Gluten is a product of the devil

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101N said:
or not...

http://www.scientificamerican.com/article.cfm?id=most-people-shouldnt-eat-gluten-free
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The article concludes:

"If you don't have celiac disease, a wheat allergy or a gluten sensitivity, you're unlikely to benefit from a gluten-free diet."

Perhaps that's true; frankly, I don't think we know for sure yet. The cited article uses a dietician and a spokesperson from the Academy of Nutrition and Dietetics (formerly known as the American Dietetic Association) as expert sources. Given the Academy's strong ties to the food industry, I'm a little suspicious of their opinions. http://www.eatdrinkpolitics.com/wp-content/uploads/AND_Corporate_Sponsorship_Report.pdf

I'd place more trust in the opinion of gluten researcher Alessio Fasano, MD, who estimates that 6% or 7% of the population may be gluten sensitive. That's about 20 million people.

So, even taking the very conservative recommendations from the article, we're talking millions of people who would benefit from avoiding gluten. That's not insignificant.
 
facetguy said:
The article concludes:

"If you don't have celiac disease, a wheat allergy or a gluten sensitivity, you're unlikely to benefit from a gluten-free diet."

Perhaps that's true; frankly, I don't think we know for sure yet. The cited article uses a dietician and a spokesperson from the Academy of Nutrition and Dietetics (formerly known as the American Dietetic Association) as expert sources. Given the Academy's strong ties to the food industry, I'm a little suspicious of their opinions. http://www.eatdrinkpolitics.com/wp-content/uploads/AND_Corporate_Sponsorship_Report.pdf

I'd place more trust in the opinion of gluten researcher Alessio Fasano, MD, who estimates that 6% or 7% of the population may be gluten sensitive. That's about 20 million people.

So, even taking the very conservative recommendations from the article, we're talking millions of people who would benefit from avoiding gluten. That's not insignificant.
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to be contrarian, the other gist of the article is that a "gluten free" diet may not be healthy for the 93-94% of the US population that, by Dr. Fasano's estimate, is not gluten sensitive. And that also doesnt obviate the possible negative effects of a gluten free diet on those 6-7% who may actually be suffering from gluten sensitivity.

Thats about 290 million people. (or at least)
 
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facetguy said:
The article concludes:



I'd place more trust in the opinion of gluten researcher Alessio Fasano, MD, who estimates that 6% or 7% of the population may be gluten sensitive

.
Click to expand...

Not sure I really put all my faith in someone who benefits from having higher numbers of people that have gluten issues either(ie books, research dollars, etc)
 
Ducttape said:
to be contrarian, the other gist of the article is that a "gluten free" diet may not be healthy for the 93-94% of the US population that, by Dr. Fasano's estimate, is not gluten sensitive. And that also doesnt obviate the possible negative effects of a gluten free diet on those 6-7% who may actually be suffering from gluten sensitivity.

Thats about 290 million people. (or at least)
Click to expand...

I guess the argument there centers on fiber. I'm skeptical.

And our expert from the article states "You can eat a healthy diet without gluten, but you have to be very knowledgeable, and most people aren't". How about we just eat real food and stop eating processed, highly refined, instant crap all the time? I don't think we have to be all that knowledgeable to do that.
 
lonelobo said:
Not sure I really put all my faith in someone who benefits from having higher numbers of people that have gluten issues either(ie books, research dollars, etc)
Click to expand...

Fair point. On some level LOTS of literature becomes suspect. (Reading Ben Goldacre's book is eye-opening.)
 
facetguy said:
I guess the argument there centers on fiber. I'm skeptical.

And our expert from the article states "You can eat a healthy diet without gluten, but you have to be very knowledgeable, and most people aren't". How about we just eat real food and stop eating processed, highly refined, instant crap all the time? I don't think we have to be all that knowledgeable to do that.
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the argument of the article appears to be saying that a lot of the gluten free food is exactly what you are railing against - highly refined and processed.

That's because whole grains, which contain gluten, are a good source of fiber, vitamins and minerals, Tallmadge said. Gluten-free products are often made with refined grains, and are low in nutrients.

If you embrace such a diet, you'll end up "eating a lot of foods that are stripped of nutrients," Tallmadge said. Studies show gluten-free diets can be deficient in fiber, iron, folate, niacin, thiamine, calcium, vitamin B12, phosphorus and zinc, she said.
Click to expand...
 
Ducttape said:
the argument of the article appears to be saying that a lot of the gluten free food is exactly what you are railing against - highly refined and processed.
Click to expand...

Unless, of course, we eat real food.
 
