Why Gluten-Free Is Just Not Enough

September 5, 2012 · 24 comments

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The scientific community is finally noticing something that nutritionists have been dealing with for years — leaky gut syndrome. In fact, a paper called Leaky gut and autoimmune diseases was published in February 2012 in the journal, Clinical Reviews in Allergy and Immunology. The author, Alessio Fasano, M.D., (he is my hero) has been researching this very topic for years in relationship to celiac disease and gluten sensitivity. The review paper he wrote is focused on the role of impaired intestinal barrier function (leaky gut) on autoimmune pathogenesis. In short, he is trying to get to the real causes of autoimmunity.

In this paper, Dr. Fasano proposes a new theory that suggests that autoimmune disease is not only preventable, but also reversible. Amazing!

Since his expertise is with celiac disease, that is what he has studied. If you read his bio you will see that he is quite accomplished:

Can celiac disease be reversed?

Typically, any autoimmune disease diagnosis comes with a life sentence. Along with the life sentence are increasingly dangerous levels of drugs to manage the symptoms.

Fasano’s new theory explains how an autoimmune condition may develop. It involves a perfect storm of three conditions:

  1. Increased intestinal permeability (leaky gut)
  2. A genetic predisposition to autoimmunity
  3. An exposure to the environmental trigger (in this case gluten)

What this means is that people who have a leaky gut, as well as the genetics for celiac disease, can develop autoimmunity when they eat gluten. This will cause intestinal damage.  The increased intestinal permeability that is part of the leaky gut, allows the environmental trigger (which in this case is gluten) to access the body and this triggers the genetic predisposition.

Conventional understanding of celiac included variable numbers 2 and 3, but instead of leaky gut, the third variable was the presence of  circulating autoantibodies to the enzyme tissue transglutaminase.

Acknowledging that autoantibodies are present does not explain why they are there. Fasano’s theory does explain this. Furthermore, it suggests that if you can cure the leaky gut, you can cure the autoimmune disease.

Alternative treatments may help a little

Nutritionists may offer supplements — something natural that can address the underlying inflammation. However, these do not get to the real problem — the leaky gut.

My frustration with allergy testing (delayed IGg allergies) is that many times the tests show that the person is allergic to everything they eat. When speaking to the doctors at the lab they say “you must heal the gut”.

Their solution? A rotation diet with food that would be difficult to obtain, like venison because the patient was allergic to most proteins, or unusual types of fish because they were allergic to all the common kinds. Who is going to do that? What child would eat that?

The other part of that solution is to take oodles of supplements three times a day. Who has the time and the money for that? Most importantly, supplements do not heal a hyper-reactive immune system. They may help, but they can not heal and seal a leaky gut.

Tight Junction dysfunction is part of leaky gut

The cells lining the intestine (enterocytes) are stacked up close together, creating the hills and valleys of the brush border, in order to increase the surface area of the intestine. That close fitting area in between the cells is called the tight junction. But since these cells are part of the intestinal lining — a barrier — certain small particles and nutrients are allowed through.

We know that a protein called zonulin is a signaling mechanism for opening and closing the tight junctions in the intestine. Zonulin also serves as an escort through the membrane for certain molecules and bacteria.

We know that gliadin (the prolamine in gluten) causes zonulin levels to increase in people with the genetic pre-disposition to celiac disease.  As zonulin levels go up, the tight junctions become lax, widening the space between the cells of the lining and increasing gut permiability. Now the gut membrane has spaces which allow large food particles into the body that shouldn’t be there. These are noticed by the immune system and targeted as foreign.

An immune response ensues and the worse it gets, the more damage to the enterocytes occurs. The more damaged the enterocytes, the leakier the gut gets and so on, in a vicious cycle. As more aspects of the immune system get involved (various cytokines involved in the cellular and innate immune systems) the worse things get, and in the process, the micro villi are damaged and eventually flattened. That is a condition that makes it very difficult to absorb nutrients.

There are many causes of leaky gut syndrome

Gliadin is just one of the ways a leaky gut may develop. Other ways, include damage to the intestinal lining from antibiotics, steroids, NSAIDS, imbalance in gut bacteria or dysbiosis, etc. But for people with the genetics for celiac, gliadin is a dangerous molecule.

