Does gluten sensitivity exist? Debunking the recent headlines

403 gluten sensitivity debunked response

Recent health headlines proclaimed gluten sensitivity doesn’t exist, fueling a backlash against the gluten-free diet as a baseless fad. These stories point to a recent study questioning the relationship between non-celiac gluten sensitivity and digestive symptoms. Sadly, they mislead the public by glossing over major points of research and cherry-picking information to debunk gluten sensitivity.

The study looked at how people with gluten sensitivity reacted to varying levels of gluten. Significant to the study was the elimination of FODMAPS (Fermentable Oligo-, Di-, and Monosaccharides, and Polyols), carbohydrates in many common foods known to exacerbate irritable bowel syndrome (IBS) symptoms. Foods high in FODMAPS include garlic, onion, beans, many fruits, yogurt, and more. Researchers removed FODMAPS to rule them out as a source of digestive symptoms, clearing the slate to determine whether gluten was to blame.

Study’s view is too narrow

The study concluded gluten had no effect on patients with gluten sensitivity who were placed on a low FODMAP diet, causing journalists to declare gluten sensitivity doesn’t exist. However, the paper doesn’t actually suggest that. Instead, the authors give nod to other factors that may have affected their results, such as the possibility that FODMAPS and gluten might work together to cause gastrointestinal symptoms. They acknowledged the results were markedly different from a previous study, and point out the need for further exploration on the topic.

Gluten sensitivity does not cause digestive symptoms in most people — affects other parts of the body

More importantly, the study did not look at symptoms outside of the digestive tract. Other research shows gluten causes digestive symptoms in only about one third of those with gluten sensitivity. In fact, gluten sensitivity destroys the brain and nervous tissue more than any other tissues in the body, and symptoms can be ambiguous for years and difficult to connect with gluten. Symptoms of a gluten sensitivity can also manifest in the skin, joints, bones and teeth; gluten has been associated with more than 55 diseases so far, most of them autoimmune.

While this recent study looks at digestive symptoms in response to gluten, it does not consider other symptoms commonly associated with gluten sensitivity, such as depression (research here), muscle pains, inflammation, neurological issues  and changes in mental function.

The study also does not consider other important facets of gluten sensitivity, such as gluten cross-reactivity seen with autoimmunity (when the immune system mistakenly attacks body tissue, such as the thyroid gland or the brain, because it so closely resembles the gluten protein), leaky gut, other foods that cross-react with gluten and cause gluten sensitivity symptoms (such as dairy), and more. These other factors need to be incorporated into a more comprehensive understanding of gluten.

So does gluten sensitivity exist?

Although there is no verified biomarker for non-celiac gluten sensitivity, researchers at the Center for Celiac Research and Treatment say they are close to determining one. Also, this recent study is but one of many in the field of gluten research and other research shows very clear evidence of gluten sensitivity.

Should you abandon your gluten-free diet?

While this new study asks valuable questions, does it mean non-celiacs who experience symptoms from gluten should continue eating it? Of course not! While this study raises new questions in relation to FODMAPS, millions of people with gluten sensitivity worldwide experience relief from their symptoms and progression of chronic disease on a gluten-free diet. Functional medicine practitioners have especially seen the beneficial effect of a gluten-free diet on myriad conditions.

The body always knows best. When we learn to listen to the body, the wisdom it shares leads us to make solid choices for greater health and wellness.

How to avoid hidden sources of gluten

352 hidden gluten

Congratulations, you’ve gone gluten free to improve your health! Perhaps you have celiac disease, or non-celiac gluten sensitivity, both of which require avoidance of gluten for optimal health. You know to avoid wheat, barley, rye, triticale, einkorn, farro, kamut, spelt, farina, emmer, durum, and semolina, plus most oats because they are commonly cross-contaminated with gluten grains in the field or factory. That pretty much sums it up, right?

Well, not quite. Gluten can actually reside as a hidden component in many common food ingredients, which can make food shopping, restaurants, travel, and potlucks a risky business. In this article, we’ll offer some guidelines for successfully navigating this tricky terrain.

Navigating Food Labels

Manufacturers are not presently required to identify gluten as an ingredient on labels. Just because a product doesn’t list a gluten grain, doesn’t mean it’s gluten-free.

