Should I be on a gluten free diet?
In todays article I want to discuss a few considerations with regards to going gluten free. I want to discuss my stance on the subject and also present some literature that was presented to me by Dr Tom O’Bryan recently along with some of my own literature that I have pulled up writing this article.
I remember around 3-4 years ago someone asking me…
“if there was one nutrition recommendation you could make that would have the biggest impact on your clients health and body composition, what would it be?”
My answer back then and now still is, to REMOVE GLUTEN from the diet completely.
Now, whilst the removal of gluten from the diet is essentially one recommendation, in the majority of cases it means a complete dietary overhaul, so the implementation can be more challenging and something that requires some professional support. The reason for this is that we continually eat gluten based foods. It makes up the foundation of the British Average Diet (BAD).
How many of you current do or in the past ate a diet something like this:
- Cereal or toast in the morning
- Sandwich for lunch
- Snacking on some biscuits
- Pasta for dinner
- Maybe you even drink the odd beer or two as well
Not only is this likely to lead to poor blood glucose management, but the foundation of all meals is gluten based foods, mostly wheat.
You don’t have to be Celiac to have problems with gluten.
A term that is widely recognised within the medical literature but less so by your primary health care provider or the general public is “non celiac gluten sensitivity”. In this article I may refer to it as NCGS.
The unfortunately reality is that testing negative for celiac disease through conventional testing is by no means a green light to go off and eat as much gluten as you like. Celiac testing is in no uncertain terms an inadequate test for establishing if your body has a problem with gluten.
Celiac testing looks at one possible mechanism in which you might be reacting to gluten and this is something known as Tissue Transglutaminase Antibodies (tTG-IgA which comes up positive in about 98% of patients with celiac who are on a gluten containing diet and then confirmation of celiac is given with a demonstration of the breakdown of your intestinal lining, confirmed by biopsy.
Around 1% of the population is confirm as having celiac disease and this level is rising, however that 1% of the population are confirmed celiac using that particular standardised testing method, which we now know can miss the majority of the population that have negative responses physiologically to gluten.
These days we have tests that are able to look at least 10x the amount of mechanisms to detect our response to gluten. Being raised in any one of these 10 would indicate a reaction to gluten, however would not be classed as classic celiac disease (CD), but instead non-celiac gluten sensitivity (NCGS).
The analogy that was used by the British Medical Journal in one article I read many years ago was that of an iceberg. If you imagine an iceberg, you see maybe 10% of that iceberg above the water, whereas 90% of the iceberg sits below the water remaining undetected and that is the reality with the misdiagnosis or at least the green light given to individuals to eat gluten when actually they shouldn’t.
Why is eating gluten so problematic?
You might be sitting there thinking, “I don’t have an issue with gluten, I haven’t got any serious bowel issues”. To a point you might be right, but the reality is that gluten affects us far beyond just our digestive system and when someone is experiencing any type of dysfunction I’m thinking about gluten, and even beyond that when my clients have family histories of it or a family history of certain degenerative diseases or immunological conditions I am again thinking about gluten.
You will notice from my Food Foundations recipe book and the recipes that I have created online they are all gluten free. For me I’d rather just switch people over to that lifestyle from the get go.
Let’s look at some of the challenges with gluten:
- In celiac disease (CD) and non-celiac gluten sensitive (NSGS) individuals 100% of them experience some level of separation of their intestinal lining after eating gluten. This means more inflammatory and immune responses, which can go systemic throughout the body causing symptoms literally anywhere in the body. For one-person brain, another person joints, another person thyroid etc. It should be noted that inflammation is the driving force behind any disease state known to man and controlling inflammation should be our number one priority when it comes to health and longevity.
- Those with neurological conditions or at higher risk of the development of neurological conditions should think about adopting a gluten free lifestyle. There is significant evidence linking now CD and NCGS with dementia/Alzheimer’s, Parkinson’s, psychosis, depression, schizophrenia and autism. Not only is it linked with these significant diseased states it is also linked strongly with recurrent headache and migraine, balance disturbances and sensory loss. From a personal perspective most of my immediate symptoms are neurological after eating gluten, I notice changes in mood and behavior that can be quite dramatic after eating gluten.
- Gluten is a major contributor to immune related disorders such as thyroid autoimmune disorders like Grave’s and Hasimoto’s along with other immune related disorders like type 1 diabetes and autoimmune liver and inflammatory bowel disease. In my opinion the onset of an autoimmune condition should result in the 100% elimination of gluten while also investigating other potential immune triggers as well, such as other foods or gastrointestinal imbalances. The prevalence of full-blown CD increases 2-19 x in those with autoimmune conditions dependent on the condition. Consider that this is full blown celiac disease and not include NCGS as well, where the numbers would undoubtedly increase.
How do I develop gluten sensitivity?
This is always an interesting question, because the reality is that you may have always been fine with gluten, or at least never noticed any issues, but now it seems like you body responds negatively, whether through gut symptoms, neurological or other.
Gluten should be seen as a low level toxin and it is not until we lose oral tolerance to gluten that it really starts to screw our body up. The reality is low level exposure to some people may never result in any obvious symptoms, and this is the same with many other low level toxins we are exposed to on a daily basis.
The trouble is these days we now have a lot more low-level environmental stressors to contend with. This can range from environmental chemicals, mental and emotional stress, alcohol, drugs, medications like PPI’s, digestive imbalances etc. We then also have significant stressors as well such as viruses or infection or perhaps significant emotional stressors such as the loss of a loved one, divorce etc.
I always like to use the analogy of the straw that breaks the camels back with this type of scenario.
The reality is we can and should be able to take a certain amount of stress, but when we tip over that threshold significant dysfunction can start to occur and our response to things that perhaps did not effect us or were at least not noticeable before now become amplified and obvious.
Immune responses start to occur and inflammatory mechanisms take hold resulting in acute and chronic symptoms.
In my personal experience I see around 50-75% of the people that work with me benefit from a gluten free lifestyle, confirmed by either resolution in symptoms upon elimination or through testing. Because of the types of clients I see it is likely to be higher than what would be seen in the general population, however my prediction would be that anywhere from 25-50% of the population would benefit being gluten free ALL THE TIME and the remaining 50-75% of the population should consider testing if they wish to remain on a gluten containing diet.
Gluten is a silent killer that can creep up on you and bit you in the ass 30 to 50 years down the line presenting in the development of significant degenerative diseases such as Rheumatoid arthritis, dementia, autoimmune thyroid etc.
For me I would just play it safe and go gluten free. That doesn’t mean replace your gluten containing products with the crappy gluten free products you find in the “free from” section of the supermarket, it means replacing with wholefood ingredients that have an overall beneficial impact on your health.
If you need help either investigating the impact of gluten on your health or putting together a gluten free diet plan please do not hesitate to contact me. Also feel free to check out all of our great recipes that are gluten free as well.