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The What, the Why and the How of a Gluten-Free Lifestyle

Gluten-free

What is the gluten-free lifestyle?

The gluten-free diet is becoming increasingly prevalent in our society; it is no longer only for those diagnosed with coeliac disease, but the associated health benefits have attracted many people to this way of life. In fact, the gluten-free industry grew 136% from 2013-2015 (1) and is continually expanding as more and more people feel noticeably healthier within weeks of giving up gluten. Notably, Djokovic, amongst a growing number of professional athletes, has attributed his successes, at least in part, to adopting a gluten-free lifestyle, describing a large range of health benefits, including less joint pain, weight loss and reduced inflammation (2).

Being gluten-free involves giving up food that contains wheat, barley and rye. Gluten is a protein found in these types of grains and food containing gluten includes bread, pasta, cakes and biscuits. But gluten is also found in several other places that you wouldn’t usually expect such as certain sauces, beer and some processed foods such as sausages. It can be a little confusing at first to know what you need to avoid when following a strict gluten-free diet, but there are plenty of great resources online to help and generally following a natural, non-processed diet is the best way to avoid eating gluten.

The idea of going gluten-free may seem daunting at first, but now is the time to do it – it has never been easier! Nowadays, all major supermarkets have a dedicated section for gluten-free products and it is rare to find a restaurant which cannot provide suitable alternatives for its gluten-free customers. However, it is important to note that just because a product is labelled ‘gluten-free’ it doesn’t automatically make it healthy – gluten-free cakes and treats are still processed food and contain high levels of sugar, but removing gluten from your diet is certainly an excellent step towards a healthy lifestyle.

Why should I avoid gluten?

Coeliac Disease and Gluten Sensitivity

People who are coeliac avoid gluten because it triggers an autoimmune response that causes inflammation in the gut and the lining of the small intestine to become damaged. Specifically the microvilli, which are small hair-like structures involved in the absorption of nutrients are destroyed, making it extremely difficult to extract the required nutrients from a meal even if you are eating healthily. This increased risk of vitamin and nutrient deficiencies can cause a whole range of other health problems including osteoporosis, infertility, depression and even lymphoma of the small intestine (3). However, while only a small proportion of the population are clinically diagnosed as coeliac, in reality a far higher proportion of the population is likely to be negatively affected in a similar way to this by eating gluten. A recent study found that in the UK, approximately 13% of the population had non-coeliac gluten sensitivity (NCGS) and even individuals without this diagnosis report a much improved quality of life after giving up gluten.

Additionally, there are other proteins found in wheat that can cause a similar inflammatory response in your gut which affect people who are not specifically gluten-intolerant. Amylase trypsin inhibitors (ATIs) and wheat germ agglutinin (WGA) are proteins found in wheat which stimulate immune cells in your gastrointestinal tract, generating inflammation (4). Even if you are not coeliac nor have NCGS, the inflammatory actions from the other components of wheat have noticeable effects that reduce quality of life such as bloating and constipation. Furthermore, research indicates that the inflammation caused by wheat/gluten is associated with many health conditions, both in the short term, but also later in life, not only for those with coeliac disease or NCGS but also if you don’t necessarily notice anything immediately after eating gluten.

Why is Inflammation in the gut so bad?

Inflammation in the gut results in increased permeability of the gut, or ‘leaky-gut’, meaning that unwanted molecules, such as dust particles, and microbes such as viruses and bacteria can pass into your bloodstream. Gluten stimulates the release of a protein called zonulin which promotes the loosening of junctions in between the gut cells and increasing the leakiness of the gut. Intestinal permeability is an essential factor in the development of several autoimmune diseases, alongside genetic and environmental factors (5). 

Gluten is also disruptive to the gut microbiome which is a collection of ‘friendly’ bacteria that reside in your gut and are extremely important as they help regulate your immune system, digest food, synthesise nutrients and vitamins and can affect brain function in several ways (read our RYH article about the gut microbiome here!). Indeed a disrupted gut microbiome has been implicated in several mental health disorders, including depression, schizophrenia and anxiety. Both people with coeliac disease and NCGS have a reduction in beneficial species and an increase in potentially pathogenic bacterial species and this can be at least partially reversed by following a gluten-free diet (6).

Gluten can affect several health conditions

Gluten is also linked to a whole host of different autoimmune diseases, including autoimmune thyroid disorders (7), fibromyalgia (8), and even potentially acts as a trigger for some cases of type I diabetes (9). Intolerance to gluten is found at a much higher prevalence in these conditions compared to the general population. Eating gluten may exacerbate these (and many more) health conditions, largely down to the effect of leaky-gut and dysbiosis of the gut microbiome. There have been many reports of people reversing or significantly reducing their symptoms after adopting a gluten-free and less processed diet. For example, Hashimoto’s thyroiditis: the thyroid gland produces thyroid hormones which are extremely important in controlling the body’s physiology and metabolism. Hashimoto’s thyroiditis is an autoimmune disease where the body attacks the thyroid gland, manifesting itself as hypothyroidism (low thyroid hormone production) which has a huge range of nasty symptoms that significantly lower quality of life, including unexplained weight gain, depression, brain fog and extreme cold intolerance. Gliadin, a protein component of gluten, has a very similar molecular structure to the thyroid gland and so, if consumed when the body is already predisposed to have an autoimmune response against the thyroid gland, it can trigger an exaggerated and more aggressive immune response against the thyroid, worsening the symptoms and the progression of the disease (10). 

