Does Gluten Sensitivity Really Exist? Learn the Truth!

If you follow a gluten-free diet, or know someone who does, you likely heard all the “hoopla” a few months ago when most media outlets picked up an article by a blogger who used a 2013 research study to claim that there was "no such thing as gluten sensitivity".

I know that I personally was deluged by questions from patients and certain YouTube audiences took me to task for talking about gluten sensitivity when it was now “proven” not to exist.

I'll be honest. I ignored the whole thing because I knew it wasn’t true. There is such a wealth of research and evidence to support the existence of gluten sensitivity, not to mention all my personal experience with my patients, that I didn’t feel the need to substantiate its existence.

Have Well Meaning "Friends" Been Causing You to Question Your Gluten-Free Diet?  

Time has passed and, frankly, with the upcoming holiday season when cheating tends to increase—and the presence of family members or “friends” who like to give gluten-free individuals a hard time about their choice to eschew gluten similarly increases, I decided that it was time to discuss the specifics behind this blogger’s claims. The last thing I want is for this  partial information to destabilize a person whom we know to be gluten sensitive. If such an individual starts to cheat with gluten because they begin to question whether their gluten sensitivity diagnosis is accurate or meaningful, they will be damaging their health to a dangerous degree.

The study the blogger promoted and that went positively “viral’ in the media was entitled “No Effects of Gluten in Patients With Self-Reported Non-Celiac Gluten Sensitivity After Dietary Reduction of Fermentable, Poorly Absorbed, Short-Chain Carbohydrates” – don’t worry we will define these terms in the next paragraph! It was a double-blind randomized placebo-controlled trial and the blogger made a big deal about that. There’s certainly much good to be said about such studies as they do tend to be the hallmark of well executed research. What the blogger didn’t do however was READ the entire study. Instead it seems that the title and perhaps the outline was as far as was gotten in doing due diligence.

What's a FODMAP?  

Of course, the title would lead one to believe the authors are stating they found people who themselves believe they have gluten sensitivity (GS) to not be affected when they consumed gluten, as long as they were restricting fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs). 

Before you go unconscious after that last sentence, let me define our terms:

Carbohydrates are sugar and starch molecules strung together. Going in order from largest to smallest, oligosaccharides are short-chain carbohydrates, while disaccharides are carbohydrates made up of a pair of sugar molecules and a monosaccharide is a carbohydrate made up of a single sugar molecule. Lastly, polyols are sugar alcohols such as xylitol, sorbitol and maltitol. All but the oligosaccharides are considered sugars.

The fermentable description points out that these particular carbohydrates are not being properly broken down and digested by enzymes as should occur normally, but instead are acting as food for pathogenic (disease-causing) bacteria in the gut. If someone is sensitive to these foods and reacts in this fashion, they can expect to have digestive symptoms such as bloating, gas, pain, diarrhea, etc. Those not reacting negatively to these foods would gain a positive effect from their nutritional content plus any aspect not completely digested would act as prebiotics or food for the good bacteria of the gut. All good things.

Below is a partial list of FODMAP foods. These foods are typically found to be a problem only in some individuals suffering from IBS and other digestive issues. This is not a diet to be recommended lightly as there are many healthy fruits and vegetables included within the list of foods to be avoided. Here at HealthNOW we use it occasionally on particular patients who seem to fall within this restricted category. Also keep in mind that, unlike with gluten sensitivity (where patients must consume zero gluten), FODMAPs have a dose response relationship, meaning that eating less of these certain foods can help the condition.

Fruits

Apples	Apricots	Avocados
Blackberries	Cherries	Plums
Pluots	Nectarines	Peaches
Pears	Persimmons	Grapes
Mango	Watermelon	Fruit Juice

 Vegetables

Asparagus	Artichoke	Beets
Broccoli	Brussels Sprouts	Butternut Squash
Cabbage	Celery	Cauliflower
Eggplant	Fennel	Garlic
Leeks	Mushrooms	Okra
Onion	Shallots	Sweet Potatoes

Dairy products - Some butter, cream and hard cheese is allowed

Grains – Wheat, barley and rye 

Protein - All legumes such as kidney beans, soybeans. etc. A small amount of chickpeas and lentils are allowed. 

