Gluten Free logic

Here are the 3 steps in my gluten-free logic:

Step ONE – the premise IF:

a) Gluten sensitivity is common: estimates show it affects over 10% of the population;
b) Gluten-related illnesses are varied and have multiple symptoms: a quote from the consensus paper on the  Spectrum of Gluten-Related-Disorders emphasises this. ‘The symptoms in GS may resemble those associated with celiac disease (CD) but with a prevalence of extra-intestinal symptoms, such as behavioral changes, bone or joint pain, muscle cramps, leg numbness, weight loss and chronic fatigue. Their symptoms include abdominal pain (68%); eczema and/or rash (40%); headache (35%); “foggy mind” (34%); fatigue (33%); diarrhea (33%); depression (22%); anemia (20%); numbness in the legs, arms or fingers 20%; and joint pain (11%);
c) There is no definitive diagnostic test for gluten sensitivity: the Consensus paper goes on to say “However, currently there are no laboratory biomarkers specific for GS. Usually the diagnosis is based on exclusion criteria; an elimination diet of gluten-containing foods followed by an open challenge is most often used to evaluate whether health improves with the elimination or reduction of gluten from the patient’s diet”;
d) There is no harm from going on a gluten-free diet; in other words if gluten-free is healthy.

Step TWO – the logical THEN

Then the logical conclusion is that “anyone“, with “any symptoms that are “chronic and unexplained (that is they do not have a definite diagnosis) and “at any time” (people can develop gluten-illness at any time in their life) should be put onto a gluten-free diet for a clinical trial for three months or more.


The logical conclusion is that whatever the test results, and whatever the symptoms, a beneficial response to a gluten-free diet suggests that their illness is gluten-related (some people might demand a double blind food challenge).
Up until now, most gluten/celiac doctors have dismissed non-celiac gluten-sensitive (NCGS) patients as having a placebo response to a gluten-free diet. This is clearly not the case. There is mounting evidence for this: see this research paper – Small Amounts of Gluten in Subjects with Suspected Nonceliac Gluten Sensitivity: a Randomized, Double-Blind, Placebo-Controlled, Cross-Over Trial.
They conclude: “In a cross-over trial of subjects with suspected NCGS, the severity of overall symptoms increased significantly during 1 week of intake of small amounts of gluten, compared with placebo”.
The above logic means that ALL people with undiagnosed illnesses should be given a trial of gluten-free. This is likely to have huge health benefits and wide ramifications on the management and burden of ill health on the community.
Already 10% of Australians and Canadian are adopting a gluten-free diet, and 30% percent of adults in the USA are interested in avoiding or cutting down on gluten in their diets, says a survey from the NPD Group, a consumer research firm. NDP has been following gluten-free issues since 2009 and its January 2013 survey revealed the highest interest in gluten-free diets yet
 (reported in HuffPost – 26 Feb 2015).
Avoid gluten in diet USA

Avoid gluten in diet USA

It is my prediction that in another generation most people who wish to remain well will also choose to adopt a gluten-free diet.

Gluten-free: is this the only way to manage celiac disease?
Well, the simplistic answer to this question is “yes”. However this is a complex question. To narrow the question down, I will first assume that celiac disease means that -a diagnosis has been made by endoscopy showing the characteristic flatness/atrophy of the small bowel mucosa. (I will address the question of how early you can diagnose coeliac disease in a later blog).
Yes, a gluten-free diet is the central management strategy for coeliac disease. But what does gluten-free mean? A gluten free diet means zero gluten for life. No exemptions. Certainly there are many people who suggest that people can eat gluten to tolerance. I disagree. Any gluten has the potential to cause you harm.
But does zero gluten literally mean non-at-all? The most complex part of answering this question is “what does a zero-gluten-diet mean in terms of every-day practicality?” Recently, there has been a lot of debate about how many parts per million (ppm) of gluten is acceptable in food. Pragmatically, because it is so difficult to get rid of cross-contamination in food production and processing, the number of 20 ppm is now surfacing as a reasonable level of gluten to be consumed (some countries have 200ppm, and the FDA likely to agree to 20ppm). This seems to be a negligible amount. However, there are still concerns for some people who seem to be exquisitely sensitive to gluten.
For me zero-gluten means no gluten. This can be achieved if you eat fresh fruits and vegetables, unprocessed meat and fish, uncontaminated rice, corn and other alternate grains, and unprocessed dairy foods and eggs, nuts also. This means no packet or processed foods.
But it is a lot more that “just” going gluten-free. Yes, there are a lot more things to do for healing someone with coeliac disease. The longer that you have had coeliac disease, the worse your body will be. More healing will be required. You may need additional minerals, vitamins and probiotics. There are a number of routine health checks to take. You should also ensure that your gut has healed (via blood test and maybe repeat endoscopy).
There is talk about vaccines for coeliac disease. I think these are a long way off. On top of this gluten is a trigger for many autoimmune diseases and neurologic conditions. So giving pharmaceutical treatment for coeliac disease will still not remove the threat of gluten to your body.
Zero gluten is the main stay of treatment for coeliac disease. I do not see this changing much in the future. I do see the gluten-free lifestyle being very widely adopted over the next decade. I do see better non-gluten grains. I do see a generation in much better nutritional health.

Please stay on gluten foods until you have had your gluten/celiac blood tests and endoscopy.

You are invited to have a “virtual” consultation at The eClinic. This will help you work out if you should be on a gluten-free diet. You might need to get some blood tests, and interpret your results. It is best to get properly tested before changing your diet.