Should we be Worried About Gluten?


February 01, 2017 by Joel Fuhrman, MD

Should everyone be concerned about consuming gluten?  Gluten-free, like fat-free and low-carb, is a dietary fad that claims to promote weight loss and enhance health. But are there real health benefits to going gluten-free?

What is Gluten?

Gluten is a generic name for the primary protein found in wheat and grains related to wheat. It comprises about 70 percent of the total protein content in wheat. Gluten is an important component in grains ground into flour and used for baking, because it provides elasticity and chewiness in breads and helps dough to rise by trapping the carbon dioxide that is produced by yeast.

Gluten is found in many grains like farro, freekah, bulgur, spelt, kamut, barley, rye, and triticale. Since processed foods like pasta, breads, baked goods and meat substitutes are typically made with wheat, gluten is ubiquitous in the American diet. According to the USDA, about 17 percent of calories in the American diet come from wheat flour -- a large proportion of the diet from a single food.1

When is it Necessary to Go Gluten-Free?

For years, wheat has been blamed in diet books as a cause of obesity, dementia, and poor health. But there are only three health conditions that are gluten-related: wheat allergy, the autoimmune condition known as Celiac disease, and non-Celiac gluten sensitivity.

In Celiac disease, eating gluten provokes the body to launch an autoimmune attack on the small intestine.  This can lead to chronic inflammation and serious health problems throughout the body, not just in the digestive tract. Estimates are that about 1 percent of the population has Celiac disease .2  Another 1 percent of the population has a wheat allergy.

People with non-Celiac gluten sensitivity do not have the intestinal damage related to Celiac disease and they do not have an allergy to wheat or gluten. A diagnosis of gluten sensitivity is usually made after Celiac disease is ruled out and removing gluten from the diet removes the symptoms. Individuals with gluten sensitivity can have joint pain, muscle aches and fatigue in addition to digestive symptoms. The disease is not well understood and the symptoms are not clearly defined.

Overall, it is estimated that three to six percent of the population are sensitive to gluten.  This includes  irritable bowel syndrome and some autoimmune diseases that are sometimes  aggravated by gluten consumption.

Does Gluten have negative effects on our health?

Wheat has been called the main cause of the nation’s obesity epidemic in diet books, and losing weight seems to be a motivator in the trend of those seeking a gluten-free diet. Yet, there have been no studies published that show removing gluten from the diet results in weight loss; furthermore, there is also no evidence that intact wheat berries (unground wheat kernels)  which contain gluten, yet are a whole unprocessed food has any negative effect on health in people who do not have a medical need to avoid gluten .3 What often happens in books and online is that the negatives of high-glycemic refined carbohydrates (like white flour products and very finely ground whole wheat flour) are attributed to gluten or wheat. It is the refining process and the increased glycemic effect upon eating refined flour products that is unhealthful and not the type of grain or even gluten in particular that contributes to the promotion of chronic disease.  What usually then happens is other refined carbohydrates without the gluten, such as white rice flour is used instead, which isn’t an improvement.

A gluten-free diet can be just as high in calories and low in nutritional value as the Standard American Diet. Refined white flour, in the form of gluten-free pasta, cookies and bread will not help you lose weight. These products  are just as harmful as refined wheat flour.

However, if you replace gluten-containing pastas and baked goods in your diet with vegetables, beans, fruit, nuts and seeds, which happen to be gluten-free, you would most likely lose weight, (and be healthier) because these foods are naturally low glycemic and high in fiber and nutrients.

What Role Should Grains Have In Our Diet?

It is clear that not everyone needs a gluten-free diet, unless there is some medical need to restrict or avoid gluten.

Of course, eating an abundance of refined flour products does promote weight gain and poor health, regardless of whether they are made with wheat or other grains. Beans and other legumes are the healthiest carbohydrate-rich foods, however intact whole grains can be a healthful part of a health-supporting diet too. . Although there is no scientific evidence that people without gluten sensitivity or Celiac disease would be harmed by gluten, there is also no nutritional requirement for grains, either.

