Gluten-Free: Fad or Fact?

If the politics and controversy surrounding gluten consumption and the current gluten-free trend leaves you befuddled, look no further! I'm cutting through the industry posturing and internet grandstanding to share with you the facts about gluten, as I understand them. Read on to learn how to figure out whether gluten is good for you, bad for you, or somewhere in between. We're all individuals, and the answer won't be the same for everyone, but I hope my article will help you figure out what is just right for YOU.

What is gluten?

Gluten is the main protein in wheat. It is what gives bread its characteristic soft yet chewy texture. There are many varieties of wheat, all of which contain gluten: spelt, kamut, rye, semolina, and durum are just a few examples. Barley also contains some gluten, and oats contain traces of gluten because, unless they are labeled “gluten-free”, they are processed on the same equipment that processes wheat.

Only people with celiac disease need to avoid gluten, right?

The problem with gluten, unfortunately, is not nearly this simple. Gluten tolerance, or gluten sensitivity, in individuals creates more of a spectrum, a bell curve perhaps, where there are people on one end who can’t tolerate even microscopic amounts of gluten, and people on the other end who can consume wheat at every meal with no ill effects. Most of us fall somewhere in the middle: we can tolerate wheat in our diet up to a certain threshold. There are many people who experience symptoms due to consumption of wheat over their individual tolerance level, and they don't realize it. The question is, how to figure out what your individual tolerance is.

About 1% of the population is estimated to have Celiac Disease, with 83% of those remaining undiagnosed. Celiac is an autoimmune condition, whereby consumption of wheat or other sources of gluten trigger the immune system to attack and destroy the villi of the small intestine. Even a microscopic trace of gluten will trigger an immune response, which can lead to long-term consequences like intestinal cancers. A person with celiac disease should not even eat food that is cooked in the same kitchen where wheat flour is used. Celiac can be diagnosed or ruled out with a blood test, but the test is only effective if it is given when wheat is still part of the patient's diet. It can also be diagnosed by inspecting the intestinal villi through endoscopy. Celiac disease can manifest through a variety of symptoms: intestinal distress, infertility, bone loss, arthritis, migraines, thyroid dysfunction, and neurological dysfunction being just a few. 

This 1% of the population with an autoimmune response to gluten represents just one end of the bell curve. At the other end are those individuals who can eat nothing but wheat products and suffer no ill effects, likely a similarly small number. 

Gluten and Non-Celiac Autoimmune Conditions

The next portion of the bell curve, those who do not necessarily have celiac but would do well to avoid gluten entirely, is comprised of those with any other kind of autoimmune disease. I had the good fortune of attending The Autoimmune Summit last November, and was struck by the lectures connecting problems with gluten to autoimmune conditions of all kinds. There are more than 80 different kinds of autoimmune conditions. For those with any autoimmune condition, gluten can be problematic. 

In particular, those with thyroid autoimmune conditions - Graves disease and Hashimoto's disease, each affecting about 1% of the population - gluten can exacerbate the problem. Thyroid disease, like celiac disease, is grossly underdiagnosed and on the rise. Gliadin, the protein component of gluten, is almost identical to the protein component of thyroid hormone. Our immune system is comprised of many parts - much the way our armed forces are comprised of different branches. Some parts of our immune system operate like snipers, accurately taking out the offending agent with little collateral damage. Other parts are more like Arnold Schwarzenegger in dark glasses inside a tank. When these parts of our immune system react to gluten, our thyroid hormone is part of the collateral damage, and vice versa.

For those with any autoimmune condition, the risk of developing another autoimmune condition is significantly elevated. Those with thyroid autoimmune conditions certainly ought to avoid gluten due to the high crossover between celiac and thyroid disease. What about those with other autoimmune conditions? During the Autoimmune Summit, one doctor asked another, "Do you recommend that all your autoimmune patients avoid gluten, not just those with thyroid autoimmunity?". The response was "Not necessarily.". The follow up question was key: "But have you ever seen a patient with an autoimmune condition who did not do better off gluten?". The answer, unsurprisingly, was "no". And the first doctor said "Right, neither have I". That's remarkable - these are two functional medicine practitioners, MDs with longstanding practices who specialize in autoimmune conditions, and neither has ever come across a patient with an autoimmune condition who did not respond positively to a gluten-free diet. Anecdotal evidence, yes, but powerful nonetheless.

So, we've constructed the extreme left side of the bell curve: those with celiac who need to exercise extreme caution to avoid any food that might be contaminated with even microscopic amounts of gluten; followed by those with thyroid autoimmune conditions, most of whom have little to no tolerance for gluten in their diets and who ought to avoid it altogether; followed by those with any other autoimune condition, most of whom also have little to no tolerance for gluten in their diets. 

