Wednesday, December 22, 2010

A Gluten-free January

Are You Gluten Sensitive?

Many people are totally unaware of the fact that they react poorly to gluten. Because they've been eating wheat, barley and/or rye products every day for virtually their entire lives, they don't know what their bodies feel like without gluten. In susceptible people, eating gluten is linked to a dizzying array of health problems that stem from an immune reaction to gliadins and other proteins in gluten (1). Are you a susceptible person? How do you know?

The gold standard way to detect a gluten sensitivity is to do a gluten "challenge" after a period of avoidance and see how you feel. People who react poorly to gluten may feel better after a period of avoidance. After a gluten challenge, symptoms can range from digestive upset, to skin symptoms, to fatigue or irritability within minutes to days of the gluten challenge.

With 2011 approaching, why not make your new year's resolution to go gluten-free for a month? A man named Matt Lentzner e-mailed me this week to ask if I would help with his (non-commercial) project, "A Gluten-free January". I said I'd be delighted. Although I don't typically eat much gluten, this January I'm going 100% gluten-free. Are you on board? Read on.

A Message from Matt Lentzner


Hi There.

My name is Matt Lentzner. I'm just some guy who lifts weights on his patio and tries to eat healthy. That's not important, but I have an idea that just might be.

I am trying to get as many people as possible to go gluten-free for one month - this January 2011.

I've considered this whole ancestral diet thing and I've come to a conclusion. If you could only do just one thing to improve your health then not eating gluten would be it. This is not to say that avoiding other nasty things like fructose or industrial vegetable oil is not important. They are, but you'd get the most bang for your buck from not eating gluten.

"Eat No Gluten" is simple and easy to remember. I think that sometimes the rules get so complicated and overwhelming and people just give up on it. We're keeping it simple here. Even at this simplified level I see that it's difficult for a lot of folks. I think people, Americans especially, tend not to pay much attention to what they're eating - what it is, where it came from, etc.

Getting people to get out of their eating ruts and think a little about what goes into their mouths is a valuable exercise. It sets the stage for better choices in the future. I hope that some success with the simple step will encourage people to further improve their diets.

I have a website at www.glutenfreejan.com. If you want to sign up just send an email with your first name, last initial, and town of residence to glutenfreejan@gmail.com. If you are on Facebook there's a community you can 'Like' called: Gluten Free January. So far I have over 120 people all over the world signed up. If you are already gluten-free then I still want you to sign up - the more the merrier. You can also use this opportunity to spread the word and sign up your family and friends.

Merry Christmas - Looking forward to a gluten-free New Year.

Matt

52 comments:

  1. For some people, it's not the gluten they react to, but the fructans that wheat and other grains contain. I'd had friends who swore up and down they reacted to wheat, but when their doctors tested them for antibody responses to gluten, they came up clear. Once I found out that wheat can cause a reaction in people with FODMAPs sensitivity, I started wondering how many people are actually be intolerant to the fructans in place of or in addition to gluten sensitivity.

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  2. Heck yeah. I just experienced the effects of an inadvertent "gluten challenge" while doing some holiday baking. I tasted the cookie dough, full of white flour (and sugar, of course), and my face and mouth starting itching immediately. Yikes.

    Goodbye, gluten.

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  3. Stephen, I'd like to publicly thank you for putting this blog up with so much life-altering information. I read it for six months thinking that you were crazy for beating the drum about the dangers of wheat. How could wheat be bad for you? I'd been eating it my whole life...

    But your blog made me aware of the issue, and when I stopped eating wheat for a week through dumb luck, and then "challenged" my system, I was shocked to discover that I was one of the people who has a severe problem with wheat.

    As you say, I had no idea how badly I felt, until it stopped. A whole host of issues that I thought were "just life" turned out to be side effects of wheat consumption.

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  4. @Christhescientist

    I think you are spot on - I think there is likely far more GI upset due to the FODMAPS in wheat flour than due to true celiac or gluten sensitivity.

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  5. Go Gluten-free for the month of January? Personally speaking...that shouldn't be too dificult, since I fast the whole month of January anyways. I've been fasting every January for the last 5 years and it's probably the best thing I've ever done for myself in my entire life.

    The hardest part about fasting, if anyone cares, is at the beginning of the fast and at the end. The first 4 days are the most difficult, and that may be due to the body converting to mainly a fat-burning metabolism from say a carb-burning one. The end of the fast is difficult for me because...well, I feel so good I don't want to end it.