- GF diet tends to be very healthy b/c fast food/pizza, etc. is out, or if you want GF pizza it is $$ or make your own, which tends to be healthier, etc.

- Gluten can be an inflamm trigger for pain pts so it is useful to be aware and engage pts who are 'inflammed' w/o clear rheum serum findings

- Many pts of mine who do well with migraines GF


It gets a stigma b/c some GF people can be really annoying about it and some hypochondriacs adopt the GF thing as part of their list of 100 issues, but dont blow it off b/c of that
 
specepic said:
- Gluten can be an inflamm trigger for pain pts so it is useful to be aware and engage pts who are 'inflammed' w/o clear rheum serum findings
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I'm assuming you just made that up?

I think it would be inflammatory if you took a handful of wheat flour and threw it in someone's eye. Otherwise... meh.
 
specepic said:
- GF diet tends to be very healthy b/c fast food/pizza, etc. is out, or if you want GF pizza it is $$ or make your own, which tends to be healthier, etc.

- Gluten can be an inflamm trigger for pain pts so it is useful to be aware and engage pts who are 'inflammed' w/o clear rheum serum findings
Click to expand...

Which is why it's overly simplistic for one of the women in the above article to say "There's nothing magical about eliminating gluten that results in weight loss". If that gluten is acting as an inflammatory trigger, who's to say that can't relate to obesity?
 
lobelsteve said:
I'm assuming you just made that up?

I think it would be inflammatory if you took a handful of wheat flour and threw it in someone's eye. Otherwise... meh.
Click to expand...

The word I used was "can" not "is". i.e, if they have an undiagnosed gluten issue is may be why they hurt in a bunch of places, or have migraines, or abd pain, or back pain. I have seen this with several pts.

Do you have some type of bias or issue when it comes to diet, gluten, etc.?

It is well documented in the lit that gluten reactions can behave in a very autoimmune way, including PN, etc. You should be aware of this as PMR/EMG guy? Or are you just in a trollish mood?
 
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Ligament said:
Up here in Seattle every woman between 30-40 is sensitive to Gluten, now including my woman....:thumbdown:

I don't get it.
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Seattle women are sensitive to all kinds of craziness. Drove me nuts when I lived there.

Seriously, something else must happen to 30-40yr old women.
This is when they get fibro, gluten allergies, IBS.

Maybe their endocrine/hormone system is tied to physical self-esteem, cuz after 30 or 35, no one hits on them anymore and they're relatively invisible at mixed single parties..........
 
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specepic said:
The word I used was "can" not "is". i.e, if they have an undiagnosed gluten issue is may be why they hurt in a bunch of places, or have migraines, or abd pain, or back pain. I have seen this with several pts.

Do you have some type of bias or issue when it comes to diet, gluten, etc.?

It is well documented in the lit that gluten reactions can behave in a very autoimmune way, including PN, etc. You should be aware of this as PMR/EMG guy? Or are you just in a trollish mood?
Click to expand...


You MIGHT be on to something.
http://www.ncbi.nlm.nih.gov/pubmed/22825366

But it does not appear very credible. You say autoimmune. Show me esr/crp. Otherwise its another fibromyalgia variant.

The Scandies report not multiple somatic complaints in non celiac gluten hypersens. But only 22 patients.

My question is: what you going to do about it? I assume just tell them to try a gluten free diet for a month?
 
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lobelsteve said:
You MIGHT be on to something.
http://www.ncbi.nlm.nih.gov/pubmed/22825366

But it does not appear very credible. You say autoimmune. Show me esr/crp. Otherwise its another fibromyalgia variant.

The Scandies report not multiple somatic complaints in non celiac gluten hypersens. But only 22 patients.

My question is: what you going to do about it? I assume just tell them to try a gluten free diet for a month?
Click to expand...

This is an interesting review that ties some of these issues together:
http://physrev.physiology.org/content/91/1/151.long

One of the known triggers of zonulin is gluten.
 
lobelsteve said:
You MIGHT be on to something.
http://www.ncbi.nlm.nih.gov/pubmed/22825366

But it does not appear very credible. You say autoimmune. Show me esr/crp. Otherwise its another fibromyalgia variant.

The Scandies report not multiple somatic complaints in non celiac gluten hypersens. But only 22 patients.

My question is: what you going to do about it? I assume just tell them to try a gluten free diet for a month?
Click to expand...

You are aware that not all autoimmune processes will show elevated ESR/CRP but can indeed cause sign pathology and organ/tissue damage. DM and thyroid ds come to mind, among many others. The medical world has evolved considerably since we attended med school, and in partic. with regard to celiac ds. and gluten reactions. It is not my job to change anyone's mind, and you are entitled to your own opinion, but "not your own facts" :cool: There is plenty of mainstream lit on these items.
 