If you have a medical need to avoid gluten in your diet  and you do want to include grains, there are plenty of  gluten-free options like , wild rice, quinoa,  buckwheat, millet, amaranth and teff. Oats are often cross-contaminated with gluten-containing grains during processing, so choose the ones  labeled gluten-free.

The Bottom Line on Gluten

The bottom line: for most people, gluten is not a problem. Within the context of an optimal Nutritarian diet, eating healthful gluten-containing foods such as wheat berries cooked in water or some coarsely ground (or sprouted) whole wheat bread will not negatively affect your health.  Many advocates of gluten-free eating programs have supplied scientific references showing the link between wheat and disease, by using studies on white flour products, incorrectly blaming the health problems resulting from white flour products on the gluten they contain, and that was not scientifically accurate. 

A Nutritarian diet relies heavily on beans as a starch source, and includes a variety of starchy vegetables like peas, root vegetables and squash.  When grains are used, they are best intact whole grains cooked in water. Water-cooked whole grains are healthier than whole wheat breads or other flour products, because more nutrient are retained, the glycemic load is favorable and water cooking does not form toxic compounds that are generated when food is browned.  And of course, always remember the foods  I want you to eat regularly for optimal health and longevity are G-BOMBS: Greens, Beans, Onions, Mushrooms, Berries and Seeds.

 
References

1.              United States Department of Agriculture Economic Research Service. Food Availability (Per Capita) Data System. [http://www.ers.usda.gov/data-products/food-availability-(per-capita)-data-system.aspx]

2.              Fasano A, Berti I, Gerarduzzi T, et al. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med 2003, 163:286-292.

3.              Brouns F, Van Buul VJ, Shewry PR. Does wheat make us fat and sick? . J Cereal Sci 2013, 58:209-215.

Comments (0):

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CherylWalker

02/02/2017 09:21 AM

Thank you, Dr. Fuhrman for clarifying this often discussed and misunderstood topic. 

kpaulin2

02/02/2017 09:44 AM

You don't address the genetic modification of the wheat.  Our wheat has been so modified, many of us can no longer digest it.  I have a colleague who can't eat gluten in this country, but is fine when in Russia, as much of Europe will not permit the level of modification our country does.  The wheat we are eating today, is not the wheat we ate as children.  I never knew how intollerant I was until I stopped eating it, lost a lot of weight, my pain eased (from inflamation), and many of my digestive problems went away.  My daughter stopped eating gluten and is now so intolerant she can't even use make-up or shampoo with gluten in it or she will breakout in a rash.  There is a good book, The Wheat Belly, written by a doctor who discusses this in more detail.

GeoffreyLevens replies:

02/02/2017 10:19 AM

Have your friend try kamut (khorosan wheat), spelt, einkorn, and emmer. These are all ancestoral wheat varieties with same genetics as 5000-10000 years ago!

Dr. Ferreri replies:

02/02/2017 11:39 AM

People with gluten sensitivity, as you are describing, should certainly not eat gluten.

Regarding how gluten has changed over time, humans have been growing wheat for over 10,000 years, and yes we have bred wheat plants (like other food crops) for desirable characteristics. For any plant, cross-breeding may result in new proteins or changes in proteins, some of which may be allergens or triggers for food intolerances. So it is possible that someone could have a sensitivity to one type of wheat, grown in a certain place, and not another type. 

There is a possibility that an increase in celiac disease could be due to breeding of wheat plants that increased in the number of the amino acid sequences in the gliadin subunity of gluten that cause the reaction. There is also some research into breeding wheat to reduce the numbers of these sequences.  (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963738/)

The overall point remains the same - gluten is not a problem unless someone has celiac disease or a gluten sensitivity. It is not necessary to eat wheat for good health, and it is also not necessary to avoid it completely.

