bueno) which completely destroy the microvilli. Those with celiac disease need to avoid all types of gluten in every situation.
A little background: prior to world war 2, a large number of people died from celiac disease. it wasn’t until WW2 when the Netherlands had little access to wheat during the war that Dutch pediatrician Dicke linked the fact that the absence of wheat demonstrated no deaths from celiac disease. Prior to that finding, they treated celiac disease with bananas- literally- they thought that bananas were the cure. However, on “recovery” children would start to eat wheat again and get dramatically ill. That finding paved the way for the rest of the world to an easy fix for those with celiac.
Labs I like to use for true Celiac Disease:
Tissue transglutaminase (tTG) IgA and IgG
Antigliadin Abs, IgA,IgG
Gliadin IgG/IgA
IgA, Immunoglobulin A
You will also likely be referred to a GI for an endoscopy and colonoscopy for tissue samples in the gut. Due to the inflammatory nature of gluten in those with celiac, oftentimes there can be tissue degradation and breakdown in the gut, and intestinal lining/ occasionally subsequent autoimmune IBDs can be found in the colon. That being said, not every single person who feels an inflammatory response to gluten necessarily needs scoped, but check with your provider and ask questions specific to your case.
The second piece.
Gluten sensitivity: this is the buzzword of the millennials and gen Z. it’s 100% backed and science-based in many cases. Just because your body doesn’t have an immune-mediated response to gluten does not mean that you are in the clear. There are two culprits at play here: their names are Gliadin (mentioned above) and Zonulin.
Your small intestine is where the majority of nutrient absorption takes place. lined by villi and microvilli, enzymes coat the surface to assist with absorption. When you consume any product containing gluten (any wheat, rye, spelt, most oats), they contain Gliadin which is the major protein component in wheat.
Gliadin
#1. Destroys the villi that line the small bowel decreasing absorption of important nutrients
#2. Increases zonulin.
Zonulin
A modulator of the tight junctions that line the small bowel. Zonulin was actually discovered by a pediatric gastroenterologist Dr. Fasano. He found that the two things that increase
Zonulin are:
#1. Gluten
#2. Bacteria in the small intestine. in 2006, a study in the Scandinavian Journal of Gastroenterology came out that linked Gliadin causing increased Zonulin in those without celiac disease, leading to leaky gut.
The tight junctions that line your gut are supposed to open to some extent in order for nutrients to be absorbed into our bloodstream. However, When levels of Zonulin are too high, “the floodgates” open, and too many larger proteins and unwanted substances cross into the bloodstream creating an immune response. This is what people are referring to when they use the term “leaky gut”.
Our body has an inflammatory response to these “foreign” substances that aren’t supposed to cross the gut lining and have an immune response to them every time they appear. The attack on the larger food particles that aren’t supposed to be there lead to sensitives to other foods, more villi damage, decreased absorption and long-term malnutrition. This is not ideal for those who already have an autoimmune disease- as they are at higher risk.
Most people who have a gluten sensitivity feel the difference in their bodies by cutting out gluten for 60 days. it takes a full 30 days for our bodies to acclimate so I typically recommend removing it for 60-90 days to determine whether or not it’s making a difference. That being said, it depends on other factors too. If you drink alcohol often, are using seed oils, have a diet high in sugar etc the difference may not be evident. You can trial this on your own easily, but i recommend working with other aspects of your diet and health as you do it in order to obtain the most information possible.
Labs I like to use for gluten sensitivity:
CRP Cardiac
GA, Immunoglobulin A
Homocysteine
Vitamin B12
Zinc and copper
Rule of thumb here is in listening to your body + utilizing tests. Even if bloodwork looks okay, but you notice you FEEL better without it, ditch the gluten. If you feel completely fine with gluten and your labs come back optimally, don’t worry about it. Perfection does not exist and there are too many things that are adversly impacting our health to be 100% all of the time. If gluten works for you and your body, focus on the other things.
In summary:
Gluten consumption = increased gliadin = destroyed microvilli and decreased absorption as well as more Zonulin.
Decreased absorption and increased zonulin = acne, inflammation , auto immune flares, low grade inflammation, leaky gut.
Final Touch: The American Agricultural system and food pyramid
The wheat on shelves today is a dense hybridized mix with much higher levels of gliadin in it. Not only do hybrid crops have a longer shelf life, but we started making these hybridized crops during the war when we created short dwarf wheat to bulk up our soldiers.
This was also around the time when the food pyramid was suggesting a ridiculous number of whole wheat servings in our diet. It is much less expensive to harvest short dwarf wheat and monoculture crops, but this is a big red flag.
The food pyramid/ myplate changes with what marketing and our industries need. Another post on this later, but listen to your body. learn to tune into what your individualized needs are when it comes to your health. your intuition is stronger than you realize. Work with a provider for tests and labs, but you are likely on the right track intuitively.
If you want to keep gluten around in lower quantities:
Look for einkorn bread, sprouted bread, stone ground bread, etc. they contain much lower levels of Gliadin.
Same goes for sourdough due to the bacteria in the dough itself that breaks down the Gliadin and makes it easier to digest
Avoid gluten:
If you have celiac disease (obviously)
You have an autoimmune disease of any kind (ie RA, MS, psoriasis, Crohns or UC etc). avoiding gluten could drastically help reduce symptoms and prevent subsequent auto immune diseases.
If you currently have leaky gut, SIBO, intestinal dysbiosis, or candida overgrowth.
If you notice you feel significantly better with removal or blood work demonstrates inflammation with consumption.
Hopefully, this shed some light on gluten sensitivity and why so many have been removing it fro the diet. I am happy to talk more in detail and share info, more places to read etc.
If you still aren’t sure if this is a change you should make, pick my brain! I love to talk about symptoms and gut patterns. gut health is my favorite.
Resources:
https://www.ncbi.nlm.nih.gov/pubmed/16635908
https://www.physiology.org/doi/pdf/10.1152/physrev.00003.2008