Why talk gluten when low-carb or grain-free?

Even with low-carb or grain-free eating, avoiding gluten still takes knowledge, awareness and vigilance.  The problem is common and the down-side is serious.

Answer:

  • because 1% plus 7% of the population equals a whole lot of people (8 of 100 people).
  • because gluten hides unsuspected in low-carb foods (e.g. most sausages).
  • because when eating out, travelling or eating at friend’s homes, people may make-do by removing croutons, removing the bun, removing the breaded coating, etc.
  • because people may sometimes make the choice to, say, have a tiny pinch of their daughter’s wedding cake or other special meaningful food.
  • because even these small exposures could cause strong symptoms. On top of that, this can be very confusing. Confusion and doubt can bring their own harm if they discourage someone from maintaining the low-carb lifestyle that was benefiting them.
  • because the consequences can be more than “just” the unpleasant hours or days of the obvious symptoms.  Unlike with other food reactions, these responses to gluten are not an allergy.  Gluten sensitivity is an autoimmune disease and celiac disease is just one version of this.  It is never good to poke-at or prod an auto-immune response, which is the body attacking itself.  There can be more health consequences on the line than you think.

When people first switch to a low-carb diet, if they are following the advice of the most knowledgable and experienced clinicians*, they will be having no grains.  Having no grains means they will not be having any gluten.  For some people, part of the improvements in health that they achieve will be due to removal of gluten from the diet.  However, for the reasons above, they may be intermittently exposed without realizing just what is happening to them.  As their health improves, they may come to a point where they are slowly intentionally expanding their diet choices to include small servings of gluten grains – for example, using a rye cracker to build a sandwich on.       (* for example Dr. Atkins, Jackie Eberstein, Dr. Eric Westman)

Because gluten sensitivity is an autoimmune disease, the true cost of even small exposures can be hidden and unrecognized.  Because the opportunity for un-intended intake of gluten is ubiquitous in our society, exposures that keep the immune system provoked are very likely unless the person has been diagnosed and is aware of what they need to be on the look-out for.

Consider:
Rev Neurol. 2011 Sep 1;53(5):287-300.

[Neurological disorders associated with gluten sensitivity].

[Article in Spanish]
Hernandez-Lahoz C, Mauri-Capdevila G, Vega-Villar J, Rodrigo L.

Source: Hospital Universitario Central de Asturias, 33006 Oviedo, Espana. carloshlahoz@gmail.com

Abstract

Gluten sensitivity is a systemic autoimmune disease that occurs in genetically susceptible individuals on ingesting gluten. It can appear at any age, then becoming a permanent condition. It is more frequent in women, as happens with other autoimmune diseases. Celiac disease is the intestinal form and the most important manifestation among a set of gluten-induced autoimmune pathologies that affect different systems. Neurological manifestations of gluten sensitivity, with or without enteropathy, are also frequent, their pathogenesis including an immunological attack on the central and peripheral nervous tissue accompanied by neurodegenerative changes. The clinical manifestations are varied, but the most common syndromes are cerebellar ataxia and peripheral neuropathy. Finally, gluten sensitivity is associated to a varying degree, with other complex diseases and could influence their evolution. The early detection of cases of gluten sensitivity with neurological manifestations and subsequent treatment with the gluten-free diet could provide remarkable benefits to the patients.

PMID: 21796607

Consider visiting the website of one of the most experienced clinicians, Dr. Rodney Ford (aka Dr. Gluten). His recently updated book Gluten Brain (http://t.co/yTonFF5t)  offers the provocative hypothesis that the principal damage involved in the gluten syndrome is to the brain and nerves.  (Note: at only $9.99 for the ebook the price is right, but myself I was not able to make the Kindle version I downloaded open in my Kindle app, so I settled for the PDF download (all versions are included in the one price) — the read was worth the inconvenience).

Consider visiting The University of Maryland Center for Celiac Research, where Dr. Fasano is one of the world’s top experts.

Addendum: Thank-you for all the interest in this article.  The subject is much too much to properly address in just a blog post.  If you are interested in more, please see my comment below and click on the Topic “Gluten and Wheat” in the side bar for my other posts, including two new ones today, May 26th.  There are foodie blogs that offer gluten-free low-carb recipes and suggestions.
Short link for this post http://wp.me/p2jTRh-6O

4 thoughts on “Why talk gluten when low-carb or grain-free?

