About 1 in 133 Americans suffers from celiac disease, or about 1 percent of the population. Every time a person with autoimmune digestive disease consumes gluten, the body essentially attacks itself.
There are many people, however, who aren’t diagnosed with celiac disease who are sensitive to gluten, something that has been deemed “non celiac gluten sensitivity.” In 2011, Peter Gibson, a professor of gastroenterology at Monash University and director of the GI Unit at The Alfred Hospital in Melbourne, Australia published a study that found gluten to cause gastrointestinal distress in patients that didn’t have celiac disease. This research became a strong piece of evidence to support non-celiac gluten sensitivity, which according to the National Foundation for Celiac Awareness, affects about 18 million Americans.
Gibson, however, has continued his research, and in his most recent publication has found no effect of gluten on patients with self-reported gluten-sensitivity. The 37 subjects in the study, all believed to have non-celiac gluten sensitivity, were fed a diet free of potential dietary triggers for gastrointestinal symptoms such as lactose, and certain fermentable, poorly absorbed short-chain carbohydrates. He then collected and analyzed the participants’ waste, concluding that “in contrast to our first study… we could find absolutely no specific response to gluten.”
Cycling through a high-gluten, low-gluten and no-gluten (placebo) diet, without knowing which one they were on, all of the diets ended up causing pain, bloating, nausea and gas, indicating that it wasn’t the gluten that was the trigger. But if gluten wasn’t the trigger, what was?
Gibson said that FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols), short-chain carbohydrates, were not well absorbed and may have been the cause of what people have been calling gluten sensitivity. Those FODMAPS are commonly found in foods that contain gluten. However, that still fails to explain the “nocebo” effect of those that experienced symptoms while on a completely gluten-free diet.
While the study group was small, the results are interesting, as researchers are still learning about non-celiac gluten sensitivity. Ultimately, people that remove gluten from their diet do so because they are experiencing a handful of problems, and even if it’s not gluten that’s causing them, something in our Standard American Diet is.
“The question is what really triggers this – and because we don’t have a clear definition with diagnosis of the disease, there’s been tremendous confusion,” Dr. Alessio Fasano, director of the Center for Celiac Research at Massachusetts General Hospital for Children in Boston, told Reuters Health, noting that symptoms of non-celiac gluten sensitivity aren’t limited to digestive issues. “We’re talking about skin rash, headaches, foggy minds, joint (pain), anemia and diarrhea – not just irritable bowel syndrome.”
Fasano points out that before someone is diagnosed with non-celiac gluten sensitivity as the root of their problems, celiac and other conditions must be ruled out, meaning that people with self-diagnosed non-celiac gluten sensitivity may in fact be suffering from something else. In fact, testing for celiac disease can be less accurate if the patient has already removed gluten from their diet.
Ultimately, this study should not serve as a reason to go back to a diet of processed flour or to poke fun at people choosing to remove gluten from their diet. It’s proof that the topic of celiac and non-celiac gluten insensitivity both deserve more scientific research. In the meantime, it should be a reminder that many of us don’t feel good on a Standard American Diet, and it’s important to know what we eat and what we’re putting in our bodies.
The fewer processed foods we consume, be they gluten-free or not, the better.
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