Just recently a controversial café in Dublin, Ireland posted on Facebook that those with a preference for gluten-free fare would be required to present a doctor’s note for celiac’s disease, before they would be served. This caused a big stir in the worldwide news and left me thinking about the growing number of individuals without celiac’s disease that have gluten-sensitivities.
So What is Gluten Anyway?
In cooking, think of gluten as the “glue” that holds a dough together and helps it rise. When flour and water are mixed, the proteins glutenin and gliadin merge. This chemical reaction creates the elasticity, chewiness and texture we associate with baked products like bread, cakes and pasta. Gluten can also be dried, powdered and added to other products too like sweets, beer and stock cubes.
We humans have been consuming gluten since at least the Bronze Age, generally with no problems. However, a small percentage of people, about 1 percent, have celiac disease, a serious disease caused by an immune reaction to gluten.
Celiac disease is what is known as a genetic auto immune disease. When a sufferer eats food containing gluten, their immune system reacts. This reaction causes inflammation and damage to the small intestine. The knock-on effect of this damage is that the intestine can't absorb nutrients from food properly, which leads to the person becoming malnourished.
Celiac disease can take years to develop, and people may not even realize they have it. With over 300 symptoms ranging from depression and itchy skin to irritability or acid reflux it is small wonder that, according to research, up to 83 percent of people with celiac disease don't get diagnosed correctly, or at all.
Not getting diagnosed with celiac disease is dangerous as it can lead to all kinds of other complications if it isn't treated, including osteoporosis and cancer.
Celiac disease is confirmed with a straightforward blood test and perhaps an endoscopy to assess the damage to the small intestine. Sufferers must then never touch gluten again. If you suspect you may have celiac disease or it runs in the family then it is a good idea to get tested. This is not something you can treat yourself.
However, what is interesting is that more and more people who don't have celiac disease are noticing bad reactions after eating food with gluten in it. They know they feel better when they avoid gluten altogether. These people are gluten sensitive and may also have a leaky gut.
Gluten Sensitivity – Real or Imagined?
You have tested negative for celiac disease yet you have noticed a bad and almost immediate reaction to eating food with gluten in it. You may have symptoms like bloating, abdominal pain, depression, aching joints or foggy thinking which all magically disappear when you stop eating gluten. This condition is referred to as non-celiac gluten sensitivity (NCGS) or non-celiac wheat sensitivity (NCWS). It has been controversial and had some bad press. It has even been referred to as a trendy, celebrity-led condition that doesn't actually exist. Understandably, that leaves you feeling upset and confused. Are you imagining things? It appears not.
Research done on 160 patients by the University of Columbia Medical College and published in the peer-reviewed journal Gut in July 2016 has found that wheat exposure is not just causing symptoms in people with NCGS/NCWS , but actually triggering an immune reaction in the body and damaging the cells in the intestines.
As well as this inflammatory immune response, the researchers found that the NCGS patients also had a “weakened intestinal barrier”, something referred to as “leaky gut syndrome”. This rather nasty sounding problem means the lining of your intestine has been damaged. So, instead of doing its normal job - allowing nutrients to pass through, but blocking larger stuff like bacteria and particles of food – it is leaking. It's letting all kinds of bits and pieces through into the bloodstream and intestines with chaotic results. No wonder you feel so bad!
Patients with celiac disease also have weakened intestinal barriers. What they don't have is the inflammatory immune response or the immediate reaction to eating gluten. Simply put, NCGS sufferers are experiencing a very real reaction to gluten, but it is different from that of celiac patients.
NCGS – Testing and Managing
Up until now, none of the ways of diagnosing NCGS can be diagnosed had been validated by medical research. They ranged from home tests bought over the internet, to cutting out gluten and seeing if symptoms disappeared, to testing how well your intestines were absorbing nutrients by drinking a mix of large and small sugar molecules then testing your urine. The Columbia research means the condition can now be confirmed by a blood test.
The study also found that the best way to treat NCGS was to eat only gluten-free grains for at least six months. In other words, the best treatment for both celiac disease and NCWS is the same – avoid gluten.
What on Earth Can I Eat?
Living gluten free does not mean boring! In fact it often leads to a generally healthier diet, because cutting out bread, cakes and processed foods mean you consume more of the “good stuff”. Here are some popular gluten alternatives and healthy foods:
- dairy products
- products labelled gluten-free in supermarkets/delis etc.
- non gluten grains and cereals like quinoa, corn, polenta, tapioca
Foods specifically recommended for leaky gut include:
- healthy natural fats like coconut and olive oil
- fermented foods, for example sauerkraut, kefir and kombucha
- non starchy vegetables, including the dark green leafy ones
- bone broth
- pasture-raised meat
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Have you experienced or heard of Non-Celiac Gluten-Sensitivity before? What are your thoughts on it? We would love to hear your stories and experiences!
In good health.