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Posted by on Mar 6, 2014 in Nutrition, Chewing It Over | 0 comments

Should You Go Gluten-Free?

Should You Go Gluten-Free?

Concern over gluten has been rising over the past couple of years, and a growing number of adults are actively eliminating it from their diet. But, what is the deal with Gluten?

Gluten is a protein composite found in several grains including wheat, barley, rye and their derivatives. It forms a glue-like cross-linked network of proteins when flour is mixed with water, allowing the dough to trap air effectively and rise when baked. risen-bread-dough

When this protein reaches the digestive tract of a gluten-sensitive person, the body mounts an immune attack against it, as if it were a foreign invader. In the most advanced form (celiac disease), the immune system attacks the gluten proteins and an enzyme (tissue transglutaminase) in the cells of the intestinal wall for a complete autoimmune reaction. Over time, this may lead to degeneration of the intestinal wall and nutrient deficiencies along with other digestive issues.leaky

Celiac disease (CD) and gluten sensitivity are a multifactorial and multisystem disorders contingent on:

  • GENETIC PREDISPOSITION
  • environmental exposure through digestive tract
  • immunologic reaction to gluten.

Celiac Disease

  • 30% of the population (mostly Northern European heritage) carry at least one variant of the celiac geneassociated HLA gene (HLA-DQ2/DQ8 ), but only 3% of these individuals develop CD [1].
  • However, a study found an increased prevalence of undiagnosed CD among Americans in the past 50 years [2] , perhaps due to loss of the immunological tolerance in adulthood[3].

Gluten sensitivity

  • Shares many classic symptoms with CD, including bloating, stomach pain, fatigue, diarrhea, as well as pain in the bones and joints, and its prevalence in the general population is variable, ranging from 0.63% to 6% [4].
  • Excessive gluten intake can induce changes in the mucosal architecture of susceptible individuals [5] and destroy the barrier function of the intestine and increase permeability to unwanted macromolecules, including bacteria, to “leak” into the bloodstream [6] and provoke the immune system.

Cerebellar ataxia, commonly attributed to malabsorption of neuroprotective vitamin E from the digestive system [7], maybe a rare but possible result of gluten sensitivity in the genetically susceptible individuals [8] and patients can benefit from a gluten-free diet [9]. In the case of schizophrenia [10], autism [11] and epilepsy [12], a gluten free diet seems to ameliorate symptoms, while more research is needed to confirm the association. Gluten-free diet may be prescribed for gastrointestinal symptoms of IBS (irritable bowel syndrome) individuals without gluten sensitivity, but there is minimal evidence for its efficacy [13].

Sum Up
As you can see a gluten free diet is a legitimate therapeutic option for people with sensitivity or intolerance to gluten. As for the population without any genetic predisposition, there is NO confirmation of a gluten induced pathology in humans.

Reasoning in support of Gluten-free

  1. Promoters claim that avoiding gluten is a much healthier diet, similar to our ancestors, but this not necessarily the case for everyone. It may only foster nutrient deficiency (more potato chips and sugared candy). History shows that when a food is demonized, we find new ways of eating badly, using aspartame to avoid sugar, chemical hodgepodge fat free products to avoid saturated fats, which was wrongfully convicted in the first place (Read more here).
  2. Observational data from World Health Organization Global Infobase shows that the highest obesity prevalence is found in wheat-eating countries, and lowest in the white rice eating region of China, India, Japan, Indonesia, and southeast Asia. Although a curious correlation, we all know, correlation is not necessarily causation.

obsMoreover, any weight loss benefit from a western gluten-free diet could easily be attributed to it’s low carb or low glycemic value, making it hard to make definite statements in support of.

What to do

The diagnosis of Celiac disease/gluten sensitivity relies on small-bowel biopsy and clinical improvement on a gluten-free diet [1]. Since, the former is neither accessible nor pleasant, the latter seems like a good place to start. If you are gluten-curious or have mysterious health issues, remove gluten from your diet for 30 days, and then, reintroduce it to see if previous symptoms resume.
On two different occasions, I experimented with a carb-controlled diet, each lasting 6-7 weeks. All carb sources were eliminated and slowly added back in at the end of the 6 week period starting with vegetables, sweet potato, rice, dairy and finally bread. When going on any long term food regimen, the body adapts by waning production of needless enzymes, and therefore, some initial digestive problems maybe experienced upon the reintroduction of ‘new’ food which resolves within days.This is not to be confused with food sensitivity.
With the addition of each carb source, I was able to increase the intensity of my physical activity, experienced less cravings, and felt more satiated only after bread was added back in. This lead me to conclude that a nutrient deficiency was met, although pinpointing the exact vitamin or mineral is not within my expertise. If you are tuned to your body’s needs rather than wants, cravings are not a sign of addiction, but valuable cues to missing nutrients. Based on the two self-studies, I decided to reduce, but not eliminate, bread from my diet, regardless of what popular nerds say. However, this may not be the case for those with different needs and overall diet. 

References:

[1] Celiac Disease, Gluten-Sensitive Enteropathy
[2] Increased Prevalence and Mortality in Undiagnosed Celiac Disease
[3] Natural history of celiac disease autoimmunity in a USA
[4] Non-celiac gluten sensitivity
[5] Gluten-induced mucosal changes in subjects without overt small-bowel disease.
[6] Gliadin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines
[7] Cerebellar ataxia due to isolated vitamin E deficiency.
[8] Cerebellar ataxia and gluten sensitivity, even in childhood
[9] Dietary treatment of gluten ataxia
[10] A double-blind gluten-free/gluten-load controlled trial in a secure ward population.
[11] A randomised, controlled study of dietary intervention in autistic syndromes
[12] Successful Treatment of Epilepsy and Celiac Disease With a Gluten-Free Diet
[13] Gluten causes gastrointestinal symptoms

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