Is There a Gluten "Happy Medium?"
For those with gluten intolerance, going entirely G-free can be life-changing, but there are some of us who'd rather eat glue than give up the occasional bowl of bucatini. Thankfully Dr. Arthur Agatston, the creator of the South Beach Diet and author of the just-out South Beach Diet Gluten Solution has positive news for us - we can have our cake and eat it, too. (Albeit sparingly.) By Meghann Foye, REDBOOK.
What are the biggest misconceptions people have about the protein gluten, and what would you like them to know?
1) Gluten problems are just a fad that will give way to another hot diet topic very soon. In actuality, medical conditions due to gluten are one of the most under-recognized and under-diagnosed issues of our time, and they're not going to go away. Because gluten intolerance masquerades as so many other ailments from stomach cramping and migraines, to depression and insomnia, doctors often fail to diagnose it.
2) Most people with a gluten problem need to be gluten free. The fact is, only those individuals with celiac disease must give up gluten entirely. If people are gluten sensitive - which is true for the majority of those with gluten-related problems - they need to become "gluten aware" and discover their own level of gluten tolerance.
3) Foods labeled "gluten free" are healthy, and they'll help you lose weight. Not true. Many so-called gluten-free products are made with highly refined non-wheat starches and have sugar added to improve taste. These foods can cause swings in blood sugar that can lead to cravings for more sugary and starchy carbs - thus leading to weight gain. It's important to read labels on all products labeled gluten-free.
4) You can be tested for gluten sensitivity. Unlike with celiac disease, there are no reliable tests for gluten sensitivity. The only way you can find out if you are gluten sensitive is to first eliminate gluten from your diet for a few weeks to see if you feel better, and then gradually reintroduce it to find out if your symptoms return.
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What does it mean and why is it so important to be "gluten aware?"
Too many people in this country have become gluten-phobic, thinking that the only way they'll feel better, or lose weight, is if they cut out gluten entirely. Being gluten aware as opposed to gluten-phobic means that you have learned where you fit in on the gluten-sensitivity spectrum, and you have discovered your own level of gluten tolerance. Can you explain what you call the "Gluten Trifecta" and how it affects people? For those who have gluten sensitivity, there are three ways gluten can cause problems. First, the incompletely digested strands of gluten protein - called peptides - are often toxic to the small intestine and cause inflammation, which in turn causes bloating, abdominal cramps, diarrhea and/or reflux. Second, the inflammation in the small intestine blocks the absorption of nutrients. For example, if the inflammation is in the area of the small intestine where calcium is absorbed, an individual may have osteoporosis. If it is in the area where iron is absorbed, anemia can result. Third is an autoimmune reaction that occurs when those incompletely digested strands of gluten protein are mistakenly identified as the proteins that make up normal tissue, such as thyroid, joint, pancreatic, or nerve tissue. The immune system sets out to destroy these "invaders" and this autoimmune reaction often results in thyroiditis, arthritis, type 1 diabetes, and fibromyalgia.
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Why is knowing gluten's effect on your system important for everyone, not just those with intolerance or celiac disease?
Gluten sensitivity encompasses a very wide spectrum of ailments from minor to very serious. On one end of the gluten spectrum are some people who never feel sick, but find cutting down on gluten increases their energy and mental focus. Toward the other end are people, like some patients of mine, who frequently feel like they've been hit by a bus when they wake up in the morning with headaches, stomach aches, joint pains, and fatigue. Once they start paying attention to gluten in their diet, they get up feeling great and pop out of bed in the morning. The transformation is amazing. And of course, there are those who do have celiac disease, which is considered the most serious form of gluten sensitivity.
Why is it important not just to go "gluten free" entirely if you don't have to?
There are no serious health problems with going completely gluten-free, but it is very difficult to do so since gluten is an additive in so many products from pill capsules, to toothpaste, and even some communion wafers. Buying gluten-free commercial products can also be expensive and unhealthy if you simply purchase gluten-free junk food that's high in processed starches and sugar. Getting enough fiber and some other important nutrients like niacin, thiamine, and riboflavin may be mildly challenging if you're gluten free, but there are plenty of gluten-free whole grains that supply fiber as well as these B-vitamins, and of course you can get your vitamins, minerals, and fiber from vegetables, fruits, and legumes as well.
It feels as though gluten has been the lone scapegoat for unexplained ailments for a few years. However, your book paints a more holistic picture. It seems like at the root, our unhealthy autoimmune and digestive processes is the bigger underlying cause here than eating the occasional pastry. Would you say that the next phase of research should begin looking at ways to strengthen the gut and immune responses again, versus focusing all our blame on gluten?
I certainly believe that recolonizing and balancing the good and bad bacteria in our intestines can help those with gluten sensitivity. Luckily, there's a promising area of research that is shedding new light on recolonizing the bacteria in our intestines with probiotics. These good bacteria, which already reside in our intestines, have populated or have been added to a vast number of products ranging from yogurt, to green drinks, and other supplements for years. But, we are still waiting for more evidence before probiotics can be established as an important component in achieving better health. That's in part because the various foods and supplements for oral delivery of probiotics don't necessarily spare these friendly bacteria from being destroyed by our stomach acid.
Is it possible that many people are suffering the brain fog, weight-related and autoimmune symptoms mentioned because of the other processed ingredients found in most commercial bread products? That it might not be the gluten protein that's causing the autoimmune response but the additives, preservative, and empty fat and calories usually found along with them?
It's clear that with the overconsumption of modern fast bread, which lacks the fermentation that pre-digests gluten, we are dumping more of the difficult to digest gluten protein, as well as preservatives and other additives, into our intestines without considering the health implications. Some of us are overwhelming our digestive enzymes with foods our bodies simply can't handle in the quantities we're eating them. And it goes well beyond bread, since gluten is added to many foods like tomato sauce, broths, gravies, and even deli meats as a thickening agent or filler. The jury is still out on whether - and to what degree - modern preservatives are affecting our health. Other than specific allergic reactions to such preservatives, I have not seen that they do. But I can't help wondering whether the widespread use of preservatives in the food supply is yet another reason why our gut flora has changed so markedly. And we know that the destruction of our gut flora is definitely a contributor to gluten-related health problems.
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How does being "gluten aware" play out in your own life?
I try to avoid all of the major contributors of gluten - bread, pasta, cereals, and baked goods. But since I am only mildly gluten-sensitive, I don't worry about the smaller amounts hidden in other products. In fact, I seem to avoid looking at the labels on my favorite dark chocolate bars, since I know gluten could be in there. To understand gluten's effect, it almost seems like you have to be a scientist, a doctor, a historian, a baker, and an economist. What do you say to people who come to you feeling very weary, jaded and cynical about what to eat and questioning whether the gluten-free lifestyle is really just another diet fad? Nobody knows how many Americans are actually gluten-sensitive, but my guesstimate from several years of experience with my own patients is that a very substantial percentage of people will experience a benefit from giving up at least some gluten. Being gluten free may be a diet fad, but being gluten aware is not. It's a conscious way of eating that can lead to better health - and sustained weight loss - for life.
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