Leave it to Jimmy Kimmel and late night TV to be the harbinger of the next big thing in dietary science. I mean, he is the guy famous for the “I ate all your Halloween candy” videos after all. So when I read a new study about gluten sensitivity (or lack thereof, as you shall soon see), the first thing I thought of was his “What is gluten anyhow?” sketch a couple weeks ago where he asked people on a gluten-free diet what it is they’re hiding from. Jimmy makes all the science fun: (click through to see video if it doesn’t show up in your reader)
“I live in LA, eating gluten is akin to satanism.” [Truest sciencey science ever]
Gluten is a combination of two proteins found wheat, barley and rye. You’ll never be dumb again. You’re welcome.
Non-celiac gluten sensitivity (NCGS) is all the rage these days and unless you live under a rock made of bread dough (which strangely just made me crave giant sourdough pretzels – they’re so hard and stale they shouldn’t be good and yet… they are), you know someone who is gluten intolerant, “allergic” to gluten or just sensitive to gluten. (Not to be confused with celiac disease, an illness where when a person eats gluten it destroys the lining of the intestines and can be very serious.) Indeed, a recent survey reported that about 1 in 100 people think that gluten affects them negatively and 30% of US adults are actively trying to avoid it.
Miley Cyrus spoke for a generation when she tweeted about her “gluten allergy” saying, “It’s not about weight it’s about health. Gluten is crapppp anyway!”
And yet nutritionists have long been giving NCGS the side-eye because, like Pop Rocks and the new Grace of Monaco movie, the hype preceded any real substance. There just wasn’t any science to back up the “crapppp” theory (catchy!). That is, until 2011 when Peter Gibson, PhD, a professor of gastroenterology at Monash University and director of the GI Unit at The Alfred Hospital in Melbourne, published research that seemed to find that gluten negatively affected all people, even those with no medical diagnosis of celiac disease. His original research supported what so many people were already thinking that it took off like a rocket, quickly becoming one of the most-cited in the field. I personally remember writing about it when I first read it. It was big news.
But now, in one of the most stunning reversals in recent memory, Gibson says he got it wrong. Like totally, completely backwards, Justin Bieber’s pants wrong.
Unsatisfied with his 2011 findings, he devised a more rigorous study to examine whether it really was gluten people were reacting to or something else. According to RealClearScience, “Subjects would be provided with every single meal for the duration of the trial. Any and all potential dietary triggers for gastrointestinal symptoms would be removed, including lactose (from milk products), certain preservatives like benzoates, propionate, sulfites, and nitrites, and fermentable, poorly absorbed short-chain carbohydrates, also known as FODMAPs. And last, but not least, nine days worth of urine and fecal matter would be collected. With this new study, Gibson wasn’t messing around.”
The subjects, all of whom reported having NCGS but tested negative for celiac disease, were all placed on the low-FODMAP diet as a baseline. After two weeks they were then put on one of three diets: the baseline plus gluten, the baseline plus whey protein or just the baseline diet (the control group).
The results were astounding. He found that people on each study diet, whether or not it included gluten, reported feeling worse. Whether they ate a diet containing gluten, whey protein or a placebo, all the subjects reported increased pain, bloating, nausea, and gas all increased over the baseline low-FODMAP diet. Clearly the effect was mental, as confirmed in a second experiment. This time the subjects reported a worsening of symptoms even when the placebo diet was identical to the baseline diet (meaning they were told their diet had been changed to have gluten in it when in reality their diet hadn’t changed at all).
I got to interview Gibson for Shape and he told me of the study design, “We the designed a study using the ‘gold-standard’ method of rechallenging food components by doing a cross-over study (each person is his/her own control) and feeding the subjects all their food. With such a design, one can get very powerful results, i.e., less prone to chance. Thus, we are convinced in our 37 subjects, at least, that gluten was not the main culprit in their gut symptoms.”
Despite self-reported gluten sensitivities being “extremely common”, Gibson added, “In contrast to our first study… we could find absolutely no specific response to gluten.” Apparently just thinking something is going to make you sick can actually make you feel sick.
I find all of this SO interesting. One of the conversations I’ve had most over the past few years with countless trainers, nutritionists and holistic docs is about this idea of population-wide gluten sensitivity. When I tell them I don’t feel any ill effects from eating gluten-containing grains (which I generally eat in their whole, most gluten-iest form, like kasha or boiled cereal) they insist that the symptoms like systemic inflammation, brain fog and ugly poops are there, I’m just not noticing them because I’m either really unobservant when it comes to my body or I’ve lived with it for so long it’s all I know.
I’ve never quite known what to make of this. Obviously if you’ve read this blog for any amount of time you know I love taking other people’s opinions of my health over my own. (Seriously, I do. I love it when other people tell me what’s wrong with me and how to fix it!) And yet, it just doesn’t jive with my reality. Even when I thought gluten might be causing my anxiety, an elimination experiment showed it to have no effect at all. (Study of 1 is allowed when you’re the only one who cares about the results, right?)
Interestingly, Gibson may soon have something to say about the mood-gluten connection. His current research is investigating whether gluten may cause psychological and cognitive problems in people with ‘non-celiac gluten sensitivity’ after another pilot study they did showed that gluten seemed to make the subjects more depressed (a placebo did not). I’m really interested to read this new study when it comes out!
Still, despite my personal experimenting, I always wondered if they were right and I was missing something important. And I’ll admit that Gibson’s original study kept coming back to my mind. Even my yoga teacher – usually the haven of vegetarians – announced she’s gone grain- and dairy- free. So maybe I really just don’t know what’s happening in my own body? Not to mention the gluten-free marketing is relentless. Plus, all the cool fitness kids were going gluten-free. So even though I still felt fine eating it I subconsciously started to avoid it. (And I think I’ve started to absorb some of that whole “carbs will make you fat” zeitgeist going around these days.)
As to the million dollar question of whether or not you should add gluten back into your diet now, Gibson says it depends upon why you went gluten-free in the first place. He says his research shows that if it is to reduce bloating and other gut symptoms, the reason why you may feel better sans gluten is that wheat also contains FODMAPs – these are sugars and short chains of sugars (oligosaccharides) that are poorly absorbed in the intestine and cause those symptoms. FODMAPs are found in other food types. He found that bloating will be greatly relieved in 70% of people if they reduce the FODMAP intake.
“The bottom line is that it is not likely that you will be able to eat a lot of wheat bread without getting bloated, but you will be able to have breadcrumbs on the schnitzel etc – i.e., you only need to limit the FODMAPs and not absolutely avoid gluten = easier but not easiest!” he says.
I never totally quit eating grains so I’m going to take this current research as permission to not feel guilty about eating what I want to eat. (Which I shouldn’t feel guilty about anyhow…) But I’m also not going to tell you to start eating gluten if it makes you feel like crapppp. I love science but even more I love it when people become a scientist of their own bodies, finding out what best makes them tick. A placebo effect is still an effect and there may be other parts of wheat that people are reacting to (like pesticides) instead of the gluten. So if taking out gluten is helping then don’t mess with a good thing!
What’s your take – are you surprised by Gibson’s 180? How do you feel that gluten affects you – big problems or no biggie? Do you just avoid carbs all together?
NOTE: The original version of this post did not contain the quotes from Gibson, I updated it 5/21 after I interviewed him as I thought it added a lot of valuable information.