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.
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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.
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I don’t really understand this study.
I can see Chris’s point re FODMAPS and other possible constituents of wheat being a problem for some.
But seriously, if I am understanding this correctly, this study gave people gluten in differing amounts alongside a placebo group.
What did they hope to show, prove or highlight?
Were they expecting to see that those taking the higher amounts of gluten suffered more intense problems?
Surely the point here is that they were given gluten!
Surely the amount is insignificant when looking for NCGS or intestinal sensitivity?
Surely even the smallest amount of gluten will initiate an autoimmune response in sensitive people. So I do not understand the study and what they were looking to prove.
Were these subjects already on a strict gluten free diet before the onset of the study and for how long and how was this proven.
A) it takes immense vigilance to become gluten free, contamination is so easy especially as you don’t even have to be able to see the gluten protein/bread crumb/flour dust etc.
B) It can take 4-6months for the autoimmune activity to diminish once having been initiated by the tiny gluten protein/s
If the participants in the trial weren’t gluten free before the study, what gives the study any relevance whatsoever. Ingesting a lot or a little gluten prior or during the study would not necessarily alter symptoms.
If they weren’t totally gluten free before the study autoimmune damage would have been occurring anyway if sensitive. Having more or less gluten during the study wouldn’t increase the damage as the damage was already occurring, the immune system was already fired up. As Dr Tom O’Bryan puts it ‘You can’t be a little bit pregnant!’
Surely that’s the point of approach re gluten sensitivity – you can’t have any.
Also as far as I understand it, unless gluten causes intestinal discomfort – symptoms! Then you are not aware of being sensitive but that doesn’t mean that you aren’t. That damage could be happening anywhere in your body and you not be aware of it or be suffering any symptoms. If enough damage hasn’t happened to your brain yet for you to recognise that you have a problem with gluten and cause symptoms let alone even relate the headaches or other health issues to wheat/other grain proteins.
I say again, I do not understand the point of the study.
Well, first off, I don’t like when “authorities” dismiss something that others have found to be valid. There is real antagonism against Paleo from various sources. Secondly, I don’t like it when I eat wheat and feel bloated, inflammed, and sluggish. Thirdly, doctors have misdiagnosed my belly-bloating for pelvic and gynecological disorders. No thanks….alleluia for paleo and for my cousin in Santa Rosa who told me about it…..
My sister had digestive issues and her doctors told her also it was gynecological and as a result ended up with a hysterectomy! The digestive issues continued. Then, they told her it was her back disk problems–and she has had numerous back surgeries. Her digestive issues continue. I have told her about the gluten/wheat issue but she lives in Ireland and is much harder to communicate as she doesn’t use the computer. Visiting her this fall, so may have to talk. her doctors sound like Neanderthals of medicine. Sickening.
I’m confused. I’m new to the paleo and ancestral worlds and trying to sort out what the best approach is. In a desperate search for solutions, I removed all gluten and most grains from my diet about 6 months ago in an effort to reverse an acute (now chronic) skin condition; otherwise I felt great and my weight/BMI was ideal. I simultaneously began a long and slow elimination diet. I’ve stuck with it and my diet add backs have brought me to the point where I follow an ancestral protocol (though I’m not quite there yet on bone broth and organ meat consumption) including safe and resistant starches. I had lost a lot of weight during elimination, and now it’s back to the pre-level. But, throughout this whole time I have seen no difference in my skin condition, energy level, or anything else. I have not had any reactions to specific foods or been aware of any food sensitivities before or after the skin outbreak first happened. So while I’ve remained gluten free (and sugar free, etc), I do question whether this has been a waste of time and energy and whether I ever had leaky gut. The reason that I bought into leaky gut as causal is due to other chronic issues that I’ve had during my lifetime (headaches, canker sores, toenail fungus, and in recent years, occasional unexplained random digestive issues) though none of them have flared or waned in reaction to any specific foods based on my self-experimentation. So it’s been frustrating to have gone through all of this and not see any changes (either positive or negative) in my appearance or how I feel physically.
This new study that Chris discusses, and the pursuant commentary and responses from Chris, leaves me wondering if I am really gluten sensitive and whether or not I’m wasting my time and unnecessarily depriving myself of food groups like grains. Note: I am a whole food foodie who has eaten extremely high quality food and tons of fresh, organic produce for many years. For years leading up to my first skin flare-up, I was an at-home vegan, meaning that I was on a animal and dairy -free, nearly sugar-free diet at home, but did partake moderately at restaurants and others’ homes, which was relatively infrequent. I did consume a LOT of gluten (oatmeal for breakfast, bread at lunch and dinner, etc).