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specepic said:
You are aware that not all autoimmune processes will show elevated ESR/CRP but can indeed cause sign pathology and organ/tissue damage. DM and thyroid ds come to mind, among many others. The medical world has evolved considerably since we attended med school, and in partic. with regard to celiac ds. and gluten reactions. It is not my job to change anyone's mind, and you are entitled to your own opinion, but "not your own facts" :cool: There is plenty of mainstream lit on these items.
Click to expand...

OK, so we make up a new disease (or clinical discovery).

What are you going to do to treat?
 
lobelsteve said:
OK, so we make up a new disease (or clinical discovery).

What are you going to do to treat?
Click to expand...

Celiac is not a new disease, although a lot of information about it has changed with further research and clinical experience in recent years

Non-celiac gluten intolerance is, I suppose, a newer entity and if suspected, I would ask for assistance of PCP, dietition, and perhaps GI

Although complicated by placebo effects, a GF diet trial is a test and treatment rolled into one. The avail of GF options and menus have exploded in recent years. The diet is much more feasible than it used to be. There is not much downside and it gives the pt some responsibility for their own health, like a HEP. The one downside is cost as GF alternatives can be pricey. otoh, if they eat less it will balanace out to come degree (and they might mose weight)
 
specepic said:
Celiac is not a new disease, although a lot of information about it has changed with further research and clinical experience in recent years

Non-celiac gluten intolerance is, I suppose, a newer entity and if suspected, I would ask for assistance of PCP, dietition, and perhaps GI

Although complicated by placebo effects, a GF diet trial is a test and treatment rolled into one. The avail of GF options and menus have exploded in recent years. The diet is much more feasible than it used to be. There is not much downside and it gives the pt some responsibility for their own health, like a HEP. The one downside is cost as GF alternatives can be pricey. otoh, if they eat less it will balanace out to come degree (and they might mose weight)
Click to expand...

according to the article, the downside is cost and possible nutritional deficiencies, if they are relying on processed gluten free food. (another individual suggesting gluten free diet is may not be healthy - Dr. Joel Mason comments


besides in celiac patients, have there been any studies that show definitively that a gluten free diet provides health benefits?

there is a diet out there that already does show health benefits - the mediterrenean diet. we should be recommending this diet.

oh and btw...

He is an anti-gluten guy tho... so the battle rages on..
 
Ducttape said:
according to the article, the downside is cost and possible nutritional deficiencies, if they are relying on processed gluten free food. (another individual suggesting gluten free diet is may not be healthy - Dr. Joel Mason comments


besides in celiac patients, have there been any studies that show definitively that a gluten free diet provides health benefits?

there is a diet out there that already does show health benefits - the mediterrenean diet. we should be recommending this diet.

oh and btw...

He is an anti-gluten guy tho... so the battle rages on..
Click to expand...

I love the fact that the article you linked to attempts to debunk gluten-free diets then provides a link for additional information...a link to the Grain Foods Foundation! :laugh: Gimme a break.
 
I like and dislike gluten free at the same time.

It is silly because everyone now thinks they have gluten hypersensitivity.
It is great because my sons friend Dan now has a lot of different foods to choose from. For those who are truesprue it really has been helpful. N/V from flour dust in a GF pizza kinda sucks.
 
facetguy said:
I love the fact that the article you linked to attempts to debunk gluten-free diets then provides a link for additional information...a link to the Grain Foods Foundation! :laugh: Gimme a break.
Click to expand...

show me where the Boston Globe article there is a link to the Grain Foods Foundation.

the second article i clearly state that he is an anti-gluten guy, no doubt about that. that link is a presentation of "the other side".
 
Ducttape said:
show me where the Boston Globe article there is a link to the Grain Foods Foundation.

the second article i clearly state that he is an anti-gluten guy, no doubt about that. that link is a presentation of "the other side".
Click to expand...

No, no. I wasn't knocking you. It's just funny how something so biased is offered as some kind of proof. It's organizations like that one that have been major funders for the
American Dietetic Assoc, or whatever it's called now.
 
So you are saying a GF diet is unhealthy if they do it wrong (eat primarily processed / manufactured foods)? That is true for any diet. What has been pointed out if that just b/c it is "GF" doesnt mean it is good for you. That should be pretty obvious, and if it isnt, that person will not be eating well anyway, and getting sick to boot

GF diet is like snowboarding. Some think it is a fad, and some are in the know, and it may eventually be in the olympics
 
specepic said:
So you are saying a GF diet is unhealthy if they do it wrong (eat primarily processed / manufactured foods)? That is true for any diet.
Click to expand...

