This article is shared with permission from our friends at dralisonchen.com.
Gluten-free (GF) is a catchy fad that has become more popular over the last year or so. You’ve probably seen expensive gluten-free options at restaurants, grocery stores and bakeries. But is that all it is? Is it just a fad?
If you don’t have Celiac disease or a known gluten sensitivity you may be scratching your head asking,
“What’s the big deal?”
What is Gluten?
Gluten is a protein found in grains such as:
- Possibly oats (due to cross-contamination)
Gluten intolerance vs. sensitivity
Gluten intolerance affects people who lack the enzymes required to break down the gluten protein, such as kumamolisin-As. Research is still being done to fully understand which enzymes are lacking and potential treatments.
The most common symptoms are:
- Explosive diarrhea
- Excessive gas
- Low energy
Dehydration, and/or malnutrition.
If ingested by a person with a gluten sensitivity or intolerance, it results in an inflammatory response which damages the intestinal lining of the gut leading to malabsorption of other nutrients (aka. Leaky Gut Syndrome- see more below).
Gluten sensitivity is a delayed hypersensitivity immune response (IgG) occurs when a sensitized person repeatedly eats gluten over a short period of time. The effects progress more gradually and are non-specific and often dose-dependent.
Symptoms can vary from:
- Cognitive ‘brain fog’,
- Behavioural difficulties in children with ADHD, to chronic digestive concerns (constipation, diarrhea, excessive gas, IBS, IBD),
- Skin issues (acne, eczema, atopic dermatitis)
- Low energy
- Weight gain
- Water retention
- Joint pain.
Testing for gluten sensitivities measures for an immune system antibody called IgG.
- In vivo (in/on the body) – muscle testing or energetic tests
- In vitro (in a lab) – IgG blood sample with finger prick
Muscle testing, applied kinesiology, and energetic tests are controversial. The idea is that the patient holds a vial of a food antigen and the body will weaken in strength if there is a sensitivity. Physical strength is manually tested by the practitioner, which offers a level of bias (conscious and unconscious). There are also various energetic tests that measure a person’s response to the potential food trigger, gluten.
I also have issues with the current IgG tests and often find them to be unreliable. I know colleagues who have sent in multiple tests of the same blood sample to different lab companies and even the same labs with varying results. Some patients have even shown to be highly sensitive to foods they have never eaten before.
Until IgG tests become more accurate and reproducible, I still prefer taking a more practical approach to identifying potential food sensitivities with the hypo-allergenic diet (we’ll take a closer look at this test later in the article).
Celiac disease varies from a gluten sensitivity like an anaphylactic bee sting to a mild mosquito bite. To diagnoses celiac disease, a combination the following tests are commonly performed:
- Anti-tissue transglutaminase (tTG- IgA)
- Anti-endomysial antibody (EMA- IgA)
- Anti-gliadin antibody (AGA- IgA)
- Deamidated gliadin peptide antibody (DGP- IgA)
- with a possible endoscopic biopsy of injured tissues
Celiac disease is an autoimmune condition of the small intestine. In celiac disease, there is both an inflammatory conditions and a loss of microvilli in a portion of the small intestine.
The loss of microvilli disrupts the mucosal cells and allows large molecules (ie. food) to pass through the tightly packed cells of the mucosal lining and into the blood stream where antibodies will be created to these ‘foreign bodies’. This is the same result as leaky gut syndrome. Now that the body has created ‘food antibodies’, the next time you ingest that food you will have an IgG response.
Sometimes food particles have similar structures as molecules in your body and the antibodies can start to attack your own cells. This is called autoimmunity and can take on many different forms, such as:
- Rheumatoid arthritis
- Addison’s disease
- Hashimoto’s thyroiditis
- Graves’ disease
- Multiple Sclerosis
Where Else is Gluten Found?
Although usually found in grains, gluten is also used as a “filler” in many processed foods, seasonings, flavourings and products, such as:
- Ales, beer, brown rice syrup, candies, deli meats, broth, sauces, imitation meats, marinades, lipsticks, and 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 are very important.
Supplements also may contain gluten as fillers or in the coating of their capsules. Read all medicinal and non-medicinal labels carefully.
What are Gluten-Free Foods?
The following types of flours are gluten-free:
- Corn meal
- Rice bran
- Corn bran
- Corn flour
- Soy (but be cautious of wheat additives in soya sauce)
- Legumes (bean, chickpea, garfava, lentil and pea)
Where to find gluten-free products?Organic versions of soy sauce and soups (easily found in the grocery store) are usually gluten free (but read your labels).
Since gluten sensitivity and Celiac disease is becoming more common, 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 and even in Wal-mart.
- Bob’s Red Mill products carry every type of gluten-free flour and baking mix, and can be found in the baked goods aisle (which all the flour and sugar) of most supermarkets.
- The Bulk Barn also sells 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) or be supportive to your health.
How to Cook Gluten-free
Below are some great websites for gluten-free recipes. Also look at paleo meals, which are wheat-free.
- Gluten Free Girl
- Glutino (also advocates their brand of gluten free products)
- All Recipes
- Lesley Cooks
- Gluten Free Network
For information on which restaurants provide gluten-free options:
Best Options for Gluten-Free Food
Asian Styled Restaurants
- Sushi – Avoid tempura and bring your own soy sauce.
- Indian Food – Rice and vegetable dishes (paneer does contain dairy).
- Korean Barbecue
- Noodle Houses – Noodle bowls contain broths and rice noodles.
- Chinese food – Rice and vegetables (note: be wary and ask questions as a lot of thickeners with gluten are used as sauces).
- Greek – Souvalaki, rice, greek salad, potatoes (avoid baklafa and spanikopita as phylo pastry paper contains gluten.
- Fish (any kind)
- Steak House – Meat, chicken or fish with baked potato or vegetable (avoid mashed potatoes as they are thickened with cream and flour).
Fresh – Contains organic food and a large amount of gluten-free and dairy-free options.
Organic Food Restaurants are more used to catering to individuals with gluten and dairy sensitivities, hence why they have more options.
How to Test Yourself For Food Sensitivities, at Home and For FREE?
The Hypo-Allergenic Diet is a great tool that I use with my patients to test for all food sensitivities, including gluten.
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 a major food sensitivity to be SOY.
Being Chinese, my family is used to eating a lot of soy products: soya sauce, tofu, fermented bean curd, edamame, miso, soya nuts, soya 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.
Hypo-Allergenic is also known as Oligoantigenic or Elimination diet.
This means that we avoid eating the most common ingredients that cause people inflammation and digestive issues. IT IS NOT A DIET TO LOSE WEIGHT. It should be viewed more as a food sensitivity TEST.
The top 5 food offenders include:
Note that some of the foods on the list are very nutritious, so if you are not sensitive to the food, bring them back into your diet (ie. eggs).
Also remember, many non-gluten 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.
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, sign-up HERE.
A thorough elimination and re-introduction is not easy, which makes the IgG blood tests more appealing to many. The hypo-allergenic diet takes 6-8 weeks to fully complete with lots of meal planning and having the people you live with (and possibly cook for) on board. If a full hypo-allergenic diet is not plausible for you at this time, you can modify the test by eliminating one food at a time, for example gluten.
Use a re-introduction schedule to keep track of your symptoms:
- Eliminate gluten for 3 days (how do you feel?)
- On the 4th day, eat 3 servings of gluten (ie. wheat, rye, barley, etc)
- If you have no change in symptoms, wait another couple of days while keeping your other foods consistent
- If you do have an aggravation, avoid eating gluten for 1 month then slowly start adding it back into your diet in reduced quantity and frequency
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