When everyone from your neighbor to your life coach is recommending a gluten-free diet, it’s easy to make light of the impact it can have. But just because we hear the term “gluten” 65 times a day doesn’t mean we know what it actually means or why we should consider living without it.
Now that we’re straight on how the gluten-free chatter has become so pervasive (whether derived from well-intended sources or those with not-so-altruistic motives), it’s time to move beyond the skewed and snarky headlines and get truthful answers on what really matters: What IS gluten, how do you avoid it, and why would you want to?
Let’s start at the beginning.
All foods are made up of 3 macronutrients – carbohydrate, protein and fat. Gluten is the protein complex that exists in grains, namely wheat, rye, spelt and barley.
Gluten is a very large protein and it is very difficult to digest. In fact, the human body doesn’t completely digest gluten at all. And there are many concerns (that were addressed in my last post) with the way our conventional, gluten-containing grains are processed and harvested today that make them especially harmful. To refresh, we’re talking about Category 2B carcinogens and glycophosphate herbicides to expedite the harvesting process and increase the yield.
Common sense would indicate (correctly) that this doesn’t sound beneficial to anyone, but for some, it creates a whole world of hurt.
This is the case for people with celiac disease, autoimmune and other inflammatory conditions and also for those with a disruption in their microbiome. As a quick refresher, this is when your intestinal lining is more tennis net than it is cheesecloth (due to a lack of enzymes and good bacteria), making it too permeable or “leaky.” As we’ve touched on in earlier posts, a “leaky gut” or “intestinal hyperpermeability” state often leads to disease. And unfortunately, medications to treat many of those diseases have a side effect of…you guessed it: even leakier guts. But, let’s say your microbiome is right as rain. You’re still not exempt, as consuming high amounts of gluten can lead to future problems. Because when you eat gluten, it causes the release of a protein called zonulin, which unzips the “tight junctions” that hold together a currently intact intestinal lining.
Let’s face it: if your body was a stage, then gluten would be the character actor in every show. The act is sometimes subtle, sometimes brash, but gluten is always a major player, creating chaos in one way or another. Here are a few of gluten’s most popular personas.
The Drunk Uncle
Gluten can become a sneaky annoyance once it’s inside of anyone’s body. In this role, gluten plays the drunk uncle you never invite to Thanksgiving but who always seems to show up anyway. He’s the guest who ends up stumbling around the house, bumping into guests and breaking things. When he’s in your home, you can minimize destruction by quietly taking his cocktail and guiding him into a cab with a smile and a wave. When he’s in your body, your brilliant internal system recognizes that drunk Uncle Gluten is where he shouldn’t be, and the attack is on (by way of inflammation).
Using my rheumatoid arthritis (RA) as an example – when I consume gluten, I have a hard time digesting it. It sits there bored in my intestine for a minute, then sneaks out through my tennis net gut lining before it has had enough time to marinate in the proper digestive juices and starts stumbling around. Eventually – and inappropriately – it gets into my bloodstream, and finally, sets itself up in my joints. My body recognizes it as a toxin, and attacks it. As a result, I develop hot, stiff, and achy phalanges. I generally lay there cursing whatever food, person or restaurant snuck that gluten into my meal and my system. I have since been able to make progress in healing my gut and closing up that tennis net, but gluten – with its ability to continue to cause more damage – is never going to make my dietary lineup.
Turns out, the fact that I have RA and a gluten sensitivity is not a coincidence. It has been shown that 48% of patients who have recently developed RA also have anti-gliadin antibodies (inflammation-causing antibodies produced by your body in response to consuming gluten). Researchers have also found celiac disease to be over five times more common among those with RA.
So for me – and for many of my RA brothers and sisters – gluten is an unnecessary evil. And if you find yourself with achiness, digestive issues or other chronic symptoms you can’t explain, consider that gluten might be an unnecessary evil for you too.