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  6. I've been gluten free for 6 months, 1 more shouldn't be too hard.

    Dr.Harris, when will we get a new post?

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  7. cherishthescientist,

    Peter of Hyperlipid has written on gluten sensitivity and antibody tests.

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  8. I'm all for a gluten-free January. I'm one of those that has to follow a low-foodmap diet. But, getting rid of the fructans in wheat bread/pasta does help. I gave up wheat for about 15 months before and didn't cure my immense intestinal issues. Unfortunately, I found I needed a stricter diet, yet. I do think there is something in potatoes that grows good bacteria. It seems to have that effect on me. I've had great success with low foodmap. Unfortunately, I found out I had additional intolerances. I can't eat spinach, flax seed or chard. But, for once in my life I'm pain free.

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  10. I'm for certain one of those people who didn't know I was reacting to gluten until I gave it up. I gave it up to follow a paleo/primal diet and haven't looked back. I've been eating without it for a while now, but the other night I had some pizza from a local place. It looked too good to pass up and I thought it would cause no harm. The next day, I felt terrible. I felt like I had a hangover, my throat felt sore, and I broke out in a rash on my scalp. If that's not enough confirmation, I don't know what would be! I'm definitely supporting Gluten Free January.

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  11. i've eliminated gluten, except for the fortnightly foray into neopolitan pizza. in jan, i'll opt for thai instead.

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  12. @cherishthescientist.net: I wasn't aware of FODMAPs sensitivity, so thank you for sharing. The only way I'll know for sure is to get the antibody response test, which I plan to do soon.

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  13. Stephan,

    I'm pretty low on glutens, but find it hard to avoid crackers for things like cheese, salmon eggs/taramosalata, and other mushy treats. Is there a best type of grain for the cracker to be made of? How about rice cakes (which I really detest)? I try as much just to use a knife or spoon, but it just seems that crackers serve as a great utensil!

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  14. So many people in my family are Gluten intolerant--maybe I should try Gluten-free January also! I just came across your health and fitness blog, I'd love if you posted some of the gluten-free recipes you'll be using. I'm looking forward to reading additional posts on your blog in the future! Since you and your readers are interested in health and fitness, you should definitely check out our ab exercise machine. It is a full body workout product called The AbStand: http://www.theabstand.net, and it's great for people of all levels of fitness! Any feedback would be appreciated as well. Thanks!

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  15. David L

    There are a variety of crispy rice crackers available now that stand in quite well for wheat crackers. Diamond Nut Co makes some that are sold in supermarkets (the nut content is minimal - they are mostly rice). These crackers are nothing like rice cakes (which are akin to eating styrofoam, IMO). I avoid the highly flavored ones, though - reminds me too much of Doritos. I don't eat many rice crackers, but they are convenient for piling high with paté at parties.

    Then again, Dr. M.D. Eades (ProteinPower.com) has a nice baked salami chip recipe that is great for a savory chip without any grain.

    Going low on gluten is NOT the same as going gluten-free, because it can take several weeks for the immune system to calm down from an exposure to gluten (even a subtle response) in a sensitive individual. So going GF all week, then having pizza on the weekend isn't eating GF. Not everyone has GI symptoms, either. Gluten exposure symptoms can manifest on skin, joints, nerves, thyroid and other glands, disturb mood, etc.

    And simply not eating obvious sources of wheat isn't eating GF, either, as gluten is often in many prepared foods, and many non-wheat grains are contaminated (oats, especially). It does take some effort to actively avoid wheat, esp when someone else has prepared the food.

    Personally, I don't feel the need to buy and eat many GF alternative grain products, as they are often packaged foods with little nutritional value (and they spike my BG just as badly as wheat flour). So my way of eating GF is also nearly grainfree. I think it's easier, cheaper, and more nutritious to add some veggies than trying to fill all the "wheat holes" with GF substitutes.

    My GF 6th grader, OTOH, likes some GF rice pasta from Trader Joe's occasionally. Even his friends don't mind it's GF pasta, though I make sure the sauce and/or other ingredients are nutritionally dense, with only a very tiny amount of pasta (no more than 2 oz dry per serving).

    One thing that makes GF eating easier is to avoid packaged foods and order the simplest things at restaurants.