I’m not throwing in the towel yet, but I am still in active search for solutions. I have made extreme lifestyle changes also (yoga, meditation, circadian rhythm entrainment, walking/running), all to no avail in terms of the condition I’m trying to reverse. Naturally I’ve tried to get into see Chris and as a poor substitute, I’ve seen 2 other functional medicine professionals (one, an MD, who was complacent and uncreative, and IMO should not be advertising himself as functional — he didn’t even evaluate my blood work on a functional range basis, as I’ve since learned should be done). In fact, he shed no light on my lab results beyond research that I’d already done. I do believe that leaky gut can be a real thing, but in my own personal doctor experience, I think it was used as a throw away line that meant “I don’t know what’s wrong with you”. BTW, I questioned whether we should pursue SIBO testing, but was told that it would be fruitless because I’m not a classic case (no chronic or excessive bloating or gas, negative for h pylori on blood work, etc, and of course I’ve since learned that blood is not the best way to test for h pylori either!)
I welcome any constructive insights/comments/help.
Susan,
“and whether or not I’m wasting my time and unnecessarily depriving myself of food groups like grains.”
By not eating grains no one is depriving themselves of anything except nutrient-poor high caloric pseudo-food.
Hi Susan, if you describe the skin condition, maybe someone can shed some light on any connections to what might have/is still causing it.
Not all gluten/wheat sensitivity comes in the form of digestive distress. When I eat wheat, I get head cold-like symptoms (sore throat, congestion, headache, groggy feeling) within 30 minutes that lasts for 24 hours. No digestive symptoms at all. I don’t have IBS or anything like that anyway though.
There is gluten intolerant which is like lactose intolerant. This intolerance effects mostly the stomach. Then there is gluten sensitive which effects the joints, muscles, brain and other things mentioned in this discussion. There IS a difference between the two that needs to be distinguished. Some only get bloating, vomiting and tummy issues (intolerant), while others get aches, migraines, arthritic feelings and don’t really get bad tummy issues which is gluten sensitive.
It’s really annoying how folks keeping crowing and gloating every time someone offers up “proof” that non-celiac gluten sensitivity is fictional. People are so defensive about it, but it could be because it has become such a fad in our culture. I have run into people in grocery stores like those in the recent Jimmy Kimmel sketch who were “gluten-free” even though they had no clue what gluten was, and they are annoying. I had one lady tell me that she was trying to eat “healthier” and was now buying the gluten-free cereal (some sort of artificially colored sugar bomb chemical spill in a box). I didn’t have time to explain to this woman that gluten-free junk food in a pretty box was NOT “healthier.”
One of our children (out of six) has a true allergy with immediate reaction to wheat. He tested positive to IgE wheat antibodies. I’ve been mostly gluten-free (99%’ish) for three years and haven’t taken an allergy medicine in all that time. It definitely helps my seasonal allergies, and I could care less what any research study has to say about it. As far as tummy issues, small amounts of gluten hidden in foods don’t seem to bother me, and I’ve wondered if it’s yeast in the bread rather than the gluten.
is there any health benefits to eating Gluten?
Perfect question and I think the answer is no. Mat LaLonde argues that grains offer comparatively low nutrition density (actually require artificial fortification) so why not simply make better choices (fish, pastured beef/pork/lamb/…, modest amounts of fruit, vegetables, tubers, perhaps dairy in some cases, et al)? That strikes me as sound logic and it eliminates gluten concerns.
I seem to be sensitive to all grains, particularly wheat and corn. Also cow dairy causes my face to break out. Wheat creates painful blisters or hives on the roof of my mouth. Not all the time though. I always have acid reflux when I eat grains or dairy.
See if ewe’s milk is better for you. It makes wonderful yoghourt!
Nice work Chris, and some really good debate going on via the Comments!
The second thing we do with Clients (after eliminating sugar) is to remove Wheat, but not Gluten, from their nutritional plans. Within 2 weeks they report back saying they have more energy, less bloating, and more regular , ‘normal’ stools.
Personally I bloat within 30 minutes of consuming wheat based products, but can handle lower Gluten content foods such as Oats and Rice in small quantities, about twice per week.
It would be great to see more studies on modern day, industrially produced Wheat rather than just Gluten in isolation.
Do I read your comment correct? Are you saying Rice contains small amounts of gluten?
Hey Maria,
Sorry, that was meant to read lower Gluten containing foods such as oats ‘and other grains such as brown rice’. Rice does not naturally contain gluten, however be mindful of cross contamination around gluten products.