Non-celiac gluten sensitivity

The question remains, what is the effect of wheat consumption for the rest of us, hanging out in the middle of our bell curve? We have no diagnosed conditions, no serious symptoms that need immediate attention, but maybe some of the discomforts that we've accepted as a normal part of life . . . headaches, fatigue, joint aches, bloating, constipation, intestinal discomfort, mild to moderate anxiety . . . are triggered by diet. For those experiencing these symptoms, they are NOT normal, and gluten is a likely culprit. Next on our bell curve are those with non-celiac gluten sensitivity. This is not an autoimmune response, whereby the immune system attacks the body's own tissues, but it is an immune response. In these folks, consumption of gluten can lead to inflammation, which can cause a similarly wide range of symptoms in the body, including intestinal distress, joint pain, migraines, fatigue, anxiety, and lack of focus. There are tests for gluten sensitivity, but they can be expensive, are usually not covered by insurance, and are still not very accurate. For someone who is experiencing uncomfortable symptoms with no explanation, a test may be a helpful gauge for whether or not gluten may be responsible. For those with less acute distress, an elimination diet can be a simple, inexpensive, and effective way to identify whether gluten is making you sick.

Trying an elimination diet is simple. Take all gluten -containing products out of your diet for 3 weeks. Be careful - gluten hides in many places! Keep a journal to track your symptoms. After 3 weeks, eat wheat 2-3 times per day for the next 2-3 days. Again, track your symptoms. If you feel better during the 3 weeks and worse during the 3 days, you know wheat is a problem for you. If you don't feel better, a more comprehensive elimination diet might be necessary - often there is more than one offending food in the diet: corn, soy, eggs, and dairy are the 4 most common offenders after wheat. If you need help figuring it out, make an appointment with me for a free health consult.

If you try an elimination diet, and you feel better without wheat in your diet, the next step is to experiment a little. Chances are, you can tolerate some amount of gluten in your diet, just not the Standard American Diet of cereal for breakfast, a sandwich for lunch, and pasta for dinner. Choose high-quality sources of wheat, and when you look for alternatives, avoid the gluten-free aisle and opt instead for meal options that are rich in vegetables. Eat wheat and barley in foods that you really enjoy, and if you find you are experiencing symptoms again, scale back your consumption.

Some people will find that they can tolerate wheat no more than once or twice a month, some once or twice a week, and some might be able to tolerate a high-quality wheat product up to once a day. These folks fill out the middle to right side of the bell curve. And the rare folks on the extreme right of the bell curve may be able to tolerate more than that - though for general health purposes, they probably ought to be eating more vegetables!

People have been eating wheat for thousands of years, why is it a problem now?

Part of the problem is that the wheat we are consuming now looks nothing like the wheat that was the foundation of our agricultural system for thousands of years. It is, instead, a highly adulterated "frankenwheat" that our evolved systems can't even recognized. Another part of the problem is the extensive use of glyphosate on wheat crops. Glyphosate is a powerful herbicide, the main ingredient in Roundup, and it is toxic to humans. It is much debated the extent to which the presence of this toxin in our foods contributes to a variety of chronic conditions, and a close examination of glyphosate is beyond the scope of this article. Suffice it to say, if you buy non-organic wheat products, you are consuming Roundup. Yum!

If you find that you're on the wheat-tolerant side of the bell curve, and especially if you want to stay there, my advice is to choose traditional forms of wheat (like spelt, semolina, or durum) that are organically grown. 

If you'd like some guidance in trying an elimination diet, modifying your diet to match your gluten tolerance level, or boosting your overall health (which can often improve gluten tolerance), schedule a free health consultation with me today! I also have two upcoming FREE talks, "Is Gluten-Free For Me?" on Tuesday, Jan 20 11:30AM-12:30PM and Wednesday Feb 4 7:30-9PM. Reserve your seat, space is limited!

Goal: Achieved!

I did it! On Tuesday, May 13, 2014, I ran one mile on the treadmill in 6 minutes and 59 seconds. I set the goal of running a 7-minute mile in October 2013 when I began my health coaching course at the Institute for Integrative Nutrition. My mission: to complete a website and launch my health coaching practice concurrently with reaching this running milestone.

This goal was impossible, unreachable. I am not a lifelong runner. I didn’t even start running until I was 31, after the birth of my third child. Before that, the last time I had run a mile was in 6^th grade. Vividly I remember spending a recess on my second attempt to meet the grade-level expectation, succeeding, under the encouragement of some classmates, with a time of 9:36. I didn’t run a mile again for over 20 years, and that remained my best time until very recently.

I made one unsuccessful attempt as an adult to be a runner, while in law school. I could study and work as an editor on the Law Review 18 hours a day, seven days a week, at the school "where fun comes to die", but I utterly failed in my quest to run one single mile without stopping.