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  16. Count me in too. :)

    It will be easy for me because I've been gluten free for many years. I eat a Paleo/Primal diet now, but the biggest most obvious improvement in my health so far has been from going completely gluten free.

    I echo what others have posted here about not knowing that gluten grains were a problem for them until they gave them up.

    I resisted the idea that gluten was an issue for me when I first learned about it. It seemed far-fetched and ridiculous. Also, at that time I was making my own bread and crackers from flour I ground myself from organic wheat berries that I first soaked and dried.

    Within 2 weeks of giving up gluten grains completely, joint pain I'd had since my early 20s disappeared! I had been told by my doctor that I would likely have that pain for my entire life and there wasn't much I could do about it. Happily that wasn't true. :)

    A few years into being totally gluten free, twice I had wheat - once accidentally, once on purpose. Within 24 hrs, joint pain again! I had kind of forgotten what it was like to have it, so that was really something to experience. I also had a canker sore within 24 hrs, something I used to get every few weeks back in my gluten grain eating days, but I had not connected it to food. Interesting.

    Turns out I have one of the Celiac genes. I also tested positive via Enterolab for antibodies, but I already knew I had a problem when I was tested, I just couldn't bear to do a gluten challenge for 1-2 wks and be in pain in order to do the standard blood test (which so often is useless anyway).

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  17. A question: how long does it take for the gluten/wheat effects to go away? is 3 weeks enough?

    Matt and Stephan, this is a fab idea, I will email/facebook everyone, and I am going to add to be WHEAT and gluten free...due to the gliadins and lectins, as well as WGA. (good post about it: http://perfecthealthdiet.com/?p=911)

    Thank you!

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  18. Another evil we can attribute to wheat is iron overload, especially in men. The mandated iron supplementation of flour is certainly a contributing factor to many diseases of civilization. I'm not ready to go gluten free just yet, but I am scheduled to donate blood tomorrow, and I encourage everyone to do the same. Just don't eat the crap cookies they try to feed you afterwards.
    http://www.ncbi.nlm.nih.gov/pubmed/20967426

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  19. Full article on iron risks:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2988997/?tool=pubmed

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  20. This will be interesting. I look forward to hearing what kind of results you have. I went gluten-free for 23 days earlier this year when I did the milk diet. That was the easiest way I could imagine for going gluten free. When you're only drinking milk, there's honestly not much temptation to eat other foods. But I have to say I didn't notice a striking difference between when I was consuming gluten and when I wasn't. In any case, I don't see the need to consume gluten as often as I used to. I've gotta have my carbs (unless of course you want to see the Mr. Hyde version of moi), but dairy, fruit, potatoes and the occasional bowl of rice seem to do the trick in that department. Though I'll admit I'm not immune to having a slice of bread slathered with butter on occasion.

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  21. @Might-o'chondri-AL: "However, reaction to first meals back on it should not be claimed as proof of a theory."

    Really, why not? If your theory is that you have a problem digesting wheat, and you have a nasty reaction to eating wheat, why is that not a confirmation?

    I eat lobster once or twice a year. I have no reaction whatsoever when I eat it again.

    Yet a week without wheat and I had a violent reaction after eating it. This occurs with only one other food.

    Sounds like a pretty good confirmation of the theory to me.

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  22. "However, reaction to first meals back on it should not be claimed as proof of a theory."

    I question this statement, too.

    After my son had been eating GF for a few months, he complained of oral canker sores a few times. He'd never had canker sores before. He isn't aware enough of gluten contamination in foods to have a psychosomatic response, either. We reviewed anything he'd eaten at friends' houses or from the nearby 7-Eleven (it was summer and he was out and about much of the day); he was certain he hadn't been eaten any wheat foods (of course, he was thinking of clearly grainy foods like bread, crackers, tortillas, etc.). Turns out he had eaten licorice candy a number of times, not realizing wheat flour is the second ingredient in licorice. Each time he ate licorice he had a breakout of canker sores in his mouth.

    Proof, maybe not, but certainly incriminating. My own gluten challenge after eating GF for nearly a year quickly produced an tremendous amount of gut pain that dissipated within a half hour without further problems. It's tempting to think it was psychosomatic, and I should repeat the experiment, but it was unpleasant enough that I really don't want to.

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  25. @Might-o'chondri-AL:

    Certainly no insult taken. Thanks for the detailed information and analysis. I've also wondered about
    the candidas.