I highly doubt it exists because of the mega billion dollar industry behind it. Usually when an industry gets this behind something to such an extent I call shenanigans. This industry has become so vast and powerful that nocebo effect is a given. People are thoroughly convinced by this massive ‘gluten is evil’ machine that it’s mostly all in their heads (aside from possible fodmap issues in a small particular subset). Imagine if someone hears “carrots are making people sick” “carrot intolerance is killing you” “whatever you do, do not eat carrots” “10 reasons carrots are destroying your gut” -hammer this into the public for years and what do you think will happen to certain types of people when they eat carrot? “Oh my god, had carrot yesterday and am now bloated and cramps, headache”. Case in point is a friend of mine claiming gluten sensitive however when I feed him gluten containing food but tell him it’s “gluten free” he has zero reaction. I did this with gluten containing cookies at work 3 days in a row. He had no reaction whatsoever. On the 4th day I gave him a different cookie also containing gluten, but an hour later I told him “oh crap dood, I think that wasn’t one of my gluten free ones”, a couple hours later he’s complaining of bloating and feeling crappy almost wanting to go home. Same brand of cookie but different flavor ingredients 90% identical. I said but the other ones last few days were fine huh? He said “yeah, where can I buy those they almost taste like real ones”. Yes, I’m a jerk lol. I have done the same with co-workers complaining of wireless routers near their desk causing their headaches only to inform them I never plugged it in. It’s just too easy and I like to wake people up to these things if I can.
Also, a HUGE HUGE issue is unprepared grains. I make my own breads and pastas using a sourdough ferment that takes 36-48hrs. The gluten and everything else is virtually completely pre-digested by the time I bake it. Fermented dough is far superior and easy to digest.
Although my husband and I never perceived we had a problem with wheat or any other gluten-containing grain, we decided to avoid them both after reading so much negativity about both wheat and gluten. Now, more than two years later of a mostly gluten free/wheat free diet, my husband and I have found that 1) I no longer get these scaly patches on my scalp that I have had my entire life and 2) he no longer gets painful canker sores. Perhaps these are coincidences, but I see no reason to add these foods back in. Too risky and we are doing great without them. My point is the negativity of gluten/wheat ingestion might be something minor, and take years to show.
Great post. I would love to stop eating gluten and wheat for 60 days. I some how manage to eat something and have to start the 60 day clock over. Please send someone over to cook all the meals 🙂 In all seriousness I stopped eating wheat and gluten and have felt 1000 times better. I was skeptical. I am a baker and use wheat all the time. However, I am less bloated, I have more energy and some other things bothering me no longer bother me.
Here’s my 2 cents: Whether or not people are allergic or insensitive to gluten, or allergic or insensitive to wheat or FODMAPS, there’s really no reason TO eat the stuff. There’s nothing in those foods that you can’t get from a whole foods Paleo type diet. So why even argue about it…just don’t eat the stuff. And if you really crave bread so badly you can’t resist then you’ve got other hormonal or psychological problems going on you need to address.
Gluten sensitivity indeed exists. However, the main reason IBS patients may do better on a low gluten diet, may not be the gluten per say, but the fact that wheat (which is high in gluten) is also one of the main FODMAPs in the Standard American Diet. This may explain why giving gluten in tablets did not show a difference in the study.
I have a really puzzling IBS history. I had been diagnosed w/ IBS (constip)~ 15 yrs ago after 5 months of bloating, cramps… I was afraid to eat, so lost (unnecessary) weight the hard way. It resolved for an unknown reason & then became an intermittent problem. Fast forward to 2 yrs ago when I went Paleo. No wheat or gluten, no more IBS symptoms until 2 mos. ago, when I began having IBS (diarr) Every day! Ugg. I have been eating 1 meal a day (dinner) to “buy” myself a diarrhea-free stretch of time each evening. I decided to mentally go back in time, to try & figure this out: My husband needed to go on a Ketosis version of Paleo last August, so I did too, by default. I started wondering if my starchy…carbs were so low that there was nothing to feed the good flora in my gut. I got my family practice md to prescribe VSL #3 DS (A Probiotic w/ 900 Billion bacteria per packet). It didn’t help much, but I took it every day. Then I started reading about resistant starches via Chris Kresser, & started taking 1 tbsp. of Bob’s Red Mill Unmodified Potato Starch in water with the VSL #3 DS each morning. (The starch feeds the good gut flora). It has been 8 days now w/ this combo, & my IBS is nearly gone. OMG, Thank you Chris! I will say, that some experts don’t agree w/ the use of resistant starch; I just received a book called “Fast Tract Digestion” (IBS version) by Norman Robillard, Ph.D (a microbiologist) that I will read ( Anything recommended by Michael Eades is worth a read)! Other possibilities causing IBS (besides wheat, gluten, dairy) include FODMAP foods and a condition called S.I.B.O. (Small intestine bacterial overgrowth), in which resistant starch can feed the bad bacteria also. So, there is much to learn, & I don’t necessarily want to recommend something that has potential to aggravate IBS for someone else. But, I felt I had nothing to lose. So far, Probiotics, resistant starch, no wheat or gluten seems to work for me. Now it’s time to learn to make fermented foods & get my gut biome in the best shape ever! I am so grateful to the generous, caring people in the Paleo Community who seek the truth, and think outside ‘conventional wisdom’s’ limited box.