I didn't say that. The lady in the initial article said that.

What has been pointed out if that just b/c it is "GF" doesnt mean it is good for you. That should be pretty obvious, and if it isnt, that person will not be eating well anyway, and getting sick to boot.
Click to expand...

I agree. There's plenty of crappy GF food. I was pointing out that, although you'd never know it from the initial article, one can find plenty of good, healthy, nutrient-dense food to eat even if avoiding gluten grains. The article made it sound as though you'll shrivel up and die if you don't eat multiple servings of wheat everyday.

GF diet is like snowboarding. Some think it is a fad, and some are in the know, and it may eventually be in the olympics
Click to expand...

:thumbup:
 
One of the threads on sermo discussed gluten free diets a few months ago. One cardiologist made a good point in relating the GF issue to the paleo diet. Humans ate meat, vegetables, and fruit for a million years as they evolved. Agriculture has only been around for maybe 10,000 years. Cows were designed to eat wheat and grass. Humans weren't and had not eaten gluten until agriculture came around very recently. Hence so many problems from grains, gluten, and a carb heavy diet.
 
No, the article made it sound that the majority of people - not celiac patients who tend to be very conscientious about what they eat - who get involved in "fad" diets are actually eating foods that are less healthy than a diet based on sound nutrition. Most people buy based on marketing. Why else are items 0.99, 1.99, 2.99, and not 1,2 or 3?

I saw a bag of food, today, with huge GLUTEN FREE sign on it. Honestly, I never realized there is a lot of gluten in teriyaki beef jerky...
 
Ducttape said:
No, the article made it sound that the majority of people - not celiac patients who tend to be very conscientious about what they eat - who get involved in "fad" diets are actually eating foods that are less healthy than a diet based on sound nutrition. Most people buy based on marketing. Why else are items 0.99, 1.99, 2.99, and not 1,2 or 3?

I saw a bag of food, today, with huge GLUTEN FREE sign on it. Honestly, I never realized there is a lot of gluten in teriyaki beef jerky...
Click to expand...

I don't disagree that many people, dieting or not dieting, eat a lot of unhealthy food. I don't think we're talking about that. We're talking about the bogus notion that gluten-containing grains are what make a diet nutritious.

Marketing, as you suggest, is very powerful and plays a role in obesity today. Especially when it comes to kids.

I can pretty much bet that Steve's son's friend Dan would never eat anything with teriyaki on it.
 
drf said:
One of the threads on sermo discussed gluten free diets a few months ago. One cardiologist made a good point in relating the GF issue to the paleo diet. Humans ate meat, vegetables, and fruit for a million years as they evolved. Agriculture has only been around for maybe 10,000 years. Cows were designed to eat wheat and grass. Humans weren't and had not eaten gluten until agriculture came around very recently. Hence so many problems from grains, gluten, and a carb heavy diet.
Click to expand...

One of the core "rules" of Paleo is no grains.

In addition to your points is the idea that grains, especially wheat, have been changed over the last half-century and are more problematic than so-called ancient grains.
 
Ducttape said:
No, the article made it sound that the majority of people - not celiac patients who tend to be very conscientious about what they eat - who get involved in "fad" diets are actually eating foods that are less healthy than a diet based on sound nutrition. Most people buy based on marketing. Why else are items 0.99, 1.99, 2.99, and not 1,2 or 3?

I saw a bag of food, today, with huge GLUTEN FREE sign on it. Honestly, I never realized there is a lot of gluten in teriyaki beef jerky...
Click to expand...

Teriyaki usually contains soy sauce. Most soy sauces contain... WHEAT!

It is something special for a teriyaki sauce to advertise that it is gluten free.

My spouse is trying gluten free because of migraines. It has decreased the number of migraines per month from more than 10 to less than 5. Maybe there is something to it. Most of the time that a migraine hits it is after eating something that was not tried yet, and we did not research it enough. Most recently, it was a Dairy Queen sunday. The whipped topping contains gluten. So we ordered one without the whipped topping... something went wrong and the next day was a migraine day (after being two weeks migraine free).

I still eat anything/everything I want, but half of my family is gluten free.

dsoz
 
facetguy said:
Just saw this. Fits in this thread:

http://www.wheatbellyblog.com/2013/03/give-harvard-health-a-piece-of-your-mind/
Click to expand...

As is this:

http://well.blogs.nytimes.com/2013/02/04/gluten-free-whether-you-need-it-or-not/

NY times article. to semiquote - Dr. Guandalini, medical director of the University of Chicago's Celiac Disease Center:

"It is not a healthier diet for those who don't need it," Dr. Guandalini said. These people "are following a fad, essentially." He added, "And that's my biased opinion."

