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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Not sure if it’s been pointed out yet but Peter Gibson whose study this is has a conflict of interest in that he wrote and is selling an IBS diet book.
If you scroll to the bottom of the study on Gastrojournal, this conflict is stated right there.
I am sure all the smug click bait article readers did not actually reD the study itself let alone the footnotes.
There’s far more to grain sensitivity or allergy, than just the gluten.
Celiac disease has long been proven as a sensitivity or allergy to gluten, OTHER factors, such as the grain being GMO’d, can cause IBS reactions to wheat, rye, etc. grains, depending on what genes were spliced into the grains that some folks are allergic/sensitive to. Also, chemical used on the grains to grow them, can cause adverse reactions.
Just like Dairy might not be allergy to lactose, but could be allergy to the feed the animal ate to produce the milk, OR, could be the presence of either the A-1 or A-2 protein, OR something else used to treat the animal, or grow their feed.
As for people going off a food for some time, then eating it again only to find themselves now terribly allergic/sensitive to it—yes, that happens
–it does not mean they weren’t allergic/sensitive before–only that now, the adverse effects scream louder from a system allowed to clean itself out from the leftovers of that food that had been compensated for.
In other words, the body will put the adverse chemistry components somewhere–often into fat cells, to sequester it.
OR, the body will adjust it’s chemistry to try to deal with it.
Remove the suspect food, the body proceeds to clean out that residue, then tries to re-set it’s boundaries……adding the offending food back is then a larger problem than it ‘seemed’, before.
But it does not mean a person was never allergic to a food before–it means their body was compensating for that allergy — so far –.
So, here’s another unscientific and fun way to test if you’re having gluten allergy or other wheat. Fast for the 60 Days, then drink beer and see what happens. Wait a few days and drink hard cider. The beer contains Barley Malt with the Gluten, but is low in FODMAPS. The Hard Cider is gluten free but has the FODMAPS. Drink up!
I’m very surprised I never hear you mention Cyrex Labs for food allergy and leaky gut testing. Perhaps you have and I simply haven’t come across it before…
Chris,
Thanks for this article. The media is killing me with this one.
“In other words, patients did react adversely to wheat, but they did not react to isolated gluten.”
That’s not exactly what the study said, if I recall correctly.
When I read the study, it sounded to me like all of the patients DID react to the isolated gluten, the only issue was that the “control group” also reacted. So everyone reacted either way, and they figured since there was no difference between the control and the gluten group, it was a bust.
I agree that they were likely having a negative response to the whey, which threw things off a bit, but I don’t think this study vindicates gluten, even in its isolated form.
Thanks again for the work you do!
Interesting, thank you for this article! I’ve seen reports of that study circulating on the internet all week (paired with the usual ignorant “See, it’s all in your head!” comments), and was curious to hear an actual professional’s take on it. As someone with a non-celiac intolerance to gluten (as verified by a blood test 4 wks after I’d stopped eating gluten…so not exactly set in stone), it’s interesting to see that this may just be wheat for me. The idea of potentially being able to bring beer back into my diet is…pretty awesome. : )
A fair number of people do eat wheat gluten specifically and on purpose. It’s called seitan. I don’t think it’s pure gluten though.