Nuts:  Pistachios, cashews

As you can see, there are a great many foods that are considered FODMAPs, the majority of which do not contain gluten. So to assume that someone who eliminates gluten and feels better is really someone sensitive to FODMAPs really doesn't take into account the true depth and breadth of the variety of foods that fall within this description.

What was This Study Trying to Prove? 

When reviewing a study it's important to look at the purpose of it. What were the researchers trying to prove or disprove? In this particular study the authors were looking specifically at patients with IBS and self-reported gluten sensitivity (also called non-celiac gluten sensitivity or NCGS) and wondering if ingesting gluten would really make a big difference in their symptoms or was it potentially more a problem with the digestion of FODMAPs, described above.

There are many points to be aware of when reviewing this study and knowing them will prove the recent media comments claiming the "non existence" of GS to be well off the mark.

(1) There were only 37 people who participated - certainly not a robust number.

(2) Participants were not formally diagnosed with GS. They were “self-reported” to have the condition. Not that there’s anything wrong with someone realizing for themselves that gluten bothers them, but there was no clinical testing involved with these participants. When you add into the equation that no human properly digests wheat,, there could certainly be a number of people within this study that fell within the wheat sensitive category, while not necessarily suffering from GS.

(3) In the authors' efforts to eliminate anyone with celiac disease (CD) they chose to eliminate from the study anyone with the HLA-DQ2 or DQ8 genes. These genes are associated with celiac disease, true, but 30-40% of gluten sensitivity sufferers also have these genes. Therefore in eliminating people with this genetic profile, they could have easily eliminated the very individuals they were trying to evaluate, those with GS.

(4) The authors discounted some individuals who reacted to the placebo when the placebo in this study was whey protein. Certainly not placebo-worthy in my book. A vast majority of the population, and certainly many people sensitive to gluten, react negatively to dairy. Almost 20% of the participants fell within this category. “Reacting” to the placebo excluded any other negative response the individual had because it was thought that their reaction weren’t valid since they also reacted to the placebo. We know better when it comes to dairy products – they are anything but a “neutral” food.

(5) Sixteen percent of the participants reacted to the high gluten diet, but that number was cut in half upon reporting the study results because half of them had the gene as mentioned above in point #3. Therefore it was stated that only 8% of the patients had a reaction and the conclusion was then made that eating gluten didn’t seem to both a significant number of these individuals – not accurate.

(6) The authors, in their effort to focus on IBS, only evaluated digestive symptoms (abdominal pain, bloating, stool consistency, gas) along with fatigue when deciding if a participant “reacted” to the gluten they were exposed to. It is well known that gluten sensitivity more frequently results in neurological problems, but no symptoms beyond those mentioned above were evaluated when these individuals were fed gluten. Additionally, other common symptoms, beyond those of the nervous system, known to be caused by gluten sensitivity such as joint pain and skin issues, too were not evaluated. In other words a participant could have ingested gluten and gotten a headache, brain fog or felt depressed, but those symptoms were not included in the study as a “reaction”. Are you starting to see the problem? The authors realized this oversight as well. In fact they mention it in the discussion part of the study. Apparently the reporting blogger and other media outlets who claimed the study "proved" that gluten sensitivity doesn't exist never got that far when reporting the facts of the study.

(7) The authors further noted in the “discussion” part of the study that those sensitive to FODMAPs are triggered to have digestive symptoms, while those sensitive to gluten can be triggered to have an overall lack of wellness. This is clear evidence that the researchers had no intention of negating that gluten sensitivity exists.

(8) The authors do state that gluten “might not be” a specific trigger of functional gut symptoms once FODMAPs are removed from the diet, but that isn’t stating that gluten sensitivity doesn’t exist. It’s simply emphasizing one point we always talk about with the secondary effects of gluten. And that is that someone with a truly healthy gut (truly healthy!) would potentially have a strong enough immune system to not demonstrably react to gluten. The problem is finding a truly healthy gut in today’s society. Not an easy proposition, I assure you. And, of course, I'm not stating that an issue with FODMAPs doesn't exist, it does. But I am trying to clarify what these authors were trying to prove and it wasn't the non-existence of GS.