The Nasty Best Friend
We’ve all heard the phrase “birds of a feather flock together.” Every bad guy always seems to have an equally toxic wingman. In the role of Nasty Best Friend, gluten plays that partner in crime. It’s not only linked with RA, it pals around with many other autoimmune diseases and chronic conditions as well. Here’s a sampling:
- skin conditions (e.g. psoriasis, eczema)
- digestive disease
- mood and cognitive issues including ADHD, anxiety and depression
And in the case of celiac disease, avoiding gluten is the ONLY treatment currently available. Continuing to consume gluten could have grave health consequences, including cancer and death. A recent study in the Journal of the American Medical Association (JAMA) found that people with celiac disease had a 39% increased risk of death. A 72% increased death rate was found in those with gut inflammation related to gluten, and there was a 35% increased risk of death in those with gluten sensitivity independent of celiac disease. The scariest part? It is estimated that 99% of people who have a sensitivity to gluten (wherever it may be on the spectrum) aren’t even aware of it.
Gluten is no joke. This is why I’m not letting you phone it in when it comes to looking into a possible sensitivity. And for those concerned with the conventional-minded headlines about the “dangers of the gluten-free diet,” I have a newsflash of my own: Wheat and gluten are not essential nutrients. We don’t have to consume either as part of a healthy diet. There are approximately zero nutrients exclusive to gluten-containing grains that can’t be found elsewhere.
The Sexy Bad Boy
Think about your favorite naughty, racy character. He’s beguiling and he’s everywhere you turn – especially in moments of weakness. The more you have, the more you want, until your appetite becomes insatiable. Why? In this case, it’s because gluten plays with your head. Literally.
If you are not completely breaking down the gluten, protein peptides can form and act on opiate receptors in the brain, mimicking the effects of opiate drugs (like heroin or morphine). Not only does this cause the obvious addiction to more of the gluten-containing food, it has been shown that these “neuropeptides” can affect cognitive function, and react with the temporal lobes involved in speech and auditory integration. This is one reason the gluten-free, casein-free diet has been so effective for autism in particular, as well as ADHD, depression and anxiety.
But gluten doesn’t just play mind games, it feeds our addiction for it by being positively insidious. It can be found in a really wide range of foods (not just grains), and it can also be found in processing plants, which can turn something without gluten, into something with gluten.
Here are a few examples of the trickery:
- Buckwheat does NOT have gluten, but is likely contaminated with gluten during processing with other gluten-containing grains.
- Spelt DOES have gluten in it, but it is NOT wheat.
- Various prepared foods, beer and other alcohol, sauces, flavorings and condiments are often hidden land mines, because they use wheat or wheat derivatives as fillers. For example, soy sauce DOES have wheat in it – so it DOES have gluten. Wasabi may have wheat it in it. Sometimes balsamic vinegar has wheat. And unless “real” or “King” crab is specified, your California Roll is stuffed with artificial crab, which features – you guessed it – gluten.
Confused? Don’t fret. A complete list of gluten sources – including hidden sources – is available here. And, I will be making other helpful tools available to you soon. In the meantime, here’s a sneak peek.
- All products made with wheat (durum, farro, graham, kamut, semolina, spelt, triticale, einkorn, wheat berry, wheat germ, wheat germ oil, wheat grass or triga, wheat gluten, wheat nut and wheat starch)
- Bakery items used with grains from the first bullet (breads…I know, this one hurts…keep reading)
- Soy sauce (not because of the soy itself, but because of the wheat)
- Many food starches, e.g. modified food starch. (This will include most breads, muffins, cookies, pastas, beer, breaded/fried foods, and many packaged foods.)
- Corn (maize)
- Potatoes (all types!)
- Nut flours
- Certified Gluten Free Oats*
- Wine and most distilled spirits (Hallelujah!)
*Often grown or processed with other gluten-containing grains, leading to cross-contamination with wheat, barley or rye. Be sure to look for the gluten-free certification.
A Peek Backstage
Gluten may be front and center in this conversation, but behind the curtain is where it all comes together. Let’s strip it down and see what gluten is really made of.
