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Most Gluten Intolerances Are Misnamed, According To A Gastroenterologist

Wheat Field In Summer
Image by Rialto Images / Stocksy
October 20, 2020

Odds are either you or someone you know leads a gluten-free lifestyle. While a sensitivity to gluten has become more popular in recent years, gastroenterologist and mbg Collective member Will Bulsiewicz, M.D., MSCI, tells mbg most people are misnaming their more probable diagnosis.

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If it's not gluten, what is it?

Since non-celiac gluten sensitivity is not well understood and there are no biomarkers for the condition, researchers wanted to determine just how accurately people were self-diagnosing their gluten sensitivity1.

A study published in the Gastroenterology journal studied 59 people with a perceived gluten sensitivity and verified they did not have celiac disease. One group ate a breakfast bar with gluten, another with fructan (a FODMAP), and the third was a placebo bar. After waiting seven days for symptoms to pass, the participants switched groups. This occurred until each group had eaten all three types of bars. 

Turns out, people with supposed gluten allergies actually had fewer symptoms from the gluten bar than they did from the placebo bar. The fructan bar triggered the most unwanted symptoms, though.

The takeaway? "We've labeled it as gluten sensitivity, but studies show that it's probably not the gluten," Bulsiewicz says. "It's actually the fructans in wheat, barley, and rye that are likely causing the symptoms." Since gluten is a protein present in those three grains, the mix-up makes sense. Unnecessarily eliminating them from the diet, though, can be harmful. 

Why eliminating gluten can be bad. 

Unless you're in the 1% of people diagnosed with celiac disease, eliminating wheat from your diet can be more harmful than helpful. "We've been taught that dietary restriction is the solution for food sensitivity," he says. While an elimination diet may help temporarily, it's not a long-term solution and can make you less healthy in the long run.

The microbes in the gut feed off of fiber, which is present in plant-based foods, including grains. "When you narrow the diversity in your diet, you narrow the diversity in the gut microbiome," he explains. "When you broaden the diversity in your diet, you broaden the diversity in your microbiome." 

Since gut health is connected to so many other bodily functions (brain health, immune functioning, skin health, etc.), neglecting to nurture those microbes can have deleterious effects across the board. 

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Bottom line.

"Gluten sensitivity has been misnamed, we call it gluten sensitivity because it occurs when people eat wheat, barley, and rye. All of those foods contain gluten," he says, "but they also contain fructans."

If you've been to the doctor and ruled out celiac disease, consider incorporating healthy grains and fiber into the diet to feed the microbiome rather than cutting them out altogether.

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