Google the words “gluten-free” and you’ll find an astonishing 40,900,000 results. It’s a term that’s been gaining buzz exponentially over the past few years, as more and more questions have risen about the safety of consuming products containing gluten. But is all this attention warranted? Do we have a serious health problem on our hands—an epidemic even? Or is “gluten-free” just the latest fad sweeping the fickle diet universe?
Tom O’Bryan—a chiropractor, nutritionist and leading researcher on gluten sensitivity and its more severe manifestation, celiac disease—is firmly in the former camp. “This is not just another condition to look at,” he says. “It’s a foundational problem that crosses over every condition. The New England Journal of Medicine published a paper in 2006 that said celiac disease is one of the most common lifelong disorders in both Europe and the U.S. There are more than 20,000 studies now in the medical literature on the impact of gluten sensitivity and/or celiac disease on the body.”
Still, there is some disagreement on how widespread the problem is. According to the Celiac Foundation, one in 133 people in the U.S. has celiac disease, and the prevalence of gluten sensitivity is six to seven times higher. However, vitalist Steve Halgrimson, who has suffered from gluten sensitivity himself, says it’s not so clear: “I’ve read studies that say one in 250; I’ve read studies that say one in 10.”
But before getting deeper into a debate about the scope of the gluten problem and whether a gluten-free diet is for you, it’s important to understand two things: what gluten is, and how it affects the bodies of those sensitive to it.
Gluten is a family of proteins found in almost all grains. For the purposes of the “gluten-free” discussion, the word has become a shorthand for the particular set of gluten peptides found in wheat, barley and rye—peptides toxic to the gluten sensitive. (There is also gluten in rice and corn, but these are different types and do not have the same potentially negative effects.)
For those afflicted by celiac (an autoimmune disease where the nutrient-absorbing microvilli lining the intestines become atrophied and unable to function properly), gluten is the trigger, in conjunction with a genetic predisposition, that causes symptoms to flare up.
“Every degenerative disease is a disease of inflammation at the cellular level,” explains O’Bryan. Inside the cell, there’s always a fire—inflammation. The first step [in care] is to stop throwing gasoline on the fire, and for many people, that’s gluten. The poor digestion of the protein initiates the immune system response.”
The broader term, gluten sensitivity (of which celiac disease is a possible end result), occurs when a person has an immune reaction triggered by gluten exposure. When the gluten-sensitive eat the grain protein, O’Bryan says, the digestive system can’t break it down because the amino acids are too tightly woven together. This undigested gluten, through a process called molecular mimicry, ends up looking very similar to the structure of different tissues in the body. As a result, the immune system produces antibodies to the gluten that end up mistakenly attacking the organs. “The immune system destroys things it deems non-self,” Halgrimson explains. “But with autoimmune diseases, it destroys the self, thinking it’s non-self.”
An impassioned O’Bryan rattles off a litany of conditions he believes are triggered by gluten consumption—everything from ADHD and depression to cataracts, angina, osteoporosis and even cancer. “Celiac disease has the big name because it was the first thing that was identified, but gluten sensitivity is the big kahuna,” he says. “Where it manifests depends on your genetics, the antecedents and your accumulated lifestyle imprints.”
For those with celiac disease, currently the only effective treatment is a 100 percent gluten-free diet. And, depending on how severe the case, those diagnosed as gluten sensitive are either cutting out or cutting down their gluten intake (according to Halgrimson, there’s a wide variety of gluten sensitivity levels—for some, a few microns can trigger an immune response, while others can tolerate far more). But there is also an increasing number of people with no signs of gluten sensitivity who are following the naturally gluten-free Paleo lifestyle, which involves shifting the human diet back to its pre-agricultural, hunter-gatherer roots: meat, fish, fruit, nuts, seeds, vegetables, mushrooms, herbs and spices. Food that humans began consuming after the Neolithic Revolution—such as grains, legumes, dairy and refined sugars—are forbidden.
