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When names become labels, their meanings often become misleading or are forgotten
In my blog Naming Convention: When Celiac becomes a Disease I discussed the controversies and confusions surrounding the definitions of gluten sensitivity and celiac disease. I also detailed why I prefer to use the terms non-celiac and/or celiac gluten sensitivity.
With the medical community still in discord over what means what, it is no surprise that media hype often makes us miss the important points. We all agree, however, that elimination of gluten from food and environment is paramount for non-celiac[1] and celiac gluten sensitive individuals.[2]
Yet unfortunately, linguistic twists and turns not only mess with what is celiac and what non-celiac gluten sensitivity, the terms "glutenfree" and "glutenfree diet (GFD)" too become open to interpretation.[3] Most scary, even research today is looking into all sorts of unnatural replacements for the carefully avoided wheat and gluten.[4] This is sheer fallacy—of course, quickly taken advantage of by the processed food industry!
Time to review why gluten becomes an issue in the first place:
Glutens and other grain-derived proteins tend to trigger autoimmune reactions in genetically predisposed individuals. The implications become clear when we consider the path that these grain proteins take in the GI tract of a gluten-challenged individual (along with the disorders they may trigger). Of course, the following list is far from being complete, and there are many more research papers that we could quote:
- Mouth: oral issues,[5] yellowing, soft teeth, loss of tooth enamel,[6] gum disease, mucous tissue inflammations…
- Esophagus: ulcers,[7] heartburn, GERD’s…
- Stomach: digestive issues, ulcers, pH imbalances, H-pylori…
- Duodenum: pancreas,[8] liver[9] and gallbladder issues, mineral and nutrient absorption[10] that affects all biochemical body functions[11] and organ systems…
- Intestines: IBS,[12] Crohn’s, Colitis and other intestinal conditions including parasitic overloads,[13] yeast overgrowth[14]…
- Rectum: hemorrhoids,[15] constipation, loose stools (with undigested food, diarrhea)…
- and…, and…, and…
In summary: Unless we want to deal with a slew of future illnesses and disorders those of us who are genetically predisposed to non-celiac or celiac gluten sensitivity (and who want to regain health) have no use for grain proteins (any and all of them).
It, therefore, appears natural that "gluten-free" would be understood as a healthy, grainfree, and contaminant-free diet (often referred to as Paleolithic[16] or Hunter-Gatherer diet). In order to keep inflammation away from our easily affected digestive system, we suggest a diet high in antioxidants and free of inflammatory triggers.[17] Unfortunately, this seems to be foreign thinking for most non-celiac and celiac gluten sensitive individuals!
I am witnessing it with most newly HLA-DQ tested or biopsy diagnosed non-celiac or celiac gluten sensitive individuals: I describe the requirement of a gluten-free lifestyle as based on straight forward, healthy, clean and unprocessed foods. They don’t hear one word I am saying. Instead, they already focus on finding high-carbohydrate, processed alternatives. Frustrating? You bet!
"Grains, grains, grains; we can’t live without bread!" Funny, there was little mention of hypertension, heart disease, diabetes, or irritable bowel disease in Europe after the wars and when all we had to eat were meat proteins, fats and vegetables, but little grain. On the other hand, since processed and grain-filled TV dinners and fast food took over in the nineteen-eighties, we have turned into a sick society. Is this really what we want?
The upside to this kind of reaction provides a final "proof in the pudding" confirmation of grain addiction; an addiction that is no different from an alcohol or opium addiction, and easy to explain: Gluten and casein contain opioid exorphins that act as drugs on the body who is genetically not set up to handle them. The fact that the majority interprets gluten-free simply as "free of gluten grains" truly is telling of our grain-addicted way of life.
This kind of confused thinking makes for an unhealthy way of living. While many of the glutenfree labeled process food fares truly may not contain damaging gluten exorphins, most of these products do contain undesirable:
- high carbohydrate[18] / high sugar alternatives (possibly containing hidden gluten)
- low levels of essential nutrients (leading to iron deficiency and bone loss)
- higher amounts of salt than the standard American diet (S.A.D.)
- higher fat amounts than the standard American diet (S.A.D.)
- additional fillers, binders, and gums selected to replace the binding and taste improving action of gluten.
I don’t see any antioxidants or other healthy components in this list... In addition, let us not forget that HLA-DQA1 0501, 0201 and HLA-DQB1 0301, 0201 individuals may show a concurrent legume intolerance[19] that doesn’t go well with the legume-rich commercial gluten-free breads and pastas.
Clearly, I have no interest in seeing my patients replace a damaging gluten diet with an unhealthy glutenfree diet.[20] What will it take to spread word that the best way of going glutenfree is to follow a grain and starch-free lifestyle along the lines of the paleo diet?
