"Gluten-Free Diets:
Separating the Wheat from the Chat" Until only a few years ago, almost
the whole of the scientific world maintained that the wheat protein gluten
would provoke negative effects only in people with rare conditions such
as celiac disease or wheat allergies, but by the early part of 2013,
it was largely becoming accepted that some nonceliac patients could suffer
from gluten or wheat sensitivity. And indeed a consensus panel of
experts now officially recognizes three gluten-related conditions, wheat allergy,
celiac disease, and gluten sensitivity. So what percent of the population
should avoid wheat? Although 1 in a thousand may have a wheat allergy,
nearly 1 in a 100 may have celiac disease, and it appears to be on the rise, though there’s
still less than about 1 in 10,000 chance Americans will get diagnosed
with celiac in a given year. How common is wheat sensitivity? Our best estimate at this point is in that same
kind of general range, slightly higher than 1%, but still that’s potentially millions of
people who may have been suffering for years who could have been cured
by simple dietary means, yet went unrecognized and unhelped
by the medical profession.
Although gluten sensitivity continues
to gain medical credibility, we still don’t know how it works, or
how much gluten can be tolerated, if it’s reversible or not and what
the long-term complications might be of not sticking to the diet. Considering the lack of knowledge,
maybe people with gluten sensitivity should be trying to reintroduce gluten
back into their diet every year to see if it’s still causing problems. The reason health professionals don’t
want to see people on gluten-free diets unless absolutely necessary is
that for the 98% of people people that don’t have
gluten issues, whole grains— including the gluten grains –
wheat, barley and rye— are health promoting, linked
to the reduced risk of coronary heart disease, cancer, diabetes,
obesity and other chronic diseases.
Just like, because some
people have a peanut allergy, doesn’t mean that everyone
should avoid peanuts. There is no evidence to suggest
that following a gluten-free diet has any significant benefits
in the general population. Indeed, there is some evidence to suggest that
a gluten-free diet may adversely affect gut health in those without celiac disease
or gluten sensitivity or allergy. They’re talking about this study that
found that a month on a gluten-free diet may hurt our gut flora
and immune function, potentially setting those on gluten-free
diets up for an overgrowth of harmful bacteria in
their intestines. Why? Because, ironically, of the beneficial
effects of the very components wheat sensitive people have problems
with—like the FODMAP fructans that act as prebiotics and
feed our good bacteria, or the gluten itself,
which may boost immune function. Less than a week of added gluten protein significantly
increases natural killer cell activity, which could be expected to improve our body’s
ability to fight cancer and viral infections. High gluten bread improves
triglyceride levels better than regular gluten bread,
as another example. Ironically, one of the greatest threats of
gluten-free diets may be the gluten itself.
Self-prescription of a gluten-free diet may
undermine our ability to pick up celiac disease, the much more serious form
of gluten intolerance. The way we diagnose celiac is
by looking for the inflammation caused by gluten in
celiac sufferers, but if they haven’t been eating a lot
of gluten, we might miss the disease. Hence, rather than being on
a gluten-free diet, we want celiac suspects to be
on a gluten-loaded diet. We’re talkin’ 4-6 slices of gluten packed bread
a day, every day for at least a month, so we can definitively
diagnose the disease.
Why does it matter so much to get a formal
diagnosis if you’re already on a gluten-free diet? Well, it’s a genetic disease so
you’ll know to test the family, but most importantly many people on gluten-free
diets are not actually on gluten-free diets. Even 20 parts per million can be
toxic to someone with celiac. Many on so-called gluten-free diets
inadvertently still eat gluten. Sometimes there’s contamination
of gluten-free products, so even foods labeled "gluten-free"
may still not be safe for celiac sufferers. That’s why we need to know. The irony, editorialized in
a prominent medical journal, of many celiac patients not
knowing their diagnosis, while millions of non-sufferers
banish gluten from their lives, can be considered a
public health farce..
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