    I have no way yet to know for sure that it's gluten intolerance that caused my reaction to the pizza. My intuition tells me that is the case, but I do plan to have some tests done in the near future. Regardless of the test results, I do play to stay away from grains. I just feel better not eating them, but my scientific mind wants to know exactly what is going on in my body.

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  26. I have never noticed any adverse reactions from eating wheat.

    Sprouted grains have a good spectrum of amino acids and seem pretty nutritious. Gluten is very high in the most abundant amino acid in the human body: glutamine! (shiitake are another good source)

    Individual adverse reactions to any food should be dealt with individually.

    For some, meat is a problem. Others can't have dairy. SOme people get sick from raw onions -- not me.

    For me, the organic milk I drink is not a problem. Even raw colostrum -- love that stuff -- never gives me a problem. But too much cheese gives me trouble. And meat gives me problems and so does too much fish. Eggs, milk, fruit are all good.

    But my idea is about individuals identifying and understanding what foods work for them.

    And so I plan to eat just as much wheat in January as always, i.e. around four slices of bread and a half lb of pasta -- not much at all for one month. I could forgo it, but I am not highly motivated to do so.

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  29. BTW, I've noticed that even when I hit the Publish Your Comment button and get an error message that my comment wasn't published, my post still goes through when I check the blog in another window. So for those others who also get that error message, to avoid double posts, check in another window to see if your post is there before you hit the button again.

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  30. Off topic, but...I wish Paleo bloggers were better at spotting and stopping spam comments.

    Blogger Brooklyn said...Awesome Blog!!! blah blah blah blah

    Funny, Brooklyn had the exact same words to say over on Dr. Davis's blog: http://tinyurl.com/2bsn66b

    His wonderful blog that he links back to says, among other things, "In the meantime, they recommend that all people, with or without diabetes, should have a healthy balanced diet, low in fat, salt and sugar with plenty of fruit and vegetables." It's also chock full of plagiarized text.

    Sincere paleo fan or linkspammer? You be the judge.

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  31. Good post. Try to post more often. Where is today post?

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  32. There is a lot of talk about gluten and experts and dietitians to doctors asking everyone to avoid it.There area also many products that are gluten free and should be consumes for better health.
    Cosmetic Surgeon Atlanta

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  34. Hi Might-o'chondri-Al,

    How can I get in touch with you. I have some questions regarding your post.

    Thanks!

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  36. Hi Might-o'chondri-Al,

    There reason I asked your contact info was because my question was off the topic. Regardless, do you mind providing me with the reference for the paper that describes that the glutathione transferase from Issatchenkia orientalis is stable? I am interested in using this transferase in my research.

    Thanks!

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  38. Stephan, I have been pretty much gluten free for some years now.. except for a few exceptions lately. I never thought I had an issue, I just dropped it when I tried doing a raw vegan diet for 2 1/2 years. Even when I ate more ominvore stuff, I still let wheat stay off my plate.
    A few weeks ago I had some fresh made soaked sourdough bread.. let's just say 1/2 of it was gone by day's end. And for xmas, making some brownies, a few of those got eaten.
    My head was super itchy the last week or so.. could not figure out what the trouble was. Now there is a bit of a crusty deal there.. and on my elbow. I deduced that this may be gluten rearing it's head.
    Now to get the family off it.. stay tuned for that one.
    xo
    deb

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  39. @Anna - you said it.

    I think I a lot of people don't realize that gluten sensitivity, with or without the presence of celiac disease or GI symptoms (people think there should be a symptom in the GI tract because it's something you ate, but that's not necessarily so), can be far-reaching, from triggering a host of autoimmune diseases, such as Type I diabetes, Hashimoto's thyroiditis, or alopecia areata (autoimmune hair loss) to effects on the central nervous system and emotional and brain function. Yes, I have friends who certainly think this is crazy, but it can all be found through PubMed searches.

    You can get genetic tests to see if you carry the HLA DQ2 and/or HLA DQ8 gluten-sensitive genes. If you do, you'd be well advised to steer clear of gluten because it can set you up for a world of hurt. If you have a relative with celiac or can convince your doctor you have celiac-like symptoms, your insurance may cover it. The main lab doing it is Prometheus. You can get a self-pay test through Enterolab, but they themselves say their genetic analysis isn't as thorough in order to keep the costs down.