This reply was last edited on 02/02/2017 11:50 AM

Benson

02/02/2017 09:59 AM

Monmouth county NJ; My son Kyle and his new friend Bri both have suffered from Lymes Andrea both developed "Chronic Lyme"  It just may be that Chronic Lyme is actually the damage cause by the treatments  

my son Kyle had extreme GI track disturbance and vomiting and weight loss which disabled him for the better of 2 years. He went from 220lbs to 130lbs with no hope in sight. Kyle read eat to live and diligently consumed to best foods he could keep down. Kyle met Bri in the summer of 2016. She had done the "Lyme Diet" and had experiences wonderful results. The Lyme Diet is much Like "Eat to Live" yet it requires the elimination of Gluten for a min of 60 days to determine if the person has a Gluten sencitivity. My son stopped Gluten, dairy and reduced sugars and in 5 weeks he stopped throwing up!! In 8 weeks he did a pull up. In three months he did 7 pull ups and started riding his skateboard. The Lyme deit suggests that the large quantity of antibiotic can cause a sensitivity to Gluten in the small intestine. If Gluten burns the receptors  in the small intestine, thus reducing the asborbtion of nutrient. 

It is great to have my son back again! We all met Dr Fuhrman on 1/28/2017 and we are on a incredible journey of health!! 

tracygf709

02/02/2017 10:29 AM

Thyroid autoimmune disease has a VERY strong connection to gluten and is VERY damaging to the gut to eat for ANYONE. Try checking out anything by Dr. Tom O'Brien about gluten. He is the premier expert. Grains, especially gluten (also there are FOUR separate proteins found in wheat and gluten is only ONE of them- the others are even more damaging to the gut) Dr. Tom says that gluten damages everyone's gut regardless of perceived sensitivity. Allergy tests usually only test one of the four proteins in gluten. Do your research. This article only supports one way of eating and does not include the full story. If you have undiagnosed thyroid autoimmunity (and if you have hypothyroid there is a big chance you also have hashimotos) you are destroying your health by eating gluten. Do more research! This is not a simple issue. 

Benson replies:

02/02/2017 10:48 AM

The Lyme Diet also suggest that everyone has a certain degree of sencevitivy. Since my son stopped Gluten I did too and my body isn't sore anymore 

Dr. Ferreri replies:

02/02/2017 12:55 PM

There are certain diseases, several autoimmune diseases and IBS for example, in which there are higher rates of celiac disease and gluten senstivity than the general population.  

However, there is no scientific evidence to support the assertion that gluten damages everyone's gut. There is some evidence of a temporary increase in intestinal permeability that is greater in those with celiac disease or gluten sensitivity, but no evidence of damage.

Of course, the proportion of calories from wheat present in the typical American diet is too much from a single food and not healthy. However, as Dr. Fuhrman says in the post, there is no evidence suggesting that occasionally eating wheat berries or a whole wheat pita damages the health of someone without celiac disease or a gluten sensitivity.

mj84 replies:

02/02/2017 01:30 PM

I have Hashimoto's, diagnosed at 9 years old. I have genes for celiac and no bowel digestive issues. I experimented with strictly avoiding gluten for 6 months and saw no change in any area of my health. I don't think autoimmunity is anywhere near being understood. Atomic bombs were exploded for research purposes before and during my childhood. I can blame this practice on autoimmune diseases as likely, if not more, as gluten or BPA's, pesticides, lead, mercury etc. We humans have done a lot of stupid things. I wish there was one clear answer for all of us but there is not. A whole food, plant based diet low in oil and salt with moderate excercise is as close as any of us will get to protecting ourselves from disease. If going gluten free improves the health of some of course that should be a part of their life, no argument there!

kpaulin2 replies:

02/02/2017 08:18 PM

I do have Hashimoto's Thyroiditis and I'm convinced gluten was a major contributor to developing it. 

tracygf709 replies:

02/03/2017 08:57 AM

Everyone wants to justify that eating gluten is fine for you. I'm just saying there's more to the story and Dr. O'Brien's work includes this research. He has seen remarkable things from people quitting gluten. Also quitting for 6 months is usually not enough according to him. I would just do more research and say that is article is meant to have everyone feel good about keeping their diet including wheat which is not helpful. 

