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What is the first thing that comes to mind when you hear the word “food intolerance”? My guess is gluten intolerance.
Surveys show that up to 20 percent of people think they have a problem with gluten — a protein found in wheat, barley and rye. Many blame it for gut symptoms like abdominal pain, bloating, bloating, indigestion, constipation, and diarrhea.
These are undeniably uncomfortable symptoms, and something is causing them — but is gluten the real culprit?
That’s certainly what the food manufacturers are betting on, expanding their “free from” range (and gluten-free doesn’t come cheap).
However, gluten intolerance can divide opinion, with some people viewing it as just an excuse for picky eating.
Surveys show that up to 20 percent of people think they have a problem with gluten — a protein found in wheat, barley and rye. Many blame it for gut symptoms like abdominal pain, bloating, bloating, indigestion, constipation, and diarrhea
To be honest, I wasn’t entirely convinced either. But science (and with it my perspective!) has come a long way in the last decade. Gluten intolerance — or non-celiac gluten sensitivity to give it its scientific name — does exist. However, the exact cause and whether other components of wheat are to blame in addition to gluten is still uncertain.
What we do know, however, is that gluten intolerance is far less common than reported. And you need to be sure that’s what you have, as cutting out gluten when you don’t have to can have unintended consequences.
Long-term food restriction can be socially isolating. Removing entire food groups can also mean unknowingly reducing other nutrients in your diet.
A Harvard University study of nearly 200,000 people found that those who consumed the most gluten had a 13 percent lower risk of type 2 diabetes than those who consumed the least gluten.
One of the reasons for this was that the gluten-free eaters also tended to consume less grain fiber, which protects against type 2 diabetes.
Another UK study looked at more than 1,700 foods and found that, on average, gluten-free ones tended to be lower in fiber (our gut bacteria’s favorite nutrient) and protein.
With that in mind, it’s not surprising that a gluten-free diet reduces gut bacteria, which are known to produce beneficial compounds that help control blood sugar and stimulate our immune system.
What we do know is that gluten intolerance is far less common than reported. And you need to be sure that’s what you have, as cutting out gluten when you don’t have to can have unintended consequences
So how do you know if you actually have a gluten intolerance? First things first — if your symptoms include chronic fatigue, anemia, unexplained weight loss, and mouth ulcers, or if you have type 1 diabetes, a thyroid condition, or irritable bowel syndrome, your doctor may want to test for celiac disease first, an autoimmune disease that damages the gut .
People with celiac disease must avoid gluten at all costs – even a tiny crumb of bread containing gluten can harm them.
There is a simple blood test that a family doctor can do. It is absolutely essential that you continue to eat a significant amount of gluten at least six weeks before the test, otherwise the antibodies that indicate celiac disease will not be detected (the next step is a biopsy).
If you do not have celiac disease but still feel that gluten is not right for you, ideally you should consult a nutritionist.
If that’s not possible, then it’s worth trying my four-day testing protocol to get a better idea if it’s really gluten that’s causing your problems (a more detailed version is available in my book Eat Yourself Healthy).
This type of gluten sensitivity testing, known as a double-blind, placebo-controlled food challenge, is considered the gold standard method.
Unlike celiac disease, there’s no simple blood, stool, or hair test for gluten intolerance — despite what the charlatans will try to sell you. That’s not just my opinion, it’s the advice of bodies like the European Academy of Allergy and Clinical Immunology.
I use this protocol at the clinic and it has helped hundreds of clients reintroduce gluten-containing foods into their lives. Note that anyone with a history of eating disorders should discuss this with their doctor before restricting their diet.
First, you need to eliminate all sources of gluten from your diet for two weeks.
Besides bread, pasta, and cakes that contain wheat, gluten is also found in things you might not expect, like soy sauce and barley squash drinks.
If your symptoms resolve, continue with the testing protocol below. If your symptoms don’t improve, reintroduce the restricted foods and see your GP or nutritionist.
The gluten test
After avoiding gluten for two weeks, it’s time to reintroduce it. Each day, add your test food — either a slice of standard wheat bread or a placebo (a wheat-free, gluten-free bread) — for up to four days before switching to the other test food for another four days.
This is where you need a friend or family member to camouflage the food so you don’t know if you’re getting the wheat bread or the gluten-free version — by mixing, toasting, or crumbling, for example. Continue your gluten-free diet during this trial period.
Day 1: Start with a slice of test food (you don’t know what it is) with your meal.
Day 2: Assess your symptoms. If you have any, wait a few days for them to subside and repeat with half the dose of the same test food.
If you have no symptoms, add two slices of the same test food to your meal.
Day 3: Reassess your symptoms. If you have any, wait a few days for them to go away, then repeat the steps from Day 1 using the other test food (i.e. either the wheat bread or the placebo – but remember, you won’t know which). experience no symptoms, eat three slices of test food in two meals.
Day 4: Assess your gut symptoms. If you have any, wait a few days for them to subside and then repeat the steps from day 1 with the other test food.
If you have no symptoms, you can start Day 1 immediately with the other test food.
After you fill out both test foods, ask your “assistant” to show you which test food was which.
If you didn’t have any symptoms with the wheat bread, you can be pretty sure that gluten/wheat is not the culprit. Hooray!
If you only had symptoms from eating the wheat bread, try two tablespoons of onion or half a clove of garlic in one meal to confirm if another component in the bread, fructans, is the problem.
If you have no symptoms after trying the onion or garlic, it suggests you have a non-celiac gluten sensitivity. Discuss this with your treatment team.
If you also respond to the onion or garlic and/or placebo, I’ve run out of space here, so stay tuned and all will be revealed in a future column.
Try this: Four ways to use dates
I like to think of dates as nature’s high-fiber candy. Her chewy sweetness makes her indulgent. You’re my go-to for a quick treat. Take a Medjool date and slice it lengthwise, remove the stone, then try one of the following fillings. (You can keep the stuffed dates in the freezer as ready-made sweet treats throughout the week.)
serves 1
Sweet and Salty:
- 1 sun-dried tomato half, preserved in oil
Seed and Nut:
- 1 tsp nut butter of your choice
- Pinch of mixed seeds, toasted
Creamy Tahini:
chocolate nut:
- Drizzle of melted dark chocolate
ask megan
Eating whole wheat and rye bread really messes up my gut. The same goes for whole wheat pasta. I have no other symptoms. I’m 22.
Henry, via email.
Both grains contain gluten, so to be on the safe side, I’d recommend asking your GP about a celiac test.
This involves a blood test (known as tTG) to check for antibodies. But for this to be valid, you must continue to eat gluten in at least two meals (aim for the equivalent of four slices of bread or two cups of pasta per day) for the six to eight weeks leading up to this.
If you’ve already cut out gluten and reintroducing it triggers debilitating symptoms, there’s a celiac disease genetic blood test — which looks for the human leukocyte antigen DQ2 and DQ8 genes — that doesn’t require you to continue eating gluten.
If this is positive, you will need to reintroduce gluten into your diet and have the tTG test done before a diagnosis can be made. If you don’t have celiac disease, you can try including these grains in your diet at half your normal serving. If you’re more tolerable, chances are your gut is struggling with another component in these grains called fructans.
These are generally beneficial as they feed your gut bacteria, so don’t cut them out – but dial back the amount you’re consuming at each session while you heal your gut.
Contact dr. Megan Rossi
Email [email protected] or write to Good Health, Daily Mail, 2 Derry Street, London W8 5TT – please include your contact details. dr Megan Rossi cannot maintain personal correspondence. The answers should be viewed in a general context; Always consult your GP if you have any health concerns.