(9) Last but not least, it’s very important to know that these same authors published an earlier study entitled “Gluten causes gastrointestinal symptoms in subjects without celiac disease”. Their intention with that study was to prove that there WAS such a thing as gluten sensitivity and prove it they did. 

The Truth? Gluten Sensitivity does exist. 

Do you feel a bit better about this now? I hope so. I’m sure these researchers who themselves know of the existence of gluten sensitivity, having successfully proven it to themselves in 2011, were a bit surprised to find their study in the maelstrom of controversy that ensued after a non-medical blogger took off with erroneous conclusions and got a tremendous amount of press as a result.

So, if you find yourself being assaulted by someone who thinks they “know” that gluten sensitivity has been disproven as a condition, you now have the ammunition you need to prove to them that it “just ain’t so”!

Seriously though, don’t let the media dissuade you from what you already know or strongly suspect. Years and years of research is rarely thrown out the window with one study. And remember, this study didn’t even set out to prove what others are claiming of it. Sadly, it was really just a misunderstanding. 

We are here to help!

If you are wondering if gluten is playing an adverse role in your health, consider contacting us for a FREE health analysis – call 408-733-0400. We are a destination clinic and treat patients from across the country and internationally. We would be delighted to help you or a member of your family.

Visit us at www.RootCauseMedicalClinic.com. If you have questions or need any help, I’m here for you! Call 408-733-0400.

To your good health,
Dr Vikki Petersen, DC, CCN, CFMP


IFM Certified Practitioner

Founder of Root Cause Medical Clinic
Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”

References: 
1. Gastroenterology Volume 145, Issue 2, Pages 320–328.e3, August 2013, Jessica R. Biesiekierski

No Effects of Gluten in Patients With Self-Reported Non-Celiac Gluten Sensitivity After Dietary Reduction of Fermentable, Poorly Absorbed, Short-Chain Carbohydrates

2. American Journal of Gastroenterology 2011; 106:508-514, Jessica R. Biesiekierski
Gluten Causes Gastrointestinal symptoms in subjects without Celiac Disease

How Fruits & Vegetables Create Health

-->

There’s good news and bad news on the fruits and veggie front.  The good news is that there definitely seems to be increased awareness of the importance of consuming fruits and vegetables.  How do I know this?  More and more commercials and ads are stressing the fact that their food contains a full serving of fruits and/or vegetables. Of course these products are such things as canned meat sauce, sugary cereals and enriched beverages.  Not the best choices but the emphasis confirms that as a society we do know the importance of these foods and marketing companies are playing to it.

I thought I would shed some facts on how to best get one’s daily recommendation of fruits and vegetables, why it’s important and some simple ways to accomplish it.  (Sorry but I won’t be recommending any of the products you see on TV or in magazine ads.)

Whether you’re gluten intolerant or not, I think this particular post has universal benefit for most Americans.  Simply said, we fail miserably in eating our vegetables!

A comment about drinking one’s fruits and veggies vs. eating them: Unless you have a juicer that retains all the fiber and pulp, drinking fruits and vegetables loses much of the benefit found within these vital foods. I recommend drinking purified water, green or white tea but eating your fruits and vegetables.

The United States Department of Agriculture (USDA) states that a serving size for fruit or vegetables is equal to about half a cup. Greens like spinach and lettuce have a serving size of one cup. One serving of sliced fruit is equal to one-half cup; however a single piece of fruit, such as an apple or an orange counts as one serving. How did the USDA decide half a cup being a serving size? It was based on the portion sizes that people typically eat and the nutritional content of fruits and vegetables.

Health experts suggest that depending on our age and activity level we should eat a total of 5 to 9 servings of fruits and vegetables every day. Children, teenage girls, most men and active women should eat at least 4 servings of vegetables and 3 servings of fruit every day – that is 7 total servings. Teen boys and active men should eat at least 5 servings of vegetables and 4 servings of fruit – that is 9 total servings. Unfortunately many people fail to eat even a small fraction of that recommendation.

