Tuesday, July 17, 2012

Is a Gluten-Free Diet Healthy?

Okay so I just saw the Dr. OZ video on gluten, the gluten diet and what he described as the myths surrounding the gluten diet. I think the purpose of the segment was to discuss the fad of a gluten-free diet as a way to lose weight and whether this is a healthy way to lose weight. The segment was a bit confusing regarding the real point he was trying to make so I thought I would discuss some points regarding a gluten-free diet, why it may be the healthiest thing for you, why people lose weight on a gluten-free diet, why a gluten-free diet may not be healthy for you, and what a gluten-free diet should not be.

First thing we should probably discuss is what is gluten?

Gluten in simple terms is a protein found in grains. The most problematic seem to be in wheat, barley, rye, and malt. But any of the grain foods can be problematic for someone for a number of reasons. I will cover more of these in a later article.

The real question is should you be on a gluten-free diet?

And the answer is may be. If you are sensitive or intolerant to gluten or its breakdown components or have Celiac Disease the answer is yes. If you are not gluten intolerant/sensitive or do not have Celiac Disease the answer is maybe. The maybe, is because we now know through research that gluten can cause cross-reactions with other food sensitivities and although you are not sensitive to gluten, eating it may make your other food sensitivities worse.

So how do you find out if you are gluten sensitive?

Well, Dr. OZ and his guest Dr. Hyman suggest you go totally gluten-free for two weeks, then add gluten back and see how you feel. While this sounds like an easy way to do it and some people notice improvement, others do this and feel no change and assume they therefore don't have a problem with gluten. There are multiple reasons a person may not notice any change:

1. Too short of a time period. I have many patients that don't notice changes until they have been off of gluten for longer periods of time.

2. They may be off gluten, but they are eating foods that can be cross-reactive like coffee, milk protein (casein), etc. These foods look similar enough to your immune system for some people that when they eat them, your body thinks its gluten and you get a response just like eating gluten. So this may not work for everyone.

3. You may have what is called "Leaky Gut Syndrome". Leaky Gut Syndrome simply means that your intestinal track has become too porous and is letting things like undigested food, bacterial toxins, etc. get into the blood stream. These undigested foods like rice protein or egg protein may continue an immune reaction even though you are off gluten and no change is noticed.

I, and others recommend an Auto-Immune or Anti-inflammatory diet if you are going to try to see if your food is making you not feel well. This diet consists of lean meat, fish, chicken, vegetables, high fiber fruits (stone fruits), nuts, olive or coconut oil and water to drink. It doesn't sound exciting but it eliminates most of the common food sensitivities and cross-reactors. If you want more information on the diet email me or send me a message.

So you may feel better, you may notice no change for the reasons I explained above or a third outcome that can happen and I see this happen frequently is a person may feel worse. That's right you remove gluten and you feel worse. Now you're thinking not only am I not gluten sensitive, I actually need it to feel better. I get the logic of this thinking, but it is only because someone hasn't explained that there is a portion of gluten called Gluteomorphin, that for some people, can create a withdraw response when removed like a junkie coming off drugs or a heavy coffee drinker quitting cold turkey. Sometimes the symptoms are mild and sometimes quite severe.

What I suggest for everyone is if you are healthy and feel great, have no chronic health challenges why bother, keep doing what you're doing. If you have chronic health problems, then getting tested for gluten intolerance may be the best investment you can make. But here is where more problems occur.

What test do you run?

Most doctors are unaware that a Celiac panel like the one mentioned on Dr. OZ is just not sensitive enough to pick up many cases of gluten intolerance. If you have full blown Celiac Disease this test is may be fine. But if you don't have Celiac Disease (I will talk about the difference later) but do have gluten intolerance you may not get a positive finding.

A new lab opened up in the last year called Cyrex Labs. Cyrex's Chief Scientific Consultant is Aristo Vojdani, PhD, MT and is one of the premier immunologists in the world. He has designed tests, called Arrays, that are now the go to tests to identify not just gluten intolerance but a bucket load of other things that make identifying the cause of many of our chronic health care problems a reality.

Cyrex Lab currently offers two unique tests that can be used to identify gluten sensitivity. The first is their Array 1. Array 1 / Mucosal Gluten Reactivity Screen, is a saliva test that is easy to perform, can be done at home, and is the most cost effective (in my opinion) for the average person who is looking to see if they are reacting to gluten. The drawback to this test is that it only tests one aspect of gluten, alpha gliadin. There are many other components of gluten that someone can be sensitive to. So if this test is negative and a person appears reactive to gluten or has chronic health problems, the more comprehensive Array 3 (Wheat/Gluten Proteome Reactivity & Autoimmunity) should be performed.

But if Array 1 is positive, game over, no more gluten. Array 3 is much more complex and too much to explain now, but as a doctor I love the test. As much as I love it, I don't run it as often as the Array 1 because the Array 3 requires a blood draw and that can be a bit more of an effort for some people. Currently these tests are not covered by insurance but they are by far, now the best tests to identify gluten intolerance and the impact that gluten intolerance is having on the body.

So who should get tested for gluten?

I suggest that anyone with chronic health care problems like allergies, sinus problems, headaches, migraines, digestive problems, and chronic pain should consider getting tested if they are looking for the cause of those symptoms and tired of treating the symptoms. If you have any sort of chronic disease or auto-immune condition like Rheumatoid Arthritis, Crohn's Disease, MS, Raynaud's, Fibromyalgia, Thyroid disorders, vertigo, depression, high blood pressure, chronic fatigue, Irritable Bowel Syndrome, etc. I highly recommend you get tested. If you are one of those people who feel lousy all the time and no one seems to know what is wrong, you are the "undiagnosed", and you are looking for a possible answer, get tested for gluten.

Now is gluten the answer to the world's health problems?

No, by far there are plenty of other things in our lives that make us unhealthy. However, it is not a bad place to start if you are looking for a reason/cause of your health problems.

Will going gluten-free if you're intolerant or have Celiac Disease be enough?

Maybe. Some people will feel much better on just a gluten-free "healthy" diet. But others won't, because as I said earlier gluten may only part of the problem. If you don't address all the problems like other food sensitivities, intestinal permeability, gut infections, blood sugar problems, etc. than going gluten-free may not be enough.

If you find out you are gluten intolerant it might stimulate questions like; what damage has been done to the body as a results, how do I find out what damage has been done, and lastly what can be done to repair the damage. Those are the questions that will have to be addressed by someone like myself on an individual basis. These are the things I deal with on a daily basis in my practice with my patients.

Dr. OZ and his guests did mention that a gluten-free diet can be worse than a gluten-full diet. To a degree they were right, but what they should have said was that any diet high in processed foods is not as healthy as a diet consisting of whole organic, non-processed foods. If you think that you can be healthy just because your ice cream, cookies, cakes, and crackers are gluten-free, roll back over because you're dreaming!

The basic principles of eating healthy do not change. The focus should be on eating lean meat, fish, chicken, vegetables, high fiber fruits, raw nuts, healthy oils and plenty of non-caffeinated, no sugar / sugar substituted fluids. If you are not gluten sensitive, eat whole grains. If you are gluten sensitive be careful, and seek guidance on the appropriate grains for you. To be healthy you need to also manage stress, get appropriate sleep, and be active.

Dr. Balcavage is a Doctor of Chiropractic in Glen Mills, Pa. He utilizes chiropractic care, nutrition, and functional neurology to help his patients maximize their health. Comments can be directed to: