Gluten Free Fitness

You don’t have to have celiac disease to be sensitive to gluten

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By Dr. John Briffa Aug 13, 2009

Many grains people eat contain gluten, which can cause various gastrointestinal symptoms.

Irritable bowel syndrome (IBS), sometimes referred to as functional bowl disorder (FBD), is characterized by symptoms such as abdominal bloating and discomfort, constipation, and diarrhea. Its cause is often said to be unknown. However, I find two approaches to be effective in combating the symptoms of IBS:

  • Identification and elimination of food triggers.
  • Correction of any underling imbalance in the ecosystem in the gut.

It is possible that any food can trigger IBS symptoms. In my experience, wheat is the No. 1 offender. Sometimes wheat sensitivity is caused by sensitivity to a protein found in wheat (as well as oats, rye, and barley) known as gluten.

In conventional medicine, gluten sensitivity is a recognized condition that is known as celiac disease. This can be tested for using blood tests and biopsies of the lining of the small intestine. If the tests come back positive, celiac disease is diagnosed. If they come back negative, it is often assumed that not only is there no celiac disease, but also there’s no sensitivity to wheat or gluten. But is this really so?

I have seen over the years many patients who have turned up negative test results for celiac disease, but who nonetheless have IBS symptoms that seem to have a very clear relationship with wheat consumption. Last year, a 4-year-old girl came to my practice whose parents told me she got diarrhea when she ate wheat, but had no diarrhea if she didn’t eat it. The test of celiac disease was negative, and her dietician (with the support of her gastroenterologist) enthusiastically advocated a diet for this child that was full of grain-based foods, including wheat.

What are we to make of individuals who don’t appear to have celiac disease but nonetheless appear to react adversely to wheat? It’s possible that individuals may react to wheat in a way or through mechanisms that are not necessarily related to full-blown celiac disease.

This concept was put forward recently in a paper that appeared in the American Journal of Gastroenterology [1]. Doctors based at McMaster University in Hamilton, Canada, and the Mayo Clinic, Minnesota, United States, put forward the idea that gluten can induce symptoms similar to FBD “even in the absence of fully developed celiac disease.”

In short, just because someone doesn’t have celiac disease, doesn’t mean the bowel symptoms are not due to gluten.

Some people are keen to be tested for food sensitivity, though in my experience, no tests are foolproof. One reason is that the body can react to food through several mechanisms. Let’s imagine that someone has a food sensitivity as a result of an antibody reaction to that food. If the test specifically looks for this antibody, then it’s got a fair chance of picking up the problem. However, if it’s testing for something else, then it’s unlikely to identify the problem.

One simple but often effective way of identifying food sensitivities is to eliminate foods to see if it helps. One problem here is that some individuals are sensitive to a range of foods, and if all of them are not removed, symptoms may persist even though problem foods have been eliminated. To be on the safe side, I tend to recommend that when they take out wheat, they take out other gluten-containing grains and dairy products.

In my experience, the overwhelming majority of IBS sufferers improve dramatically on this regime. Foods can be added back into the diet (about one every two days) to see which foods cause a return of the IBS symptoms.

References:

1. Verdu EF, et al. Between Celiac Disease and Irritable Bowel Syndrome: The “No Man’s Land” of Gluten Sensitivity, American Journal of Gastroenterology, May 19, 2009 [epub ahead of print publication]


Dr. John Briffa is a London-based physician and health writer with an interest in nutrition and natural medicine.

His website is drbriffa.com

There’s no food in your “food!”

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Classic line from a classic 80’s flick-“Say Anything.” Joan Cusack, while watching her brother, says…”There’s no food in your food!” I can’t tell you how many times I’ve felt the same. (Also, the coolest guy Lloyd Dobler is played by John Cusack. Lloyd was so cool that my girlfriends and I rated guys on the “Lloyd-O-Meter” for quite a while. But I digress.)

Take a look at what you’ve eaten today. Is there food in your food? Did you get in some highly nutrient dense food with a minimum of ingredients? To give you an idea, this is what I had today: (not including portion sizes, just items)

  • Egg whites
  • Spinach
  • Cheese
  • Coffee with 1 TBsp of half and half and stevia
  • Red grapefruit
  • Chicken breast
  • Green beans
  • Brazil nuts
  • Tuna
  • salad greens and sundried tomatoes, carrots and cauliflower
  • Flank steak
  • Asparagus
  • Mushrooms
  • Cottage cheese
  • Fish oil supplement

As you can see, really nothing with multiple ingredients. I feel pretty comfortable that there’s food in my food.

So, whaddya think-was there food in your food today? And if not-what is one thing you can do tomorrow to change that?

Where to begin on the healthy eating journey…

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It can be overwhelming, can’t it? Eat this, don’t eat that, not too much of this, yes-eat that, but only on alternating days every other week when the moon is ascending…yikes! It’s enough to make you want to dive headfirst into a pint of Ben and Jerry’s. (Which is fine, as an occasional -yes, occasional-like 1 serving once a week-and a serving is NOT the entire pint-but I digress.)

It does not have to be that complicated.

_market_4 Michael Pollon said:

Eat food. Not too much. Mostly plants.

And truly, although it’s not quite that simple, it’s not too far off. We are deluged with marketing campaigns of food companies, especially in the celiac community.

It’s easy to lose sight of the fact that there are TONS of wonderfully healthy, tasty, NATURALLY GLUTEN FREE foods!! YES!! A chicken breast is gluten free, as are green beans and sweet potato! Viola! Dinner!