We get lots of enquiries about digestive health and many requesting further information about gluten free nutrition and under what circumstances it is really necessary. We truly believe most people benefit from limiting if not completely avoiding gluten. The best thing to do is read up on the essential information and make your own decision, our guide to gluten should help you here.
What is gluten?
Gluten is a protein found in wheat; specifically in the endosperm, part of the seed ground down to make flour. Gluten is primarily beneficial in baking as it promotes elasticity and stickiness (think glue!) in dough, making bread, cakes and biscuits chewy.
Most people are aware that wheat contains gluten but in fact many other grains, including rye, spelt and barley contain composites of gluten. It is also increasingly used in condiments, sauces and random foods like Liquorice Allsorts (that was a sad discovery!)
Are You Gluten Sensitive Or Coeliac?
In order to explain this we have to understand a little more about the body’s immune system. We often liken the immune system to an episode of Game of Thrones; so many clashes, betrayals and overall chaos that we’ve never clear who is on who’s side and so settle for knowing the general gist of events and the underlying plot. The complexities of the immune system are still being unravelled by scientific studies. A simplified version of events is that our immune system has cells known as Antibodies that recognise intruders in the body by their molecular structure or shape. Your immune cells may decide that one or many of the components of gluten look like an enemy , each time it encounters this it will go into attack mode. As this is taking place in your gut you may experience symptoms such as bloating, gas, cramps or diarrhoea as it all kicks off.
One of the issues in determining whether your immune system is reacting to gluten is that the testing available by the NHS is limited and doesn’t investigate the full spectrum of antibodies that can be produced when you consume gluten.
Most GP’s will specifically looks for inflammation and the activation of an antibody known as IgA Anti-tissue Transglutaminase Antibody (TTG) . They will also check for damage to the gut villi. These are tiny finger like structures that line the wall of the intestines and with Coeliac disease our immune system get’s a little confused and begins to attack these villi so they will appear worn down. However, if the results of these examinations are returned negative or inconclusive a GP may inform you that gluten is not the culprit causing your health issues.
This is problematic as new research has established that there are actually 20+ immune reactions that could potentially take place when you consume gluten. In many cases our immune system maybe reacting to gluten but because tests do not reveal damaged villi or TTG you are sent away believing food really has nothing to do with the situation.
Luckily, more advanced testing methods are being developed to measure a more extensive spectrum of the immune reactions to gluten and other allergenic foods. Currently these are only available privately through Cyrex Laboratories (available via Regenerous Labs in the UK) who specialise in gluten sensitivity, autoimmune disorders and immunology.
On a positive note this observation has led to some diversification in the classification of reactions to gluten and many health practitioners now investigate for the following:
(i) Coeliac Disease
A defined autoimmune illness where the immune system attacks the body each time gluten is consumed. This damages the cells lining the gut compromising nutrient absorption. A test will look for elevated inflammation, damaged gut villi and activation of tTG.
(ii) Non-Coeliac Gluten Sensitivity
This is when individuals experience symptoms similar to coeliac disease, however, there are no sign of the tTG antibodies associated with Coeliac’s Disease nor the same wasting of the gut villi. Tests will look for the production of IgA and/or IgG against gliadin protein and other gluten-related autoantibodies.
(ii) Wheat Allergy/Intolerance
Another common cause of digestive distress maybe an immune response or intolerance to the proteins found in wheat but not necessarily gluten, in which case you would be able to eat rye and barley without experiencing any negative symptoms.
We love this graphic by Nutritionist Carrie Dennett simplifying the gluten symptom hierarchy:
Long Term Impact
In Fitter Food we talk about the importanceof the gut. It is the true foundation of your health, over 80% of the immune system is situated there so if you ignore digestive symptoms long term you increase your risk of more chronic and severe health issues.
A study in the Journal of the American Medical Association discovered people Coeliac disease or gluten sensitivity had a higher risk of death from heart disease and cancer.
Almost all autoimmune conditions such as rheumatoid arthritis, lupus, multiple sclerosis have been shown to improve with the elimination of gluten. Gluten has also been associated with neurological and psychiatric disorders such as depression, migraines, dementia, autism and epilepsy.
