Written By: Kevin Cann
In recent weeks my Facebook feed has been inundated with articles claiming that gluten sensitivity is not a real thing. This has led to many questions and left a lot of people out there unsure of what to believe. Hopefully this article can help clear up a few of the questions you may have.
Most of the articles are citing research that was published back in 2013. This research entry was titled “No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates” and it was published in the Journal of Gastroenterology.
This study looked at 37 patients with non-celiac gluten sensitivity (NCGS). There was one caveat though, they also had IBS. The researchers then placed the groups on a 2 week low FODMAP diet and then randomly assigned them to a high gluten, low gluten, and control diet. This was a double blind crossover study and the researchers found no evidence of gluten being the culprit of symptoms (1).
This study did not say that wheat has been wrongly accused of gastrointestinal distress. In fact, it said the opposite. This study showed that wheat was problematic due to the high amounts of FODMAPs in it. Barley on the other hand is a grain that is low in FODMAPs. This research may warrant trying this out in your diet if you so choose to.
This study also looked at a small sample size. There is no way you can base conclusions for the masses off of a study that looked at 37 participants. On top of that these participants were a specific population. They had a diagnosis of IBS. It is difficult to compare subjects with IBS to the average healthy individual. Each group may react differently to gluten.
Alessio Fassano and colleagues have been doing some groundbreaking work in how gluten impacts our digestive health. In one study Fassano and colleagues published titled “Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines” concluded by saying:
“Based on our results, we concluded that gliadin activates zonulin signaling irrespective of the genetic expression of autoimmunity, leading to increased intestinal permeability to macromolecules” (2). They are saying that regardless of whether you have celiac’s disease or not, gliadin increases zonulin leading to an increase in intestinal permeability.
Now we have one article that states that gluten sensitivity is not a real thing and another that is telling us it is. Let us look at some of the other research:
1. Type 1 diabetes: Authors concluded “This population-based study showed the highest reported prevalence of celiac disease in type 1 diabetes in Europe. Patients with celiac disease showed clinical improvements with a GFD. We recommend screening for celiac disease in all children with type 1 diabetes” (3).
2. Body Mass Index: Researchers concluded by stating “A GFD had a beneficial impact on BMI, underweight patients gained weight and overweight/obese patients lost weight. The improvement in BMI adds to the impetus to diagnose celiac disease. Expert dietary counseling may be a major factor in the beneficial effects we noted” (4).
3. Autism: Research is unable to find certain biomarkers to show the positive correlation between gluten, casein and autism, but one study stated “several parents reported improvement in their children” (5). Other researchers agreed with these findings and concluded “Results suggested that participants on a gluten-free diet showed an improvement on a number of behavioral measures. However there was no significant decrease in specific urinary compounds excreted when compared with controls and a gluten challenge group” (6)
We cannot forget about the millions of people who have claimed to feel better by removing gluten from their diets. A study of 37 participants cannot outweigh the millions of people that have improved symptoms by going gluten free.
When looking at research we need to take into account ALL of the research and draw up the best conclusion possible. In my opinion the research combined with the results gained in my practice tells me that gluten sensitivity is a real thing. I reserve the right to change my mind as new evidence is presented.
With this newer study I may allow clients to eat low FODMAP grains such as barley. This study brings to light that maybe not everyone responds to gluten in the exact same way. I still encourage everyone to ditch the grains, legumes, and dairy for 30-60 days. After this time period try reintroducing a low FODMAP grain such as barley and see how you feel. Make sure that this is the only food that you reintroduce in a 7 day period. Otherwise it will be impossible to tell what caused your symptoms. I would still recommend making lower FODMAP grains a sometimes food choice in the diet and not a staple.
We also need to look at this on a risk versus reward scale. The risk of gluten causing damage is there. You cannot deny that no matter what side of the fence you sit on. There is no risk to removing it from your diet. However, there may be a large reward from doing so. Just to be on the safer side of things why not remove it from your diet? In fact, most foods that contain gluten should not be consumed on a regular basis anyways. They tend to be low in nutrients and high in calories.
I would love to hear others stories on how going gluten free enhanced their health and well-being. If you went gluten free with negative results I would love to hear about that as well. Perhaps there is a simple tweak you can perform to truly get the health benefits so many others have experienced.