Nonetheless, Dr. Guandalini agrees that some people who do not have celiac receive a genuine health boost from a gluten-free diet. He just cannot say how many...

(pertaining the number of ppl with celiac sensitivity) "No more than 1 percent," Dr. Guandalini said, although he agreed that at present all numbers were speculative.
Click to expand...

And most importantly:

Celiac experts urge people to not do what Ms. Golden Testa did — self-diagnose. Should they actually have celiac, tests to diagnose it become unreliable if one is not eating gluten. They also recommend visiting a doctor before starting on a gluten-free diet.
Click to expand...
 
To diagnose celiac disease you need a positive test for 3 specific antibodies, a small bowel biopsy showing sloughing of the villi, and finally a good response to a gluten free diet. In about 2006 there was a study showing that some people have only 1 or 2 antibodies to gluten and so missed the diagnosis. I don't remember any mention of small bowel biopsy on those patients. So if you have 1 or 2 of the antibodies it wouldn't be unreasonable to think that eating gluten could cause problems.
 
onewithpain said:
To diagnose celiac disease you need a positive test for 3 specific antibodies, a small bowel biopsy showing sloughing of the villi, and finally a good response to a gluten free diet. In about 2006 there was a study showing that some people have only 1 or 2 antibodies to gluten and so missed the diagnosis. I don't remember any mention of small bowel biopsy on those patients. So if you have 1 or 2 of the antibodies it wouldn't be unreasonable to think that eating gluten could cause problems.
Click to expand...

There are those who don't have any of the typical antibodies, yet do well on a GF diet.

Some believe the standard labs for gluten issues are too limited. They're pretty good if you're full-blown celiac but miss everyone else. There are newer tests, albeit still early on, that are much more comprehensive and perhaps will someday become the standard.
http://www.cyrexlabs.com/CyrexTestsArrays/tabid/136/Default.aspx
 
facetguy said:
There are those who don't have any of the typical antibodies, yet do well on a GF diet.

Some believe the standard labs for gluten issues are too limited. They're pretty good if you're full-blown celiac but miss everyone else. There are newer tests, albeit still early on, that are much more comprehensive and perhaps will someday become the standard.
http://www.cyrexlabs.com/CyrexTestsArrays/tabid/136/Default.aspx
Click to expand...

Do you sell gluten lab testing to your patients?
 
101N said:
Do you sell gluten lab testing to your patients?
Click to expand...

No, I don't "sell" them lab testing. I don't do much of this work. Just an interesting topic.
 
High-priced serum testing is clearly a scam, but I've seen enough patients get better on a gluten free diet that I don't think it's all B.S. I will freely admit that it's unclear what the actual mechanism is -- when someone goes gluten free, they usually stop eating fast food and increase their consumption of veggies and such. The problem in the U.S. is that I people can never just leave it there, it has to become the anti-gluten crusade and the next big food fad all in one. I liked it better when we were all doing the Atkins diet and eating two steaks a night.
 
Ducttape said:
in my experience, right around 30% get better on a gluten free diet.


that number is vaguely familiar....
Click to expand...

It that because it's the same # who get better with a lumbar fusion?
 
SeniorWrangler said:
High-priced serum testing is clearly a scam, but I've seen enough patients get better on a gluten free diet that I don't think it's all B.S. I will freely admit that it's unclear what the actual mechanism is -- when someone goes gluten free, they usually stop eating fast food and increase their consumption of veggies and such. The problem in the U.S. is that I people can never just leave it there, it has to become the anti-gluten crusade and the next big food fad all in one. I liked it better when we were all doing the Atkins diet and eating two steaks a night.
Click to expand...

So it's not the absence of gluten but the absence of Big Macs and the increase in veggies that is at the root of any benefits from a GF diet? I doubt that.

If someone does indeed react to gluten, there is no in-between. You either avoid gluten or you don't. So in a way it is a crusade, although I wouldn't use that term.
 
101N said:
It that because it's the same # who get better with a lumbar fusion?
Click to expand...

ive been reading/listening to a lot of physics, esp. with quantum mechanics. they get to name things real cool names (Higgs Boson, TOE, quarks, hadrons, etc.)

So im calling this number the:
Placedo Bomingo Constant.
 
Ducttape said:
ive been reading/listening to a lot of physics, esp. with quantum mechanics. they get to name things real cool names (Higgs Boson, TOE, quarks, hadrons, etc.)

So im calling this number the:
Placedo Bomingo Constant LASER!.
Click to expand...

Fixed it.
 
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