Before you read any further, I want to emphasize that I am not a medical professional (yet) and everything in this blog post is my opinion based on years of reading, observation, personal research and experimentation. This topic is extremely complex, which is why a google search yields roughly 53,000,000 results (yes that’s a million) ranging from “Why You Shouldn’t Go Gluten-Free” to “10 Steps To Begin a Gluten-Free Diet.” I am not writing this to promote any type of diet, nor is my goal to give you medical advice. My goal is to simply help you understand what the gluten-craze is all about and help you make your own decisions about the health of yourself and your family. Lastly, note that this is an extremely shallow dive into this topic and if you are interested in learning more, google has 53 million articles you can sift through.
Let’s start with some introductions:
Gluten- Gluten is a protein that helps to make up a variety of grains. The best way it’s been described to me is as the “glue” of grains such as wheat, barley, and rye, making up 80 percent of the protein found in these grains.
Celiac Disease-Celiac Disease is an autoimmune condition in which the immune system generates an attack against gluten, resulting in an inflammatory cascade. This means that the body is producing antibodies against gluten itself (alpha-gliadinin and/or tisse transglutaminase-2 are most commonly tested). There is also a genetic component to celiac, with the HLA-DQ2 and HLA-DQ8 genes being the genes of interest.
Gluten or Wheat Allergy- First, note that I am bundling the two of these together for simplicity, but wheat allergies can be caused by proteins other than gluten. Allergies are not autoimmune conditions. An allergy to gluten or wheat generates an immune response, but through a different mechanism that Celiac Disease.
Non-Celiac Gluten Sensitivity- Okay, so this is where things get confusing for many people, even the experts from what I’ve read. NCGS is defined as a “clinical entity induced by the ingestion of gluten.(1)” I’ll be honest, that definition is a joke to me, so I’m going to provide my own spin on it- NCGS is when symptoms such as digestive issues, cognitive impairments, and even more serious chronic issues such as joint pain and dementia develop in response to gluten consumption but in the absence of Celiac Disease or a Gluten Allergy.
Okay, I Get It, But How The Heck Do I Know If I Should Eat Gluten?!
This is where things get really dicey! Here’s the deal- there is a lot of misconception on the prevalence of Celiac disease (CD). The prevalence of CD has risen since the introduction of wheat some 10,000 years ago. Currently, the number associated with CD is around 1%, though I suspect this to be higher (2). Non-celiac gluten sensitivity is difficult to quantify, as you can’t test for it. So, my suggestion for those of you who may suspect or fear gluten is to do the following before ordering a box of pizza and picking up a twelve pack of IPA’s:
1) Rule Out Celiac Disease, Wheat and Gluten Allergies- This is by far the most important as those in this population should adhere to a gluten-free diet at all times.
2) If You Still Suspect Gluten is The Cause of Symptoms, Test It! If you are not found to have CD or an allergy, but still suspect gluten is an issue, you can test it. This is most easily done by eliminating gluten products for 30 days, tracking your symptoms, and then re-introducing gluten to see if symptoms return (if they ever left).
If you do all of the above and see no difference, gluten-on in my opinion! However, I do believe overconsumption of gluten containing products is why CD and NCGS rates have risen dramatically and certainly think everyone should avoid excess consumption of gluten, especially in the form of refined carbohydrates and processed foods with zero nutritional value. Think of it this way, gluten is in almost everything we consume in a Western Diet: cereal, bread, pasta, crackers, pizza, and much more. This is a fairly recent change evolutionarily, which is why I tell people that can tolerate gluten to enjoy it in moderation and accompanied by a diet rich in meat, fish, vegetables, and fruits.
Again, this is a very basic dive into this topic, and I am by no means an expert. However, I hope this basic summary helps you better understand the gluten-craze and avoid getting caught up in the mess!