What Is Gluten?

Gluten is a protein found in cereal grains such as wheat, rye (called secalin) and barley. It comes from the endosperm tissue found in seeds that are ground to make flour. Gluten helps give some of our favorite foods their shape. For example, gluten makes bread fluffy by trapping air bubbles during the kneading/rising process.

It’s made up of two different protein classes called gliadin and glutenin. Glutenin allows bread to rise during baking, while gliadin contributes to that chewy elastic texture common in bread.

Now that we know what gluten actually is, let’s breakdown the common misconception about grains and gluten.

Do Grains Contain Gluten?

There is a difference between grains and gluten. Not all grains have gluten. There are some naturally gluten free grains including rice, buckwheat, quinoa, polenta, corn, and oats. These grains don’t have the gluten protein in their most basic form. You've probably noticed that grains like quinoa or polenta don’t have that gooey elastic consistency either. So when we talk about going gluten free, it’s important to know what that actually means in terms of what you eat. You can remove gluten from your diet but still have grains.

Reasons to Go Gluten Free

We don’t all have the same internal response to digesting gluten.

Here are some common symptoms that may mean you have allergy or sensitivity to gluten:

• Diarrhea
• Bloating
• Constipation
• Mood swings
• Depression & fogginess
• Acne
• Eczema
• Craving for breads, pastas, cereals, bagels

If you experience more than 2 of these symptoms after you eat gluten, the best thing to do is remove them for 40 days. This is the time period suggested to allow your body to reset. After the 40 days are up, add gluten back in and see how your body reacts. If the symptoms come back, you may have a sensitivity or autoimmune response. A gluten free diet is a good place to start while you figure out which category you fall into.

Gluten Sensitivity or Celiac Disease?

When some people eat foods containing gluten, it causes a response from the immune system that damages the small intestine and causes inflammation in the gut. Specifically, your T cells attack other cells that have picked up the gluten molecules. This very specific T cell response against gluten is diagnosed as Celiac’s disease, an autoimmune condition. More specifically, it attacks the small intestinal tissue, which eventually can cause enough damage to prevent nutrient absorption into the bloodstream, possibly contributing to major nutrient deficiencies.

Even though research on intestinal healing ability remains inconclusive, taking gluten out completely is a surefire way to prevent the disease, so if you have Celiac’s disease or suspect you have it, you’ll most likely benefit from going gluten free. Make sure to reach out to your doctor to get tested if you think you might be experiencing issues when eating gluten containing food.

Celiac disease is just the tip of the iceberg when it comes to gluten responses. There are other aspects of gluten that can cause inflammatory issues, but are not characterized as Celiac disease. Some individuals react very strongly to gluten consumption but when tested are not found to have T cells specific for gluten. They are lumped in the non-celiac gluten sensitivity category or “NCGS”. While the etiology is unclear, eating gluten triggers a similar reaction still disrupts the digestive system.

Interestingly, both Celiac disease and NCGS are associated with a variety of chronic conditions including Hashimotos’s, hypothyroidism, osteoporosis, IBS, fibromyalgia, insulin resistance, depression, endometriosis and diabetes.

A Final Comment on Gluten & Inflammation

An often overlooked fact is that gluten can trigger a pro-inflammatory receptor called CXCR3 expressed on certain innate immune cells. This low-level inflammation driven through CXCR3 happens in EVERYONE. In other words, gluten is 100% capable of causing some inflammation in all people, but the extent to which this impacts our health is not well understood.

Reasons to Keep Gluten

If you don’t experience uncomfortable or debilitating symptoms from gluten, you may want to continue eating it (and not just because it’s delicious!) There is some interesting research from Dr. Bryan Walsh explaining why gluten may be an important part of the modern day diet. Essentially, gluten helps improve the first phase insulin response, which is crucial to maintaining healthy insulin sensitivity in the body. When you eat foods containing gluten, the gluten molecules promote an important hormone called Glucagon-Like Peptide-1 (GLP-1). GLP-1 increases first phase insulin response and improves your overall insulin sensitivity. Insulin sensitivity refers to how sensitive your body’s cells are using blood glucose effectively. By improving your first phase insulin response with improved GLP-1, you are hypothetically improving your insulin sensitivity as well.

Gluten promotes GLP-1 by directly blocking an enzyme called Dipeptidyl Peptidase-4 (DPP-IV). Basically this enzyme breaks down hormone GLP-1, which we just learned is crucial for insulin sensitivity. In theory, if you take gluten out of your diet, you are changing the balance of enzyme DPP-IV and hormone GLP-1 in your body. With more DPP-IV, you experience less of a first phase insulin response from food and may change your overall insulin sensitivity, your body’s ability to use blood glucose efficiently.

If you don’t currently experience symptoms and haven’t tested positive for a wheat allergy or Celiac disease, it's fully OK to keep gluten in your diet. It could be helping you regulate your blood sugar levels without you even knowing it. Obviously, this doesn’t mean that every meal should be filled with pasta, breads, and bagels! But it does mean that having gluten containing carbohydrates like minimally processed whole grains is a beneficial part of your diet.

When to add gluten in:

• Experience No NCGS or Celiac’s disease symptoms
• No wheat sensitivity or allergy
• Tested negative for Celiac’s disease
• Eating whole food based diet on a regular basis
• You feel fine with it!

Big Picture Takeaways

• Gluten is the protein molecule found in some whole grains.
• Not all grains contain gluten.
• You can have a gluten sensitivity without testing positive to Celiac’s disease.
• “NCGS” stands for non-celiac gluten sensitivity.
• Both Celiac’s disease and NCGS are associated with chronic disease.
• Gluten may improve your insulin sensitivity.
• Insulin sensitivity is an indicator of good health.
• If you don’t have to take away gluten, consider keeping it in.

References:

Akçay, M. N., & Akçay, G. (2003, December). The presence of the antigliadin antibodies in autoimmune thyroid diseases. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15244201

Groom, J. R., & Luster, A. D. (2011, March 10). CXCR3 in T cell function. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065205/

Lis, D. M., Stellingwerff, T., Shing, C. M., Ahuja, K. D. K., & Fell, J. W. (2015, February). Exploring the popularity, experiences, and beliefs surrounding gluten-free diets in nonceliac athletes. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24901744

Marziali, M., Venza, M., Lazzaro, S., Lazzaro, A., Micossi, C., & Stolfi, V. M. (2012, December). Gluten-free diet: a new strategy for management of painful endometriosis related symptoms? Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23334113

Niland, B., & Cash, B. D. (2018, February). Health Benefits and Adverse Effects of a Gluten-Free Diet in Non-Celiac Disease Patients. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866307/

Sategna-Guidetti, C., Bruno, M., Mazza, E., Carlino, A., Predebon, S., Tagliabue, M., & Brossa, C. (1998, November). Autoimmune thyroid diseases and coeliac disease. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/9872614