You’ve probably seen the recent glut of sensational headlines in the media proclaiming that non-celiac gluten sensitivity is some kind of widespread collective delusion—simply a figment of the imagination of anyone who claims to experience it.
These stories point to a new study which found that a group of patients with irritable bowel syndrome (IBS) were not sensitive to gluten. (1) The researchers who performed this study had previously published a paper showing that IBS patients were sensitive to wheat, and that removing wheat from their diet led to an improvement of symptoms.
Gluten sensitivity: real diagnosis or collective delusion? Read this to find out. #glutensensitivity #gluten #foodintolernance
However, in this new study, the authors specifically isolated gluten and found that there was no difference in symptoms between the patients eating high-gluten diets and those eating low-gluten diets.
Why This Study Doesn’t Disprove Gluten Sensitivity
First, this study examined the effects of gluten in a specific population: people with irritable bowel syndrome. Even if it is true that gluten sensitivity is no more common in people with IBS than in people without IBS (which is premature to conclude on the basis of a single study), it does not overturn the large body of evidence that links non-celiac gluten sensitivity to a variety of health problems ranging from allergies to schizophrenia to autism spectrum disorders. (2, 3, 4, 5)
Second, this study does not suggest that people with IBS—or anyone else with gluten sensitivity—should feel free to start chowing down on wheat. In fact, it suggests the opposite. For the first week of the trial, all patients were put on a gluten-free diet that was also low in FODMAPs (a class of carbohydrates present in wheat, as well as other foods).
After this lead-in period, the participants were assigned to one of three groups: a high-gluten diet, a low-gluten diet, and a placebo. Those on the high gluten diet were given 16 grams per day of purified wheat gluten; those on the low gluten diet were given 2 grams per day of purified wheat gluten plus 14 grams per day of whey protein isolate; and those on the placebo diet were given 16 grams per day of whey protein isolate.
The majority of participants experienced a significant improvement of symptoms during the 7-day gluten-free, low FODMAP lead-in period. But there was no difference in symptoms between the high gluten, low gluten, or placebo groups during the subsequent treatment period. In other words, patients did react adversely to wheat, but they did not react to isolated gluten.
This of course suggests that something other than gluten in the wheat was causing the problems patients experienced. We now know that there are several compounds in wheat other than gluten that could be to blame. These include not only FODMAPs, but also agglutinins (proteins that bind to sugar), prodynorphins (proteins involved with cellular communication), and additional proteins that are formed during the process of wheat digestion, such as deamidated gliadin and gliadorphins (aka gluteomorphins). (6)
However, it is certainly possible for people to react adversely to whey, and in my experience this is more common with patients with digestive problems. If some of the “placebo” and low-gluten patients were, in fact, sensitive to whey, then that would invalidate the results of the study.
Like what you’re reading? Get my free newsletter, recipes, eBooks, product recommendations, and more!
How to Find out If You’re Sensitive to Wheat, Gluten, or Both
This study showed that for people with IBS on a low FODMAP diet, eating isolated gluten does not cause symptoms. But one might ask: who cares? Do you eat isolated, purified gluten? Do you know anyone who does? I doubt it. People eat wheat—not gluten. And as both this study and numerous other studies have demonstrated, there are several components of wheat other than gluten that cause problems.
In practical terms, this study still supports the idea that patients with IBS should avoid wheat, because it contains FODMAPs and possibly other compounds that make them feel worse. What this study does tell us is that it’s possible that IBS patients may be able to tolerate other non-wheat products that contain gluten, presuming they are low in FODMAPs and other compounds that they may react to.
Here’s the best way to determine if this is true for you:
- Remove all gluten-containing foods and products from your diet for 60 days.
- At the end of the 60 day period, cook up a bowl of barley, eat it, and see what happens.
- A few days later, eat a piece of wheat bread.
Barley is a gluten-containing grain that is low in FODMAPs. If you react to it, that suggests you’re intolerant of gluten or other gluten-like compounds. If you don’t react to barley, but you do react to the wheat bread, that suggests you are intolerant to something in wheat specifically.
You may be able to safely consume gluten-containing products other than wheat—though it’s worth pointing out that many of these products (primarily grains and processed foods) would not be foods you should be consuming regularly anyways.
Is “Non-Celiac Wheat Sensitivity” a Better Label?
In fact, this distinction was originally proposed by researchers in response to another study which found no effects of gluten in patients on a low FODMAP diet. (7)
Please share this article with your friends if you think it might help clarify this issue for them.
Better supplementation. Fewer supplements.
