By Dr. Mercola
In recent years, the benefits of a gluten-free diet have become widely recognized and, according to recent research, people are embracing gluten-free in ever-growing numbers, even though the number of Americans diagnosed with celiac disease has not increased since 2009.1,2,3,4
In 2009, an estimated 0.5 percent of Americans were on a gluten-free diet. By 2014, that number had more than tripled, to 1.69 percent. Meanwhile, the number of people diagnosed with celiac disease remained fairly steady, declining only slightly, from 0.7 percent to 0.58 percent.
Gluten-free diets are particularly popular among Caucasian women and younger adults between the ages of 20 and 39 — many of whom do it simply because it makes them feel better.
It's well worth noting though that while gluten-free has many advantages, just because a food is gluten-free does not automatically make it healthy. There are plenty of gluten-free junk foods out there.
Just because a food is gluten free doesn't make it a health food, just as a food sold at Whole Foods does not make it a health food. There are plenty of lousy fake foods in both categories.
For most people, drastically cutting down on your net carbs (total carbs minus fiber) is the key to optimal health. This includes but is not limited to grains (not just wheat, as all grains will spike your insulin levels and contribute to insulin and leptin resistance).
Doing this will help your body burn fat rather than carbs as its primary fuel, which helps optimize your mitochondrial function and boost weight loss.
Is Going Gluten-Free a Pointless Fad?
Some doctors dismiss gluten-free as a mere fad,5 fueled by celebrity endorsements and an increasing number of books linking wheat and gluten to a wide range of health problems, from gut dysfunction and allergies to neurological diseases and autoimmune problems.
This includes The New York Times Best Seller, "Grain Brain: The Surprising Truth About Wheat, Carbs, and Sugar; Your Brain's Silent Killer," written by Dr. David Perlmutter, a neurologist, in which he reveals how processed grains contribute to dementia.
My own book on this subject, "The No-Grain Diet," was published in 2003. While still in medical practice, I recommended eliminating gluten as a first line intervention before I would further fine-tune a patient's diet to address their specific health problems.
As the title of my now 13-year-old book indicates, I believe most everyone would benefit from avoiding all grains, not just gluten, as doing so well help you burn fat much better. Plus, healthy fat is a far cleaner and more efficient fuel for your body.
Despite the prevailing skepticism, studies are now confirming that many people do indeed experience adverse reactions to gluten even if they test negative for celiac disease. This suggests gluten-sensitivity is a real problem,6 and that gluten-free diets may benefit many — not just those with celiac.
Celica Disease Versus Wheat Allergy and Gluten-Intolerance
Celiac disease is an autoimmune disorder. People with celiac suffer severe gastrointestinal (GI) reactions and malabsorption of nutrients in response to gluten found in wheat and other grains, and a strict 100 percent gluten-free diet is critical for these people.
Celiac disease is typically diagnosed by measuring the presence of autoantibodies such as transglutaminase 2 (TG2), which is thought to be the most sensitive marker for celiac.
Many others have wheat allergy or some level of gluten intolerance or sensitivity, and fare better on a gluten-free diet even if they don't have celiac disease. If you're allergic to wheat, consuming it will result in an immune reaction that can be diagnosed by measuring antibodies called IgE and/or other immune system markers.
Food intolerances, on the other hand, are typically related to a lack of a specific enzyme to break down the food in question. Food intolerances tend to generate fewer symptoms that are slower in onset, and can therefore be more difficult to diagnose.
Diarrhea or constipation, bloating, headache, anxiety and fatigue are common symptoms of a food intolerance, but may not appear until hours or even days afterward. Gluten sensitivity IS real though, researchers say, and may affect up to 6 percent of the population.
Gluten Sensitivity Is Real
As reported by WebMD:7
"Some people suffer changes within their bodies after eating gluten that are separate and distinct from those that accompany either celiac disease or wheat allergy …
'We don't know what is triggering this response, but this study is the first to show that there are clear biological changes in these individuals,' said senior researcher Armin Alaedini [Ph.D.] … an assistant professor of medicine at Columbia University in New York City.
'Based on our findings, we hope there would be greater recognition of this condition. This is a real condition. There are individuals who may not have celiac disease or wheat allergy, but still have a sensitivity to wheat,' Alaedini said."
