Walk into just about any grocery store these days, and you’re going to find an entire section devoted to gluten-free (GF) foods. Eliminating gluten from your diet has become so popular that celebrities and authorities alike have jumped on the gluten bashing bandwagon. Our growing aversion to this protein has spawned a massive market for GF products. An estimated 100 million Americans go GF every year, meaning one in three are trying GF diets in the US. This drives the $2 billion annual market for GF foods.1
The GF craze is so profound it’s easy to believe gluten may indeed be the lynchpin in our chronic illness epidemic. The message seems to be: Just remove gluten and your symptoms will vanish along with your excess pounds overnight.
But does science truly support this idea? Is gluten really the problem? And does removing it from the diet work for everyone and guarantee good health?
To find the answer, let’s turn to recent research on this controversial protein.
I think the truth will surprise you.
How is Wheat Intolerance Different than Celiac Disease?
Celiac disease (CD) is an autoimmune disease whereby gluten protein peptides trigger an immune response that injures the small intestinal lining and has dozens of adverse effects throughout the body. Non-celiac gluten sensitivity (NCGS), CD and wheat allergy (immunoglobulin E (IgE)-mediated) have similar symptomatology, however wheat allergy (WA) and CD are mediated by the immune system and diagnosed by blood testing and intestinal biopsy.1
In contrast, the currently accepted criteria for a diagnosis of NCGS requires reproducible symptoms when gluten is consumed and improvement upon abstinence.1 The typical presentation of NCGS is a combination of gut symptoms (diarrhea, abdominal pain), and systemic features such as headache, arthralgias, numbness, chronic fatigue, eczema, anemia, and can sometimes include behavior disturbances and depression. 1 These symptoms of NCGS typical appear hours to days after ingestion whereas WA is more immediate—beginning within minutes and up to 2 hours after ingestion.
Patients with NCGS typically lack the classic CD serological and biopsy findings. However, there is growing evidence that they may suffer from derangements in gut permeability, inflammation and immune reactivity to gluten.2
How Common is NCGS?
First let’s examine how the prevalence of CD has shifted. Although experts agree that the prevalence of CD is 1:133 in the USA, the prevalence of CD appears to have risen. The prevalence of CD in those over the age of 50 appears to have doubled since 1998 and a study that examined stored blood samples from 9,133 US Air Force recruits (1948-1954) revealed that CD was 4-times less common in those recruits than it is today.3 Before we speculate why CD is rapidly on the rise let’s examine what is known about NCGS epidemiology.
NCGS is most commonly seen in middle aged females and its prevalence ranges from 0.63–6.0% of the US population.1
Why is Intolerance to the Golden Grain on the Rise?
As Dr. William Davis brilliantly describes in his book Wheat Belly the source, digestibility, gluten content and processing of wheat has radically shifted over the years leading to intolerance.4
One of the most popular theories is that the chemical glyphosate, the active ingredient in the herbicide, Roundup®, may be an important causal factor in this epidemic. Fish who are exposed to glyphosate develop a CD-like illness disrupts the gut microbial balance in animals favoring the growth of disease-inducing pathogens.5
Another possible contributor to NCGS are amylase trypsin inhibitors (ATIs) which are plant-derived proteins that protect the wheat plant against infection by parasitic microbes. ATIs comprise 2-4% of wheat protein, their activity is 7-fold higher in modern hexaploid wheat and feeding at levels consumed by humans provokes autoimmunity in mice.1
Finally, gluten-rich grains are highly fermentable and cause gut distress in those with gut bacterial imbalances.
Collectively, CD, WA, NCGS are not uncommon, but that doesn’t mean they affect everyone. So should everyone on the planet go GF? Aside from cost are there other downsides to going GF?
There is growing evidence that getting rid of wheat and gluten from the diet lowers bifidobacteria which play a critical role in gut immune function and weight regulation.1
Thus, you may want to enrich your diet with foods that bolster your friendly gut flora if you eat GF.
There is on final point I’d like to make about GF living: It isn’t inherently healthier. Eating GF cookies, crackers, and cakes that contain little fiber and are packed with sugar is unlikely to help you achieve your health and weight goals. Take a skeptical eye to them.
What about other whole grains? Obviously, not ALL grains contain gluten. So are you, your health, and your waistline safe if you focus on these alternatives?
Check out my next blog for an in depth review of whole grains where I reveal how they impact your gut microbiome and why you may want to include them in your diet if you’re going to be a good gut bug gardener.
To your health,
Dr. Gerry Mullin
1 Fasano, Alessio, et al. Non-celiac Gluten Sensitivity. Gastroenterology (2015). 2015, Jan 9. pii: S0016-5085(15)00029-3. doi: 10.1053/j.gastro.2014.12.049. [Epub ahead of print]
2 Hollon, J., et al. Effect of gliadin on permeability of intestinal biopsy explants from celiac disease patients and patients with non-celiac gluten sensitivity. Nutrients. 2015. 7(3): 1565-76.
3 Tapia-Rubio, A., et al. Increased prevalence and mortality in undiagnosed celiac disease. Gastroeterology. 2009. 137(1):88-93.
4 Davis, W. Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health. Rodale Books. New York.
5 Shehata, AA., et al. The effect of glyphosate on potential pathogens and beneficial members of poultry microbiota in vitro. Curr Microbiol. 2013. 66(4):350-8.
6 Sanz Y. Effects of a gluten-free diet on gut microbiota and immune function in healthy adult humans. Gut microbes 2010;1:135-7.