Close the nutrient gap to feel and perform your best.
A daily stack of supplements designed to meet your most critical needs.
The article that started this, and to a lesser extent, this article both focus too much on gluten. From the comments, it’s clear that this is really confusing people.
A better frame and title would be something like “does a gluten free diet help people for reasons other than gluten elimination?”
The referenced study suggested that a low FODMAPs diet helps people with IBS, and that this characteristic of a GF diet may be significant. I think that supposition (and message) is a lot better than arguing about whether gluten itself is the culprit (for non-celiacs).
And Chris, thanks as always for your sensible assessment of the available evidence!
So the study was funded by a bread company. That might explain the exaggerated conclusions.
It looks as if the study was confounded on two counts: low FODMAPS and whey protein. Why confuse the issue by involving these factors in the study?
Observable digestive symptoms are only one of many possible adverse reactions to gluten. I have neurological and digestive symptoms. A friend of mine had neuro symptoms only including partial blindness – was found to have celiac with classic villous atrophy. Her neuro symptoms are vastly improved without gluten.
Celiac/NCGS can be silent (the same way osteoporosis is – no symptoms till you break a bone, but the bonethinning shows on a scan).
A low FODMAPS diet did not improve my digestive issues. I did not react to any of the many low FODMAP foods when reintroduced after 3 months. But I was in hospital after eating gluten again. Celiac tests negative but unreliable as couldn’t complete gluten challenge.
For the sceptics who think this is merely a fad or a choice: if any food made you that sick believe me you would stop eating it. If it doesn’t make you sick – how lucky are you. Have compassion for those who are stuck with this for life.
I read most of the comments above and skimmed the rest and didn’t see any mention of the FODMAP/gluten/wheat connection. This has proven to be my key to understanding the foods that bother me. I can eat wheat once (though I haven’t for over a year) and it doesn’t seem to bother me as long as it is a modest serving and not half a pizza or something. And I seem to be able to eat other grains the same way, but when I went off of all grains 4 months ago, the brain fog went. I was on very low intake of grains even then, but I think it cleared my system. My reaction to the wheat was the same as my reaction to a number of high FODMAP foods and as soon as I left them all out of my diet, the bloating and gut inflammation I was feeling went away. I know immediately if I have ingested something that doesn’t agree as I get the bloating again, so I stay away from it. I now eat a very clean, very low processed diet, organic, grass fed or free range when possible and all is well. I used essentially the Paleo re-set diet to start and except for recently leaving all dairy out that worked quite well. Leaving the dairy out was to try and reduce joint inflammation, which the other omissions had not. It worked. I have lost zero weight, but I would think I am very near to what I should weigh anyway, so that was never a priority.
http://med.monash.edu.au/cecs/gastro/fodmap/faq.html (where the FODMAP began)….
#4 – rye and barley are all high in FODMAPs
So I’m stumped, is there another food item besides Barley to use?
I appreciate the scientific endeavor, especially if it might help others, but I suspect it’s missing the point. As Chris and others have noted it’s not just about gluten. Optimal diets are likely to be highly individualized.
I started eating GF two years ago after suffering from GI symptoms. I started with GF because I had friends with CD, and had heard their stories, and wondered if it could help me. Symptoms disappeared quickly when I started the diet. My extreme fatigue began to wane, and I began to notice weight loss even though I had not started the diet with weight loss as a goal.
Since then I found other research, including but not limited to Chris Kresser’s site, and continued to experiment. I never reintroduced gluten but I’ve added back some foods known to affect certain Celiac sufferers, such as dairy and oats. I handled those fine.
When I learned later about the dangers of phytic acid I kicked most grains out of my diet, save for a few “safe” starches (yams and potatoes mostly, and a little white rice). I noticed further improvement. Fatigue was gone and I had more energy than I could remember having before my GF trials.
Next I removed sweeteners. My only sweets now are what occurs naturally in fruits and vegetables, plus a little sugar in dark chocolate (85%), and a little honey here and there. After several months I feel like I’m zeroing in on my ideal diet. I feel better than I ever thought would be possible with food alone. I’m still losing weight and I have energy to work throughout the day, come home, and continue projects until bed if needed. I no longer dread exercise. At the same time I enjoy food as much or more than ever before.
I’ve heard stories similar to mine, but I’ve also talked to others with very different experiences. I sometimes still say I am GF when eating out or in casual company, because many people know what that means and it’s just easier than explaining the intracacies of my diet. But I know there are “GF foods” I won’t touch, at the same time I might try something a Celiac sufferer wouldn’t consider.
