The topic of gluten is difficult to approach but SO important. There are such striking contradictory arguments regarding gluten sensitivity, celiac disease and how it’s intertwined with diet culture.
So- here is my attempt to simplify, provide some context, explain some rudimentary science and leave you with some of my thoughts on gluten sensitivity, intolerance and who might benefit from avoiding gluten!
First thing is first. The difference between celiac’s disease and gluten sensitivity. Celiac disease is a genetically predisposed autoimmune disorder. If people who have celiac disease consume gluten, or more specifically gliadin, their body literally attacks the small intestine and destroys the villi, leading to poor absorption, malnutrition, increased intestinal permeability and diarrhea, bloating, and a myriad of other symptoms. Gliadin is the protein found in wheat that makes it rise (which I will go into more detail about later) but those with celiacs disease dont have an enzyme to break it down. The body releases inflammatory cytokines, prostaglandins, and leukotrienes (no bueno) and completely destroys the microvilli. Those with celiac disease need to avoid all types of gluten in any way shape or form (duh).
An interesting tid-bit on celiac disease- prior to world war 2, a crazy number of people died from celiac disease (30%-40%). it wasn’t until dutch pediatrician Dicke linked that during WW2 when the Netherlands didn’t have access to wheat, there were no deaths from celiac disease. Prior to that finding, they treated celiac disease with bananas- literally- they thought that bananas were the cure. However, on “recovery” children would start to eat wheat again and get dramatically ill. Needless to say, we’ve come a long way!
But what about everyone else? why is “gluten free” written on everything? When did this become such a trend? or is there even science to back this up?
Gluten sensitivity: this is the buzzword of the millennials. But it’s 100% backed and science based. Just because your body doesnt have an immune mediated response to gluten does not mean that you are in the clear. There are two culprits at play here: the names are Gliadin (mentioned above) and Zonulin.
Let me explain:
Your small intestine is where the majority of nutrient absorption takes place. lined by villi and micrivilli, enzymes coat the surface to assist with absorption. When you consume any product containing gluten (any wheat, rye, spelt, most oats), they contains Gliadin which is the major protein component in wheat.
Gliadin: Gliadin as mentioned above is what those with celiac disease respond to. However, it can cause problems in those without celiac disease as well. It #1. destroys the villi that line the small bowel decreasing absorption and #2. increases zonulin.
Zonulin: A modulator of the tight junctions that line the small bowel. The tight junctions are supposed to open to some extent in order for nutrients to be absorbed into our bloodstreams. However, When levels of zonulin are too high, “the flood gates” open, and too many larger proteins and unwanted substances cross into the blood stream creating an immune response. This is what people are referring to when they use the term “leaky gut”. Our body has an inflammatory response to these “foreign” substances that arent supposed to cross the gut lining,and have an immune response to them every time they appear. The attack on the larger food particles that aren’t supposed to pass lead to sensitives to other foods, more villi damage, more decreased absorption and long term malnutrition. This is no bueno for those who already have autoimmune disease- as they are at higher risk.
Zonulin was actually discovered by a pediatric gastroenterologist Dr. Fasano. He found that the two things that increase zonulin are #1. gluten and #2. bacteria in the small intestine (SIBO – see a few posts back). in 2006, a study in the Scandinavian Journal of Gastroenterology came out that linked Gliadin causing increased zonulin in those without celiac disease, leading to leaky gut.
summary: Gluten consumption = increased gliadin = destroyed microvilli and decreased absorption + more Zonulin = leaky gut, GI symptoms, acne, autoimmune flares, inflammation and less nutrient absorption.
I am going bring one more interesting tid bit in regarding the American Agricultural system and the food pyramid. The wheat we get on our shelves today is a dense hybridized mix with much higher levels of gliadin in it. I was listening to a registered dietician address this, and she explained that not only do hybrid crops have a longer shelf life, but we started making these hybridized crops during the war when we created short dwarf wheat to bulk up our soldiers during the war. This was also around the time when the food pyramid was suggesting a ridiculous number of whole wheat servings in our diet (im sorry, what?!). It is much less expensive to harvest short dwarf wheat and monoculture crops, but this is a big red flag.
If you want to keep gluten around: look for einkorn bread, sprouted bread, stone ground bread, etc. Significantly lower levels of gliadin. Same goes for sourdough bread due to the bacteria in the dough itself that breaks down the gliadin and makes it easier to digest. Not to say indulging on a bagel or a slice of pizza every once in awhile is a sin, but these are some things to think about.
my thoughts: Avoid gluten if
1. You have an autoimmune disease that flares of any kind (ie RA, MS, psoriasis, Crohns or UC etc) avoiding gluten could drastically help reduce symptoms. This is less true for stable conditions.
2. Anyone with leaky gut, SIBO, intestinal dysbiosis, or candida overgrowth (like me!)
Hopefully this shed some light on gluten sensitivity and why people cut it out to decrease inflammation. I am happy to talk more in detail and share where I got info, more places to read etc. If you still aren’t sure if this is a change you should make, pick my brain! I love to talk symptoms and gut patterns with any day.