Many people today are going on gluten free diets. You can find extensive gluten free sections in Kroger, HEB, and Whole Foods. Gluten has been in the national spot light receiving recognition on Discovery Health, CNN's Larry King, Oprah, David Letterman, The View, Good Housekeeping Magazine and more. There is even a "dummies book" available for those with gluten sensitivity.1
So What is Gluten?
Gluten is a protein found in the following grains: wheat, barley, rye, and oats. It is also found in processed foods derived from wheat, barley, rye, and oats. Breads, cereals, and pastas are rich in gluten. Other foods and/or food additives can be derived from gluten containing grains. Examples include soy sauce, gravies, soups, whiskey, and modified food starch. Traditional medical thought is that the protein gluten interacts with some people's immune systems causing an autoimmune reaction which damages the intestine. However, newer research is identifying that the protein gluten is only part of the problem. Some scientists argue that many grains (including corn) can create similar reactions.
So what is gluten sensitivity?
It depends on who you ask. Many people use the term gluten sensitivity interchangeably with celiac disease (an autoimmune intestinal disorder). Some call gluten sensitivity a food allergy or intolerance. Both are correct to some degree. Gluten sensitivity causes celiac disease, but not all people with gluten sensitivity develop celiac disease. This is where the problem in traditional diagnosis can occur. The only way to confirm whether or not a person has celiac disease is to perform an intestinal biopsy. If the results reveal villous atrophy (flattening of the intestinal folds) then celiac disease is diagnosed. If the results are negative, then both celiac disease and gluten sensitivity may be dismissed. Newer research is finding that gluten sensitivity can exist independently without causing celiac disease. There are more than 180 different disease conditions, syndromes, and symptoms that have been linked to gluten sensitivity in the medical literature.2,3 Some common conditions include thyroid disorders, seizure disorders, vertigo, osteoporosis, irritable bowel syndrome, and PCOS. There have been two proposed names in the medical literature for this classification of gluten sensitivity. 1. Non-Celiac Gluten Intolerance4 and 2. Gluten Syndrome.5
Diagnosing Gluten Sensitivity & Celiac Disease
The proper tools must be used to accurately diagnose gluten sensitivity. Relying solely on a biopsy can delay a diagnosis for several years. I have personally seen cases of celiac disease where up to 8 biopsies were performed before a diagnosis was made. Blood antibody tests provide a better degree of accuracy but still have a great degree of false negatives. Genetic testing offers the greatest degree of accuracy and when combined with a patient's history and examination a diagnosis can be made early and accurately. However, the greatest tool is patient improvement. If a person starts to feel better on a gluten free diet it doesn't matter what blood tests or biopsies reveal. The proverbial proof is in the pudding.
Once Again, Common Sense Applies -
Several years ago, many Americans played an unknowing role in the social experiment known as the Atkin's diet. This diet, largely devoid of grain provided many with better health through weight loss and reduction of many generalized symptoms of poor health. However, there were also those whose health did poorly on the Atkin's diet. People are different and unique. Renowned Nobel Prize winning scientist, Roger Williams, wrote a book called Biochemical Individuality examining these individual differences. Bottom line: one diet is not right for everyone. Because going on a gluten free takes a great deal of education and commitment, it is recommended that proper testing be performed to identify whether the diet is right for you. Remember going gluten free is not a trendy diet; it is a permanent lifestyle that should be taken very seriously as even small amounts of gluten exposure can cause problems. This month I will leave you with a final thought on gluten and grains. When farmers want their cows and pigs to gain weight before going to market, they feed them more grain. In the past 100 years, grain consumption has dramatically increased, paralleling a rise in the incidence of heart disease, diabetes, obesity, and cancer. Despite the above facts many doctors and dieticians continue to blindly prescribe "heart healthy" diets high in grain.
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References:
1. Korn, Danna. Living Gluten-Free... Wiley Publishing 2006.
2. Libonati, Cleo J. Recognizing Celiac Disease. GFW Publishing Jan 2007.
3. towncenterwellness.com:80/webwellness_newsletter.html
4. gluten.net/about.htm
5. Ford, Rodney. The Gluten Syndrome. RRS Global Ltd publishing. Sept 2007.
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