Going gluten-free: Melinda’s story and insights
A few years ago I made the decision to go on a gluten-free diet and have stuck to it ever since. It wasn’t easy, especially since I had been told by my doctor that I likely did not have celiac disease (after testing negative on a blood test). So I didn’t have a concrete reason for avoiding wheat, except for my personal opinion that I felt better. Instead of being doubled over in pain after consuming a large bowl of pasta and feeling awful, my belly seemed much happier when I stayed away from wheat.
Gluten-free diets are quickly gaining in popularity and many people report improved digestive and mental health after adhering to a gluten-free diet. However, this trend has been met with dismay by some health professionals. There are good reasons for their precautions – consumption of whole grains such as wheat are loaded with healthy nutrients and have been linked to reduced risk of type 2 diabetes, cardiovascular disease and lower weight1. Furthermore, baked goods marketed as gluten-free are often loaded up with extra fat, sugar and starch to make up for the lost gluten. Not to mention that going gluten-free is a huge hassle and you might not get invited to as many dinner parties. With all this on the table, was I crazy for avoiding wheat? My personal and somewhat stubborn answer was “no.” I knew my body best and I felt better avoiding wheat so I was sticking to my guns, no matter what anyone else told me!
While the level of scientific evidence for gluten-free diets didn’t change my personal stance, I still enjoy delving into research studies on gluten-free diets and happy to report some new studies that provide groundbreaking evidence in support of gluten-free diets for those afflicted with digestive issues. In 2011, a landmark clinical study on the use of gluten-free diets was undertaken in response to the growing group of consumers undergoing gluten-free diets2. The study investigated the effect of gluten in subjects that did NOT have celiac disease, but had irritable bowel syndrome (characterized by abdominal pain, bloating and abnormal bowel movements). The study design was randomized, placebo-controlled and double blind – so both the people facilitating the experiment and the subjects did not know if the food was gluten-free or not. The participants consumed either two slices of gluten-free bread plus one gluten-free muffin or the same baked goods which appeared identical, but had gluten added. The study found that the group consuming gluten reported increased gastrointestinal symptoms and reported more fatigue after 1 week. More recently, another larger study looked at over 900 patients with irritable bowel syndrome, finding that 30% had a sensitivity to wheat which caused gastrointestinal symptoms3.
Medical professionals now recognize this condition by the term “non-celiac gluten sensitivity (NCGS)”, which differs from both celiac disease and wheat allergy. Although NCGS was described as early as the 1980s, most health care professionals were initially skeptical of the idea and only in recent years has it gained clinical recognition4. NCGS tends to overlap with irritable bowel syndrome as both involve gastrointestinal symptoms such as abdominal pain, bloating and abnormal bowel movements. Symptoms of NCGS occur after consuming wheat or gluten-containing foods within hours to a few days. It’s generally accepted that the gastrointestinal symptoms are accompanied by neurological symptoms including feeling “foggy” headed, headaches, tiredness, disturbed sleep and mood swings5. Other symptoms often associated with the condition include dermatitis (eczema or skin rash), joint and muscle pain, anemia and depression4,5. The causes of NCGS are still not well understood, and it may actually be due to other components in the wheat such as poorly absorbed and fermented carbohydrates called fructans6. For this reason, the term “non-celiac wheat sensitivity” has been proposed as a more appropriate label5. There is still much to be learned about the condition and researchers believe that the level of understanding is “where we probably were with celiac disease forty years ago”4. It’s unclear exactly how prevalent NCGS is, but a conservative estimate is that is affects 5-10% of the population1.
Should you go gluten-free? My biggest recommendation is to listen to your body. How do you feel after you eat wheat? You may be perfectly fine and in this case there is no need to avoid wheat. If you are experiencing gastrointestinal symptoms and not feeling well, it may be time to look at removing wheat from your diet. Talk to your doctor first to get their perspective, and he/she may recommend getting testing for celiac disease to rule this out. It may be helpful to perform an elimination diet for a month to see if your symptoms improve in the absence of wheat and whether or not they return after reintroducing wheat.
If you do decide to go gluten free, try to avoid processed gluten-free foods because they often contain extra sugar and refined starch. I liked how William Davis put it in his novel Wheat Belly, “Eat gluten free without eating gluten free”. The very foods that have a “gluten-free” claim are likely processed foods that often contain extra sugar and starch. Try to replace wheat with alternative gluten free whole grains such as brown rice, and consume plenty of fruits and veggies.
In summary, the gluten-free diet appears to be more than a fad and new research findings indicate that it may improve gastrointestinal symptoms in some people without celiac disease.