A lot is made of wheat/gluten sensitivity and gut issues. That’s not why I stopped eating gluten. I am a woman, 64, with low thyroid, osteoporosis (which is in the ‘severe’ category), and 40 years of asthma and persistent cough plus almost debilitating seasonal allergies. Maybe it is my age, but I saw no improvement right away on any of these issues, but now after being wheat free for more than 2 years my asthma and cough are completely gone. People have even commented about it. Also, it is spring now, a time when my allergies should be at their worst and I have no symptoms. The other day I threw our several expired packages of Claritin. I love to sing-2 community choirs and solo work-and so vocal and throat health matters to me. I can say that at age 64, my voice has never been better. Maybe for young people it’s different, but it took way more than the standard 60 days to see any difference at all. (still waiting to see improvement in my thyroid or bones-but maybe that will take longer. )
I wasn’t aware of any ‘fallout’ but I just had a personal experience with this. I usually don’t eat wheat and the sorts. But after the holidays season and lots of bad food I went gluten free in January to see if my IBS symptoms would improve. After 4 months I decided to have a regular meal of spaghetti. It was delicious but I paid for it for two weeks. Don’t need to go into detail I assume. But I took laxative for the first time in 4 months. I don’t really care what is it called but I am going gluten free for forever. Or perhaps I should say wheat free after reading this article. (Although I cannot eat any carb based food without getting symptoms, except rice and yes, also most veggies. Low FODMAP doesn’t do any good either) My symptoms are still there without gluten, but a lot less. My next step is to eliminate dairy..
Chris – are you aware of the study by Aristo Vojdani and Igal Tarash Cross Reacton between Gliadin and Different Food and Tissue Antigens, publishedin 2013 in the Food and Nutrition Sciences Journal? The researchres show high cross reactivity between gliadin and whey, rice, millet, and other foods, little to no cross reactivity with sesame, buckwheat, tapioca, teff, egg, dark chocolate, pure coffee. There are some other interesting articles by the same authors.
I very much believe I had celiac disease. I remember being 10 years old and experiencing terrible chest pain. This pain I had all the way through college. Sometimes it got so bad that I tried not to breath. I also used to experience IBS symptoms or a lot of very bad abdominal pain/discomfort. Well, I don’t get any of this stuff anymore and I suspect I probably used to have a leaky gut. I used to extremely overeat. I never gained weight, but my blood sugar levels were a little higher than where it should’ve been. I cleaned up my diet, but it took maybe a whole year(?) to get back to normal. By normal, I mean losing the cravings, excessive eating, and losing the side effects. I don’t overeat anymore. I eat tons of dairy now with no symptoms.
I have no sensitivities to gluten or wheat that I know of and I am eternally grateful for that. Of course, I might have sensitivities that just haven’t manifested yet but I just don’t know about. I choose to avoid these products because, frankly, they are silly. Why would I waste my time putting nutrient-deficient foods into my body when there are so many delicious nutrient-dense whole foods out there? It just doesn’t make sense to me. Once I stopped looking at wheat products as containing gluten and simply as highly processed foods just like any other non-gluten containing processed foods it became so much easier. I tell people that I don’t try to be gluten free, I just eat vegetables and fruits, meats, healthy fats, nutrient-dense carbs, nuts and seeds which are all minimally processed. By eating this way gluten is just not in the picture. In this way I avoid the eye-rollers who for some reason feel like they need to judge me for not eating gluten. I say just tell people what you do eat and leave it at that. If someone says they don’t eat pork I don’t assume they have some undocumented pork sensitivity that needs to be debated. They don’t eat it because it makes them feel bad, or they think pigs are dirty animals or it has to do with their religion or whatever. Who cares? This study is just pointless and stupid and only serves to divide people.
David makes a good point when he mentions the importance of eating nutrient dense foods. The question is how do you know which foods are nutrient dense, if any? Food was given to us primarily to provide nutrients to our body so it can use these nutrients to construct the cells which make up our body. Sort of like following a blue print when building a house. If you follow the blueprint using the proper components and the home is designed properly you will have a strong and functional home. Plants too have a design given by our Creator. Not only did He give plants a design he provided
all the nutrients plants needed to yield forth their bounty to man. As a result people lived up to 900 years of age in some cases. Eventually mankind and the earth itself was destroyed by a worldwide flood with only Noah and his family surviving. This catastrophic flood destroyed the soil structure of the earth. Minerals which were in the soils in the proper quantity and relationship to one another were drastically altered. Plants no longer could uptake nutrients like they did before the flood and as a result disease from nutrient deficiencies greatly reduced our life span. In addition these nutrient deficiencies caused disease in plants also.
