FAQ: Should I Go Gluten Free?
Gluten: today’s hottest buzzword. It seems that overnight, every grocery store had a gluten free (GF) aisle and every restaurant boasted GF options. But, is there any science behind the trend of going gluten free? Read on to find out.
What exactly is gluten?
Gluten is a protein found in grains like wheat, barley, rye, spelt, triticale, bulgar and kamut. It is actually made up of two smaller proteins: the glutenins and gliadins. Gluten is a sticky molecule, so it helps hold baked foods together and hold their shape.
What’s the difference between Celiac Disease and Gluten Sensitivity?
Celiac disease is a genetic autoimmune condition characterized by inflammation and malabsorption of nutrients in the small intestine. It is diagnosed by endoscopy, which shows flattened villi in the small intestine. Think of villi as the loops in a rag rug carpet. They are responsible for the breakdown and absorption of many nutrients. The consumption of gluten causes them to flatten, causing malabsorption of many important minerals and nutrients. Someone with celiac disease may experience chronic diarrhea, fatigue, various nutritional deficiencies, undigested food in the stool, and abdominal pain. In kids, failure to thrive is common. Someone diagnosed with celiac disease needs to stop eating gluten completely for life. Be aware that the intestinal lining recovers upon elimination of gluten, so an endoscopy won’t detect celiac disease if someone is already eating a GF diet.
In contrast, someone who is sensitive to gluten does not experience the tell-tale flattening of the villi or the malabsorption that happens in those with celiac. However, digestive symptoms such as nausea, constipation and/or diarrhea as well as bloating are very common.
I recommend a trial to assess if gluten is the culprit behind your digestive symptoms by removing it for at least a month.
If I don’t have any digestive symptoms, could I still benefit from eliminating gluten?
Even if you don’t have digestive issues or celiac disease, it’s not a guarantee that you aren’t experiencing adverse effects of consuming it on a daily basis.
In his book, “Grain Brain”, Dr. Perlmutter calls gluten the “silent germ”, meaning that you might be experiencing negative effects of eating gluten but not experience symptoms. He argues that gluten is especially insidious when it comes to brain health and neurological function (Yep, think increased risk of Alzheimer’s Disease) and posits that, from the standpoint of brain health, we might all be sensitive to gluten. One of the reasons could be because gluten is known to increase intestinal permeability which could potentially cause adverse effects on brain health. A study published in the journal Nutrients concluded that gliadin (a component of gluten) exposure caused increased intestinal permeability in not only those with celiac disease, but also healthy controls.
Leaky gut allows foreign particles into the blood stream causing a while spread inflammation and even other food sensitivities. Additionally, leaky gut may allow a toxin from the gut known as lipopolysaccharide (LPS) into the blood stream, where it can cross the blood brain barrier and cause neurological issues and damage. One small study published in the Journal of Neural Transmissions found that 16 out of the 22 Alzheimer’s patients included had increased intestinal permeability.
And, this isn’t old news! In fact, a 1996 study published in The Lancet found that gluten sensitivity should be considered in the face of unexplained neurological disease.
What’s the final word?
In my opinion, there is strong scientific evidence for removing gluten from your diet and replacing it with other GF grains such as rice, quinoa, millet, oats or teff and eating lots of fiber rich fruits, vegetables, legumes and nuts. You may benefit long term by lowering your risk of Alzheimer’s disease, dementia and other neurodegenerative conditions. I would also recommend removing gluten from your diet for 6-8 weeks as a trial if you have or have a family history of:
- ADHD or ADD
- Celiac Disease
- Irritable Bowel Syndrome
- Chronic migraines
- Depression or anxiety
- Unexplained neurological disease
Whole books have been written on this topic. This blog post is by no means comprehensive on the subject. But, I hope it offers a snapshot into the role of gluten in health and longevity. If you want to read more about this topic, check out Dr. David Perlmutter’s book “Grain Brain” or “Wheat Belly” by Dr. William Davis.