Helping Your Clients Navigate the Gluten Debate

By August 28, 2018Uncategorized

By Angela Wallace, MSc, RD

What is gluten?

Gluten is a type of protein made from two molecules known as gliadin and glutenin. Gluten is found in rye, wheat, barley, spelt and is responsible for the sticky elastic texture found in grain products. Think about mixing batter for muffins, bread, or even pizza dough – that sticky texture comes from gluten. That sticky texture is also what helps us feel satisfied post meal.

How does gluten cause irritation in our bodies?

1% of the Canadian population has Celiac disease, in which the absorptive surface of the small intestines is damaged by gluten. This causes a variety of symptoms which often include abdominal pain, malabsorption of nutrients, diarrhea, weight loss, fatigue, anemia, osteoporosis, infertility etc. Celiac is treatable through a gluten free diet, however, just 1% of our population is following a gluten free diet.

Why are others following a gluten free diet?

There are a variety of reasons as to why people might be following a gluten free diet, but I would argue that there are two main reasons.

  • Non-celiac gluten sensitivity (NCGS) has been a frequent diagnosis. Unfortunately, there are no biomarkers to definitively diagnosis this disorder, although many blood intolerance tests are offered on the market. Typically, gluten sensitivity is associated with similar symptoms to those with celiac disease (e.g., bloating, abdominal pain, diarrhea, etc.) Others might describe other symptoms such as fatigue, foggy thinking, skin rashes, joint pain etc.
  • 1% of Canadians have celiac, 6% have gluten sensitivity, and 22% avoid gluten. The reason why 22% of Canadians avoid gluten is unknown, but one can presume it’s associated with perceived health benefits (e.g., weight loss, reduced risk of chronic disease etc.) and the health ‘halo’ effect, which is where we overestimate the health benefits of a product based on one ingredient.

But is gluten the real culprit here?

Some research has suggested that those suffering with gluten sensitivity might be reacting to different components in wheat rather than gluten. FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are types of carbohydrates that people cannot fully digest, causing the bacteria in your colon to ferment these indigestible carbs. This fermentation leads to gas, abdominal pain, bloating, diarrhea etc., all symptoms present in irritable bowel syndrome (IBS) and gluten sensitivity.

What should you do with your clients?

Have them seek support from a health care professional who specializes in nutrition. A nutrition expert should be able to help assess your client’s diet and make individualized recommendations to improve their symptoms and ensure they are eating a well balanced diet (whether they avoid gluten, FODMAPS, or something else entirely).

Should you be avoiding gluten?

We need more long term research that studies the effects of a gluten free diet on health to make more definitive claims, so what I am about to offer is my professional opinion (as a nutrition expert) on the gluten debate based on the research that is available thus far.

  • If you have celiac disease, avoiding gluten is necessary.
  • It may be beneficial for those with gluten sensitivity.
  • Gluten free doesn’t equal healthy.
  • Portion and quality matter most.

For the 1% of people living with celiac disease, avoiding gluten is a MUST. Not doing so will lead to dangerous health complications.

I am a big advocate for listening to your body, you are the expert of your own body. If gluten is bothering you or causing irritation, it is worth looking into. But perhaps it isn’t gluten at all, maybe it’s a FODMAP containing food or maybe something else entirely. Don’t blame gluten, but definitely take time to look into what is causing inflammation in your body.

If you are not sensitive to gluten, then there is absolutely no reason to eliminate it from your diet. Gluten free doesn’t = healthy. The gluten free research is mixed. Some studies have found that, regardless of celiac disease, it can help improve gastrointestinal issues, while other studies have found no linkages at all.

What about when you’re trying to lose weight?

There is no evidence to suggest that a gluten free diet is linked to sustainable weight loss. Gluten free does not mean fat or calorie free. In fact, many gluten free products are high in fat, sugar, salt, and low in fibre, iron, zinc, and B vitamins.

Bottom line: a gluten free cookie is STILL a cookie. It might actually have more fat and sugar than its gluten containing counterpart. In addition, gluten free products often cost more, so unless you need them, save your money!

We live in world of over consumption. We buy too much, spend too much, and often eat too much. I truly believe that the quality and portion of our foods matter most. Perhaps we are consuming too much gluten each day, which leads to discomfort (abdominal pain, gas, bloating etc.). In fact, the way we process wheat is very different than the way our ancestors ate it. Until the 19th century, wheat was mixed with other grains (e.g., beans, nuts, seeds, etc.). We only began milling and refining our bread to create white flour in the last 200 years. Some would argue that this refinement process has lead to high-gluten containing breads.

Perhaps what we need to do is cut back on the amount of processed and refined grains we eat each day, maybe even start making some of your own grains (see homemade granola recipe below).

What do you tell your clients asking about a gluten free diet?

  • We still need more research on a gluten free diet and its relationship to our health; however we do know that gluten free doesn’t necessarily mean healthier.
  • Following a gluten free diet may have some potential health benefits for those with gluten sensitivity; however the large majority of people do not need to avoid gluten.
  • Instead focus on the quality of your grains (less refined and processed sources) and the amounts you are eating each day.

Bio

Angela is a registered dietitian, nutritionist, family food expert, and certified personal trainer. She specializes in women’s health, with a focus on weight loss and digestive conditions. She uses a ‘non dieting approach’ with her ultimate goals being to help people find a balanced lifestyle and healthy relationship with food.