Regine

02/02/2017 10:45 AM

Thank you for clarifying this. I am French and I was raised eating French white bread. The French eat a lot of white bread  (baguette) with cheese. When you buy it just after it has been baked it tastes and smells divine. I now avoid white flour but once in a while I still indulge in a slice of crunchy Baguette 😋.  I have heard that sourdough bread is healthier because the fermentation caused by sourdough helps to improve the digestibility of the bread. Also I heard that modern wheat has been modified to have a much higher content of gluten to suit the needs of the food industry who doesn't really care about people's health but wants to obtain a flour that produces huge fluffy bread, cakes etc...because most people are ignorant and more attracted to huge loaves. Bon appétit!😉 

lbuuck

02/02/2017 11:27 AM

Any Help with FODMAPs I a have been diagnosed with IBS constipation.. And Onions and mushrooms are a big no no..

Lisa

 

Dr. Ferreri replies:

02/02/2017 11:48 AM

I'd recommend reading Dr. Fuhrman's position paper on IBS, which has detailed information on FODMAPs. https://www.drfuhrman.com/learn/library/position-papers/13/irritable-bowel-syndrome

As a side note, there is a theory that many people with gluten sensitivity are acutally sensitive to FODMAPs, not gluten.

There is evidence from randomized controlled trials that a low FODMAP diet can improve IBS symptoms and reduce abdominal pain and bloating. https://www.ncbi.nlm.nih.gov/pubmed/25982757

 The problem is that a low FODMAP diet restricts a lot of healthful foods, like apples, garlic, onions, beans, etc. which have many benefits, including their prebiotic properties. See the position paper for more detail, but Dr. Fuhrman thinks it may be beneficial to restrict FODMAPs temporarily, but then slowly reintroduce small amounts of higher FODMAP foods over time.

taitum45

02/02/2017 12:18 PM

Thanks to whomever sent me this post of Dr. Fuhrmans new blog regarding gluten free diets. I really appreciate this. Have a great day! Jan

This comment was last edited on 02/02/2017 12:19 PM

Becky JoAnn

02/02/2017 12:46 PM

I.ve heard a theory that one reason people are more sensitive to gluten in the USA, is because our wheat, though not GMO, is sprayed with roundup. I hear roundup residue is damaging to the gut bacteria, damaging the same pathway as that in the "weed." Humans don.t have this pathway and so roundup was deemed safe. But our gut bacteria do have the pathway that roundup interferes with.  Is this true? If so, it makes me wonder if there is any data on gluten sensitivity for those who eat exclusively organic wheat or verified non-roundup treated wheat as I hear is the case in Europe.   Thank you for any replies.

kpaulin2 replies:

02/02/2017 08:22 PM

My research has discovered the same thing.  The wheat is GMO, that's why it can now survive being sprayed with roundup, it was engineered to do so.  There are some good documentaries on Netflix.

The pesticides also kill the natural digestive enzymes in our food, so we have more trouble digesting the food.  I've found taking a good digestive enzyme with each meal to help with digestion and it also gives me more energy and less cravings.  After all, if your able to digest your food, you'll get more of the nutrients and less will be passed to the colon where it can't be digested and causes gas, bloating, etc.

 

This reply was last edited on 02/02/2017 08:36 PM

lynxsiam replies:

02/03/2017 04:10 PM

Read that organic food including organic wheat have been found to be contaminated with glyphosate.

Here is a good link to order food products that are tested glyphosate-free and organic. Some of the products listed are already at local stores near me so I'm thankful for this guide. Other products listed at are not sold at stores near me, I plan to order from this website to protect my health further.                

healthytraditions.com/glyphosate-tested

Dr. Ferreri replies:

02/03/2017 05:43 PM

Glyphosate exposure has been shown to alter gut bacteria profiles in animals, and there is a theory that this in turn could increase the risk of celiac disease. However, no research has been published testing this yet. Glyphosate is used especially on glyphosate-resistant soy and corn. Just to clarify, there is no glyphosate-resistant wheat currently on the market, but glyphosate is sometimes used on wheat.  Since the USDA organic program does not permit the use of glyphosate, buying organic versions when eating soybeans, corn, or wheat is probably the best way to minimize exposure to glyphosate.

