This amazing guest post was written by Dr. Andreia Horta, ND and Dr. Emily Lipinski, ND, founders of Infusion Health! You can check out their website here!
What do beer, soy sauce, and wheat all have in common? These products all contain a substance called gluten!
Gluten is a protein that is present in cereal grains and especially found in wheat that is responsible for the elastic texture of dough. One of the primary reasons a freshly baked bun is so fluffy, chewy and delicious is because of this protein! Gluten consumption has been increasing over the last few years. In fact, in the 30 years between 1970 and 2000, gluten consumption increased by 25%!
Given the typical North American diet, this isn’t all that surprising. Breakfast often includes toast or cereal (containing wheat products), lunch for many is a sandwich with 2 pieces of bread or pasta made of wheat and it’s easy to find gluten show up at dinner (think hamburgers, hot dogs, pasta, couscous, lasagna, wheat tacos, wraps, dinner buns). Gluten is found in the all of the following substances:
- Barley (malt, malt flavoring, and malt vinegar are usually made from barley)
- Triticale (a cross between wheat and rye)
- Durum flour
- Graham flour
- Soy sauce and other common condiments
Celiac Disease vs. Gluten Sensitivity
Gluten has been a hot topic in the media lately, bringing into question if gluten is actually healthy to consume. For some individuals that suffer from celiac disease, gluten should never be ingested. Celiac disease is an autoimmune disorder in which the immune system mistakenly attacks the lining of the small intestine. If an individual with this disease ingests gluten, they will suffer from moderate to severe gastrointestinal symptoms, including abdominal pain, diarrhea, and bloating.
Below is a picture of the cells of the intestinal tract of an individual without celiac disease, vs the cells of a person with this condition. As you can see, the gluten particle actually damages the cells of the digestive tract if a person has celiac disease.
Some people may also have an allergic reaction when they eat gluten. In these individuals affected by a wheat or gluten allergy, hives, itching, redness and swelling presents almost immediately after the ingestion of wheat or other products containing gluten. This is similar to any other food allergy such as the common peanut food allergy. Rarely, some individuals develop a severe anaphylactic allergy response to gluten.
However, for some people, gluten may still make them feel lousy, even if they do not have celiac disease a gluten allergy.
More About Gluten Sensitivity
For years, researchers have struggled to determine why some individuals, who lack the characteristic blood, tissue, or genetic markers of celiac disease, and do not have an allergy to gluten but yet they experience gastrointestinal symptoms. These people often have other symptoms related to gluten consumption headaches, fatigue, cognitive difficulties, or mood disturbance, after ingesting foods that contain wheat, rye, or barley.
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Studies now show that non-celiac gluten or wheat sensitivity (also known as a gluten sensitivity) causes a different type of immune response in some folks. Exposure to the offending grains containing gluten somehow triggers acute systemic immune activation, rather than a solely localized intestinal immune response and an allergic reaction. Researchers estimate that gluten sensitivity affects about 1 percent of the population, or 3 million Americans, roughly the same prevalence as celiac disease.
The interesting, and important thing to note when it comes to gluten sensitivity, is that the reaction may not be immediate- unlike a gluten allergy or celiac disease. If one has a gluten sensitivity, the immune response can take 1-2 days to increase. This means that you may have had pizza Monday, felt fine on Tuesday, but had a reaction on Wednesday. This makes food sensitivities sometimes difficult to determine.
What are the symptoms of gluten sensitivity?
Studies have shown that this immune response found in people with a gluten sensitivity can be associated with anxiety, depression, migraines and dementia. Food sensitivities have also been linked with
- Atopic dermatitis (eczema)
- Bloating & IBS symptoms
- Postprandial fatigue (Feeling tired after a meal)
- Chronic post nasal drip
- Sinus congestion
- Weight gain
It’s pretty clear that if you have a sensitivity to wheat, going gluten free, or reducing your intake of gluten may not just be beneficial for your gastrointestinal track but also for your mood!
There are two ways that we typically test for gluten sensitivity: the elimination diet and a food sensitivity test.