Fruits and vegetables contain important vitamins, minerals, phytochemicals, antioxidants and fiber. They are usually low in calories as well. Generally speaking, those with the most color -- green, red, yellow, and orange -- have the highest nutrient content. Organic produce is by far the best choice in that they contain the highest quantities of these beneficial nutrients.

The unique substances found only in fruits and vegetables can help provide detoxification, immune support and prevention of many diseases. They are naturally anti-inflammatory which is important in helping to prevent chronic diseases such as heart disease, cancer and diabetes.

Eating at least 7 to 9 servings of vegetables and fruits each day may be less daunting when you see how small one serving is: 

• 1/2 cup of sliced fruit
• 1 medium piece of fruit – about the size of a tennis ball
• 1 cup of leafy vegetables – this would be 4 large leaves of lettuce or the size of a baseball.
• 1/2 cup of cooked or raw vegetables

VEGETABLE SERVINGS: SIZES

• Asparagus, fresh - 5 spears
• Avocado Half
• Broad beans - 3 heaping tbsp (1/2 cup)
• Broccoli - 2 large florets
• Brussels sprouts - 8
• Cabbage - 3 heaping tbsp shredded, (1/2 cup)
• Carrots - 1 large
• Celery - 3 sticks
• Cherry tomatoes - 7
• Chickpeas - See Pulses
• Curly kale - 4 tbsp (1/2 cup)
• Eggplant - One-third of a large one
• French beans - 4 heaping tbsp (1/2 cup)
• Kidney beans - See Pulses
• Lentils - See pulses
• Mixed salad - Cereal bowl full (1 cup)
• Mushrooms, button - 14
• Onion - 1 medium
• Parsnip - 1 large
• Peas, fresh - 3 heaping tbsp (1/2 cup)
• Potatoes - Never count towards your daily vegetable servings, in any form
• Pulses, cooked: kidney beans, chickpeas, lentils etc  - 3 heaping tbsp (1/2 cup)
• Salad leaves, lettuce etc - Cereal bowl full (1 cup)
• Scallions - 8
• Snowpeas - Handful
• Spinach, cooked - 2 heaping tbsp (1/2 cup)
• Spring onions - 8
• Sugarsnap peas - Handful
• Tomato - 1 medium
• Vegetable soup - 1 serving of fresh or canned soup
• Vegetable sticks - Handful of mixed - celery, pepper, carrot etc
• Zucchini - Half a large one

FRUIT SERVINGS: SIZES

• Apple, fresh 1 medium
• Banana 1 medium
• Blackberries Handful
• Clementines 2
• Cherries, fresh 14
• Figs, fresh 2
• Fruit salad, fresh  3 heaped tbsp, (1/2 cup)
• Kiwi 2
• Grapefruit Half
• Grapes Handful
• Mango 2 slices
• Melon 1 large slice
• Peach, fresh 1 medium
• Pear 1 medium
• Pineapple, canned 2 rings
• Pineapple, fresh 1 large slice
• Plums 2 medium
• Nectarine 1 medium
• Raspberries 2 handfuls
• Strawberries 7

Healthy Tips for Getting Your Daily Serving of Fruits & Vegetables

 1:  Enjoy fruit for dessert. In season, fruit can taste like “candy”. Eating seasonally not only provides variety, but you can get organic varieties that provide higher nutritional value. Blueberries, raspberries, blackberries, citrus and pomegranate are all excellent choices.

 2: When cooking a main dish add some extra grated or chopped vegetables. Those that will add nutrients and vitamins include organic carrots, zucchinis, broccoli, bell peppers, mushrooms and onions.

 3: When the afternoon munchies hit, reach for a quick but healthy snack. Opt for a small bowl of cherries, berries or apple and a handful of nuts or some nut butter. Or try some of your favorite sliced vegetables with a healthy olive oil and vinegar dressing. A hardboiled egg is another possible addition for additional protein.