The study, published in the journal Gut, found that:8,9
"Individuals with wheat sensitivity had significantly increased serum levels of soluble CD14 and lipopolysaccharide (LPS)-binding protein, as well as antibody reactivity to bacterial LPS and flagellin.
Circulating levels of … a marker of intestinal epithelial cell damage, were significantly elevated in the affected individuals and correlated with the immune responses to microbial products …
These findings reveal a state of systemic immune activation in conjunction with a compromised intestinal epithelium affecting a subset of individuals who experience sensitivity to wheat in the absence of [celiac] disease."
In short, people who reacted to gluten despite not having celiac disease were found to have leaky gut, which is likely what caused the immune activation.
CD14 and LPS-binding protein are microbial markers, so elevated levels suggest microorganisms from the gut are leaking into the blood stream. The presence of microbes in the blood is what causes your immune system to ramp up an inflammatory response.
Gluten Sensitivity and FODMAP Reactions
While wheat allergy is a reaction to certain proteins in the wheat, non-celiac gluten sensitivity or gluten intolerance can be related either to a reaction to the proteins, or to poor absorption of carbohydrates called fermentable oligo-di-mono-saccharides and polyols (FODMAPs).10
FODMAPs (which include fructose, lactose, galactans and polyols) are sugars that are either poorly absorbed in your small intestine or completely indigestible. They can cause symptoms very similar to those of gluten sensitivity, and FODMAPs are often found in things that contain gluten, making the two problems a bit tricky to separate.
While FODMAPs are typically beneficial for your gut microbes, in those who are sensitive to them, such as those with irritable bowel syndrome (IBS), FODMAPs can cause severe GI distress, and many who are diagnosed with IBS are urged to follow a low-FODMAP diet to manage their condition.
Gluten Sensitivity May Affect a Majority of People
Gluten is a protein made up of glutenin and gliadin molecules, which in the presence of water form an elastic bond. Gluten can be found in grains other than wheat, including rye, barley, oats and spelt.
Gluten can also hide in processed foods under a variety of names, including but not limited to11 malts, starches, hydrolyzed vegetable protein (HVP), texturized vegetable protein (TVP) and natural flavoring.
If you do a search of the U.S. National Library of Medicine, you will find that gluten-containing grains have been linked to dozens of adverse health effects12 and adverse modes of toxicity. Topping this list is neurotoxicity, and in his book, "Grain Brain," Perlmutter specifically looked at the neurological impact of gluten (wheat) and casein (dairy) on both our brain and autoimmune diseases. He also believes gluten sensitivity may be involved in most chronic diseases, because of how gluten affects your immune system.
According to Dr. Alessio Fasano, director for Celiac Research and the chief of pediatric gastroenterology and nutrition at Massachusetts General Hospital, gluten sensitivity may be far more prevalent than previously suspected.13 He estimates virtually all of us are affected to some degree, because we all create something called zonulin in the intestine in response to gluten.
This protein, found in wheat, barley and rye, makes your gut more permeable, which allows proteins to get into your bloodstream. This sensitizes your immune system and promotes inflammation and autoimmunity. In the press release announcing the publication of his new book, "Gluten Freedom," Fasano said:14
"We've shown now that gluten sensitivity actually exists. It's moved from a nebulous condition that many physicians dismissed to a distinctly identifiable condition that's quite different than celiac disease. Gluten sensitivity affects six to seven times more people than celiac disease."
How Wheat Affects Your Health
Wheat is one of the most widely grown crops in the Western world. But the wheat of today is vastly different from the wheat our ancestors grew and ate, and these differences help explain the rise in gluten intolerance:
• Hybridization has increased the proportion of gluten protein in wheat. Until the 19th century, wheat was also typically mixed with other grains, beans and nuts; pure wheat flour has been milled into refined white flour only during the last 200 years. The resulting high-gluten, refined grain diet most of you have eaten since infancy was simply not part of the diet of previous generations.
• Glyphosate contamination may also play a distinct role in the development of celiac disease, wheat allergies and wheat sensitivity. The use of glyphosate, the active ingredient in the broad-spectrum herbicide Roundup, has dramatically risen over the past 15 years.
