Tonight I was poking around Facebook and saw an amazing homemade raspberry pie made with homegrown berries coming out of the oven. It looked beautiful. I also saw the baker go from happily showing off her skills, to making a sad face because someone asked her if her pie crust was gluten-free. I am so very tired of seeing this.
In the same way that I was tired of allopathic physicians refusing to acknowledge the idea of food sensitivities, I am also tired of seeing food guilt forced on people because going gluten-free is trendy right now. Orthorexia nervosa is a type of disordered eating which translates quite literally to “fixation on rightous eating.” The number of diagnoses is on the rise and I can’t help but think that all this diet dogma in society is fueling this trend.
I am also tired of hearing holistic providers instantly fall back on gluten as a catch all for every physical ailment just because they don’t take time to dig for the core problem. I had a consultation a few years back with a practitioner who immediately jumped into the gluten thing – not knowing that I had been thoroughly tested for all such issues previously. I lost respect for her the moment the word “gluten” came out of her mouth. This isn’t a limited phenomenon.
I’ve also had holistic practitioners tell me that I would get my weight under control by getting my blood sugar down. At last check my fasting blood glucose was 84, but of course they wouldn’t know that because they jumped the gun. I am careful not to fall into the same trap. I do my research and listen to my client’s story.
Gluten is a catch all term for over 70 different proteins in wheat with similar properties which are further categorized into gliadins and glutenins. If a practitioner tells you there is no way to diagnose wheat issues, they haven’t done their research.
Celiac disease is an autoimmune enteropathy with ~1% prevalence. That’s right less than 1 percent of the population has Celiac’s disease and all Celiac’s sufferers present with Celiac disease-specific antibodies (anti-TG2, anti-D-gliadin) and a positive biopsy.
Wheat Allergies also exist. Sufferers present with wheat-specific IgE antibodies, specific clinical symptoms and positive skin prick tests.
Non-Celiac gluten sensitivity (NCGS) also exists. These people will test negative for the anti-TG2 and anti-D-gliadin antibodies but will test positive for anti-gliadin antibody.
If you have any of these serologic or genetic markers, you need to stop eating wheat. But that still may not be enough.
Studies have shown that the IgG antibody response to gluten does not necessarily indicate an innate sensitivity to gluten. This is huge in terms of the bunk advice being tossed around on the Internet and picked up on by providers. The focus on removing gluten from the diet as a “cure” may be causing practitioners to overlook the fact that dysbiosis is causing the health concerns. In more simple terms, the reaction to gluten may be a symptom of disease, not the cause.
So the frequently offered diagnostic suggestion – an elimination diet – isn’t going to help make the call as to whether you have one of the gluten/wheat sensitivities or whether it is just a case of your gut flora being off-kilter.
If you don’t have these serologic and genetic markers of celiac disease or gluten sensitivity, it is entirely possible that your reaction to gluten lies in an imbalanced microbial presence in your gut.
Dysbiosis may lead to increased gut permeability which is allows passage of gluten, casein and other proteins into the body where the body’s proper immune function is to create antibodies to these foreign invaders. Eliminating gluten from the diet may ease some symptoms, but in the end another protein such as casein in dairy, or zein in corn, will take gluten’s place and soon you end up with an individual who can’t eat anything. You all know that person who is allergic to everything.
If this is the case, you are going to need turn to a protocol that restores intestinal flora AND rebuilds the lining of your gastrointestinal tract. Just as an aside, that does not mean “go out and drink a bunch of sugary probiotic drinks”. I learned this lesson the hard way, setting back my own health progress using water kefir as a quick fix for probiotics. There are no quick fixes.
Now I am not saying that you won’t feel better if you cut out gluten. Replacing gluten with some other sort of more easily digested grain may feel better for you. I do not have any of the above reactions to wheat and still make a conscious choice not to overdo the gluten in my diet. When I do have wheat, I often eat sourdoughs because the traditional manner of fermenting grains, starts to break down the proteins to a more digestible form. But I am super cautious about all allergy causing foods because I have an autoimmune disorder.
Most people with autoimmune conditions will benefit from the removal of wheat, casein, zein and other foods known to result in allergies and sensitivities. I generally suggest elimination diets for autoimmune clients but that is not for the purpose of rechallenge, it is just to give the system a break. You have to be careful about this because I often feel worse when I eliminate grains because my diet swings too low-carb. I feel better when I add a little bit back into my diet.
I have additional concerns about the gluten-free craze. A lot of these gluten-free mixes are still full of preservatives and additives. On top of that, they are expensive. I don’t know how many young family’s I have seen struggling to stay on top of a food budget while trying to make “gluten-free” substitutions.
Secondly, substituting “gluten-free” for wheat doesn’t alleviate the fact that there are too many carbs in the standard American diet. Replacing your giant morning muffin with a “gluten-free” alternative still contributes to chronic health issues like insulin resistance and diabetes mellitus.
Replacing one finely ground white powder for another does not necessarily mitigate health concerns surrounding gluten. Todd Caldecott states in his book Food as Medicine, “Very few of these alternatives were traditionally milled into a fine flour and used in baked goods, and many of them have the same types of anti-nutrient factors and immune sensitizers as gluten-containing cereals such as wheat.” (Caldecott, 2011, p. 53) Furthermore the companies don’t tell you that oats and barley contain gluten-like substance with very similar properties, avenin and hordein respectively.
Personally I’d rather see a client eating a whole wheat sourdough pancake than something made from finely processed white rice flour. Also I hate the idea of imposing a certain dietary dogma on people.
Here is the deal. As a practitioner, I’ve seen people improve on paleo diets, I’ve seen people improve on whole grain diets. I think how you eat is a personal choice. Most people who start thinking about how they eat show improvement. They start making choices that are going to be more healthful. They start cutting out additives and preservatives from their diet. They start cooking their food. They start having more family meals and they start feeling better about their food. That’s what I want to see. I don’t care what they have in the pot.
Alaedini, A. (2013). Celiac Disease, Gluten Sensitivity and Neuropsychiatric Disease. National Celiac’s Awareness Foundation.
Caldecott, T. (2011). Food as Medicine. Vancouver.
Nga M. Lau, P. H. (2012). Markers of Celiac Disease and Gluten Sensitivity in Children with Autism . Columbia University: Celiac Disease Center, http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0066155.