Your greatest tool in determining what is safe to eat is to read food labels, and become familiar with stealthy ingredients that may include gluten. Have you ever seen an ingredient that you can’t identify? If so, it’s best to avoid it. Here is a (non-exhaustive) list of some common ingredients that can contain gluten:

  • Malt, and barley malt
  • Food starch and modified starch
  • Dextrin and maltodextrin — sourced from corn or wheat
  • HPP = Hydrolyzed Plant Protein
  • HVP = Hydrolyzed Vegetable Protein
  • TVP = Texturized Vegetable Protein
  • “Natural flavor”
  • “Spices”
  • “Artificial flavor”
  • Brewer’s yeast
  • Gelatinized and pregelatinized starch
  • Brown rice syrup

Pre-packaged foods can add a challenge as well. Below are some common foods that may have gluten in them. Look for a certified GF label if you aren’t sure; otherwise, pass it up.

  • Soy sauce (a good replacement is coconut aminos, or wheat-free tamari — 100% soy)
  • Many salad dressings use gluten thickener
  • Gravies, sauces, marinades
  • Fish sauce (common in Thai restaurants)
  • Canned and boxed soups
  • Soup mix
  • Bouillon
  • Licorice candy
  • Instant coffee
  • Coffee substitutes
  • Condiments
  • Puddings and pie fillings
  • Processed meats (gluten is used as a binder in cold cuts, hot dogs, sausages, and some specialty/reformed meats)
  • Many reduced-fat and ready-made foods have binder starches sourced from wheat
  • Ice cream –- look out for added gluten (cookie dough, anyone?) and beware of scoop cross – contamination where ice cream is served
  • Mashed potatoes
  • Imitation crab
  • Some wasabi
  • Vegan meat substitutes
  • Chips (factory cross-contamination)
  • Beer
  • White sauce (made from a wheat flour roux)
  • Worcestershire
  • Communion wafer (ask your church about bringing your own GF version)
  • All Chinese condiments contain wheat, including soy, oyster, hoisin, and bean sauces
  • Some spice companies use glutenous fillers; use only pure, high-quality herbs and spices with no fillers

The Restaurant Dilemma

Restaurants can pose their own challenges. Here are some things to look out for:

  • Fried food; those delectable fries may have been cooked in the same oil that fried the onion rings doused in wheat batter
  • Vegetables may have been par-boiled in the pasta water
  • At Asian restaurants, you may ask for GF but the busy chef may not be looking at the ingredients on the hoisin or fish sauce; ask for no sauce if uncertain.
  • GF foods may be prepared on the same surfaces or with the same utensils that glutenous foods touch.

If you are uncertain at a restaurant, talk to the chef directly. If you aren’t happy with the answer, don’t eat there. Many restaurants are becoming aware of the need for truly GF foods, but it’s always good to make sure they are careful about food prep. Ask friends, and ask local online GF groups about recommended eateries.

Gluten Free Shopping: When In Doubt, Go Without!

When you are new to eating GF, restaurants and grocery shopping can be daunting, but the more you do it, the better you’ll get at determining what goes in your belly. If you aren’t sure, don’t eat it. Ask questions, read ingredient labels; just because those noodles say, “Rice” on the front, that doesn’t mean they don’t have a gluten grain added in. “Wheat-free” doesn’t necessarily mean gluten free. Lastly, always check product labels for warnings that state a food is produced in a factory that also makes gluten-based products; if it is, cross-contamination could be an issue.

The more you do it, the more natural it becomes, and soon you will be navigating your gluten-free life with ease.

Gluten cross-reactivity with non-gluten foods

Non-gluten grain options include: rice, corn, amaranth, millet, quinoa, sorghum, teff, and buckwheat (not actually in the wheat family). However, these grains can cross-react with gluten in some people. This means their body recognizes them as gluten and responds with a reaction. An elimination/provocation diet or food sensitivity test  can let you know which grains are safe to eat. Dairy is another food that commonly cross-reacts with gluten, as is coffee. If your gluten-free diet is not helping you feel better you may need to consider cross-reactive foods.

Diet soda, artificially-sweetened foods

Though it does not actually contain gluten, the artificial sweetener aspartame is recognized as a serious offender for many with gluten intolerance or celiac disease. Since aspartame often triggers similar allergic symptoms, including severe stomach pain and bloating, avoiding it can spare you the pain and suffering.