Rates of celiac disease, an autoimmune disorder in which people are unable to digest gluten, is now 100 times more common now than it was 10 years ago. The same goes for a condition known as gluten sensitivity, wherein people don't test positive for celiac but still suffer problems when they eat gluten, which is believed to affect 7 percent of the population.
"There's no question that gluten, the major protein found in wheat, barley, rye, and products made from these grains, has become a problem in the American diet," says Arthur Agatston, MD, author of The South Beach Diet Gluten Solution and the forthcoming South Beach Diet Gluten Solution Cookbook. But, he cautions, "The information out there about gluten and gluten-free diets is still really lousy."
He says that many people avoid gluten simply because it sounds possibly beneficial. In fact, according to consumer surveys by the market research firm The NPD Group, about a third of U.S. adults say they want to cut down or be free of gluten in their diets. Ask them why, he says, and they probably don't have a good answer.
He wrote his book to give people the facts so they can decide whether going gluten free really will benefit their health. Here are some of the most surprising facts about gluten:
#1: Quick-rising breads gave rise to greater gluten intolerance.
There are a few theories as to why people are having a harder time tolerating gluten, and two of the prevailing ones center around the quality and the quantity of the gluten we're eating. First, farmers have bred wheat with a much larger endosperm that contains higher levels of gluten (which makes bread elastic—a desirable trait from a food-processing standpoint) than heirloom varieties—and second, we are being inundated with it. Food processors have found a way to use gluten in everything from salad dressing and soy sauce to toothpaste and lipstick.
However, Dr. Agatston says, the reason we have a harder time tolerating gluten is more basic: We no longer ferment our breads the way our ancestors did. "The reason we have problems with gluten, as opposed to the proteins in rice, is that gluten is hard to digest," he says. Traditional breads usually involved soaking and basically fermenting the wheat, which "predigests" the gluten, Dr. Agatston says. That's one of the reasons that breads like sourdough are sometimes more tolerable to people with gluten sensitivities than processed breads. But as food processing has moved away from fermentation—a long, slow process—food makers have moved toward quick-rise breads made from yeasts and other chemical leavening agents. "We're not predigesting the gluten," he says, "and that's causing an even bigger problem with gluten sensitivity."
#2: Gluten could be causing your [insert health condition here].
"If you have any health problems you can't resolve," Dr. Agatston says, "it's worth doing a month off gluten." That's because gluten can have so many, and such varied, impacts on your immune system. Dr. Agatston says he's had patients with a huge variety of ailments—asthma, heartburn, psoriasis, neurological problems and even just general brain fog—find their issues resolve after they avoid gluten.
It all circles back to your gut. When you digest gluten, your body breaks it down into various amino acids that are then absorbed by your small intestine. But if you aren't digesting gluten properly, or are just partially digesting it, some of the original strands of gluten protein can seep through your small intestine's barrier and work their way into your system. Your body then develops antibodies to this foreign material, causing all sorts of acute and chronic health problems, ranging from diarrhea to rheumatoid arthritis, iron-deficiency anemia, and thyroid problems. "One of the reasons gluten sensitivity is so hard to diagnose is that there's such an incredible variety of presentation," Dr. Agaston says. "It's the most under-recognized medical problem there is."
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#3: Our antibiotic addiction isn't helping.
Whether it's through our overuse of antibiotics in livestock or doctors and patients looking for an easy fix, having too many antibiotics in our world is changing our gut flora and increasing gluten sensitivity, Dr. Agatston says. It's well documented that overusing antibiotics can kill off friendly gut bacteria that boost your immune system, aid in digestion, and, research is finding, produce enzymes that help people digest gluten. "Without sufficient good bacteria in our small intestine, we may not produce enough enzymes to help break down gluten protein, which in turn could result in gluten sensitivity," he writes in his book.
#4: Neither is our overuse of painkillers and preservatives.
Like antibiotics, nonsteroidal anti-inflammatory painkillers, such as ibuprofen, can damage gut bacteria, Dr. Agatston says. "We know that, taken in excess, these drugs can poke holes in the stomach," he says, referring to the certain painkillers' tendency to give people stomach ulcers. "But what's not as well appreciated is that they can poke holes in the small intestine, where gluten causes problems." Though research on preservatives in food is less definitive, he says it stands to reason that preservatives, which are designed to kill bacteria that cause food spoilage, could be killing off friendly bacteria in the small intestines as well.
#5: "Gluten-free" does not equal "good for you."
One of the biggest misconceptions about gluten-free foods is that they're all good for you, says Dr. Agatston. Many of them are made with refined starches, such as potato flour, that contain a lot of empty calories. "The original gluten-free foods were made for celiac patients, who tend to be malnourished because they aren't absorbing nutrients in their small intestine," he says. "If they have a few extra calories, it won't hurt." But if you're avoiding gluten for non-celiac gluten issues, it's important to stick with whole foods that are naturally gluten free, like quinoa and vegetables. "When people just avoid gluten but are still having other processed carbs, they're not going to lose weight," he adds.
#6: You probably don't need to avoid it completely.
In spite of all this, says Dr. Agatston, "you don't have to be completely gluten free in the end, just be gluten aware." Only people with a diagnosis of celiac disease need to avoid it completely. "We're finding that people have a spectrum of sensitivities to gluten," he says, adding that the condition is similar to lactose intolerance in a lot of ways (and in fact, there's often crossover between the two conditions, he says): Some people can't tolerate any dairy at all, while others can deal with a small amount of milk in their coffee every morning. "Simply understanding that gluten could be causing your health problems is the first step to gluten awareness," he says. Then he suggests following the plan laid out in his book, which involves eliminating gluten completely for a few weeks then gradually reintroducing gluten-containing foods in order to find out which foods—and how much of each food—can be consumed without triggering symptoms of gluten sensitivity.
Published on: October 8, 2013
Updated on: November 7, 2013