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Gluten sensitivity fact or fiction: Non-celiac gluten conditions debated

Wheat Thins aren't for everyone.
Wheat Thins aren't for everyone.
Photo by Michael Loccisano

The gluten-free trend has created a marketing bonanza for many food companies, with Americans spending more than ten billion dollars on gluten-free foods last year. Although celiac disease can be verified with a test, most of those who say that they have a gluten sensitivity base it on their symptoms because no definitive test exists. But now a new study is causing some to question whether those symptoms actually are caused by short-chain carbs known as FODMAPs, reported Newser on Sunday.

Researchers tested participants to see if isolated gluten is the culprit with regard to gastrointestinal problems. They reported that the presence of gluten did not appear to contribute to symptoms. Instead, they nailed FODMAPs.

"Reduction of FODMAPs in their diets uniformly reduced gastrointestinal symptoms," said researcher Peter Gibson. But does that mean that gluten sensitivity does not exist? No, say many experts.

Paleo guru Mark Sisson tackled the topic in a blog recently. He's the author of "The Primal Blueprint: Reprogram your genes for effortless weight loss, vibrant health, and boundless energy."

Mark notes that the study does imply that "gluten sensitivity may actually be wheat sensitivity triggered by the fermentable FODMAP fibers found in the grain." But he feels that does not negate (a) the potential benefits for many of giving up gluten and (b) the possibility that for some people with IBS, gluten sensitivity is very real?

For those with health issues ranging from fibromyalgia to migraines to bloating, that study does not "affect the people, here today, dealing with health issues who cannot wait around for a consensus in the literature. They need results, and going gluten-free tends to work more often than not," points out Mark.

We asked another expert, William Lagakos to comment in an exclusive interview on Monday. He has a Ph.D. in Nutritional Biochemistry and Physiology with a focus on obesity, inflammation, and insulin resistance, and is the author of "The poor, misunderstood calorie: calories proper."

William explains that "non-celiac gluten sensitivity would be a response to gluten involving neither allergic nor autoimmune mechanisms. There are certainly going to be people who experience a genuine resolution of gastrointestinal symptoms by excluding gluten-containing foods from their diet. Whether or not the main culprit is gluten, or some other closely related nutrient or non-nutrient, however, remains to be seen."

Among those symptoms that could be resolved by eliminating gluten: "Bloating, abdominal discomfort or pain, diarrhea, constipation, fatigue, and mood disturbances." And the study is not the final word on whether gluten sensitivity is real.

Bottom line, adds William: "All of the study participants responded positively to a reduction in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). Then, they were given whey protein or gluten. Symptoms returned in all participants."

One problem with determining the validity of gluten sensitivity: No definitive test exists, notes Cynthia Sass in a Time magazine column. She's the author of "S.A.S.S. Yourself Slim: Conquer Cravings, Drop Pounds, and Lose Inches."

However, she notes that even if you don't have celiac disease, in her experience avoiding gluten can ease certain symptoms. And for that reason, she feels that those who "test negative for Celiac may also benefit from going gluten-free if they’re experiencing a condition called gluten intolerance, or gluten sensitivity."

Cynthia advises those who experience symptoms such as bloating, mental fogginess, tummy trouble and fatigue to try eliminating gluten. If you feel better, you may have a gluten sensitivity or intolerance.

Offering additional insights on non-celiac gluten sensitivity is David Perlmutter, M.D., author of "Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar--Your Brain's Silent Killers." He contends that gluten sensitivity is not only common but can cause symptoms and conditions ranging from depression to dementia to diabetes.

To those who argue that unless someone has celiac disease, whole grains are advisable, Dr. Perlmutter disagrees. "Gluten-containing foods stimulate inflammatory reactions in a significant number of individuals, well beyond the 1.8% of the population that has celiac disease," he said in an interview with Medscape.

Moreover, Dr. Perlmutter cites new research indicating that all people may have some degree of sensitivity to gluten. Beyond gastrointestinal problems, he and many other experts link gluten to neurologic concerns.

However, before you spend your money on the massive amounts of processed foods labeled gluten-free, be warned. Dr. Perlmutter views those products, typically high in carbohydrates, as harmful to your health.

Thus everyone can benefit from foregoing gluten, according to Dr. Perlmutter. His food-as-medicine prescription for health and weight loss: A low-carb diet high in healthy fats and small amounts of carefully selected protein such as grass-fed beef.

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