Gluten and Wheat Sensitivty - Do They Exist?

man with stomach ache

(Healthcastle.com) Recent studies both for and against non-celiac gluten sensitivity (NCGS) have been conquering the headlines lately. Read on to help wade through the debate and find out if your symptoms might be related to gluten or wheat or if you should start looking elsewhere for solutions.

What is gluten?

Gluten is one of many proteins found in wheat, and is also found in barley, rye, triticale and a few other grains. It is the protein that those with celiac disease (an autoimmune reaction to the gluten in wheat)  react to. Traditional testing for those showing symptoms associated with celiac disease (such as bloating, gas, diarrhea, frequent illness and lethargy) only test for an autoimmune reaction to very particular forms of this portion of the wheat.

What newer studies, including some gold standard double blind placebo controlled trials,  have shown is that it is possible to not react to gluten while still producing symptoms in response to one of the other subsets of proteins in wheat (1 , 2 , 3). Many long-time sufferers of sensitivity to wheat rejoiced when their symptoms were finally validated by science. No longer did they have to be told that their symptoms are in their head, not related to wheat or both.

Why are some people saying it doesn’t exist?

  • Another study, by the same group who released the study showing that non celiac gluten sensitivity did exist, was pushed forward as a case for NCGS being a false concept (4). News outlets quickly picked up the story and it has since been a battle of the headlines.  Unfortunately, this is a single study and not well designed enough to prove that NCGS doesn’t exist. This is another lesson in letting single studies and sensational headlines get the best of us. Let’s look at why this study doesn’t support the headlines.
  • Limited population.  In research, we don’t apply results tested on only one type of population (in this case only those with Irritable Bowel Syndrome (IBS) were tested on) to the rest of the world. Larger studies are needed to confirm initial results. 
  • The “control” wasn’t neutral.  Those with IBS often react to something called FODMAPS – certain types of fermentable carbohydrates of which lactose is one. Those who are very sensitive may react to small amounts of lactose, and in general those with severe digestive issues are often sensitive to more than one portion of dairy (such as casein or whey proteins). The control used here was whey protein – and interestingly enough the researchers noted that all the groups (those given purified gluten and those given only whey) had significant increases in symptoms when they began the experimental part of the study. That doesn’t show me that gluten or wheat sensitivity doesn’t exist, it shows me that this particular group reacted to both compounds.
  • It is just one study. One study is never the be all and all of nutrition research. The results should be replicated, tested on different groups and under different conditions. For a single study that received a lot of attention it was also a very small study – only 37 participants in the initial test and 22 participants moved on to the crossover test. It was a short study, which is not a limitation of just this study but of much of nutrition research but certainly worth noting – only 3 weeks for the initial part and 38 days for the those who continued on in to the crossover trial. Those who report symptoms of sensitivity may have been accumulating low level inflammatory reactions over months or years, this isn’t necessarily reproduced in a few weeks.

How do I know if I’m sensitive to gluten?

I think the most important question is to find out if you are sensitive to wheat  or all gluten containing products. There are lab tests that can be done, but are typically costly and rarely offered by any mainstream health professionals.

Instead, try a gluten challenge at home:

  • Eliminate all sources of gluten from your diet for at least 30 days.
  • After that have a bowl of barley – a food high in gluten but low in the fermentable carbohydrates found in wheat that others may have difficulty with. Record any changes in your body or symptoms that returned.
  • Two days later try a piece of wheat bread.  Record any changes.
  • Compare your symptoms – if your symptoms returned after the bowl of barley then you likely are sensitive to a component of gluten. If you felt fine with barley but symptoms returned after eating wheat then you are sensitive to something other than gluten in wheat.

Final Thoughts

Wheat and gluten sensitivity is by no means a closed book – we don’t clearly understand how it begins, why it affects some and not others and if it can be “cured”.  I tell my clients to do with what works for them – whether it means eating wheat or avoiding it. Your body and health is the true marker of a good diet. To find out what I look for when helping clients find their best diet by listening to their body check out this post.

There is certainly a need for more research to help clarify both the mechanism (of which there is likely more than one) and help identify biomarkers so that testing of patients with celiac like symptoms, but a negative test, can be more complete and helpful.

Links

For a more in depth look at the science behind gluten and wheat sensitivity you can check out this article from Chris Kresser:
50 shades of gluten intolerance

Find out what foods contain gluten here: Canadian Celiac Association - what not to eat

What is your experience? Share your thoughts (respectfully as always) in the comments below!
 

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