    @ Amy - Do you think you may be sensitive to oxalates? They can cause pain in people who either have a leaky gut (due to gluten and/or other insults) or who don't metabolize it well. The foods you listed are high in oxalates. I'm just beginning to become aware of this. It's kind of a bummer because my diet's so limited anyway, but I'm hoping maybe staying moderately low-oxalate for a time may be enough.

    Oxalates can exacerbate an already-leaky gut. I'm not sure if they cause one, though. So I'm wondering that if you get off gluten and other gut disruptors (like NSAIDS) for a year, and keep your oxalates relatively low at the same time, if eventually you can reintroduce them. Probiotics may help, too. Oxalobacter formigenes helps digest oxalates, as does l. acidophilus (oddly, a high-oxalate diet depletes one of l. acidophilus). I'm not sure if any supplements are yet available with oxalobacter formigenes, but raw milk is said to contain it. Lactobaillus acidophilus is common in yogurts and probiotic supplements.

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  40. @Helen: Thanks for sharing the information on testing with everyone. I'm going to pursue it after the New Year.

    @Might-o'chondri-AL: Do you have sources to back up your claim? "European stock have almost twice the gluten intolerance of other groups. Their agriculturists came west from where cereals were domesticated."

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  44. "The gold standard way to detect a gluten sensitivity is to do a gluten "challenge" after a period of avoidance and see how you feel."
    Isn't the gold standard to do a serum test for transglutaminase antibodies?

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  45. Might'ochondri'AL -

    Those numbers look like the numbers for celiac disease, which has a lower incidence than gluten intolerance, which sounds like a lighter affliction than it is.

    Johan -

    Antibodies might not be present until disease is advanced, and also can be suppressed if a person is not a bit IgA producer or something like that.

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  46. Where is the new post??? Try to put up a new one soon today or tomorrow!! Don't get lazy over the holidays!!

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  47. Hi Johan,

    anti-transglutaminase antibodies are a test for celiac disease. Gluten sensitivity is much broader and affects at least 10X more people than celiac. There are serum antibody tests for gluten sensitivity, IgA and IgG anti-gliadin (AGA). Roughly 1 in 10 people in Western nations are AGA positive.

    I think AGA is a useful test, but it isn't the last word. Several studies suggest (but do not prove) that many people can react to gluten without producing AGA. If you get rid of gluten and you feel better, that's the gold standard in my opinion. I'm sure not everyone would agree with me on that.

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  48. Helen,

    Thank you for your suggestion. I'm not sure what is going on with my system. But, I'm not sure I need more bacteria. I was diagnosed with SIBO (bacterial overgrowth). Certain foods, especially large amounts of fructose, broccoli, beans and leeks cause the overgrowth immediately. I can tell when I have the overgrowth because I'm severely constipated. Other foods like spinach and flax seed send me running to the bathroom.

    I've tried raw milk and raw yogurt. Yogurt makes me constipated. I have a food combination issue with milk. I can't eat foods with small amounts of fructose in them and drink milk. I end up in severe pain. I don't want to give up potatoes, celery, carrots and peas. If I don't drink milk, I can eat these foods in small amounts.

    Potatoes, large amounts: 4 ounces at a meal is okay. The others I can only eat an ounce or two of depending on the day. On a really good day I can eat an ounce of blueberries.

    I admit, I'm about the short term. I've tried other diets long term for my digestive issues, that have failed. If I eat nothing but potatoes and meat for 4 days, I can have completely normal digestion. And I admit, that if I'm on any type of antibiotics for 3 days I have normal digestion. I haven't eaten spinach and flax while consuming antibiotics.

    I think flour, even white flour is bad because it has 1 gram of fructan in it. Fructan is a type of fiber that is hard to break down for some people. White flour does not have an instant constipation affect on me like leeks, but over time it causes the overgrowth. In general, I have trouble with different fibers. If I can stay away from those fibers, my digestion is better. From what I've read most people that have trouble with various types of fibers and large amounts of fructose usually have diarrhea and not constipation. I'm a bit of an oddity because I have both depending on what I eat.

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  51. Regarding gluten challenges, people who go without meat for while often lose the ability to digest it and feel sick after eating it.

    Do you take that as evidence that meat is harmful?

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  52. Hi First,

    I take your point. However, the inability to digest meat is due to the undersecretion of digestive substances required for protein and fat breakdown, which typically corrects itself over time. The inability to digest gluten is due to an immune reaction that persists.

    Although it's not always that simple, as some people have meat allergies as well.

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