According to Stephanie Seneff, Ph.D., a research professor at the Massachusetts Institute of Technology (MIT), glyphosate use on genetically engineered (GE) corn, soy and conventional wheat is strongly correlated with the rise in celiac disease.
Her initial findings were published in the journal Entropy15 in 2013, which was followed by a second paper16 linking glyphosate to celiac disease specifically. Glyphosate destroys the villi in your gut, which reduces your ability to absorb vitamins and minerals. Also, wheat contains gliadin, which is difficult to break down.
Normally, a reaction takes place that builds connections between different proteins in the wheat, but glyphosate gets right in the middle of that process, resulting in wheat that is highly indigestible. The end result is gut dysbiosis, (a condition of microbial imbalance in your intestines that can lead to gut inflammation and leaky gut) and an overgrowth of pathogens.
Additionally, your gut produces serotonin in response to tryptophan. Wheat is a good source of tryptophan, but when the wheat is contaminated with glyphosate, your gut cells go into overdrive and begin producing too much serotonin, which in turn produces many of the common symptoms of celiac disease, such as diarrhea.
• Wheat proteins can cause leaky gut and associated health problems. Glutinous proteins called prolamines increase the permeability of your intestinal tract, thereby sensitizing your immune system.
As gaps develop between the cells that make up the lining of your intestines, undigested food, bacteria and metabolic waste products can leak into your blood stream, hence the term "leaky gut." These foreign substances challenge your immune system and increase inflammation in your body.17
Gluten can also contribute to health problems you might not immediately associate with gut dysfunction, such as acne,18,19,20 atopic dermatitis,21 recurrent aphthous stomatitis (RAS — a type of mouth sore)22 and vitiligo, a skin condition that results in the loss of pigment.23
Gliadins Are Responsible for Many Adverse Health Effects
Two of the substances found in wheat responsible for many of the associated cellular problems you face are gliadin and lectins. Gliadin is the primary immunotoxic protein found in gluten and is among the most damaging. In celiac disease, gliadin triggers a genetically mediated immune process that ultimately causes an inflammatory reaction that results in the destruction of the intestinal villi.
Gliadin gives wheat bread its doughy texture and is capable of increasing the production of the intestinal protein zonulin, which in turn opens up gaps in the normally tight junctures between intestinal cells (enterocytes).
Elevated gliadin antibody levels have been linked to psychiatric disorders such as schizophrenia. In one such study,24 the blood work of 950 schizophrenics was compared to that of 1,000 healthy controls. The odds ratio of having anti-gliadin IgG antibodies was 2.13 times higher in schizophrenics. The discovery of antibodies to gliadin in the blood of both celiac disease patients and schizophrenics implies that undigested gliadin can act as antigens, provoking an antibody-mediated immune response.
The presence of gliadin in the blood also indicates intestinal permeability, and gliadin has been shown to up-regulate zonulin in the gut regardless of whether the person has celiac disease or not.
Gliadin may also provoke your immune system to attack your nervous system, thereby contributing to neurological problems such as neuropathy, seizures and neurobehavioral changes.25 Besides schizophrenia, gliadin may also play a role in autism. A 2004 study found that autistic children tend to have elevated antibodies against gliadin.26
Many children with attention deficit/hyperactivity disorder (ADHD) also do not respond well to most grains, especially wheat. The psychological and behavioral symptoms of ADHD are similar enough to those of celiac disease and gluten sensitivity that researchers suggest celiac disease should be included in the ADHD symptom checklist.
This suggestion was prompted by a 2011 study,27 which found people with ADHD who tested positive for celiac disease improved significantly after following a gluten-free diet for six months.
Psoriasis has also been linked to gliadin. In a study published in the British Journal of Dermatology, participants with psoriasis who tested positive for antibodies to gliadin improved when they were placed on a gluten free diet.28 The National Psoriasis Foundation also recommends those with celiac disease or a gluten sensitivity adhere to a gluten-free diet to reduce or eliminate their symptoms.29
How Lectins Affect Your Health
Lectins are a key mechanism plants use to protect themselves and perpetuate the plant species. They are found in highest concentration in their seed form, and are known to cause digestive irritation. Lectins can withstand degradation through a wide range of pH and temperatures, so neither sprouting, fermenting nor cooking will negate its ill effects.
