03/29 2012

Is Gluten-Free the Way to Be?

This is Part One of a two part series about gluten-free diets.

gluten-free

About two years ago, my husband was diagnosed as gluten sensitive. Upon his (primary care) doctor’s recommendation, he immediately cut out gluten from his diet. This subsequently resulted in a huge investment in gluten-free foods, including everything from flour to pasta to cereals to beer. As the family chef, I was willing to abide by the doctor’s orders, despite my skepticism. Part of me wondered if gluten sensitivity was a giant marketing scheme with some sort of mysterious cut to all doctors involved.

Why the skepticism?

One. In 2010, sales of gluten-free foods tallied $2.6 billion. Someone is profiting from all these diagnoses, that much is clear. (Source: Wall Street Journal)

Two. Rob, my spouse, was only experiencing one of the symptoms of gluten sensitivity, and his primary care doctor could not say with certainty that gluten was the culprit. Moreover, his GI doctor told him that no studies had linked gluten sensitivity with upper GI conditions (only lower GI). According to dummies.com, symptoms of gluten-sensitive happen to be very similar to people who are gluten-intolerant (=celiacs). Gastrointestinal (GI) issues include:

  • Abdominal pain and distension
  • Acid reflux
  • Bloating
  • Constipation
  • Diarrhea
  • Gas and flatulence
  • Greasy, foul-smelling, floating stools
  • Nausea
  • Vomiting
  • Weight loss or weight gain

Non-GI symptoms include a myriad of issues, such as fatigue and weakness (due to iron-deficiency anemia), vitamin and/or mineral deficiencies, headaches (including migraines), joint/bone pain, depression, irritability, listlessness, and mood disorders, “fuzzy brain” or an inability to concentrate, infertility, abnormal menstrual cycles, dental enamel deficiencies and irregularities, seizures, clumsiness (ataxia), nerve damage (peripheral neuropathy), respiratory problems, canker sores (apthus ulcers), lactose intolerance, eczema/psoriasis, rosacea (a skin disorder), acne, Hashimoto’s disease, Sjögren’s syndrome, lupus erythematosus, and other autoimmune disorders, early onset osteoporosis, hair loss (alopecia), bruising easily, low blood sugar (hypoglycemia), muscle cramping, nosebleeds, swelling and inflammation, night blindness.

Of this long list, Rob was only experiencing hair loss, a condition that was highly likely to occur despite any dietary exclusions (sorry Rob).

Three. Being a believer in moderation, I doubted the need to cut out gluten completely. Could a person cut back on gluten and see an improvement in symptoms?

Four. When I asked the physician how many patients at their clinic were diagnosed as gluten sensitive, she answered, “Just over 90%.” Though admittedly my radar may have been on high, I found this percentage a bit startling.

What is the prevalence of gluten sensitivity in the population?

According to the Wall Street Journal, less than 1% of children have a gluten allergy by the age of five, at which point they tend to outgrow it. The rate of those diagnosed with celiac disease has increased four fold in last fifty years, to one in every 133 Americans. Some think 1 in 20 people are gluten sensitive.

So though the 90% rate at the clinic in Boise was high, relatively speaking, what is causing this trend?

Why is gluten intolerance on the rise?

Though no one knows exactly why gluten intolerance appears to be increasing all over the world, a few factors have been sited.

Damaged gut flora – According to Food Renegade, sugar, alcohol, antibiotics, environmental toxins, and other allergens (like the introduction of GMOs into our food supply within the last 15 years) all contribute to imbalanced intestinal flora which can lead to gluten-intolerance.

Genetic and environmental influencesNaturopathic Living suggests the most likely explanation for such a phenomenon to be a combination of genetic and environmental influences. The strongest of these influences appears to be gluten overload. Modern humans simply eat more gluten than in days past. Gluten-containing grains, especially wheat, displaced all other grains. The majority of wheat breeds on the market contain 40 to 60% more gluten than wheat contained 50 years ago.

How is someone diagnosed?

Rob was initially diagnosed with a blood test. However, no tests are 100% reliable for gluten sensitivity. Why?

Celiac disease, a condition that can lead to malnutrition, osteoporosis and other more serious health problems that can result in early death, is most accurately diagnosed via an intestinal biopsy, says WebMD. The disease itself causes the immune system to mistakenly attack the body’s own tissue. Antibodies triggered by gluten flatten the villi, or tiny fingers in the intestines, needed to soak up nutrients from food. An intestinal biopsy in a celiac shows damage to the villi.

In a patient who is gluten sensitive, the intestine remains normal in appearance, so a biopsy is not useful. The only real way to know is through a gluten-free diet.

Is gluten-free the way to be?

Despite my skepticism, if a gluten-free diet alleviates uncomfortable and disruptive symptoms, then by all means, a person should do what makes them feel good. But as Gluten Intolerance Symptoms suggests, constipation, diarrhea, gas, bloating, fatigue and joint pain, the most common celiac disease symptoms, can often be associated with other diseases and ailments, too. So it’s important to consult a medical professional, and even then, ask questions and/or seek second opinions.

Back to normal

After 3-4 months of making homemade gluten-free bread and buying those expensive gluten-free beers, Rob decided to re-introduce gluten into his diet. He saw no changes in the way he felt and has been happily eating a healthy, balanced diet ever since.

Next week I will continue the series by delving into gluten-free foods and recipes.

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