How important is it to got Gluten-Free?

Avoiding or eliminating Gluten is the elephant in the room in all conversations about using food to heal. People (practitioners and patients alike) dance about this topic, talk about how it would be a nice thing to try, or dismiss it as new agey woo-woo.

In the context of going Gluten Free, you might have heard the words

  • “fad”,
  • “unscientific”,
  • “trend” associated with it.

You may have also heard the terms

  • “celiac”,
  • “gluten sensitivity”,
  • “leaky gut”.

The current mainstream OPINION (and that, most likely, of your doctor) is that there is no conclusive evidence that a gluten free diet helps unless you have celiac disease. 

 

This is in fact not true! Actually, there is plenty of evidence that the ingestion of gluten HURTS or DAMAGES the intestinal barrier.

A gluten-free WHOLE FOODS diet transformed my son from laughing maniacally for hours every day to a more regulated and a calmer child.

If you search a research database for the impact of gluten on eczema, psoriasis, asthma or autism, you will find:

  1. a number of papers that claim that a gluten-free diet DOES NOT HELP and
  2. a number of studies that demonstrate the benefits of eating a gluten-free diet.

Who is right? We live in the age of conflicting information from coffee to low-carb to gluten. How are you supposed to know what is right?

I knew by trying it out.

Can going gluten-free really heal your child (eczema or autism symptoms)?

I have seen it and heard of it with dozens of families that have tried it out. I have seen the effect on reintroducing gluten and seeing dysregulation come back in less than a week. This is my favorite piece of evidence: empirical and practical evidence.

What about the papers? The conflicting information?

My way to parse through information like this is:

  1. critical analysis of the publication (check for controls, confounding factors, bias),
  2. search for empirical evidence, and
  3. compare with traditional food habits.

In the words of Sid Baker, renowned Autism doctor and researcher: (to paraphrase): “If you are sitting on two thorns, removing one thorn isn’t going to make you feel better.”

Have you heard the story of the elephant and the 5 blind men?

Every study you see is one part of that elephant, partly true, and significantly misleading. When the conditions of viewing that elephant change, the story also shifts.

The most common flaw in papers that diss gluten as a factor in anything is that the gluten-free diets they study are often so based in junk and devoid of nutrition (i.e., they have not controlled for replacing the gluten with a whole food diet), that observing any change becomes hard.

In this blog, we are talking about one path-breaking paper, which gives a bigger (and almost complete view) of the effect of American wheat on a subset of the American population.

“Effect of Gliadin on Permeability of Intestinal Biopsy Explants from Celiac Disease Patients and Patients with Non-Celiac Gluten Sensitivity.” Hollon et al.

Gliadin is the protein we usually mean when we say GLUTEN. This paper tested the response to gliadin exposure on 4 types of subjects: a) those with active celiac, b) celiac in remission, c) those with non-celiac gluten sensitivity, and d) healthy controls.

Part of their conclusion states that :

“gliadin exposure induces an increase in intestinal permeability in all individuals regardless of whether they have celiac disease.”

Given the fact that intestinal permeability is strongly suspected to be increased in children with Autism,  people with eczema, asthma and other inflammatory diseases, this is HUGE revelation. It would follow that trialing a period of no gluten would be good sense. [Check references below].

  • Try a reintroduction after this period of staying off gluten. Assess your symptoms, remember effects can be, and are often delayed.

 

How do I trial this for my child?

  • A 4-6 month trial of a gluten-free whole foods diet followed by a reintroduction is usually a great idea when dealing with chronic disease or dysfunction.
  • Remember that a gluten-free diet that is processed and refined may offer no great improvement over a gluten based diet.
  • Casein protein (from dairy) often cross reacts with dairy. If you don’t see improvements, think about the number of thorns you may be sitting on (it often takes a removal of gluten, dairy and sugar to see a significant effect, though sometimes just gluten may do the trick).
  • The best improvements that I have seen have typically been found with a gluten, casein and sugar free whole foods diet.
  • Remember that in order to assess the impact of being gluten-free, you need to be COMPLETELY gluten-free. 95% gluten-free is like 0% gluten-free in this context.  

There are a 100 other questions about gluten and the gluten-free movement that must pop up.

Why is gluten inflammatory? How could our ancestors so easily eat it? And so on … My colleague Deepa and I have brought answers to you in our very first podcast titled:  “gluten free living: myth, fad, or science?”

 

REFERENCES:

1. “Effect of Gliadin on Permeability of Intestinal Biopsy Explants from Celiac Disease Patients and Patients with Non-Celiac Gluten Sensitivity.” Hollon et al. 2014

2. "Alterations of the intestinal barrier in patients with autism spectrum disorders and in their first-degree relatives." de Magistris et al.  2010

3. "Increased intestinal permeability in atopic eczema." Pike et al. 1986

4. "Intestinal permeability is increased in bronchial asthma." Hijazi et al. 2004.

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