The takeaway for us is that if so many people are presenting with an immune responses to this stuff whether it be a full autoimmune or a sensitivity it sort of suggests its not doing many of us that good and is best avoided most of the time.
Cross Reactive Proteins
It’s been established that other proteins may elicit a similar effect to gluten. The diagram here illustrates what a molecule of gliadin (a protein composite of gluten) might look like and how our immune cells latch onto it.
Cross reactive proteins are essentially other things we may consume that contain protein molecules with a similar shape to gliadin, for example, the diagram shows how a casein molecule (casein is the protein found in dairy) could cause the body to launch a similar immune reaction that it does when it encounters gluten, however, the protein in rice looks very different and is therefore considered to be non-reactive. Now brace yourself, we have some bad news here…. COFFEE is on the list of cross reactive proteins! It gets worse…..CHOCOLATE is also on the list!!
If you’ve eliminated gluten and not experienced the benefits it could be worth experimenting with eliminating some cross reactive proteins. Again, Cyrex Laboratories (available via Regenerous Labs in the UK) offer a test array on Gluten Associated Cross Reactive Foods and other sensitivities that will measure your individual response.
Elimination Diet
Whilst testing maybe useful for your own compliance it can prove expensive. The simplest, most cost effective way to establish your bodies response to gluten is to eliminate it for at least 30 days but ideally aim for 2-3 months to really experience the full benefits. Be strict and persist as gluten reactions can continue for some time even after elimination so symptoms may take a while to disappear and even the smallest exposure could compromise your experiment so it’s also worth becoming an avid label reader, even some personal care products like shampoo and moisturisers contain gluten.
Gluten Free Options
Take some time familiarise yourself with foods that contain gluten. There’s often a great deal of confusion here and Balanced Bites have put together a fantastic comprehensive Guide to Gluten, including the grains, sauces and confectionary that may contain it. When eating out your best bet is to always ask the question “Does this contain gluten?”
Avoid The “Gluten Free” Supermarket Section
We took a few screen shots of the gluten free goodies in our local supermarket and you can barely recognise the product, in fact we should offer a prize if you guess it. It’s tempting to see these as healthy alternatives but as you can see in place of the gluten is a stack of refined grains, additives and preservatives. Dr William Davis author of the Wheat Belly calls these “Junk Carbs” and highlights that many gluten free foods will actually spike our blood sugar levels higher than the gluten based original.
Keep It Simple
Fitter Food is never a fan of complicating things, we avoid gluten as much as we can and just favour foods like rice or potatoes as our carbohydrate sources. When eating out we might ask about certain dishes when ordering and request dressings or sauces on the side. Most places now are labelling gluten free dishes and some are even offering entirely gluten free menus. It’s much easier than you might think.
Gluten Free Booze
We cover this in a little more detail in our book, alcohol can be pretty aggressive on the gut, if you’ve been subjected to 48 hours worth of beer farts after a heavy night out you’ll know what we’re talking about. There are a few ingredients in alcohol like yeast and preservatives that may cause an immune reaction but also many sources of alcohol contain gluten.
Beer is made from wheat, barley and hops so obviously contains gluten. It’s rumoured (don’t hold us to this) that Corona and Heineken contain the lowest amounts of gluten. Increasingly breweries are coming to the rescue by providing a range of certified gluten free beers and ales. Sourcing these online is much easier at the moment but this does appear to be changing as more and more consumers ask for gluten free alternatives. Green’s Gluten Free Beers offer a great range of beers and ales which also don’t contain added allergens and preservatives. If you’re a connoisseur in these things Paste Magazine offer a comprehensive review of the best and worst gluten free beers.
Other gluten free choices of alcohol include spirits made from rice, berries or potatoes. With regard to spirits most of the gluten is destroyed during the distillation process. NOTE: distillation removes most of the gluten BUT not all so sensitive individuals are best avoiding it full stop. Ciders are naturally gluten free but always check and they do contain higher amounts of sugar plus preservatives like potassium sorbate and sodium benzoate which can also negatively effect immunity.