[Related article: The Dark Side of Wheat]
References
[1] http://www.ncbi.nlm.nih.gov/pubmed/22149581 Expert Rev Gastroenterol Hepatol. 2012 Feb;6(1):43-55. Gluten sensitivity: problems of an emerging condition separate from celiac disease.
[2] http://www.ncbi.nlm.nih.gov/pubmed/1923558 Panminerva Med. 1991 Apr-Jun;33(2):83-5. Effects of small amounts of gluten in the diet of coeliac patients.
[3] http://www.ncbi.nlm.nih.gov/pubmed/11762742 J Am Diet Assoc. 2001 Dec;101(12):1456-9. Wheat starch, gliadin, and the gluten-free diet.
[4] http://www.ncbi.nlm.nih.gov/pubmed/22385166 Annu Rev Food Sci Technol. 2012;3:227-45. Epub 2011 Oct 24. Functional replacements for gluten.
[5] http://www.ncbi.nlm.nih.gov/pubmed/22135701 Open Dent J. 2011;5:174-8. Epub 2011 Nov 4. HLA-DQB1 Haplotypes and their Relation to Oral Signs Linked to Celiac Disease Diagnosis.
[6] http://www.ncbi.nlm.nih.gov/pubmed/22471157 Refuat Hapeh Vehashinayim. 2011 Oct;28(4):12-8, 37. [The relationship between celiac disease (CD) and dental problems].
[7] http://www.ncbi.nlm.nih.gov/pubmed/21438963 Dis Esophagus. 2011 Sep;24(7):470-5. doi: 10.1111/j.1442-2050.2011.01190.x. Epub 2011 Mar 25. Esophageal manifestations of celiac disease.
[8] http://www.ncbi.nlm.nih.gov/pubmed/22481956 Case Report Med. 2012;2012:813461. Epub 2012 Mar 5. Osteogenesis Imperfecta with Celiac Disease and Type II Diabetes Mellitus Associated: Improvement with a Gluten-Free Diet.
[9] http://www.ncbi.nlm.nih.gov/pubmed/22448309 Int J Prev Med. 2012 Mar;3(3):167-72. Should We Look for Celiac Disease among all Patients with Liver Function Test Abnormalities?
[10] http://www.ncbi.nlm.nih.gov/pubmed/22484003 Dig Liver Dis. 2012 Apr 6. [Epub ahead of print] Cognitive performance is impaired in coeliac patients on gluten free diet: A case-control study in patients older than 65 years of age.
[11] http://www.ncbi.nlm.nih.gov/pubmed/22449104 Ital J Pediatr. 2012 Mar 26;38(1):10. [Epub ahead of print] Celiac disease in type 1 diabetes mellitus.
[12] http://www.ncbi.nlm.nih.gov/pubmed/22447132 Curr Pain Headache Rep. 2012 Mar 25. [Epub ahead of print] The Bowel and Migraine: Update on Celiac Disease and Irritable Bowel Syndrome.
[13] http://www.ncbi.nlm.nih.gov/pubmed/22504243 Intern Med. 2012;51(8):881-3. Epub 2012 Apr 15. Nonresponsive Celiac Disease due to Strongyloides stercoralis Infestation.
[14] http://www.ncbi.nlm.nih.gov/pubmed/22162465 J Clin Endocrinol Metab. 2012 Feb;97(2):E292-300. Epub 2011 Dec 7. Loss of enteroendocrine cells in autoimmune-polyendocrine-candidiasis-ectodermal-dystrophy (APECED) syndrome with gastrointestinal dysfunction.
[15] http://www.ncbi.nlm.nih.gov/pubmed/14746419 South Med J. 2004 Jan;97(1):30-4. Prevalence of occult celiac disease in patients with iron-deficiency anemia: a prospective study.
[16] http://www.ncbi.nlm.nih.gov/pubmed/22262579 Am J Hum Biol. 2012 Mar-Apr;24(2):110-5. doi: 10.1002/ajhb.22218. Epub 2012 Jan 19. Paleolithic diets as a model for prevention and treatment of Western disease.
[17] http://www.ncbi.nlm.nih.gov/pubmed/22441607 An Acad Bras Cienc. 2012 Mar;84(1):175-84. Glutathione redox cycle in small intestinal mucosa and peripheral blood of pediatric celiac disease patients.
[18] http://www.ncbi.nlm.nih.gov/pubmed/21309052 Diabetes Metab Res Rev. 2011 Mar;27(3):230-2. doi: 10.1002/dmrr.1171. High-protein low-carbohydrate diets: what is the rationale?
[19] http://www.ncbi.nlm.nih.gov/pubmed/18447142 J Investig Allergol Clin Immunol. 2008;18(2):123-5. Cold urticaria and celiac disease.
[20] http://www.ncbi.nlm.nih.gov/pubmed/20528829 Aliment Pharmacol Ther. 2010 Aug;32(4):573-81. Epub 2010 Jun 4. Evidence of high sugar intake, and low fibre and mineral intake, in the gluten-free diet.
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