Stephen Soandso

02/02/2017 01:10 PM

I also take issue with this blog post because non-Celiac gluten sensitivity (NCGS) is so new and boosts the risk of gluten being a problem for up to 6% of the population (and that is the conservative estimate). That is not an insignificant risk. There are currently no verified tests that can tell a person if they have NCGS, so it's a crap shoot. We know for sure that the incidence of autoimmune diseases in general is increasing (up to 5 fold) since WWII. Even most people with Celiac disease don't know it, and there are good tests for that. Is it worth the risk given this info, to not worry about it and eat gluten? As a minimum, I'd recommend that people get the blood test for the two Celiac genetic markers HLA-DQ2 and HLA-DQ8. If you don't have either of those, you probably won't have a problem with gluten according to Dr. Alessio Fasano, one of the world's most prominent authorities and researchers on gluten-related diseases.

This comment was last edited on 02/02/2017 01:12 PM

kpaulin2 replies:

02/02/2017 08:24 PM

I was just tested and don't have either of the genetic markers, but I for sure have a sensitivity.  I never knew I had it until I went gluten free after my Chiropractor suggested it and Dr. Fuhrman promoted it on PBS about 5-years ago.

This reply was last edited on 02/02/2017 08:25 PM

scook67

02/02/2017 01:18 PM

Thanks Dr. Furhman , again you always debunk mytths out there on False news.

Love & Respect to you 

nandogg33

02/02/2017 03:00 PM

Great post, Thank you for the information. See you tonight Dr. Fuhrman!

scblondin

02/02/2017 05:15 PM

Husband recently rec'd results of a food sensitivity test - He tested severely sensitive to wheat but not sensitive to gluen. This seems very strange to me. Anyone have any experience with this.

 

kpaulin2 replies:

02/02/2017 08:26 PM

I would guess due to the genetic modification of the wheat.  What test did he take for the sensitivity?

lynxsiam

02/02/2017 05:31 PM

Yes, do the research. Because of the following:

I grew up without problems until in around 1990, I had cluster of symptoms: headaches, bloating, itchy skin, short term memory problems. With a new doctor in 2004 with instruction to stop eating wheat/gluten, my symptoms disappeared. They return right away whenever I eat wheat. This doctor said she saw an increase in IBS cases - what is going on out there, eh?

My friend with celiac disease had no problem eating wheat in Italy. I researched and found that Europe has strict regulations with food while U.S. is profit-driven. Roundup is used in U.S. crops the past years. Glyphosate in Roundup damages gut flora....an example of what is going on out there.

The wheat we know is called dwarf wheat that is altered for easier farming practices (at human body's expenses?) Not the vision of 'amber waves of grain' with taller grasses from before.

Food for thought....

terrotusk

02/02/2017 05:40 PM

Dr. Furhman, thank you so much for this article. As an avid reader of most everything you write, I know this is not the first time you have tackled this issue. However, increasing the opportunities to discuss this issue will hopefully increase the liklihood that people will begin to understand the scientific facts surrounding gluten.

My wife is a very experienced physician, triple board certified in Family Practice, Preventive Medicine, and Aerospace Medicine, and has been a nutritarian advocate for years. It pains her everytime a patient comes in and complains about the evils of gluten and asks "what is the best way to get gluten out of my diet?" It is very difficult at this point to try and dispell the myths, since patients at this point have bought and accepted the diagnosis of the thousands of internet doctors in which the general population has placed their faith.

I am disappointed in the environment in which you and my wife have to work in, constantly battling misinformation that nowdays is so easily propagated. But, I applaud your efforts to stay steadfast and keep up the good fight for it will result in huge benefits in the long run.

kpaulin2 replies:

02/02/2017 08:30 PM

They used to say asbestos didn't harm you as well.  Time will tell who is right and who is wrong.