Chinese vegetarian dishes rely heavily on beans, mainly soy, and gluten for protein. Every year as part of a cleansing ritual, my mother would make a vegetarian dish for Chinese New Year consisting of mixed Chinese vegetables, mung bean threads, soybean sheets, deep fried tofu, wheat gluten and oysters (we’re not vegetarians, just liked the taste). My favorite in that dish was always the chewy chunks of gluten stewed in the delicious oyster sauce. I loved the taste and texture so much that I learned how to make it from scratch. The name in Chinese is mein gun, meaning the tendon of the wheat. If you are interested in getting some isolated gluten, compound, to test your own sensitivity, here is a recipe
http://www.wikihow.com/Make-Wheat-Gluten
to facilitate the washing of the gluten, which can be very tedious, I usually soak the dough for a few hours before washing the starch away.
I don’t eat much of it, because I have had skin problems most of my life. My mother told me that I had Pneumonia when I was a baby and I remember a period of time when a friend of the family’s came to give me a shot every night for a week when I was five. As soon as I arrived in America, at six, I developed a rash. My mother took me to a dermatologist that gave me more antibiotics. Then when I reached puberty, the rashes turned into pimples and has stayed with me my whole life.
I’m now 68 and I do notice that my skin breaks out more when I eat wheat. I suspect, though, that my skin problems, and perhaps all the issues that people have with leaky gut, Celiac and the myriad of diseases that have no cure are actually due to antibiotic over dose that destroyed the gut and the immune system.
Caveat – I work in mainstream healthcare and I’m an advocate for integrative medicine.
I obviously can’t comment for anyone else, but going gluten free has significantly changed my health. I did a lot of research prior to eliminating this from my diet and didn’t look to do this due to the current trend. I could go on and on regarding all of the changes, but I think the proof fell into the reintroduction of gluten into my diet. I thought perhaps I was full of delusions – I’ve read the articles – until I reintroduced gluten as a food challenge after eliminating it for 8 weeks. I expected no impact from this challenge and had every intention of joining the easy eating crowd again.
I ended up in bed for two days with a heating pad on my abdomen, feeling like I got ran over by a car. 3-4 days after eating gluten I developed inflammatory nodules on my face, chest, and back (at 48 years old). I honestly felt and looked horrible. My physician wanted to test me for celiac, but I now can’t go back on wheat products without significant health concerns.
I am so thankful for my delusions over the past 2 years! The effort
I am definitely gluten sensitive, but not the normal symptoms. I get a rash that lasts for a day or two. Very itchy and it was very hard to diagnose. I know it’s gluten because if I eat something with gluten I will suffer the next couple of days with itchy rash.
Eating purified gluten failed to address the complex interaction of nutrients. In some sense it’s the inverse of the overblown mercury scare in fish which was considered in the absence of selenium. At a minimum, gluten needed to be introduced in a naturally occurring form.
The two week trial period was inadequate to develop any generalized conclusions about the overall safety of gluten.
Industry funding requires above average due diligence. This study was supported by George Weston Foods as part of a partnership in an Australian Research Council Linkage Project and the National Health and Medical Research Council (NHMRC) of Australia. George Weston Foods is a wholly owned subsidiary of Associated British Foods plc (ABF), a diversified international food, ingredients and retail group with operations across sugar, agriculture, retail, grocery and ingredients.
Even if gluten was harmless, Mat LaLonde’s reasoning about nutrient density is still a very compelling reason to avoid virtually all of the gluten containing foods.
I have tried both taking out wheat and gluten then tried bringing back gluten then wheat and I can say with confidence that I cannot tolerate gluten. I have also had an endoscopy to determine if I had celiac since I get classic symptoms but my GI Dr did something the celiac foundation said was wrong. He did the scope when I was gluten free for a few months. They say you should eat gluten for 2 months then get the scope. Dr. said that he can tell even if one isn’t eating gluten. The treatment the same. Any thoughts on this?
With a quick pass through of the study it looked like only three days of gluten before changing again. Not only did they not allow for a delayed allergic reaction but concluded that the symptoms the people had on the 4-6 day of placebo was reverse placebo rather than a delayed reaction. Poorly designed study.