In the U.S. alone, it’s estimated that 31 million people are gluten-free. That’s a lot — equivalent to almost 80% of my entire country’s population in Canada! And despite the critics who called it a trend 20 years ago, it’s still on the rise — the American gluten-free market is expected to be worth almost $44 billion by 2027. If you ask most people who’ve removed gluten from their diet, they’ll tell you they feel better.
So what’s going on — are that many people truly allergic or intolerant to gluten?
First: what exactly is gluten?
Gluten is a combination of 2 proteins (gliadin and glutenin) that give wheat and other grains the stickiness and stretchiness needed to make bread dough, pizza dough, or the many other baked goods we enjoy. It’s what allows those foods to be light and airy (like a croissant).
What foods contain gluten?
It’s found, in order of highest to lowest gluten content, in wheat, spelt, kamut, barley, and rye. If you’ve ever tried to make rye bread with only rye flour, you’ll know how heavy that loaf is — that’s because of its low gluten content.
What about oats? Nope. It’s not a gluten-containing grain, but rolled oats are often processed with a small amount of wheat flour. Your best bet is to use steel-cut oats. Totally gluten-free, and one of your best options for soluble fiber and a low-glycemic grain.
But I digress….
Gluten is also found in a huge number of packaged foods, like… most of them, from soup to spices to salsa to yogurt. It’s often the main ingredient (cookies, crackers, cereal, muffins, and so on…) but it’s also an effective way to bind ingredients together and provide a certain consistency for just about any food, like salad dressing.
Basically, it’s everywhere, and because it’s cheap, it’s in almost everything. It’s also highly processed in most foods now, and has been genetically altered (in North America, anyway) which often changes the nature of the protein, attracting attention from the immune system. These two factors together provide a highly likely explanation for why — after 12,000 years in the human diet — we no longer seem to tolerate it. And just to add one more factor to the pile: there’s a strong correlation between the development of food intolerances and the ubiquitous use of antibiotics over many decades. Why, you ask? It’s all about depletion of the gut microbes — our microbiome. We now know what an essential role these microbes play in our immune responses and our digestion of food. If we deplete those on a regular basis, we change the way our gut responds to certain foods.
Celiac Disease v Gluten-Intolerance: what’s the difference?
Both of these involve the immune system in the gut. And both result in damage to the intestinal lining because of the immune responses.
But they are not the same.
Celiac disease is an autoimmune reaction to gluten, specifically to the gliadin part of the protein. It’s less common than people think, occurring in an estimated 1% of the global population. There are very specific tests that will detect antibodies to the protein, and can provide a definitive diagnosis. Celiac is a genetic condition that may not appear until triggered by pregnancy, childbirth, viral infections, severe emotional stress, or even later in life with the onset of menopause. Symptoms can be severe — if you have celiac, you can’t eat any gluten at all without a great deal of pain and a flare up. It’s kind of like a kid with a peanut allergy … total avoidance is advised.
Gluten intolerance is a different kind of immune response, and can be diagnosed with a test for another antibody, called IgG. It’s less serious than celiac, even though many of the symptoms are similar. It tends to develop over time, usually because of daily overconsumption of refined flour products.
What are the common symptoms?
- gut pain
- gas
- recurring abdominal pain
- bowel changes — usually quite loose and frequent
- nausea and heartburn — what many people call ‘indigestion’
- heavy fatigue and brain fog
- unexplained anemia
- joint or muscle pain
- mood and behavioral changes
- numbness in hands or feet
- ulcers, in the gut or in the mouth
So… what to do?
The trend seems to be to buy ready-made gluten-free products that closely mimic all of the things we love that are normally made from wheat flour. I get it… it lets everyone sit down to the ‘same’ meal, so nobody stands out, or is left out of the treats and the things they’re used to.
The problem is this: think of what has to go into these products to give them the taste and the consistency of gluten-containing grains. Next time you pick up a box of gluten-free donuts, look at the ingredient list. From my experience in practice, my patients often traded one set of symptoms for another, by bringing those foods into daily life.
Here’s my advice:
- if you have celiac disease, pay VERY careful attention to labels of things like canned soup and salad dressing — that’s the hard part, because gluten is ‘hiding’ — you’ll want to get a list (it’s long) of all the names that gluten goes by on food labels
- also for celiac, but the same goes for gluten intolerance: shift your diet to center around brown rice, wild rice, cornmeal, millet or buckwheat, and then increase your veggies to make up the amount of carbs you need in your daily diet — there are plenty of international diets out there that do not focus on flour.
- talk to a naturopath or functional medicine doctor to get properly tested — see if you have antibodies that would indicate either celiac disease or gluten intolerance, so that you know for sure
- fermented foods — there’s nothing quite like kombucha or other fermented foods to help replenish the microbes in your gut
LAST THOUGHTS
If you’ve been defending your gluten sensitivity to everybody and their neighbor, you are not alone. The use of the word “real” when it’s applied to celiac disease, implies that gluten intolerance isn’t real. It definitely is. Those IgG antibodies are measurable. Either way, you can enjoy a healthy, balanced diet without gluten, so it’s your choice.