Subsequent to this flood man has been ever increasingly exploiting the land rather than stewarding over it which was his duty. This exploitation we see not only in farming but in every area of life. And So we are reaping what we have sewn and we don’t like it. But the fact remains that unless we adopt a sound program of soil remineralization according to the Albrecht model of soil balancing no diet, no genetic modification of plants and humans wii ever correct our nutrient deficiencies leading to disease and death for plants, animals and mankind.
The solution is simple but are we willing to pay the price now so that we can live a healthy and long life or do we want spend this money to build larger hospitals to deal with the symptoms of malnutrition in plants and therefore humans ? We hold the keys !
I haven’t read all of the responses yet and so I might be repeating someone else’s comment, but my first thought is to find out if you are celiac before you consider the possibility of gluten sensitivity. Do not stop eating gluten until you get tested for celiac. It may be your best chance to get accurate blood results.
I know this sounds like conventional wisdom, but they are right about this one.
I did the remove it for sixty days thing and subsequently found out that some family members were testing positive for celiac. Now I want to know if I am celiac and I am in the midst of a 90 day gluten challenge in hopes of getting accurate labs. So far I don’t feel, or am unable to notice, any negative effects from eating wheat for the past 53 days.
Why 90 days? It can take up to 90 days of gluten challenge for antibodies to show up in labs after living gluten free, and that is true for previously diagnosed celiacs. Dig this literature review: http://www.ncbi.nlm.nih.gov/pubmed/24284613
After removing gluten for 60 days you won’t always necessarily be able to feel or notice the damage that could be happening when you reintroduce wheat, you could possibly be a silent celiac and never know it.
If you can afford to test independently or can convince you doctor to order it, get tested first before removing gluten.
As someone with non-celiac gluten sensitivity, I can tell you that relying on research studies which change almost daily or on medical tests alone will not help you as much as doing the gluten challenge. It was clear after 4 weeks on a gluten-free diet that my issues were related to gluten. When I started to consume gluten after the 4-week trial, all of my symptoms began to return. So I’ve avoided gluten ever since and am feeling remarkable better, praise the Lord ! 🙂
I stayed away from gluten and lot of my symptoms vanished like Sinus, joint pain etc I lost lot of weight.
But now my body is very sensitive to gluten in form Bread and pastries.
I certainly react to whey protein as well as casein. I challenged it once without even meaning to and the reaction was severe and obvious. So I see an inherent flaw in this study – thanks for pointing it out, Chris!
Eating wheat and wheat products gives me terrible IBS. But I seem to be able to tolerate barley and rye. These other grains make me feel bloated and lethargic, but do not provoke IBS. Thank God, because I love beer. So n = 1, I have “non-celiac wheat sensitivity.”
Which is the better usage, “sensitivity” or “intolerance”?
Mr. Pollan is someone quoted in those recent glut of sensational headlines for saying “There are a lot of people that hear from their friends, ‘I got off gluten and I sleep better, the sex is better, and I’m happier,’ and then they try it and they feel better, too.” I have a lot of respect for Mr. Pollan but he disappoints me with his next sentence, in continuation of that quote, “The power of suggestion.” What an unfortunate, disarming, disempowering leap he made with that “declarative” final statement.
To answer Dr. Kresser’s question: 18 year old son, 8 months gluten free, one hamburger bun, severe stomach cramps in 3 hours, violently sick in 6. Two weeks later, digestion still upset, acne is back, depression is waning (peaked the day after). Does not have celiac.
Thanks for taking this issue, on Chris! I saw an article about the gluten study in Business Insider and thought immediately that I hoped you would write about it. Your post really cleared things up for me!
I’m adding a link to the source of this research that has hit mainstream. Take a close look at the last paragraph about the funding of this 37 person study. Isn’t George Weston Foods a major producer of bakery products? Would they not have a vested interest in confusing public understanding of this issue? One must always consider who funded the research, and not get caught up in the spin.
http://www.gastrojournal.org/article/S0016-5085%2813%2900702-6/abstract