Gluten can also have an impact on brain function and mental health. The disturbance to the microbiome caused by gluten and other proteins in wheat alters the microbial gut-brain axis and can not only present itself as brain fog and fatigue, but also more seriously in conditions such as depression and Alzheimer’s disease (11). Nearly 50 years of research has established a tentative link between schizophrenia and wheat intake and there has been evidence of successful treatment of relapsed schizophrenia patients with a grain-free diet (12). The link between gluten and these disorders is thought to be because the systemic inflammation caused by gluten consumption can reach the brain and trigger neuroinflammation, which is an important factor in many psychiatric and neurodegenerative disorders. 

How do I go gluten-free?

Adopting a gluten-free diet lends itself to a more natural lifestyle with much less dependence on heavily processed foods. Whilst there are several gluten-free products available, they often are still very high in sugar and other unhealthy chemicals.

To get the best out of a gluten-free diet, you should try and reduce your intake of processed foods and focus on more natural alternatives. It is important to eat foods high in fibre as fruits, vegetables, nuts and seeds as whole-grains are usually a common source of fibre in people’s diet.

Fibre is also excellent for restoring the microbial flora in your gut which is extremely important for your overall physical and mental health.

Probiotics and prebiotics are another way of boosting your gut microbiome and can be found in foods such as natural yoghurt, kefir, cheese and sauerkraut.

Grains such as (gluten-free) oats, brown rice, quinoa and buckwheat are good gluten-free substitutes for wheat-based carbohydrates. These are good in moderation, but increasingly research points towards lower carbohydrate lifestyles as being significantly healthier than following a low-fat diet. If you are following a low-carb diet (which often goes hand-in-hand with being gluten-free), it is important to make sure you eat enough protein and saturated fat to provide you with sufficient energy. 

Here at Reset Your Health, we have created hundreds of recipes, which are not only gluten-free and non-processed, but also affordable and delicious! Following our 4 weeks’ worth of delicious recipes and they will get you on track to feeling much healthier, both physically and mentally. As convincing as this may all sound, the best way to be persuaded is to try a gluten-free diet for yourself and see the results and we can help with that! 

References

1. Gluten: A Benefit or Harm to the Body? [Internet]. The Nutrition Source. 2021 [cited 23 June 2021]. Available from: https://www.hsph.harvard.edu/nutritionsource/gluten/

2. Novak Djokovic Is Gluten-Free: Should You Be Too? [Internet]. Men’s Journal. 2021 [cited 23 June 2021]. Available from: https://www.mensjournal.com/health-fitness/novak-djokovic-is-gluten-free-should-you-be-too-w208969/

3. Coeliac disease and gluten sensitivity – Better Health Channel [Internet]. Betterhealth.vic.gov.au. 2021 [cited 27 June 2021]. Available from: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/coeliac-disease-and-gluten-sensitivity

4. 11 Ways Gluten Can Damage Your Health | Paleo Leap [Internet]. Paleo Leap | Paleo diet Recipes & Tips. 2021 [cited 27 June 2021]. Available from: https://paleoleap.com/11-ways-gluten-and-wheat-can-damage-your-health/

5. Visser J, Rozing J, Sapone A, Lammers K, Fasano A. Tight Junctions, Intestinal Permeability, and Autoimmunity. Annals of the New York Academy of Sciences. 2009;1165(1):195-205. 

6. Marasco G, Di Biase A, Schiumerini R, Eusebi L, Iughetti L, Ravaioli F et al. Gut Microbiota and Celiac Disease. Digestive Diseases and Sciences. 2016;61(6):1461-1472. 

7. Sharma B, Joshi A, Varthakavi P, Chadha M, Bhagwat N, Pawal P. Celiac autoimmunity in autoimmune thyroid disease is highly prevalent with a questionable impact. Indian Journal of Endocrinology and Metabolism. 2016;20(1):97. 

8. Nisihara R, Marques A, Mei A, Skare T. Celiac disease and fibromyalgia: Is there an association?. Revista Española de Enfermedades Digestivas. 2015;. 

9. Barbeau W. What is the key environmental trigger in type 1 diabetes — Is it viruses, or wheat gluten, or both?. Autoimmunity Reviews. 2012;12(2):295-299. 

10. Hyman M. Why gluten needs to go if you have Hashimoto’s | Dr. Mark Hyman [Internet]. Dr. Mark Hyman. 2021 [cited 27 June 2021]. Available from: https://drhyman.com/blog/2019/10/08/why-gluten-needs-to-go-if-you-have-hashimotos/

11. Daulatzai M. Non-Celiac Gluten Sensitivity Triggers Gut Dysbiosis, Neuroinflammation, Gut-Brain Axis Dysfunction, and Vulnerability for Dementia. CNS & Neurological Disorders – Drug Targets. 2015;14(1):110-131. 

12. Dohan F, Grasberger J, Lowell F, Johnston H, Arbegast A. Relapsed Schizophrenics: More Rapid Improvement on a Milk- and Cereal-free Diet. British Journal of Psychiatry. 1969;115(522):595-596.