Fast forward 10 years: I was a stay-at-home-mom to 3 kids under 5 and the 20-minute trek to the gym never failed to take less than an hour. Then check them into childcare, work out, check them out, nurse my infant, give my toddler a snack, struggle to get them back in the car and a quick 30-minute workout was almost an all-day affair. I needed to be able to tie my shoes, walk out the door, finish in 30 minutes, and get on with my busy day. Under pressure from my friends, all avid runners, I decided to give it another go.

One turn around a quarter-mile track was too far at first. The mantra I replayed, over and over in my head, was “if you can get through 48 hours of labor with no pain medication, you can run for 30 minutes”. I cajoled my feet to keep moving; I slogged my way through the slow miles; I enjoyed the freedom and silence of a run, if not the running itself. I worked my way up to a distance of 10 miles before finding myself pregnant for the fourth time.

One year later, I began again. It was only a little easier the second time around. I suffered injuries – chronic hip and knee pain, joint stiffness, a stress fracture. Some doctors say that running is too hard on the body, but I read “Born to Run” and I believe that we are, in fact, perfectly designed to run. I decided never to take health advice from anyone not obviously healthier than myself.

Runners accept aches and pains as an inevitable side effect of running, but I learned that this conventional wisdom is simply wrong. If I avoid wheat and sugar before a run, my joints feel great after, as if I hadn’t run at all. There are foods and supplements that support running by calming inflammation and strengthening tissues. Mark Hyman’s prolific writings taught me about metabolic processes and the danger of sugars, and I was inspired by David Perlmutter’s wisdom about the inflammatory effects of grains. Food changes EVERYTHING. 

I brought yoga to my run. Instead of gritting my teeth and pushing forth out of sheer determination, I learned to sit back, breathe, and relax. My favorite meditation guru, Jonathan Foust once told a story about a trip on which he fell ill, and in this state of misery, he was wise enough to turn to his meditation practice. As he tells the story, he realized as he practiced that, actually, his pinky finger felt OK. I learned to focus on what feels good. If you can find an element of joy in the most uncomfortable of moments, you can work through any challenge.

By October 2013, I could run a single mile in a respectable nine and a half minutes; I was right back where I was at 10 years old. I read an article about applicants to the state police, who must run a mile in 7:30. That seemed impossibly fast – are there really enough people that can achieve this time to staff the entire CT state police? I love a challenge, and if I want to set the tone for my coaching business and challenge my clients to achieve the impossible, I ought to pick some crazy-impossible goal time for my one mile. So I determined to do it in seven minutes. Why not? What is there to lose?

Seven months later, and mission accomplished! I worked hard. I struggled with setbacks: weeks of too many other commitments, or illnesses, or simply showing up and finding that I didn’t have it in me to achieve that day's intention. Often I bumped up against the belief that perhaps I just wasn’t capable of running that fast. In the end, I did it. More importantly, it wasn’t that difficult. What seemed impossible seven months ago was, ultimately, eminently achievable. I am grateful to the many sources of inspiration and wisdom that guided me on my path. Isaac Newton credits his scientific accomplishments to “standing on the shoulders of giants”, and don’t we all? We rely on the wisdom, discoveries, and teachings of others to lead us down the path to our goals. 

Feats of impossible proportions, much greater than my simple one mile run, occur every single day. Part of my inspiration and passion is the recovery of children from the chronic illnesses that are epidemic in the current generation. It is heartbreaking to walk into a classroom and watch so very many children struggle. If you listen to the mainstream media and conventional medical wisdom, things like autism, ADHD, allergies, digestive disorder, and autoimmune illness are simply genetic and a permanent fixture in our culture; there’s nothing we can do but bandage the symptoms and send families on their way. Beth Lambert has written on the topic and is currently leading a documentary film project to show the world that the seemingly impossible is possible. Kids can and do recover from these seeming life sentences every day, and not just a few inexplicable outliers. The impossible is not only possible, it is imminently achievable.

In my health coaching practice, I work with CEOs, from small business owners to household executives, who take care of their projects and their families before themselves, and who feel that there is just not enough of them to go around. Sound familiar? I help these individuals take a step back to see the big picture, relax into their work, and optimize their health. We work together to find ways to nourish body and soul. With a little TLC, they discover new energy and untapped potential. I am pursuing additional training and accreditation to learn to work with parents who seek recovery and healing from chronic illness for their children. I strive to be the Sherpa that guides the way up the often rocky, less-travelled path to wellness. The impossible peak is within reach, if you just put one foot in front of the other and trust that eventually, you will reach it.  

What’s your impossible? What do you desire to achieve that seems just out of reach? Find your inspiration, listen to your giants, take the first step today. Grasp the possibility!

I am grateful for all the support and encouragement I have received from family and friends as I pursue this new business venture. I am thankful for those who have already entrusted me to coach them toward optimal health. I am pleased and excited to introduce my new business, and welcome you, readers, to explore my website and subscribe to my blog. I hope as I build my content that you will return frequently to find inspiration and guidance. And if you feel inspired and ready to make a change today, I welcome you to schedule a free health consultation with me. A la santé!