4: Eat a few servings of green vegetable every day. An organic dark and leafy green vegetable is recommended. Choose from dark green lettuce, chard, kale, spinach, asparagus, broccoli and cabbage to begin. If you haven’t tried them since you were a kid– give them one more shot. If you sauté or steam them lightly such that they are still bright green and a little firm and top with some organic butter and seasonings, you may be presently surprised. Adding onions, garlic and mushrooms can create a nice flavorful medley.

5: When eating out ask for an extra serving of vegetables. When they arrive eat them first. If there isn’t a vegetable served with the meal, ask for a salad.

6: Keep a bowl of fresh fruits and veggies on the kitchen counter. 

7: If time is a consideration, try the prewashed, precut organic vegetables at the grocery store.

I hope you find this helpful. I truly can’t think of a better health recommendation than dramatically increasing your consumption of these vitally nutritious foods.

Visit us at www.RootCauseMedicalClinic.com. If you have questions or need any help, I’m here for you! Call 408-733-0400.

I look forward to hearing from you.

To your good health,

Dr Vikki Petersen, DC, CCN, CFMP


IFM Certified Practitioner

Founder of Root Cause Medical Clinic
Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”

A Healthy Organic Gluten-free Diet

There is a “dirty dozen” currently amongst are fruits and vegetables. One receives this moniker by being one of the top twelve fruits or vegetables with the highest pesticide load.

We’ve been speaking lately about what a healthy diet entails and the importance of eating organic as much as possible. But what if you can only mostly eat organic? Is there a “Must” category?

Yes. When it comes to the “dirty dozen”, they are so bad that it would be better to forego eating them altogether if you can’t get the organic variety. Here they are:

1. Peach (worst)
2. Apple
3. Sweet Bell Pepper
4. Celery
5. Nectarine
6. Strawberries
7. Cherries
8. Kale
9. Lettuce
10. Grapes – imported
11. Carrot
12. Pear

Some of these are true staples of the American diet. Sorry to be the bearer of bad news, but better you know the truth than eat the “innocent” apple in ignorance.

If you enjoy fruit like peaches and strawberries, I might suggest the frozen organic variety when they’re not in season fresh. The frozen variety are great for smoothies and available pretty much year round.

Visit us at www.RootCauseMedicalClinic.com. If you have questions or need any help, I’m here for you! Call 408-733-0400.

I look forward to hearing from you.

To your good health,

Dr Vikki Petersen, DC, CCN, CFMP


IFM Certified Practitioner

Founder of Root Cause Medical Clinic
Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”

Components of a Healthy Diet When Gluten Sensitive

Once you realize gluten is not your friend and you eliminate it from your diet you are likely to feel much improved. That improvement may “flatten” after a time and you’re left feeling not quite as good as you’d hoped.

What to do?

I’ve posted before on the secondary effects of gluten and gone into the need to diagnose the presence of pathogenic organisms, adrenal fatigue, malabsorption, etc. But today I’d simply like to talk about a healthy diet.

All too often once we remove gluten, finding substitutes for all of our most favorite gluten containing foods becomes the highest priority. So you buy the gluten-free pizza crust, brownie mix, crackers, etc. In moderation that’s fine, but we still haven’t answered the question as to what a healthy diet truly is.

Obviously for you it’s not going to contain whole wheat, rye or barley. But what must it contain?

Vegetables and fruits are critical to maintaining good health and something we typical Americans tend to minimize in our diets. Every meal should contain a good amount of these, preferably fresh and organic whenever possible. Organic produce does provide a much higher amount of nutrition than its pesticide-laden counterpart. If you buy seasonal produce from a local grower it will be more affordable than trying to purchase strawberries in December!

The best fruits and vegetables are the ones that are very brightly colored as they provide the highest amounts of anti-oxidants that are protective against heart disease and cancer. Such things as blueberries, raspberries, pomegranate, blackberries, and citrus are very healthy. Vegetables such as peppers, broccoli, cauliflower, artichoke, spinach, kale, brussel sprouts, onions and garlic are very beneficial.

Oils are also important for their anti-inflammatory, hormone-producing qualities, not to mention being a good source of fat. Olive oil, coconut oil, avocado oil and some organic butter or ghee are all recommended. Coconut oil is nice for high heat cooking as it isn’t altered by the temperature. Olive oil is better when used on a medium heat. Fresh, raw nuts are another good source of fat. Good fat must be consumed in adequate amounts to prevent sugar or simple carbohydrate cravings and to stabilize blood sugar.

