Gluten and your gut

If you or any of your family members are suffering from inexplicable health issues that are not getting better through medical protocols, I suggest you read this article.

It might or might not be an answer to your problems but either way it contains information that, in my opinion, everyone should know about.

Gluten sensitivity is a subject close to my heart.  In 2004, after suffering from symptoms ranging from fatigue to skin allergies and digestive problems, I was diagnosed by my medical practitioner with intestinal permeability caused by the consumption of gluten.

“I am Dutch!” was my first reaction. “I grew up on bread!”. How was it possible that the very foundation of my diet was causing these health problems? And I was eating wholegrain wheat instead of the unhealthy refined white flour products! Despite my disbelief, I adopted a gluten free diet and “miraculously” healed my digestive system as well as all the other lingering health issues I was suffering from.

In the past 9 years global awareness has increased, especially with respect to Celiac Disease which is the most severe level of gluten intolerance. What many people don’t fully understand is that Celiac Disease is only the tip of the iceberg. For every Celiac patient there are many more people that suffer from lower levels of gluten sensitivity which stay undiagnosed. Adding to the problem is the fact that symptoms are not limited to digestive issues and can show up in countless different ways.

Why is this happening? What has changed in the wheat that we eat that is leading to this rise in numbers? How can you find out if you suffer from gluten sensitivity and most importantly: what can you do about it? In this article I will try to answer, to the best of my ability, all these questions and more.

First, some background information on grains and anti-nutrients

If you consider human evolution grains are a relatively “recent” addition to our diets. They were added approximately 10,000 years ago when the shift happened from a hunter-gatherer lifestyle to an agricultural lifestyle.

From a dietary point of view grains provide us with all the major nutrient groups that our bodies need: carbohydrates, protein, fats, vitamins, minerals, and fibre. It is therefore not difficult to understand that grains have been an important and popular dietary component. There are however a few potential problems associated with grain consumption:

• Anti-nutrients

The inherent purpose of a grain is to find fertile soil, germinate and grow into a new plant. To ensure that this happens and to protect themselves against predators (which include human beings), grains contain certain toxic compounds that interfere with digestion. The most well known example of this is gluten, a toxin found in wheat (as well as some other grains) that damages the lining of our digestive track, leading to a compromised digestive system that can be the underlying cause of many different health problems.

It is possible to reduce the anti-nutrients in grains to a certain extent. Cultures all around the world that eat traditional diets have successfully included whole grains by adopting specific cooking techniques to make them more easily digestible, such as soaking, sprouting and fermenting.

Too much of a good thing?

Today grains, mostly in the form of wheat, make up a huge portion of our diets: wheat cereals for breakfast, sandwiches for lunch, pasta, bread with dinner and biscuits and crackers in between. To give an example of the problems this can cause, let’s have a look at gluten.

Once gluten enters our bodies, it is broken down by digestive enzymes into peptides, which are too large to be absorbed through the small intestine. To allow these peptides to enter into the bloodstream, the wall of the intestine has to separate. Once let through, these peptides trigger an immune response. In a normal, healthy situation the immune system takes care of the invader, the wall of the intestine closes back up and the body is ready to go on with its regular business.

Just imagine what happens if there is a non-stop supply of gluten coming into our digestive track? Continuous fire in the belly, so to say, which leads to inflammation in the gut, an out-of-control immune system, and eventually different kinds of health problems. And it doesn’t help that most of us already have an impaired immune system as well as a compromised digestive system due to stress, poor diet and over use of antibiotics.

Modern wheat

The wheat we eat today is very different from the wheat that was grown many years ago. Through genetic modification scientists have been able to cultivate higher-yielding crops that have lower mineral content, higher gluten content and a different kind of gluten protein which a majority of people with Celiac disease react negatively to.  Furthermore, wheat is prepared very differently now. During his studies of traditional diets in the 1930s Dr Weston Price came upon a number of cultures that thrived on wheat but used special preparation methods that included stone-grinding and fermentation. Today, most wheat products are mass produced in factories, made of refined white flour with fast rising yeasts instead of a slow fermentation processes.

All of the above factors are likely to be major contributors to the rise in gluten and wheat allergies world over. We have an “impending epidemic”, a quadrupling of people with Celiac Disease in the last 50 years, and fast growing numbers of people suffering from different levels of gluten or wheat sensitivities. Let’s have a look at what can happen if you are one of those people.

Celiac Disease

The most severe form of gluten intolerance is Celiac Disease (CD), an auto-immune disease that causes the immune system to attack the body’s own tissues. It causes intestinal atrophy, which is a wearing down of the intestinal lining (more specifically the “villi”) thereby seriously interfering with nutrient absorption. Celiac Disease can cause all kinds of other auto-immune diseases of which thyroid auto-immune disease is the most common.