I’ve never been tested, and I don’t know if I will be. I don’t need any laboratory verification of what I’ve discovered through self-experimentation. I may be sensitive to gluten or not–it may be other components of wheat and grains–and there may or may not be a name for what I am but that doesn’t seem important, not nearly as important as the process of discovery, finding out what works and what to avoid for the best health. And if I feel healthy, and the things I can measure (weight, blood sugar, blood pressure) all look normal, I most likely am healthy. Which is good enough for me.
What I’ve learned along the way, and will tell anyone who cares to listen:
1) Diets can be highly individualized. Everyone may have different food intolerances, whether tested or not, whether we give them a label or not.
2) Nutrition is greatly undervalued for its potential benefit to society. Not just in our subjective health, but overall costs of health care (very very high in the US!), productivity, treatment of diabetes, obesity and depression, etc.
3) The experience of discovering nutrition and how my body responds to foods, types and proportions of macronutrients, frequency and volume of meals, etc. has been both enlightening and extremely satisfying, and is a journey I would heartily recommend for anyone, whether nutrition aware or not, healthy or not.
4) While not discounting the importance or potential benefits of drugs and medications, the power of food to control our health, mood and happiness is so powerful I’ve become disappointed that western society doesn’t do more to indoctrinate us on the usefulness of both nutrition and medicine. Those who practice alternative healing methods, while shunning traditional medicine, are often regarded as dangerous if they do not explore all avenues to health. So why aren’t medical doctors who disregard nutrition also regarded the same? Both may be completely missing paths to wellness for some patients.
Thank you for taking the time to read my story.
Great breakdown Chris.
The true point in my eyes is that we don’t eat isolated extracts, we eat food. These studies seem to be for pure click bait and ideally won’t solve anything as people who believed it didn’t exist already will say “see it’s true!” and those who do believe it’s an issue will say the studies don’t mean anything. That always seems to be the issue on a hot button topic. Hopefully people are encouraged to continue to do research
I was diagnosed with gluten sensitivity after yrs. of going to dermatologist with hives and numbs and terrible unbearable itching! I gave it up and feel terrific although my stomach dis ending after every food I eat has not changed nor cnstipation
OMG it took me years to find out I have the same issue
Some have gluten sensitivity, and some have something else. Gluten is just one very limited item to be sensitive to. There are such things as intolerance to a category of foods. Once you have found it, if you avoid those foods, you will be fine. Also, these intolerances can develop late. There might be a genetic or epigenetic effect. You will need to figure what hurts (that takes careful planning and recognizing of symptoms), then find safe products and ways to cook them. Unprocessed, uncolored, unflavored, organic etc – expensive but cheaper than the doctor.
I suspect that some of what people experience as gluten sensitivity and/or wheat sensitivity may really be a reaction to non-traditional (or industrial) ingredients put into industrial bread. Traditional bread making can take a week to produce a loaf of bread if starting from scratch and if you already have a fermentation starter as much as two days. Industrial bread making takes 30 minutes from ingredients to oven. This is made possible by special industrial ingredients and industrial mechanical manipulation.
I have a 12 year old son who has been on ADD meds for 4 years. His morning breakfast is a white bagel with cream cheese every morning. I know how bad bagels are in general, but he’s VERY picky and I decided it’s more important to send him to school full that to battle him and try and talk him into trying something new.
I’ve recently been doing a lot of reading about nutrition, gluten, and ADD and I convinced him to try Greek yogurt in the mornings. First miracle – he liked it! But more importantly, he noticed a marked difference in his ability to concentrate in the mornings.
He’s still on his meds, and we haven’t gone gluten free yet (still so much love for pasta), but he’s made an important connection between what you put in your mouth and the way it affects your brain and everything you do.
ADD and picky eating are both associated with zinc deficiency. Becoming zinc deficient will give you a poor appetite and an aversion to food textures etc, which tend to put the person on the “white diet” (grains and dairy), which contains very little zinc, thus deepening the cycle. Consider giving him a good multi (Alive tablets by Nature’s Way is the best children’s I’m aware of) to up his zinc status, and see if that helps, either with behavior or with openness to new foods. Zinc food sources, if you can open his mind to that are: beef, lamb, oysters, and pumpkin seeds. Omega-3 and magnesium sometimes help with ADD, if you haven’t tried those.
From what I understand, people were only on each of the 3 diets (after the low FODMAPS) for a few days at a time. I wonder how much you can really tell from that, since for many people gluten reactions tend to be delayed and then can last for weeks before you start feeling better.
