Gluten free diets have been trending for a while now, and are promoted by many celebrities, food manufacturers, and food service establishments. But is gluten really bad for you? Let's explore this topic together.

First of all, what is gluten? Gluten is a protein (not a carbohydrate!) naturally found in grains such as wheat, barley, and rye. Gluten is an important component in foods that contributes to its physical properties, such as the texture in bread (1) .

For individuals with celiac disease (about 1% of the Canadian population (2)), consuming gluten triggers an autoimmune response in the body which causes damage in the small intestine. This often leads to symptoms such as nutrient malabsorption, fatigue, abdominal pain, bloating, diarrhea, and anemia. It is important to note that not all people with celiac disease experience physical symptoms, but this does not mean that they do not have the disease! Celiac disease is first screened for by blood test, if this test comes back positive it should be followed by a small intestine biopsy to confirm the diagnosis. The only treatment for individuals with celiac disease is to follow a strict, lifelong gluten-free diet. Celiac disease, if left untreated, can lead to increased risk for nutritional deficiencies, colon cancer, neurological problems, bone density loss, and infertility (3). If you have recently been diagnosed with celiac disease, please book an appointment with us so we can make sure your diet is strictly gluten-free while also providing your body with all of the nutrition that it needs.

Wheat allergies (affecting about 0.7% of the Canadian population) are immune responses to any protein in wheat - which may or may not be gluten! Other proteins in wheat that may cause an allergic response are albumin, globulin and gliadin. Symptoms can range from mild (nausea, vomiting, rashes) to severe (breathing difficulties or anaphylaxis) (7). To learn more about how wheat allergies are diagnosed, click here to read our recent blog post about food allergy testing. Treatment for a wheat allergy includes following a strict wheat-free diet, just like any other food allergy.

Diagnosis of gluten sensitivity has been increasing from 0.6-6% (4) of individuals in the Western world. This condition is known as non-celiac gluten sensitivity (NCGS) but it is not an autoimmune disease or an allergic reaction. For these individuals, following a gluten-free diet may alleviate symptoms (5). However, there is conflicting evidence on whether it is removal of gluten from the diet that relieves symptoms, or the removal of another component of the diet. These individuals may also have irritable bowel syndrome (see below) or undiagnosed celiac disease which may explain the cause of their symptoms. More research on NCGS is required.

As we can see, the prevalence of individuals diagnosed with celiac, gluten sensitivity, and wheat allergy are relatively low, but many people report feeling better by eliminating gluten.. so why is that?

1. Irritable Bowel Syndrome: IBS is a common disorder that affect over 5 million Canadians (8). IBS can cause symptoms such as abdominal pain, gas, bloating, constipation, and/or diarrhea (9). Certain foods may trigger or exacerbate IBS symptoms (such as wheat, dairy, beans, and more), but “trigger foods” are different for everyone! There are evidence-based dietary approaches you can follow to find relief from unpleasant IBS symptoms, however it is recommended you seek the help of a registered dietitian before starting any dietary changes. If you suffer from IBS, book an appointment with Alex or Stephanie today to help find you relief from your symptoms.

2. Gut health: The symptoms you experience may not be caused by gluten, but by poor digestive health which leads to symptoms like bloating and discomfort. Your digestive tract could use some help from prebiotics and probiotics to promote a healthy gut! Some sources of prebiotics and probiotics in our diet include fermented foods such as kombucha and kimchi, dairy products such as yogurt and kefir, fruits and vegetables such as bananas, garlic, leeks and onions, as well as whole grains including oats and barley.

3. Processed foods: Perhaps it is not the gluten or wheat that is the culprit of your digestion discomfort but the quality of foods that you consume. Try incorporating more fresh vegetables, fruits and whole grains, and decreasing your intake of processed foods such as fast food, sugary foods, and packaged foods to see if you feel better.

Unless it is due to an allergy or autoimmune disease, it is not recommended to eliminate specific foods from your diet. There are many things that could be causing your gut troubles, and gluten may not be the culprit after all! Book an appointment with Alex or Stephanie to learn more about your gut health and how you can find relief through diet.

Reference

1. https://khni.kerry.com/news/blog/what-is-the-science-behind-gluten-free-a-handy-faq/

2. https://www.canada.ca/en/health-canada/services/food-nutrition/reports-publications/food-safety/celiac-disease-gluten-connection-1.html

3. https://www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5677194/

5. https://www.google.ca/search?q=non-celiac+gluten+sensitivity&oq=non-&aqs=chrome.0.69i59j69i60j69i57j69i60l2j0.1485j0j4&sourceid=chrome&ie=UTF-8

6. http://allergen-nce.ca/wp-content/uploads/Canadian-food-allergy-prevalence-Jul-2017.pdf

7. https://www.healthline.com/health/allergies/gluten-allergy-symptoms

8. http://www.cdhf.ca/en/statistics#15

9. https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016

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