Symptoms of Celiac Disease are of many different kinds. The first symptom that one would think of would be gastrointestinal related but research shows that for every CD patient with gastrointestinal symptoms, there are 8 others who have their symptoms somewhere else:

• Neurological (fatigue, insomnia, sleep disorders, brain fog, depression, headaches, anxiety, irritability, neuropathy etc.)
• Reproductive health issues
• Skin problems (eczema, acne, etc)
• Bone and joint issues (osteoporosis, arthritis, joint pain, bone pain, fibromyalgia etc.)
• Dental problems
• Other chronic diseases including diabetes and cancer

Gluten sensitivity

People who are gluten sensitive cannot tolerate gluten and may develop symptoms similar to those in Celiac Disease. They do not, however, have flattened villi or the permanent “leaky gut” intestinal permeability in the intestinal walls. Their intestinal permeability is transient and milder and sometimes non-existent.

Their immune reaction is also different in the sense that it activates the innate immunity as opposed to the adaptive immunity as is the case in CD patients. The latter is a more sophisticated response where specific cells are developed that fight foreign bodies and can mistakenly attack the body’s own tissues.

As with Celiac Disease symptoms are not limited to gastrointestinal issues but can also show up in the form of skin conditions, headaches, foggy brain, fatigue, depression, joint pains, etc. According to Dr William Davis who wrote the book “Wheat Belly”: “When in doubt, suspect wheat.”

How do you find out if you have a problem with gluten?

There are tests that can be done to determine if you have Celiac Disease. Doctors will normally prescribe a blood test and if this comes back positive a biopsy can be done to further determine the extent of intestinal atrophy. However, if the intestinal lining is only partially worn down, the blood tests may come back negative. According to experts this happens 7 out of 10 times.

Testing for gluten sensitivity is even more difficult. There are only a handful of labs that have been able to develop a comprehensive panel of blood tests that can accurately diagnose more people. (Cyrex Labs)

The most foolproof method is to go on a gluten elimination diet: remove all gluten-containing foods for a period of 30 days and then reintroduce it and see how you feel. If you have gluten sensitivity you should experience an immediate and heightened reaction at that stage. Lab testing for Celiac Disease should be done before you start an elimination diet as the test will not work if you are not consuming gluten.

How do you deal with gluten sensitivity?

If you have determined that you are sensitive to gluten, you will need to take the following steps:

1. Remove all gluten containing foods from your diet. This includes:

• Wheat, barley, rye, spelt and triticale and products made from these grains
• All processed foods that likely contain gluten in the form of hydrolysed protein, starch/modified starch, malt, binders and natural flavourings
• Foods that may have been contaminated during the manufacturing process such as oats

As this may involve a complete diet makeover it is advisable to work with a healthcare professional.

2. Heal your gut

According to Dr Thomas O’Bryan, an internationally recognised speaker and workshop leader specialising in Gluten Sensitivity and Celiac Disease, “there is nothing more important than having a healthy gut.”

To heal your digestive system you may need to eliminate not only all gluten containing products but, depending on the severity of the problem perhaps also other foods that can interfere with the gut healing process such as other whole grains, dairy, soy, corn and coffee.

Introducing good gut flora through high quality pro-biotic supplements and/or fermented foods as well as prebiotic rich foods is another important step to take.

Stress affects the body’s immune system so managing stress levels is a critical aspect as well.

3. Clean up your diet

Adopt a diet that contains a variety of whole foods, seasonal and local fruits and vegetables, high quality fats, no sugar and eat with awareness and appreciation.

I personally think that one of the best things that happened to me was my gluten sensitivity diagnosis. I was lucky to be working with an “enlightened” alternative medicine practitioner at the time who guided me through the initial stages of living with gluten sensitivity. In order to get well I had to remove much-loved foods from my diet and become more aware of the important connection between diet and health. It forced me to look at everything I put into my mouth and as a result I now feel better than ever. I have healed and repaired my digestion to a point where I can even occasionally enjoy food that has gluten without an issue.

Gluten sensitivity might not be your issue but knowing about it will hopefully increase your awareness level and help you make better choices for yourself and your family that will benefit you tremendously in the long run.

Monique Jhingon is a Functional Nutrition & Lifestyle Practitioner who offers select private coaching to Thailand expats whose health and digestion has been compromised as a result of transitioning into new environments, cultures, climates and foods.

You can read more on her website and sign up for a free Nutrition Breakthrough Session here: www.moniquejhingon.com