  1. I suspect that the percentage of people who have a problem with gluten is substantially higher than 8%. I think that 8% covers just the folks whose gluten problem is bad enough to be easily discovered. In my case, I discovered my gluten problem by accident — after years of complaining about crippling hand pain (I’m a violinist, and the hand pain pretty much ended that career), and even having one “doctor” tell me I needed to see a shrink, because there was nothing wrong with me that could be causing the hand pain. I went on low-carb in 1999, and one of the things I cut out early in the process was grain (I kept a detailed diet log). The sudden and complete relief from the hand pain came as a surprise (I present a more complete version of the story in my blog).

    I may get the book Gluten Brain, but I suspect that in my case, Dr. Ford would be preaching to the choir. I have read and reviewed Dr. Davis’ book, Wheat Belly, which I recommend to anyone who thinks grain (whole or otherwise) is healthy. BTW, one of the take-homes from Wheat Belly is that gluten is not the only problem with wheat.

    • Howard, thanks for the story about your hand pain. Yes, gluten is not the only thing about wheat that is of concern, but it is the thing that is understood and agreed upon within medical/research circles. Discussions based on gluten succeed in crossing the divide. Also, it is difficult enough to get wider awareness of (1) the actual true nature of gluten sensitivity as an auto-immune illness (2) that can come on at any age, not a disease that either shows up in childhood or you’re not going to get it, (3) that even tiny exposures can cause hidden prolonged harm, not just symptoms, (4) that gluten sensitivity even is a valid entity, in the absence of diagnosed celiac disease.
      Once people become savy to the true impacts of their nutrition and food choices, as you have, they value learning more and taking action. If a person is not interested enough to even learn about gluten, they are not likely to instead respond to other topics about wheat (besides the carb content, and avoiding carbs is far from a successful strategy to avoid immune-system-relevant exposures to gluten).
      Extensive research internationally has pegged celiac disease itself at about 1% of the population, but it is understood that this rate has been growing rapidly and may still be growing rapidly.
      All estimates of the extent of gluten sensitivity are known to be very rough initial approximations. I have used here Dr. Fasano’s estimate because of his solid mainstream cred. Also, I would think it would actually harm the wide-spread adoption of acceptance of gluten sensivitity as a valid medical condition if the estimate were pegged much higher. What do I mean by that? Yes, gluten sensitivity has now been formally recognised by a large panel of the top international experts in the field. Walk in to 90% of the doctor’s offices in North America and they likely will not know this, will not care if you tell them and mostly will not take the time to even check out the facts for themselves.
      Generally speaking, when people start low-carb, they are not expressly given the info they need to understand all this and to understand the profound health implications of NOT understanding. This had its place a couple of decades ago when celiac disease was thought to be rare and mostly something that showed up in childhood and gluten sensitivity was not formally recognised (and even among those who recognised gluten sensitivity, it was not understood as auto-immune). I think its time for the low-carb world to catch up to the present day. Pretty much all people starting low-carb, or going grain-free, are at least intending to eliminate known servings of grains. This should always be accompanied by the knowledge needed to understand what may be going on in their bodies.
      Soy sauce anyone? A few crumbs in that butter? Did some-one put some bread crumbs in that burger patty? Were there bread crumbs on the cutting board that your food was prepared on?
      A whole other topic is that once a person has been off gluten for a while, you can’t rely on blood tests to pick up celiac disease. And there is no agreed, reliable, no-fail test for gluten sensitivity in the absence of celiac disease and dermatitis herpetiformis.
      The big decision is whether or not a person has to be that strict. If you don’t need to be strict (no auto-immune attack), no big deal, just cut back or eliminate grains as much as works for you. The problem is that N=1 is not enough to answer that question. If you have a reaction when you deliberately have a test intake of wheat (after a period of gluten elimination, otherwise the reaction is hidden), then that is useful info. If you don’t have an evident reaction – you just don’t know what the non-obvious impact might be.
      With the immune system, the dose causing impact is orders of magnitude less than for the blood-sugar control system.
      With the immune-system, the price to pay for small intakes is out of all proportion.

  2. Pingback: Gluten awareness even for low-carbers | it's the satiety

  3. Pingback: Anything “chronic skin”, give thought to gluten | it's the satiety

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s