To understand gluten, you have to know the protein fractions it breaks down into – gliadins and glutenins. There are actually 10’s of 1000’s of protein fractions in wheat, but gliadin is thought to be the most harmful to the digestive tract for persons with gluten sensitivity or celiac disease because of its ability to illicit an immune reaction. So, in all honesty, gliadin is the primary troublemaker here. Gluten is just a more generalized and familiar term. This is why you will hear of gliadin, especially as it relates to food labeling. Gliadin is what is actually measured in meeting thresholds for “gluten-free” certification standards. For example, the World Health Organization (WHO), and now the FDA as of August 2013, require foods labeled “gluten-free” to be lab tested to assure gliadin levels are less than 20 parts per million (ppm). Don’t get too bogged down with these details now (or ever really, unless you want to). We will cover exactly what you need to know as far as food labels go in later posts.
That’s A Wrap
Have you noticed a theme? Gluten is never cast as America’s Sweetheart. It’s always the one who comes in rude and reckless. And yet, whether obvious or stealth, gluten is – for many of us – playing a starring role on our plates. I don’t suggest eliminating a mainstay of your diet as an intentional buzz kill. (I mean, it’s totally a buzz kill, but it’s for your own good.)
It may be hard to see now, but I promise you – I used to preach the food pyramid and love my bread. I was starch-obsessed, grain-heavy, and vegetable-averse, until I was also aching and crazy. Now I eat differently, and feel better, and once you make it through the change, you won’t ever look back.
So no matter what your pantry looks like today, I encourage you to take a ride with me on this gluten-free journey. It’s a tricky path at first, so do it slowly, and carefully – and ideally, work with a knowledgeable practitioner. Take the time to learn, try new things, and find out what works best for you.
Because whether you have a recognized sensitivity or a diagnosed disease – or you just don’t feel great and don’t know why – know this: If you take gluten out of your diet, you could literally be saving your own life…and that tastes better than any wheat-laden meal ever could.
And at this point, if you aren’t sure if you could have a sensitivity or celiac disease (or what the difference is between the two), don’t panic. My next post will demystify the diagnoses. Stay tuned.
- Challem, Jack. The Inflammation Syndrome: The Complete Nutritional Program to Prevent and Reverse Heart Disease, Arthritis, Diabetes, Allergies and Asthma. Hoboken, NJ: J. Wiley, 2003.
- Braly, James, and Ron Hoggan. Dangerous Grains: Why Gluten Cereal Grains May Be Hazardous to Your Health. New York: Avery, 2002. Print.
- Bizzaro, N., R. Tozzoli, D. Villalta, M. Fabris, and E. Tonutti. “Cutting-Edge Issues in Celiac Disease and in Gluten Intolerance.” Clinical Reviews in Allergy & Immunology3 (2012): 279-87.
- O’Bryan, Tom. “The Evolution of Autoimmune Disease.” The Evolution of Medicine. 14 Sept. 2014. Lecture.
- Ludvigsson, J. F., S. M. Montgomery, A. Ekbom, L. Brandt, and F. Granath. “Small-Intestinal Histopathology and Mortality Risk in Celiac Disease.” JAMA: The Journal of the American Medical Association11 (2009): 1171-178. NCBI. Web. 15 June 2014.
- Potocki P, Hozyask K. Psychiatric symptoms and coeliac disease. Psychiatr Pol. 2002 Jul-Aug: 36(4):567-78
- Pynnonen PA, Erkki T, Isometsa ET, Verkasalo MA, Kahkonen SA, Sipila I, Savilah E and Aalberg VA. Gluten-free diet may alleviate depressive and behavioral symptoms in adolescents with coeliac disease.BMC psychiatry. 2005
- Fukudome, Shin-ichi, and Masaaki Yoshikawa. “Opioid peptides derived from wheat gluten: their isolation and characterization.” FEBS letters 296, no. 1 (1992):107-111.
- Kalaydijian AE, Easton W, Casella N, Fasano A. The gluten connection: the association between schizophrenia and celiac disease. Acta Psychiatr Scan. 2006 Feb;113(2):82-90.
- Matthews, Julie. “Food Allergies and Sensitivities and Gluten-Free/Casein-Free Diet.” Bioindividual Nutrition Advanced Training for Practioners. 21 July 2014. Lecture.