The Elimination Diet
The elimination diet consists of completely removing the most common foods that cause food sensitivities for 4-6 weeks. This means no gluten, eggs, dairy, sugar, corn, alcohol, white potatoes, tomatoes, peppers, eggplants, beans and nuts! This is definitely a challenging task but can provide you with a lot of information.
By removing all these foods for the allotted period of time allows for the immune response to decrease, hopefully decreasing the symptoms you have been experiencing, but also allowing for a food re-introduction challenge. After the 4-6 week time period is up, the foods are slowly re- introduced one by one back into the diet and symptoms are tracked.
For example, let’s say on Monday you had finished the 6 weeks elimination diet without consuming any of the foods listed above. If you wanted to test gluten first, you would consume a product that contained gluten but none of the other products that you had been avoiding. For instance, you would eat a dinner bun but not a cupcake as the bun just contains wheat whereas the cupcake contains wheat, dairy and sugar… this would confuse the re-introduction process.
Ideally, you would consume 2 servings of the gluten product on Monday, and the on Tuesday and Wednesday of that week you would go back to the elimination diet and track your symptoms. This is necessary because the sensitivity response may take a few days to show. If you ate wheat on Monday, and then dairy on Tuesday you might not be able to determine what is causing your symptoms on Wednesday- the gluten or the dairy??
Once you have tested gluten on Monday, you would test the next food- eggs, on Thursday and then go back to the elimination diet for Friday and Saturday. You would continue to re-introduce foods, and track symptoms until all the foods had been challenged.
Food Sensitivity Testing
If the elimination diet seems difficult to follow and track, there is always the option of a food sensitivity test. This test is commonly ordered by Naturopathic Doctors and some Medical Doctors. The process consists of eating many different foods first (within a 2 week period), then going to have your blood taken at a lab. The blood is sent off to be tested for the immune response your body has produced to various foods. Once complete, you receive a report from your doctor looking at the foods that could be causing the symptoms you are experiencing. The report looks like this:
This is only a partial report of a patient, but clearly shows that this patient has a sensitivity to wheat, but not couscous or rye. There are also other foods, such as egg whites and milk that is causing a response in this patient and thus should be avoided to decrease symptoms.
If you think you might be sensitive to gluten, or another food, download our elimination diet here. This is a 21 page e-book with a complete list of what to eat, is full of fantastic recipes and has some great tips to keep you on track
If you are interested in how foods can affect your mood, download our free e-book here.
Yours in Vitality,
- Donald D. Kasarda, American Chemical Society 2013.
- Columbia University Medical Center, 2016.
- Margutti P, Delunardo F, Ortona E. Autoantibodies associated with psychiatric disorders. Curr Neurovasc Res. 2006 May;3(2):149-57. Review.
- Ludvigsson JF, Reutfors J, Osby U, Ekbom A, Montgomery SM.Coeliac disease and risk of mood disorders–a general population-based cohort study. J Affect Disord. 2007 Apr;99(1-3):117-26. Epub 2006 Oct 6.
- Ludvigsson JF, Osby U, Ekbom A, Montgomery SM. Coeliac disease and risk of schizophrenia and other psychosis: a general population cohort study. Scand J Gastroenterol. 2007 Feb;42(2):179-85.
- Hu WT, Murray JA, Greenaway MC, Parisi JE, Josephs KA. Cognitive impairment and celiac disease. Arch Neurol. 2006 Oct;63(10):1440-6.(26) Bushara KO. Neurologic presentation of celiac disease. Gastroenterology. 2005 Apr;128(4 Suppl 1):S92-7. Review.
- Millward C, Ferriter M, Calver S, Connell-Jones G. Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev. 2004;(2):CD003498. Review.
- Yoshida, S., et al, Beta-lactoglobulin-Specific IgE and IgG in Sera of Patients with Milk Allergy. 5Th International Food Allergy Symposium. Atlanta, Georgia, 1984.
- Akinon et al. Gut. 2004 Oct; 53(10): 1459–1464 6. Alpay et al Cephalalgia. 2010 Jul; 30(7): 829–837 7. Mullin et al. Nutr Clin Pract. 2010 Apr;25(2):192-8.
- Suen and Grodon 2008. A Critical Review of IgG immunoglobins and Food Allergy, Implications in systematic Health. US Biotek pp.1-6
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