What is the first thing that comes to mind when you hear the words ‘food tolerance’? I think it is gluten intolerance.
Studies show that up to 20 percent of people think they have a problem with gluten – a protein found in wheat, barley and rye. Many complain that it causes gastrointestinal symptoms such as abdominal pain, bloating, gas, malnutrition, constipation and diarrhea.
These are unpleasant symptoms, and there is something that causes them – but is gluten the real culprit?
Food manufacturers are certainly putting the bank on this as they expand their ‘free-from-the-line’ (and gluten-free) cheaper ones.
Still gluten intolerance can still divide opinions, with some people taking it as an excuse to eat fussy.
Studies show that up to 20 percent of people think they have a problem with gluten – a protein found in wheat, barley and rye. Many complain that it causes gastrointestinal symptoms such as abdominal pain, bloating, gas, indigestion, constipation and diarrhea.
In fact, I was not quite sure. But science (and, therefore, my opinion!) Has come a long way over the last decade. Gluten tolerance – or sensitivity to non-coeliac gluten, to give it its scientific name – exists. However, the exact cause, and whether other wheat components are to blame with gluten, remains unclear.
But what we do know is that gluten intolerance is much more common than reported. And you need to be sure that this is what you have, as cutting gluten if you don’t need it can have unintended consequences.
Long-term dietary restrictions can isolate people socially. Eliminating all food groups can also mean unknowingly reducing other nutrients in your diet.
A study of nearly 200,000 people conducted by Harvard University in the United States found that those who consumed more gluten had a lower risk of type 13 diabetes compared to those who had a lower gluten intake.
This was partly because gluten-free consumers also had a habit of eating less fiber, which protects against type 2 diabetes.
Another study from the United Kingdom examined more than 1,700 foods and found that, on average, gluten-free foods were more likely to be high in fiber (a favorite nutrient for intestinal bacteria) and protein.
In view of this, it is not surprising that a gluten-free diet reduces the digestive bacteria known to produce beneficial compounds that help control blood sugar and stimulate our immune systems.
What we do know is that gluten intolerance is much more common than previously reported. And you need to be sure that this is what you have, as cutting gluten if you don’t need it can have unintended consequences.
So how do you know if you really have gluten intolerance? First things first – if your symptoms include chronic fatigue, anemia, unexplained weight loss and oral ulcers, or if you have type 1 diabetes, thyroid disease or irritable bowel syndrome, your doctor may want first look at celiac disease, an autoimmune condition that destroys the gut.
People with celiac disease should avoid gluten at all costs – even a small piece of bread is and can be harmful.
There is a simple blood test for this that a doctor can do. It is absolutely essential that you are still eating large amounts of gluten for at least six weeks before the test, otherwise it will not detect antibodies that indicate celiac disease (the next step is a biopsy).
If you do not have celiac disease, you still feel like gluten does not agree with you, you would like to see a nutritionist.
Did you know?
Although barley is gluten-free, many are processed in the same place with cereal-containing grains, and are therefore not suitable for those on a gluten-free diet due to contamination.
If that is not possible, then it is best to try my four-day test protocol with a better idea of whether gluten is actually causing your problems (there is a more detailed version in my book Eat Yourself Healthy).
This method of measuring gluten tolerance, known as a double-blind placebo-controlled dietary challenge, is considered a gold standard method.
Unlike celiac disease, there is no easy test of blood, feces or hair for gluten tolerance – no matter what charlatans will try to sell you. That is not just my opinion, but the advice of organizations such as the European College of Allergies and Clinical Prevention.
I use this protocol in the clinic, and it has helped hundreds of clients welcome gluten-free foods into their lives. Remember, anyone with a history of eating disorders should discuss this with their doctor before restricting their diet.
First, you need to exclude all sources of gluten from your diet for two weeks.
Along with bread, pasta and wheat-based cakes, gluten is found in things you would not expect, such as soy sauce and squash barley drinks, too.
If your symptoms resolve, go to the trial protocol below. If your symptoms do not resolve, then restart restricted foods and see your doctor or nutritionist.
After avoiding gluten for two weeks, it is time to reintroduce it. Each day you will include your experimental diet – either a piece of regular wheat bread or a placebo (which is whole wheat bread, gluten-free) – for up to four days, before switching to another experimental diet for more. four days.
This is where you need a friend or family member to hide the food so you don’t know if you are getting a loaf of bread or a gluten-free version – for example, by mixing, baking or grinding. Continue to use your gluten-free diet during this trial period.
Day 1: Start with one piece of experimental food (you never know what it is) with your diet.
Day 2: Assess your symptoms. If you have it, wait a few days until it subsides and repeat half the dose of the same test diet.
If you do not have symptoms, include two test food snacks similar to your diet.
Day 3: Review your symptoms again. If you have it, wait a few days until it subsides and then, using another experimental diet (i.e. whole wheat bread or placebo – but, remember, you will not know), repeat the steps of Day 1. experience no symptoms, including three food test pieces in two meals.
Day 4: Assess your gastrointestinal symptoms. If you have it, wait a few days until it subsides and then repeat the steps of Day 1 using another experimental diet.
If you do not have any symptoms, you can start Day 1 by using another experimental diet immediately.
After completing both experimental foods, ask your ‘assistant’ to reveal what the tested food was.
If you had no symptoms with wheat bread, you may feel confident that gluten / wheat is not the cause. Hooray!
If you only had symptoms when eating wheat bread, then try two tablespoons of garlic or half a clove of garlic in the diet, to prove if it is another part of bread, fructans, that is the problem.
If you have no symptoms after trying onion or garlic, it is recommended that you have a gluten-free gluten sensitivity. Discuss this with your health team.
If you are also touched by garlic or garlic and / or placebo, I have run out of space here, so wait and it will all be revealed in the next vertical column.
Try this: Four ways to date
I like to think of dates as natural fiber with high fiber. Their chewing sweetness makes them feel comfortable. They are going to me for immediate treatment. Take one date of Medjool and cut it in length, removing the hole, then try one of the following items. (You can paste the filled dates in the fridge with sweet items ready to go all week.)
Sweet and salty:
- 1 tomato cut in half, stored in oil
Seed ‘n’ nut:
- 1 tsp peanut butter option
- A pinch of mixed, baked seeds
- Sprinkle with dark melted chocolate
Eating whole grains and rye bread is very stressful for my gut. It is similar to flour pasta. I have no other symptoms. I’m 22.
Henry, by email.
Both of these grains contain gluten, so being on the safe side I would recommend asking your doctor about testing for celiac disease.
This involves a blood test (known as tTG) to check antibodies. But for this to be valid, you must continue to include gluten in at least two meals (the equivalent of four loaves of bread or two cups of pasta a day) for the next six to eight weeks.
If you have already cut off the gluten and returned it causes depressive symptoms, there is a blood cell of the gene cylinder – which looks for the leukocyte antigen DQ2 and DQ8 genes – which do not require you to continue eating gluten.
If this is positive, then you will need to put gluten back into your diet and measure tTG before the diagnosis is made. If you do not have celiac disease, you can try to include these grains in your diet for half of your regular portion. If you tolerate this better, it is likely that your gut will suffer from other components in these grains called fructans.
These are generally beneficial as they feed on the bacteria in your gut, so do not overdo them – but take lightly the amount you use for each session when 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 contact details. Dr. Megan Rossi cannot enter into personal communication. Answers should be taken in the general context; always contact your GP with any health concerns.
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