Summary: Your gut and body are killing you from the inside out, and gluten might be the cause of it all… maybe. A quick deep dive into the issue, the media, and what’s really matters: how you respond.
The Rise of the Gluten Sensitive
Gluten sensitivity is the hot trend right now. Everyone from Dr. Oz to your local grocer is recommending removing gluten for a slew of health reasons: better digestion and fat loss, among others. Those suffering from Celiac’s Disease (the physical, allergic reaction to gluten) are in heaven as production of gluten-free food options have opened up to big box grocery stores, a response to the populace’s new sensitivity towards gluten.
It isn’t that a bunch of people started getting Celiac’s, forcing stores to respond with gluten-free food products. The influx of new food choice is backed by sufferers of Non-Celiac Gluten Sensitivity (NCGS for short). The claim: gluten has been harming them and that removal from their own diets has made them happy and healthy.
Anecdotal evidence is common. Ask your health-conscious neighbor, your workout-obsessed friend, or any number of co-workers in your office. Watch any health food show on cable TV. They hear about gluten hurting people, removed it, and felt better. Now they’re expounding the virtues of removing wheat, rye, barley, and grain from the diet. They are armed with marketing messages and blog posts that hang research articles like Christmas lights — the more the merrier. Their peer groups righteously exalt the benefits of gluten-free dieting, and it’s becoming easy and trendy to agree.
It seems that PubMed and other science journals have their hands full with new papers on gluten, trying to determine if gluten is responsible for irritable bowels, poor micronutrient absorption, and fat gain. One such study making some big waves was done by the American Gastroenterological Association and published in Clinical Gastroenterology and Hepatology. A link to the gluten study is here.
News outlets spend no time hopping on the high momentum gluten-free train, implying proof that NCGS is a thing. A link here, and here.
And in fitting irony, the creators of the landmark study imply that isn’t the case:
Upon closer examination, however, the researchers noticed that 50 of the 59 subjects who completed the study (two dropped out) either had en equally negative response to gluten or placebo (likely due to the nocebo effect), showed no statistically significant differences, or experienced a worse response to the rice starch pill! In other words, the researchers identified only nine subjects who they suspected might actually be sensitive to gluten.
And:
Our study does not provide any progress in identifying possible biomarkers of NCGS
Which seems to imply that gluten sensitivity has not been evidently proven, to the chagrin of the Internet hype train. It really demonstrates how powerful the nocebo effect is.
So what’s the real answer here?
“The Simple, Perfect Answer”
Here’s what I think: There’s probably a small population that actually has gluten sensitivity. There is a larger group that will likely experience a nocebo effect, or feeling that the substance is harming them after knowing about it.
If you find that you feel better after ceasing the ingestion of gluten-based foods, then keep it out. If your health is positively affected, then who cares whether it was caused by a physical gluten sensitivity or psychology? If knowing you’re eating gluten stresses you out subconsciously, then avoid it. It’s your life, so do you.
Similarly, if you suspect some of your ailments are caused by nocebo effects, then try changing your thinking. Really take this message to heart – don’t just tell me, “Ok I’m tryyyying, but it isn’t working!” You have to internalize the science intuitively, not just rationally. Just because you know you shouldn’t eat that damn cupcake doesn’t mean you won’t.
Take gluten out of your diet. If you feel better over the course of a few months, keep it out. If not, then keep it.
Whatever you choose, don’t be an asshole when talking to other people about it. Likewise, don’t let people get you down. Got someone on your back talking down to your gluten-free diet? Tell them that you recognize NCGS may not be a thing, but you still feel better when not eating it. Whether a physical issue or a psychological hangup, the symptoms are still there, so you’d rather avoid it.
If they tell you that you should change because you’re losing out on experiences (I admit, eating most desserts, pasta, and noodles is an awesome experience), tell them you accept there might be social consequences, but it’s your life.
Next time, we talk about FODMAPs, a food category of molecules that has received less media attention, but likely deserves it.
Do what you need to do.
-Aaron
