Yesterday I explained how Celiac is just the beginning of the gluten conversation, hardly the end. I also discussed how our conventional model of testing is barely skimming the surface of those of us with gluten issues as it’s catching only 1 in 8 people reacting to gluten. (More on better testing at www.cyrexlabs.com) But let’s say you’ve done some gluten testing and you appear, on paper, to be in the clear. Whew! Should you still avoid it? Maybe. In this article I’ll explain why we all may want to at least minimize gluten, how tough is it to avoid, why you can’t really be “almost” gluten free and why you may be more reactive to gluten now than you were before. First, our food supply is a mess. Wheat is one grain that is very “modified genetically” (although it does not meet the criteria to be considered genetically modified, aka GMO) in our country. (With most grains and all of our soy being modified, picture me now fist shaking in the air cursing, “Monsanto!”) While it’s not technically “GMO” our adulterated gluten has been genetically spliced and diced enough that it fires up our tummies and our T cells. Our immune system doesn’t like this new gluten much, so whether it’s GMO or not is sorta 6 of one, half dozen of the other….but at the end of the day, this modified gluten is largely to blame for the rash of gluten reactivity we’re seeing today. The wheat/gluten we’re eating today is not what our parents ate and certainly not what our grandparents ate – and also not what our counterparts in Europe are eating. Our homegrown American gluten is a completely foreign molecule that our bodies, namely our immune systems, have never dealt with evolutionarily. Just like when we shake hands with our friend who has a cold and our immune system sees that virus and launches the attack, it does the same with our modern gluten. This GMO issue makes gluten unarguably an inflammatory food in general, for us all, positive gluten testing or not. And here’s a few more ways gluten is firing up our immune system, causing inflammation and generally being naughty: In order to make gluten mix well with other ingredients, food manufacturers deaminate it. This chemical process makes the gluten molecules water soluble in order to make processed, packaged foods. However, this also creates a molecule that is much more reactive than plain gluten or gliadin (see my post yesterday for a graphic showing how wheat becomes gluten and gliadin, etc). We grow and farm massive amounts of wheat and it’s stored in large bins for long periods of time, allowing mold to act on it and create little immune aggravators called enterotoxins. Many of us have “intestinal permeability”, aka a “leaky gut”. A leaky gut is due to inflammation in the gut that has caused a bit of swelling in the cells of our intestines, damaging the junctions between the cells allowing larger proteins to get through. Normally only small things pass through such as a single amino acid, a vitamin, or a molecule of glucose. When these larger proteins end up in our blood stream, our immune system sees them, gets all wound up and here comes the inflammation baby! We can get a leaky gut from years of a bad diet, various medications, having hypothyroidism, being under high stress, eating foods that we are sensitive to, taking antibiotics or doing anything that disrupts the delicate balance of bacteria in our gut. Many of us have poor digestion including low stomach acid production (either inherently or we take acid lowering medications such as TUMS or Zantac) or low enzyme output to digest our food (we need different enzymes to breakdown fats, proteins and carbohydrates). Any of these can disrupt the healthy gut bacteria in our intestines or cause inflammation (leading to the leaky gut issue) making us more intolerant to foods (think to back when we were young and could “eat anything” and now there are various foods that give us mild to significant digestive distress). Ok, back to the question: if gluten is inflammatory and I could have any number of issues listed above, should I stop eating it? Is gluten inherently just bad? Well inflammation is bad and we know this genetically modified Franken-Gluten is causing inflammation so yeah, it’s bad. Is it terribly bad for everyone? Not necessarily. If your immune system is healthy and your gut is healthy and you don’t have a lot of other inflammation in your body, you’ll do OK vs. someone who is struggling with any of those things. For those of you lucky ones, I’d say going totally gluten free is probably not necessary but I’d still discourage anyone from eating several servings of gluten per day. Always focus on more vegetables and fruit