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Should I Be Gluten-Free?

A woman hand picks up a Gluten Free loaf of bread.
chameleonseye via Getty Images
A woman hand picks up a Gluten Free loaf of bread.

GLUTEN-FREE (GF) IS A CATCHY FAD that has become more popular over the last few years. You've probably seen many different gluten-free options at restaurants, grocery stores and bakeries. But is it really healthier to eat gluten-free? Or is that all it is... just a fad?

If you don't have Celiac disease or a known gluten sensitivity you might be scratching your head asking,

"What's the big deal?"

As a Naturopathic Doctor it's my job to help my clients understand more about their individual health and not only help them eat healthier in general but also eat what is healthier for THEM!

Don't be confused:gluten-free does NOT mean healthy.

While everyone's physiology is constructed from the same blueprint our bodies can react differently, especially when it comes to the foods that we eat. While what's served up for dinner on your neighbor's plate might have little to no negative effect on their body, these same foods may leave you feeling sluggish, bloated, and fatigued.

It's important to understand what foods are good for you. Determining if gluten should be included in your diet is definitely something worth investigating if you're looking to understand more about your individual health.

So what is gluten anyway?

Gluten is a protein found in grains such as wheat, rye, spelt, as well as others, that when ingested by a person with a gluten reaction results in an inflammatory response which damages the intestinal lining of the gut leading to malabsorption of other nutrients (aka. Leaky Gut Syndrome) (1, 2). Not all gluten reactions in the body involve the same mechanisms however and typically we think of 4 different ways the body can react to this protein:

  1. Gluten intolerance affects people who lack the enzymes required to break down gluten proteins. Gluten intolerance is the least understood gluten condition and research is still being done to fully understand which enzymes are lacking and potential treatments that might be beneficial (12). The most common symptoms include explosive diarrhea, excessive gas, low energy and fatigue, dehydration, and/or malnutrition.
  2. Gluten sensitivity is a delayed hypersensitivity immune response (IgG) that occurs when a sensitized person repeatedly eats gluten over a short period of time (3). It has also been found that 50% of people with gluten sensitivity have genes encoding HLA-DQ2 or DQ8 molecules, while 95% of people with Celiac disease have this genetic code (12). Symptoms of a gluten sensitivity can include headaches, behavioral difficulties in children with ADHD, chronic digestive concerns (constipation, diarrhea, excessive gas, IBS, IBD), as well as skin issues, (eczema, psoriasis, dermatitis herpetiformis) (4, 5, 6, 7, 8, 9)
  3. Celiac disease is an autoimmune condition of the small intestine that includes both inflammation and damage to specialized cellular extensions known as microvilli (11). This loss of microvilli compromises the intestinal mucosal cells and allows large molecules (ie. food) to pass through the normally tightly packed cellular junctions into the blood stream where antibodies will be created to these 'foreign bodies' (11). Sometimes these 'foreign bodies' have a similar biochemical make-up to the body's cells and can cause an immune attack on your own cells, hence the name autoimmune condition.
  4. Wheat allergy creates an IgE immune reaction by the body within 2 hours of ingesting wheat, specifically to a protein called ω5-gliadin (12). Typical anaphylaxis symptoms can be seen, such as systemic inflammation, swelling of the throat and tongue leading to difficulty breathing and potential death. People with wheat allergies should carry an Epipen with them in cases of accidental ingestion and contamination. Once injected, the person should immediately go to the hospital as the dose of epinephrine from the Epipen only buys time and does not treat the anaphylaxis.

Note: There are several studies that use gluten intolerance, gluten sensitivity, gluten hypersensitivity, non-celiac gluten sensitivity (NSGS), and non-celiac gluten intolerance interchangeably. These interchangeable terms can be confusing to read, so it is important to understand if your gluten condition is a lack of enzyme production (genetic or acquired) or a hyper-responsiveness via immunoglobulin G (IgG) (12).

How do I know if I have a problem digesting gluten?