Fascinating article. I’ll be passing this one on for sure. Thank you!
I’ve been off of grains, rice, soy and beans for the better part of ten years. I got immediate relief from my IBS-C type symptoms within three days and generally felt better and better the longer I went without these foods but it’s been only since this spring that I finally am starting to feel that my health is really returning. This is complicated by a three year period of extreme stress (mother dying of breast cancer, family falling apart, moving, hypothyroid diagnosis plus adrenal exhaustion and about a year of chronic fatigue, etc.) but this spring I am definitely on the upswing. I was even able to eat some rice the other day with no problems! Very exciting! I won’t be adding grains, rice, soy or beans back into my diet in any meaningful amounts, though. I’m too happy with how things are going. For the record, my blood tests are excellent- which kind of freaks out my various western doctors due to my meat/veggie/fat centric diet. My naturopath just laughs and says I’m doing great!
Does anyone have an opinion on this article on the same topic and study?
http://chicagoist.com/2014/05/19/being_gluten_free_isnt_dumb_but_it.php
I began eating what the book Wheat Belly suggests, a year and a half ago. I’ve had good results! I used to have IBS (along with other health issues) which is the reason I decided to do this. Last week, while eating out I lapsed and had some home-made onion rings which I will tell you were good but not worth it. The following day my stomach felt like I’d had a flame-thrower hit it…I felt horrible and it lasted for hours with nothing relieving it. Every day since I feel a bit better but I know that something in the wheat of those onion rings aren’t my “friend”. I’ve eliminated sugar and processed foods as well. When I grocery shop I need to read lables (no matter what it is…codiments and seasonings all have gluten in them..sometimes hidden). Now, I’m trying to learn more about my health in order to address some other things that are happening (auto-immune issues). For sure, I know I’m gluten-sensitive. My new way of eating is the way it will have to be the rest of my life….doesn’t matter what the “studies” say…I know I’m feeling better now that I’ve eliminated all of the stuff from my diet.
Libby, I cannot eat onions of any kind and have this same reaction you spoke of. Onions are fairly high in fructose, which is why they caramelise so nicely! Never mind that onion rings are fried, usually using wheat crumbs. Anything with high fructose corn syrup in it sends me off the planet too. Understanding the link between wheat and some fruit and vegetable reactions was the key for me. I hope this helps.
I struggled for years before discovering that it was soy that was giving me IBS symptoms. All those years of not knowing caused my lower intestine to become extremely inflamed. It took several years of trying my best to keep soy out of my diet for my intestine to heal. Soy is in so many foods these days that I suspect that a lot of people with IBS have it because of soy – not gluten or anything else. Soy is what we should be taking out of our diet! It needs to be exposed to the public how bad it can be for people. The government needs to stop supplementing farmers who are growing soy by the tons!
I meant to write “subsidizing”, not supplementing in my previous comment! Sorry about that error.
I have been tested for gluten allergy and came back neg. No allergy. That said, I have removed all (wheat) from my diet and then re-introduced bread. Right way there is significant bloating (I look ~4 months pregnant) and headaches eventually return. This is but my own experience but the test has reproduced the same results several times.
I concur with your suggestion about eliminating gluten and then trying barley. Not sure it has to be 60 days either.
However if one reacts to barley that does not necessarily conclude that they are reactive to gluten. One can lose oral tolerance to antigens specific to barley.
There are many potential antigens. Not just proteins. Sugars can be an antigen. Anything. So we cannot say it is the gluten that one is experiencing symptoms with the provoking challenge.
I know I don’t give a damn what studies say when I have experimented myself and I feel tons better when I don’t eat wheat. The feedback from your own body is so much more important than what scientists try to disprove.
Great article. 😉
Great article Chris! I had all the symptoms of low thyroid which lead me to the idea of wheat/gluten elimination. Ironically, I had been having digestive issues for most of my life that had gotten worse in the last five years. One beer and a piece of bread at Texas Roadhouse sent my belly into a tailspin and by the time my meal arrived, I was miserable!! This happened every time I ate whether it was a wheat product or not. Eating meant 2 hours of bloating, gas and pain practically every meal. It affected every aspect of my life. I have been wheat/gluten free for 3 months. It took 3-4 weeks to feel improvements, it took 8 weeks to have a lot of good days in a row. For the past month I almost forgot what the pain feels like! Its a freedom I can not explain! I don’t need a study or a test to tell me I have an allergy or intolerence. However, I did recently get tested because my doc felt that I may have other food sensitivities as well. I could not feel better after the elimination of wheat/gluten!!