This reply was last edited on 02/02/2017 08:30 PM

rosieromaine

02/02/2017 06:06 PM

Hi, I was following your method of eating for two years and felt good, until one day I did not. I was diagnosed with Hashimotos, an autoimmine diesase that attacks your thyroid. I have been told by my naturopath, and I ahev read in numerous books on the subject of hypothyroid that gluten is to be avoided. What are your thoughts?  I have been off gluten for a little over a year and my blood tests look awesome and I feel great. I was inundated with information on what to eat and not eat and made myself a bit crazy, all the while gaining weigt again. I decided this past month to re-read your book and start sticking to the plan, minus the meat everyone told me I hate to know eat and I have already dropped 7 lbs and still feel good. I would love your oinion on the gluten and thyroid issue.

 

Thanks you Roseanne

 

SuzanneDHale

02/02/2017 07:11 PM

Thank you so much for this information.  My sister has developed IBS and her doctor had her try avoiding gluten for relief and it helped.  I also have a friend with Rhumetoid Arthritis and her doctor wanted her to try gluten free (generically avoid wheat I think) to help with the inflamation.  It helped her as well. I have been confused about the gluten issue in general and your writing has really helped me understand better why it helps to avoid in some situations, and that it isn't "evil gluten".  

I don't have any of those issues.  But I've found that not eating wheat products helps my weight (I don't eat gluten free replacements- too much other bad refined flours).  Again, thank you for sharing your wisdom and educating us.

Suzanne

Janharlow

02/02/2017 07:34 PM

Juli here. When I read Dr. Fuhrman's article about synthetic FOLIC ACID linked to increasing BREAST and Prostrate CANCER, I AVOID ENRICHED FLOUR, which is in almost everything, to avoid the folic acid, so I chose gluten-free products when I want a treat but still be healthier. This also cuts out some GMO (if the product has no corn in it). Am saddened that some health food store products now use UNbleached flour but still ENRICHED.. I look at the nutrition label for folic acid too.

parrotfur

02/03/2017 06:31 AM

I for one feel so much better not eating gluten products. 

Would like Dr Fuhrman to address other sensitivities/allergies and why they occur in adults when the same foods were eaten as a child without any issue.  Those foods are, apples, pears, peaches, plums, kiwi, almonds and guacamole all cause severe stomach issue, and constriction and itching of throat.  So many of these foods are a part of all recipes you provide. 

Dr Fuhrman stated in the past to have an epi-pen on hand if these were ever ingested without knowledge, however, have allergic reaction to the epi-pen also.

MochaTrain

02/03/2017 11:38 AM

This is what I know about myself: If I eat gluten in the US I will get a bad stomach ache and usually throw-up; if I eat gluten in Europe I will end up with hemorroids.  If I eat the sprouted bread that DR Fuhrman suggests (food of life, 7 sprouted grains) I am completely fine.....anything "sprouted" seems to work for me.  I found this interesting....I went to a Japanese event and they were serving mochi---which is pounded sweet rice---(think gooey balls)  I had the same reaction to that, as I did US gluten....sick and throwing up.  They say that mochi has gluten in it, but that it's gluten-free.....(whatever that means!)

 

Mkayewalsh

02/03/2017 01:04 PM

Thank you for this article. As an additional comment, I have noticed that gluten free products have more sweeteners and salt. These are worse than the gluten. What about products that have gluten added to them? They can't be good for you. 

LarryLL

02/03/2017 09:10 PM

As a former Nutritarian I enjoyed the article and value anything Dr. Furhman writes about. However, after successfully complying with the nutritarian diet for 3 months and seeing significant health progress I was unable to adhere to the diet and resumed eating very unhealthy foods for snacks while maintaining many of the points from the diet.  My point is that I was unable to stay on the diet and am now following the Wheatbelly diet and having more success.  What I have not read in the previous comments is about the addictive properties of the Gliadin protien(hope I got that right!).  I'll continue to focus on fruits and vegetables in my diet as encouraged by Dr. Furhman while avoiding all wheat.  Always great to get more nutritional information.