Life University student and cross-fit enthusiast David Jennings, who has no known gluten issues, heard about the Paleo approach from his friends at the gym. Inspired by a trio of books (Mark Sisson’s “The Primal Blueprint,” Loren Cordain’s “The Paleo Diet” and Robb Wolf’s “The Paleo Solution”), Jennings ditched gluten, eliminating most grains from his diet, which—from a Paleo perspective—are digestive irritants hindering your body’s ability to process other proteins and complex carbohydrates.
After adopting the Paleo diet, Jennings noticed an immediate change. “I lost two inches off my waist, and I’m not a big guy to begin with. I’m 37 years old, and I’m in my high-school pants size … six months later, I noticed a big difference in my fitness level. I had more energy all day. Instead of burning simple sugars, I was burning fat as a primary energy source.”
What types of meals is Jennings eating? For breakfast, scrambled eggs with sauteed vegetables—zucchini, spinach, onion, garlic. Maybe some bacon. During the day, smoothies with green vegetables, fruit, lettuce, avocados and pumpkin-seed oil (for healthy fat content). Grilled salmon and a sweet potato for dinner. “I do a lot of crock-pot meals, too,” he says. “The other day I made soup with all the vegetables left in the fridge, some chicken, chicken stock, salt, pepper and seasonings. In place of noodles I used julienned parsnips—they were long, thin and looked the same. That visual helps.”
The biggest adjustment for Jennings, aside from giving up the real versions of his many favorite traditional meals, was how time consuming it was to cook everything from scratch. “You can’t eat out of a box any more,” he says. “You look at the ingredient list—it has words you can’t pronounce, and it’s often got wheat or gluten added to it. So you have to like being in the kitchen. [If not], you can get into a rut—always eating the same things. And that will wear you out.”
As Jennings points out, going gluten-free isn’t easy. While attempting this challenge, many people end up feeling deprived of some of life’s great pleasures. “Who doesn’t love to sit down to a comforting pasta dinner, followed by a delicious slice of cake?” writes chef and author Aine McAteer for Oprah.com.
Nor is going gluten-free cheap. Medical scribe and EMT Elizabeth Otto, in a column for livestrong.com, notes that specialty gluten-free products can strain your budget, which—in the midst of a belt-tightening recession—is something to consider.
While it’s essential for people with celiac disease and gluten sensitivities to avoid eating foods containing the protein, many health professionals believe it’s overkill for the rest of us. “There’s not really any benefit,” says Jaleh Dehpahlavan, head of Life University’s Department of Nutrition. “If you don’t have any problem digesting gluten, then it is not necessary for you to avoid gluten.”
Halgrimson, however, as a proponent of the Paleo lifestyle, prefers to err on the side of caution. “Some people can digest gluten all right, but I [still] think it can leave them more susceptible to problems further down the road,” he says. “It hasn’t been that long in our human genome that we’ve been consuming those grains. The body doesn’t handle them very well. Do we need wheat in our diet? I don’t think we do.”
Despite conflicting opinions over the scope and severity of the gluten problem, many recent studies—including a fascinating 2009 report by the Mayo Clinic, which used frozen blood samples taken from early-1950s Air Force recruits to compare the rate of celiac disease then and now—suggest that gluten sensitivity is becoming more common. But what’s driving this relatively sudden shift?
All of the experts TCL consulted agree: The modern Western diet—with its heavily processed, refined, chemical-additive and pesticide-laden, nutrient-deficient makeup—is a huge part of the problem. “[People’s] intestinal milieu, the environment of the gut,” O’Byran says, “is so much more stressed now than it ever has been—because of the poor quality foods we’re eating, the increased antibiotics people take … the increased hormones we’re being exposed to. The environment of the intestines is much more toxic than ever. It’s like we have a PTSD—a post-traumatic stress disorder of the gut.” And as with PTSD, sometimes even the most minor trigger can stimulate an adverse reaction. Foods our overly taxed digestive systems might once have been able to handle are becoming, for many, the straw that breaks the camel’s back.
O’Bryan, a DC himself, sees a special role for chiropractors in helping patients consider the dietary roots of their health problems. “[Those in our profession] should be on point because we have more intimate conversations with people,” he says. “We put our hands on people all day long, and it would be very easy for us to say, ‘You know, you’re not quite responding the way you should to musculo-skeletal care … let’s take a look at what you’re eating.’”