vs. grain based carbohydrates. Think sweet potato, pumpkin, squash, fruits and legumes vs. breads, pastas, rice, etc. However, if you have an autoimmune disorder, a thyroid condition, PCOS, digestive trouble, depression, anxiety, mood issues, acne or are struggling to get pregnant, my advice is to avoid it. Not sold? Give it up for 45 days at least. The skies may not part and the heavens may not open up, but many of your symptoms may clear up. If they don’t add it back in and see if you feel any different. Is It Hard To Be Gluten Free? At first, yes. But after you’ve done it for a while, at times, still yes. It can be tough if you don’t plan ahead , you will find yourself in restaurants awkwardly ordering some off the menu concoction, you will have friends and family give you a hard time for eating “so weird”. But it does get easier and if you feel better, look better, have more energy, are less depressed and losing weight, then it’s worth it. And the question on everyone’s mind: is Dr Brooke gluten free? Yes. I wouldn’t ask any of my patients to do something I was unwilling to do myself or didn’t think was that important. And knowing all of the info I’ve just shared with you in the past two blogs, how could I not be? And how could I feed this food to my family? Do I like being gluten free? Well I like feeling better – gluten makes me tired, cranky, irritable and depressed – although my gut doesn’t react at all. But no, I don’t like it all of the time. I have been very hungry in an airport when I’ve forgotten to pack snacks for myself, I’ve been sad perusing a menu seeing how limited my options are and I’ve never tasted the delicious looking chocolate croissants at my favorite Park Slope coffee shop. I can live without bread or pasta but I do miss the occasional beer, but hey, that’s life! No sense dwelling on the downsides of it and feeling restricted, that just makes it all so exhausting and depressing. I’d rather focus on all the literally thousands of foods I can eat. Feeling badly and knowing I’m damaging my body just isn’t worth the few minutes of yum I’ll have from that buttery, flaky croissant. What’s more, most of the gluten containing foods are simple carbs that wreak havoc weight loss – one more reason to avoid them. One of my patients put it best last week when asked if she felt deprived not being able to eat gluten. She brilliantly replied, “No! I felt deprived before when I had lower energy, worse allergies and funky digestion.” It’s all in our perspective. Can You Make Yourself Sensitive to Gluten? How about this conundrum: I used to eat gluten with little ill effects, avoided it and now when I eat it I feel like a truck hit me! Did I make myself allergic to it?? No, not really. If we eat a food that we are even mildly reactive to on a daily basis our immune system just plain gets tired and depleted. When we take it out for a while and the antibodies have time to replenish, they are ready to rock when they see that food again and your reaction is quicker and seems more severe. This will not get better, the longer you avoid something you are sensitive to more often the more significant your reaction will be. (Unless the issue was due solely to a leaky gut, in this case fixing the leaky gut issue should remedy the sensitivity…but there are often multiple factors at play.) Does this mean, to save yourself a nasty reaction you should dose yourself every day? Definitely not! This just tells you that you’ve done the right thing by cutting this food out of your daily diet. And remember, even if your symptoms seem slight such as a “little tummy ache” or just a bit of bleeding gums when you have gluten, you are reacting and it is a stress on your body and your immune system. Can’t commit? Can you go “almost gluten free”? If you are not someone with an autoimmune disorder or the conditions I mentioned above, don’t have significant symptoms when you eat it but still are a bit warry of this ubiquitous protein, can you just eat it on occasion? Sure. But if you do have any autoimmunity, hypothyroidism, PCOS, etc then remember this scary fact: the inflammatory reaction created from a bite as small as a crouton lasts for 3-6 months . Having a bite here and there really doesn’t let your immune system recover. That said, less is better than more so if the best you can do is minimize it, then at least do that. Like I always say: if you can’t do everything, don’t not do anything….at least do something! So for my final trick, I’ll answer the aggravating question: Why when I ditched the gluten, I didn’t lose any weight!! What gives???? Tune in tomorrow for 7 Reasons Why You Didn’t Lose Weight Going Gluten Free. See you soon!