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Marcelle Pick, OB-GYN N.P. Headshot

Is Going Gluten-Free the Next Fad Diet?

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I never thought I'd see the day that Betty Crocker came out with a gluten-free brownie mix. I'm astounded at the amount of gluten-free advertising out there -- Subway, Pizzeria Uno, Boston Market, Chili's, P.F. Chang's, Ruby Tuesday, King Arthur Flour, the list goes on and on. And it isn't that these huge corporations are suddenly becoming more concerned with food allergies.There's big money in going gluten-free, because more and more Americans are discovering they have a sensitivity to it.

It may seem like a fad, but I've been taking patients off of gluten for years, and I honestly can't think of anything in my practice that makes as dramatic a difference in health and wellness as following a gluten-free diet.

What at first seemed to cause digestive disturbance has turned out to be a body-wide toxin in many people (though, of course, plenty of people can still tolerate gluten just fine without any problems). Symptoms like mental fogginess, tingling in the extremities, fatigue and minor digestive symptoms can go unnoticed for years. Yet on a larger scale, gluten can affect our joints, thyroid, brain, heart and bones. [1] It's even affecting the way our children learn, behave and interact in the world. [2] I never dreamed how many people could feel better by simply removing one thing from their diet! And it makes me wonder, how the heck did we get here?

Celiac disease has been around for thousands of years, but research is now showing us that gluten sensitivity is a distinct and very real diagnosis, separate from celiac. It's estimated that 6 percent of our population has a sensitivity to gluten. That's about 18 million people. [3] But from what I see, I believe this number is a lot higher.

If you're serious about your health and curious about the effects of gluten, I urge you to try a gluten-free diet for one month (you can do anything for a month!) and pay attention to how you feel. I'm willing to bet you'll see a difference.

Here's What We Know

We've known that celiac disease leads to serious GI symptoms and eventual health issues like infertility, neurological disorders and even cancer.[4] Inflammatory and autoimmune disorders, such as Type 1 diabetes, thyroid disease, osteoporosis and rheumatoid arthritis, are 10 times more likely in celiac patients than in the general population. [5]

But what about people experiencing symptoms who don't show positive markers for celiac?

As I mentioned, we are now learning that celiac and gluten sensitivity are likely two separate entities with potential overlap. A recent study out of the University of Maryland Medical School showed us that the characteristic intestinal permeability present with celiac disease is generally not present with gluten sensitivity, and that many of the markers or signs in the small intestine that show up in celiac are not the same in patients with gluten sensitivity. [6] This can make it even more difficult to diagnose gluten-sensitive patients.

The common symptoms of gluten sensitivity actually occur primarily outside the gut: low energy, brain fog, skin rashes, numbness in the extremities, fibromyalgia, abdominal pain, headaches, muscle and joint pain, as well as problems with coordination.

Dr. David Perlmutter, neurologist and author of "The Better Brain Book," wrote a great blog on gluten and the brain, which outlines the case study of a 9-year-old girl with memory and learning problems. Once he tested her for gluten sensitivity and had her parents try a gluten-free diet, she improved by leaps and bounds. This story is becoming more and more familiar as I talk with people in the functional medicine world.

How Did We Get Here?

I've often wondered why we are seeing such an increased number of patients with gluten sensitivity in recent years. After all, bread has been a staple for millennia. I have several theories, but I haven't hung my hat on any single one. It's probably more like a combination of factors. First of all, in a matter of decades we've gone from varied wheat crops grown and stored in small batches to just two species of wheat grown and stored in huge quantities and sprayed with pesticides.

We also consume much more wheat than we did 100 years ago, and when the body sees too much of the same food, it is more apt to develop sensitivities or allergies to it. We evolved to eat a richly varied diet. Our genetics simply haven't caught up to a modern American diet that includes large quantities of wheat, dairy, soy and corn.

Another thought has to do with our current environment. We're living in a much more toxic world than ever before, and this does not go unnoticed in the body. Our bodies are working overtime to cleanse us of pollutants in the air and water, pesticide-covered vegetables, plastics and other stressors. In an environment of stress, the body is much more likely to react negatively to foods like wheat, soy, dairy or corn.

When I stopped eating gluten 10 years ago, I had no idea how big the gluten story would become. For more information, read my article on gluten and why we're so sensitive to it. You also might like to take a look at gluten sensitivity and celiac specialist, Dr. Thomas O'Bryan's website. He's made a career of researching and speaking about gluten and its effects in our bodies.

Life Without Gluten is Still Delicious!

The gluten-free market is big, and it won't be long before the pharmaceutical industry finds a way to tap into it. Don't wait for a drug to mask your gluten sensitivity symptoms: Going gluten-free can lighten your body's overall toxic load. It isn't a fad like the low-fat or low-carb craze. Many people don't have problems with gluten; however, for those of us who do, I'm afraid our issues with gluten are here to stay.

But a gluten-free diet is just as satisfying and delicious as your normal diet. The choices these days are endless! I've noticed when I'm eating out that more and more restaurants are offering gluten-free options. Be mindful of the ingredients in gluten-free alternatives and choose products made with whole grains like buckwheat, millet, quinoa and brown rice.

Carol Fenster has a great cookbook called "1000 Gluten-free Recipes," and she has everything under the sun in there. I offer loads more gluten-free resources in my article on gluten intolerance and celiac disease.

My advice to every person I see at the clinic is to eat a variety of foods. Don't eat the same things every day. I know that it takes more thought and perhaps more work, but your health will benefit from a variety of fruits, vegetables, seeds, nuts, high quality meats, fish and whole grains. With gluten off your shopping list, I grant you the opportunity to experience all the healthy, delicious alternatives out there.

References:

[1] Vojdani, A, et al. 2008. The immunology of gluten sensitivity beyond the intestinal tract. European Journal of Inflammation, 6(2). URL: http://www.thedr.com/images/immunologyofgs-2.pdf.

[2] Zelnik, N, et al. 2004. Range of neurological disorders in patients with celiac disease. Pediatrics, 113(6), 1672-1676. URL: http://pediatrics.aappublications.org/content/113/6/1672.full.pdf+html.

[3] Center for Celiac Research. 2011. University of Maryland School of Medicine researchers identify key pathogenic differences between celiac disease and gluten sensitivity. URL: http://somvweb.som.umaryland.edu/absolutenm/templates/?a=1474

[4] Center for Celiac Research. 2011. University of Maryland School of Medicine researchers identify key pathogenic differences between celiac disease and gluten sensitivity. URL: http://somvweb.som.umaryland.edu/absolutenm/templates/?a=1474

[5] Helms, S. 2005. Celiac disease and gluten-associated diseases. Alt. Med. Rev., 10(3), 172-192. URL: http://www.thorne.com/media/Celiac.pdf

[6] Sapone, A, et al. 2011. Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity. BMC Medicine, 9 (23). URL: http://www.biomedcentral.com/1741-7015/9/23/abstract.

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