Wheat germ agglutinin (WGA), which is not eliminated through sprouting and found in higher concentrations in whole wheat, is particularly tough, as it's formed by the same disulfide bonds that give strength and resilience to human hair. Because lectins are so hard to digest, they can bioaccumulate in your body and interfere with biological processes. WGA is particularly troublesome, and studies have shown it has a number of health-harming characteristics and activities, including the following:
✓ Pro-inflammatory: WGA stimulates the synthesis of pro-inflammatory chemical messengers (cytokines) in intestinal and immune cells, and has been shown to play a causative role in chronic gut inflammation.30
✓ Immunotoxicity: WGA induces thymus atrophy in rats,31 and anti-WGA antibodies in human blood have been shown to cross-react with other proteins, indicating that they may contribute to autoimmunity.32
✓ Neurotoxicity: WGA can cross your blood-brain barrier33 through a process called "adsorptive endocytosis," pulling other substances with it.
WGA may attach to your myelin sheath34 and is capable of inhibiting nerve growth factor,35 which is important for the growth, maintenance and survival of certain target neurons.
✓ Excitotoxicity: Wheat, dairy and soy contain exceptionally high levels of glutamic and aspartic acid, which makes them all potentially excitotoxic.
Excitotoxicity is a pathological process where glutamic and aspartic acid cause an over-activation of your nerve cell receptors, which can lead to calcium-induced nerve and brain injury.
These two amino acids may contribute to neurodegenerative conditions such as multiple sclerosis, Alzheimer's, Huntington's disease and other nervous system disorders such as epilepsy, ADD/ADHD and migraines.
✓ Cytotoxicity: WGA has been demonstrated to be cytotoxic to both normal and cancerous cell lines, capable of inducing either cell cycle arrest or programmed cell death (apoptosis).36
✓ Endocrine disruption: WGA may contribute to weight gain, insulin resistance and leptin resistance by blocking the leptin receptor in your hypothalamus.
✓ Cardiotoxicity: WGA has a potent, disruptive effect on platelet endothelial cell adhesion molecule-1, which plays a key role in tissue regeneration and safely removing neutrophils from your blood vessels.37
✓ Adversely effects gastrointestinal function by causing increased shedding of the intestinal brush border membrane, reducing the surface area and accelerating cell loss and shortening of villi.
It also causes cytoskeleton degradation in intestinal cells, contributing to cell death and increased turnover, and decreases levels of heat shock proteins in gut epithelial cells, leaving them more vulnerable to damage.38
How to Treat Gluten Intolerance and Celiac Disease
The treatment for celiac disease and gluten intolerance is a gluten-free diet, which means abstaining from any food that contains gluten. In August 2013, the U.S. Food and Drug Administration (FDA) issued a standard for gluten-free labeling. According to the rule, in order for a food to bear the label "gluten-free" it must be:
- Naturally gluten-free. Naturally gluten-free grains include rice, corn, quinoa, sorghum, flax and amaranth seed.
- Any gluten-containing grains must have been refined in such a way to remove the gluten. The final product may not contain more than 20 parts per million (ppm) of gluten.
A blood test can verify whether or not you actually have celiac disease. If you do, you'll need to be extremely vigilant, as exposure to gluten could make you severely ill and threaten your long-term health and longevity. If you're gluten intolerant, you do not need to be as strict with your diet and you may eventually discover your own tolerance level to gluten.
For example, one piece of bread may not result in any discomfort, but two pieces, or bread two days in a row, might. Typically, avoiding gluten for a week or two is enough to see significant improvement. Considering the many potential culprits at play, be it wheat hybridization, gluten, other wheat proteins, FODMAPs or glyphosate contamination, it's not surprising that wheat and other grains cause such problems for so many.
In my experience, nearly everyone benefits from avoiding grains, even whole sprouted grains, whether you have a gluten intolerance or not, and that's because grains have high net carbs and avoiding them will help improve your mitochondrial function. Impairing mitochondrial function can exacerbate health problems related to insulin resistance, such as overweight, high blood pressure, type 2 diabetes and more serious problems like heart disease and cancer.