Protein is an interesting issue. We consume 6 – 8x more protein than any other country in the world. While protein is critical for growth and repair we could likely decrease our intake somewhat while increasing the quality of what we do eat.

With the chemicals and hormones being fed to our animals (3 million pounds of antibiotics/hormones given to livestock), it’s becoming increasingly difficult to find a “clean” source of animal protein.

Fish that are wild or farm raised on good quality feed are available. Eggs from organic farms that enhance the chicken’s feed with fish oil creates an egg that is higher in omega-3 fatty acids.

Of course there’s always the vegetarian option of whole grains (gluten-free of course!), legumes, beans, raw nuts, etc. I must admit to being quite leery of soy. I know it’s a “go-to” protein source but I find many of our patients to react poorly to it. I don’t know if it’s the genetic modification of the bean or what exactly, but I would caution moderation if you do seem to tolerate it. Another note, Dr Gonzalez, from New York who specializes in cancer treatment and gets outstanding results through use of diet, enzyme therapy and more, cautions his patients to “cross the street” if they see a soybean!

Dairy products, based on my most recent research, may very well not be a good idea for any of us. The enzymes that we have available to digest milk (and that’s human milk) stop getting produced after about the age of 3. It is thought that the proteins in cow’s milk are actually damaging to our gut lining, while creating a mucous buildup that prevents the absorption of some vital nutrients.

This theory segues very nicely with some recent research that makes the supposition that in order for gluten to initially create damage in the small intestine, there has to be an initial insult to the gut. Could this initial insult come from dairy? More on that in a future blog.

The toxic burden on our bodies from living in the US is huge as compared to other countries. Our FDA has approved 3,200 food additives to be used in our food while the European union only allows 6 different food additives.

My recommendation is to consume moderate amounts of protein from as clean a source as possible, meaning organic, grass-fed, hormone and antibiotic-free, etc.

I know that it’s extra work but remember than you can control what you put into your mouth. The other sources of toxins coming our way from air pollution and chemical exposures from industry are more difficult, if not impossible, to avoid. So if you control toxic exposure as much as possible in your food it will help a great deal.

I realize that I am promoting cooking and mostly eating from home. And I also realize that this isn’t the American way. But may I point out that the “American way” is not really working? Witness the statistic of dropping form 11th in the world for life expectancy down to our current ranking of 42nd.

To summarize, clean and pure sources of all food products is what you should be striving for as much as possible. This would entail also eating food that is in its natural state. E.g. a piece of organic fruit vs a fruit roll-up!

Increasing one’s consumption of fruits and vegetables is something we commonly see as needed in our patients. Balancing carbohydrates with good protein and fat in a meal is another good recommendation. If all you ate for a snack was a banana, you’re likely to find yourself “craving” in a couple of hours. Had you balanced that out by eating only half the banana with some raw nuts you likely would have felt much better.

Don’t forget to stay hydrated. Other than some green or white tea, your beverage of choice should be good clean water in the quantity of eight to ten or more 8 oz glasses per day, depending on your weight. (Hint: take you weight, divide it in half and you’ll have the number of ounces of water you should consume each day.)

While we’re all thrilled that Betty Crocker has come out with a line of gluten-free bakery mixes and that other companies have perfected that perfect brownie or cake, don’t fool yourself into thinking they’re good for you. Enjoy them in moderation on special occasions, but don’t make them a daily habit.

I think I could write another book on this topic alone, but until then I hope this helps.

Visit us at www.RootCauseMedicalClinic.com. If you have questions or need any help, I’m here for you! Call 408-733-0400.

I look forward to hearing from you.

To your good health,

Dr Vikki Petersen, DC, CCN, CFMP


IFM Certified Practitioner

Founder of Root Cause Medical Clinic
Co-author of “The Gluten Effect”

Author of the eBook: “Gluten Intolerance – What You Don’t Know May Be Killing You!”