There has been a lot of media hype recently surrounding gluten. Practically every packaged food product that can list “gluten free” now does.
What we need is a medical doctor who specializes in weight loss and nutrition to help us understand what is really going on. So I hopped in the Skepchick-super-jet to find the perfect person to answer some questions.
I found Dr Terry Simpson.
Dr Terry Simpson is a surgeon who specializes in nutrition and weight loss. He has written articles about gluten in the past, having discovered that a number of his patients who have undergone gastric bypass ended up by passing the area where gluten was absorbed and therefore developed a sensitivity to gluten. He is an amazing chef as well as a surgeon and whenever I need some realistic information about food he is the man I call on.
One a side note, he travels all across the country to find just the right ingredients for his gourmet meals, so you really need a jet to keep up with him. He answered half of my questions in Alaska and the other half in the wine country of Napa Valley.
Thanks for taking the time to answer my questions, Terry!
Gluten sounds like a scary thing made from glue but really gluten is just a protein composite found in food processed from wheat. Is it found in other foods?
Gluten is a great protein- found commonly in wheat, rye, barley – and is the protein that makes wheat a great bread or dough product. The reason pizza dough can be tossed and stretched is gluten – if you ever try to do that with ground corn it would fall apart. The reason you can roll out dough is the gluten provides an elasticity.
Is there anything that sets apart gluten from other forms of proteins? What makes it special?
The special part of gluten is what it does for baking, for breads, and for people who are vegetarians. For vegetarians gluten is an important source of protein. It is deficient in the amino acid lysine (an essential amino acid that is needed) – but for vegetarians, gluten becomes an important source of non-animal protein.
What is celiac disease?
Like all proteins, one can have an allergy to them. Celiac disease is an allergy that affects the immune cells in the gut. There are many immune cells in the body — so some people develop allergies on their skin, some develop them to where they get a swollen tongue, or closed off airway. Celiac disease is an allergy to gluten that causes a problem in the small intestine. Essentially destroying the absorptive surface of the gut.
Celiac disease is more common in Northern Europeans (fair skin, fair haired).
How is one tested for celiac disease? Is there an objective test that one can take?
There are several blood tests that one can do which are pretty good at determining if you have celiac disease. But they do miss some. The blood tests are far from 100 per cent. The most objective test is to have someone remove all gluten from their diet for several weeks. This is a difficult thing to do as gluten is used in many agents like soy sauce, thickener in soups — so it takes a lot of work. Then introduce a bit of gluten to see if the symptoms happen– this is not subtle. If someone has celiac disease, and becomes gluten free it takes them a few weeks before their gut returns to normal. The introduction of a single Wheat Thin cracker will cause severe cramping, bloating, and diarrhea.
Can one suddenly acquire celiac disease or catch it? Is it passed along genetically?
People can acquire celiac disease suddenly- much like one can acquire any allergy. We discovered a high incidence in patients who had undergone gastric bypass surgery — we assumed that we had bypassed the traditional area for gluten breakdown in the small bowel, and the protein being seen further down began a process of an acquired celiac disease.
The predisposition for celiac disease is genetic- but is expressed at variable rates– meaning, some people will have the tendency for it, but they don’t develop it- or develop it later in life.
Is gluten safe to be eaten by a normal healthy person?
Quite safe– and delicious.
Is it good to cut gluten out of your diet just to be safe even if you have not been diagnosed with celiac disease?
There is no reason to remove gluten from your diet unless you have celiac disease. Going gluten free is difficult. Until recently there was no real flour substitute that made great foods. Cutting gluten out is popular among people who sell “gluten free” products– but there is no evidence that removing gluten from a diet will be better for anyone.
Think of gluten allergies as you would a peanut allergy. If you are not allergic to peanuts, there is no reason to avoid them. If you are allergic to peanuts, there is every reason in the world to avoid them.
Can a diet rich in wheat barley and other grains be beneficial?
A diet rich in grains provides a lot of nutrients – from micronutrients (vitamins, minerals) to the macronutrients – complex carbohydrates. Plus barley is where beer comes from, and that is pretty beneficial to some.
If you think you have a gluten sensitivity what should you do to actually find out?
First- the real tests for gluten should be performed by a licensed physician (DO or MD) — not a chiropractor, or naturopath. Those tests are called anti-endomysial antibody and anti-gliadin antibodies. They are a good indicator as any. They can be fooled if someone is on a gluten free diet.
Celiac disease is real, and an important disease among people. They are typically thin, with problems with diarrhea, abdominal pain and cramping, and have a history of the problem. These people need to know that they have an increased risk of small bowel cancers, and lymphoma – and need to have screening for them.
There is no advantage to going gluten free for people who do not have celiac disease. Gluten is simply a protein- and there is not a good way to bake bread, make good pizza or cookies without it. While one could argue that those highly processed foods are not good for a person- it isn’t because of gluten – it is the quantity of that food. Until recently, there was not a great gluten free flour.
Gluten has become the “hypoglycemia” of this decade. A fad. For those who have celiac disease, gluten free provides the only way to heal themselves. If you have a family history of celiac disease, and are unable to gain weight – then please see a real physician and get tested.
Thank you so much for taking the time to explain gluten and celiac disease to us! To find out more about Dr Terry Simpson, check out his website: yourdoctorsorders.com.
And I’m not sure about the rest of you but I’m gonna try to catch up with Dr Simpson in Italy to grab some pizza!
EDIT 9/20 11:49am: Dr Simpson has posted a more detailed article along with a video on this topic on his site to add to this discussion. You can access it by clicking here.