The Hypo-Allergenic Diet (also known as the elimination diet or Oligoantigenic diet) is a great tool that I use with my patients to test for all food sensitivities, including gluten. It involves the avoidance of the foods and ingredients that most commonly cause people inflammation and digestive issues, including:

  1. Wheat
  2. Dairy
  3. Corn
  4. Soy
  5. Eggs

I completed my first hypo-allergenic diet in my 3rd year of medical school. It was challenging but insightful. Never in a million years would I have guessed I have a major food sensitivity to SOY.

Being Chinese, my family is used to eating a lot of soy products: soya sauce, tofu, fermented bean curd, edamame, miso, soy nuts, and soy milk. I knew that I was sensitive to cow dairy and when I switched from cow milk to soy milk I was still experiencing bloating, gas, stomach pains, and fatigue. It seems obvious looking back now, but at the time I never imagined someone with a Chinese background could have difficulties ingesting soy.

One of the biggest things I remind my clients when it comes to the hypoallergenic is that IT IS NOT A DIET TO LOSE WEIGHT. It should be viewed more as a food sensitivity TEST.

Note that some of the foods commonly eliminated are very nutritious, so if you are not sensitive to the food, bring them back into your diet (ie. eggs).

And remember, many gluten-free foods may not be healthy. Just because they remove those ingredients does not mean they haven't replaced them with other poorer quality ingredients.

Try and stay away from packaged, canned, processed and deep fried foods. And be cautious of dehydrated and dried foods for they often contain added sugars and preservatives. Raw and fresh is often your best bet for optimal health.

Where else is gluten found?

Although usually found in grains, gluten is also used as a "filler" in many processed foods, seasonings, flavorings and products, such as:

  • Ales, beer
  • brown rice syrup
  • candies
  • deli meats
  • broths
  • sauces
  • cooking oils
  • milk alternatives
  • imitation meats
  • marinades
  • lipsticks
  • balms

Malt, a popular substance used in candies and beverages has gluten. Caramel colouring and caramel also contain gluten. Wheat flour (glutinous) is found in many things from soy sauce and soups to condiments such as mustard, so reading labels is very important.

Supplements also may contain gluten as fillers or in the coating of their capsules, which is why it's important to read all medicinal and non-medicinal labels carefully or consult with your Naturopathic Doctor about what supplements you should take.

What are gluten-free foods?

The following types of flours are gluten-free:

Organic versions of soy sauce and soups (easily found in the grocery store) are usually gluten-free (but read your labels) and be cautious of wheat additives in soya sauce.

Where can I find gluten-free products?

Since gluten sensitivity and Celiac disease are more recognized than they used to be it is much easier to find gluten-free products. Yes, health food stores have the best variety in products, but they can be expensive.

  • Gluten-free options can be found in the health food aisle or in the frozen food section (as many of the products are frozen) of any supermarket.
  • Bob's Red Mill products carry every type of gluten-free flour and baking mix, and can be found in the baked goods aisle (with flour and sugar) of most supermarkets.
  • Bulk food stores also sell gluten-free flours, baked good mixes, pancake mixes and even powered soup mixes.

But remember, just because something is gluten-free, doesn't mean it is healthy. These two terms are not synonymous. Many gluten-free products substitute with other products that may not agree with your digestive system (ie. egg, dairy, soy, corn, potato) or be supportive to your health.

While it might be common knowledge that eating a salad is probably healthier than a chocolate bar, sometimes it's not so easy to know what foods are healthy for you. While that multigrain bagel or muffin may look appetizing it might be the last thing your body needs if you have difficulty digesting gluten and knowing if your body is reacting to this protein may help shed some light on why that extra plate of spaghetti had you feeling the post-dinner bloat. Gluten-free might not be for everyone, but it just might be for you.

To get your free comprehensive Hypo-Allergenic eManual including dietary guidelines, recipes for a 7-day meal plan, shopping lists, and food re-introduction schedule, check out my website for more information.

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