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Food & Nutrition

Food as Medicine: Should You Follow a Gluten-Free Diet?

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Get the scoop on gluten sensitivity, how to get tested, what foods to avoid, and why modern wheat is not what it used to be.

By Christine M. Okezie, CHHC

There is a serious gluten-free frenzy out there, with almost 30 percent of American adults reporting a desire to cut down on gluten or follow a gluten-free diet. But many don’t

understand what gluten is, or what, if anything, they should be doing about it. Also, wheat, which contains gluten, was once hailed as the “staff of life,” and is now under attack for its role in America’s health crisis.

So, what is gluten? It’s a composite of starch and protein found in grassy grains like wheat, barley, rye, spelt, kamut and some oats. It’s found in foods I call the obvious suspects, such as bread, pasta, pizza, crackers and baked goods. But gluten is also

present in condiments, including soy sauce and pre-packaged dressings, soups, gravies and marinades. There are also some hidden sources of gluten, such as hot dogs, deli meats, imitation crab and any packaged foods that contain certain ingredients like maltodextrin, malt flavoring, hydrolyzed vegetable protein or vegetable starch.

Interesting to note, gluten is actually a relative newcomer to the human diet. Our ancestors began eating grains at the earliest, 15,000 years ago, which is a snapshot in our 2 million-year history. As a result, many people did not adapt to these significant environmental changes, so adverse effects related to gluten ingestion developed around that time.

Fast-forward to the 1950s, where an American plant scientist named Norman Borlaug began crossbreeding wheat in an attempt to address world hunger concerns. The result was a hybridized plant that was shorter, hardier and higher yielding. But this new wheat, with its exponentially higher amounts of starch and gluten, has since proved troublesome for many people.

For some, gluten can quite overtly be a matter of life and death. These people have a condition known as celiac disease, which is an autoimmune disease that damages the lining of the small intestine when a person eats gluten, preventing the intestine from absorbing necessary nutrients. It triggers systemic inflammation, contributing to a whole range of health problems, including chronic diarrhea, abdominal cramping, depression, diabetes, osteoporosis and even certain cancers.

Once considered extremely rare in the U.S., a recent study found the rates of celiac disease actually increased 400 percent in the last 50 years, affecting 1 percent of the American population. This translates into 1.8 million people, but sadly about 1.4 million people with the condition may not even be aware they have it. A recent study

reported approximately 47 percent of celiac patients are misdiagnosed, and of those with “classic” GI symptoms, 59 percent are told they have irritable bowel syndrome.

We as a society are in “gluten overload.” Our national obsession with processed carbohydrates has us consuming over 150 lbs. of this new dwarf wheat. Combine this with the assault on our guts from poor diet, lifestyle and over-reliance on pharmaceutical drugs, and you create the perfect storm for the gluten intolerance and disease rates we are seeing today.

GLUTEN SENSITIVITY
People with celiac disease represent only a fraction of those who are wronged by gluten. Recent studies confirm that 7 percent of the population, or 21 million people, may suffer from a less understood (but no less serious) condition known as Non-Celiac Gluten Sensitivity. In this case, low level inflammatory reactions to gluten trigger the same health problems, even if a person doesn’t have full-blown celiac disease. There is compelling new research showing adverse reactions to gluten may result from problems in very different parts of the immune system than those implicated in celiac disease.

A major study in “The Journal of the American Medical Association” reported that non-celiac gluten sensitivity was shown to increase risk of death by 35 to 75 percent, mostly by causing heart disease and cancer. Just by this mechanism alone, over 20 million Americans are at risk for heart attack, obesity, cancer and death.

Indeed, groundbreaking studies are showing gluten has many more far-reaching effects than previously believed. Oftentimes undiagnosed or dismissed by the medical community, gluten sensitivity masquerades as a host of other diseases.

A study in “The New England Journal of Medicine” listed 55 “diseases” that can be caused by eating gluten. These included osteoporosis, irritable bowel disease, inflammatory bowel disease, anemia, cancer, fatigue, canker sores, rheumatoid arthritis, lupus and multiple sclerosis.

Moreover, not only is the new wheat superinflammatory, it acts like a super-drug that can impair your mental state and leave you hungry and addicted to it. When digested, wheat is broken down into polypeptides or shorter proteins that leak across the blood brain barrier and sit on the opiate receptors in the brain. Thus, gluten has also been linked to many neurological diseases, including anxiety, depression, schizophrenia, dementia, migraines, epilepsy and neuropathy. It has also been linked to autism. This super-drug quality also causes addictive eating behavior including sugar and carbohydrate cravings and binge eating. The bottom line is, over time, if you are gluten sensitive and you continue to eat gluten, you increase your risk for a whole host of inflammatory and autoimmune diseases.

GETTING TESTED FOR GLUTEN ISSUES
So how do you know if gluten might be the root cause for your health challenges? Gluten sensitivity can manifest in the form of low energy, fatigue, insulin resistance, diabetes, thyroid imbalance, abdominal bloating, depression, chronic digestive problems, brain fog, skin rashes, numbness in the extremities, muscle and joint pain, and even problems with coordination. Also, all forms, whether overt or silent, of gluten sensitivity, can have devastating long term consequences all over the body. Gluten, because of the severe inflammation it triggers throughout the whole body, has wide ranging effects on all organ systems including the brain, digestive tract, bones, joints and more.

If you suspect gluten may be negatively affecting your health, one option is to get a blood test. One of the most sensitive tests screens for antibodies that target tissue transglutaminase (tTG for short). If you’ve got them, chances are you’ve also got celiac.

To find out if you’re gluten intolerant, you can have your blood tested for the presence of gliadinsensitive antibodies, including IgG and IgA. If the tests turn up large numbers of these antibodies, it’s a sign that the body is in some way hostile to gluten. At this point, you can follow up with a gastroenterologist who can perform an endoscopy to biopsy the lining of the small intestine and look for celiac-related damage.

Be aware, however, as discussed, ruling out celiac disease doesn’t in any way mean you’re off the hook with gluten. Many doctors consider elevated anti-gliadin antibodies in the absence of a positive intestinal biopsy showing damage to be “false positives.” That means the test looks positive, but really isn’t significant. However, the new research supports we can no longer take this approach. In light of the new research on nonceliac gluten sensitivity, if your antibodies are elevated, you should go off gluten and test to see if it is leading to your health problems.

In other words, one should consider any elevation of antibodies significant and worthy of a trial of a gluten elimination diet, which is a lot less expensive and invasive, and widely recommended by functional medicine doctors and other holistic health practitioners. I recommend testing your gluten suspicions by eating a gluten-free diet for at least four weeks to see if symptoms improve.

Of course, the success of your diet is based on your ability to eliminate gluten 100 percent from your food. Then after the trial period of being gluten-free, eat a slice of bread and see what happens. If you observe the onset of symptoms, such as digestive distress, brain fog, joint pain or skin troubles, you’ve got your answer.

THE GLUTEN-FREE FOOD CRAZE
If you’ve determined gluten sensitivity is playing a role in your unwanted symptoms or health challenge, going gluten-free can still undermine your health if you eat too many processed gluten-free foods, like muffins, pizza, pasta, bread, cookies, etc. Processed junk foods, whether they contain gluten or not, wreak havoc on your blood sugar balance and set the stage for the same inflammatory diseases previously mentioned.

So beware the explosion of gluten-free food in your supermarket. The gluten-free packaged food industry is one of the fastest growing markets today, weighing in at $4.2 billion in 2012 and projected to be a $6.6 billion industry in 2017. Remember, vegetables, fruits, beans, nuts, seeds and animal proteins are all naturally gluten-free. Make these the foundation of your food to optimize your health.

And remember, whether sensitive to gluten or not, wheat is a super inflammatory and super addictive substance. The problems with wheat are real and scientifically validated, so the next time you reach for that whole wheat bread, consider it may not be that wholesome after all. Simply eliminating this insidious substance from your food can help you get to the root cause of your unwanted symptoms and health challenges, and in the end, put you on the path to achieve long vibrant health.

christine_okezieABOUT CHRISTINE M. OKEZIE
Christine M. Okezie is a graduate of the Natural Gourmet Institute for Health and Culinary Arts in New York, and the Institute for Integrative Nutrition. She founded her company, Your Delicious Balance, where she counsels individuals to heal themselves through real food and positive lifestyle choices. Her healing strategies are based on whole foods nutrition, and she guides her clients to adopt a plant-centered way of eating that offers anti-inflammatory and detoxifying benefits to the body. For more information, visit her Web site at www.yourdeliciousbalance.comor call (201) 889-5001.