For people with the genetics for celiac, gliadin is like kryptonite was to superman. It is very destructive and should be avoided like the plague.

Gliadin is a protein that is very difficult to digest. Even in a  properly prepared grain, gliadin can be difficult to digest — it is especially difficult for people with the celiac gene. Even in healthy people with the gene for celiac, particles of gliadin will be bouncing around the intestine, undigested. This starts an immune response and a vicious cascade of inflammatory cytokines which eventually leads to flattened and destroyed microvilli.

What you can do to heal and seal a leaky gut

The gluten-free diet is conventional treatment for celiac. Some people do very well with this but there is research that shows that only 66% of celiacs fully heal on the gluten-free diet after 5 years.

Those 66% need to go beyond gluten-free

Research also shows that celiacs have a four fold increase in morbidity and mortality. That means that even with a gluten-free diet, celiacs will be sicker and die younger.

The Solution

The solution is to go grain-free and eat a diet that includes foods that are very easy to digest and assimilate, which are full of the nutrients so desperately needed.

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This post is shared at: Creative Juice Thursday, Keep it Real Thursday, Full Plate Thursday, Simple Lives Thursday, Eat Make Grow, Pennywise Platter, Fresh Bites Friday, Freaky Friday, Country Homemaker Hop, gluten-free friday, Foodie Friday, Friday Food, Superfoods Sunday, Seasonal Celebration, Monday Mania, Barnyard Hop, Meatless Monday, Traditional Tuesday, Hearth & Soul Hop, Tasteful Tuesday, Allergy Free Wednesday, Sustainable Ways, Mommy Club, Healthy 2Day, Real Food Wednesday

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{ 14 comments… read them below or add one }

1 Nicole Reilly September 6, 2012 at 8:23 am

Thank you for this article. It has come right when I needed it. I have been gluten free for 5 years. However, I have a c ray amount of inflammation in my body which has become obvious to the naked eye. I am so disgusted! I am so full of fluid I have a difficult time doing yoga. I recently had the Cyrex lab test done and have discovered an allergy to eggs, casein, dairy, nuts, soy and whey. Now it’s all making sense. Thank you. I am interested in your class however am concerned about you using foods that I am allergic to. Your thoughts?

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2 Jill September 6, 2012 at 9:48 am

Hi Nicole,
Clearly, you still have leaky gut which is why you have so many allergies. I have found that when people remove the major groups like grains and dairy — things start to get better. Nuts should be removed for a while and also eggs. However, some people can tolerate the egg yolks – it is usually the protein in the whites that cause the problem.

As far as the class goes, if you can tolerate the yolks, all the baking can be done with yolks. If not, there are certain things to use for egg replacer, but I have not tried my recipes that way. You can also use just coconut flour for baking instead of any nut flours. As you get better, you can add in some of the foods you eliminated.

Hope this helps!

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3 Diane Balch September 7, 2012 at 3:05 pm

I have been haunted lately by my childhood food allergies. I heard this discussion yesterday on National Public Radio. It might be of interest to you too. http://www.radiolab.org/2009/sep/07/

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4 Miz Helen September 8, 2012 at 10:40 am

Hope you are having a fabulous weekend and thank you so much for sharing with Full Plate Thursday.
Come Back Soon!
Miz Helen

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5 leslie September 8, 2012 at 4:31 pm

Great article! Dr. Peter Osborne on you tube may interest you about this subject. He basically states because all grains have prolamines that they all have gluten very interesting. Too bad so many believe soaking and sprouting takes care of the problem.

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6 Jill September 9, 2012 at 11:05 am

Hi Leslie,
Supposedly there are some grains that are gluten-free. Soaking and sprouting takes care of the problem of phytates and lectins in the grains but has nothing to do with the gluten.

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7 Mary Hudak-Collins September 10, 2012 at 9:32 am

My daughter was diagnosed with Celiac and food allergies to dairy (both Cassein and Whey), eggs, corn, wheat, soy, tomatoes, and peanuts. She recently has gone through challenge to soy, tomatoes, and corn. At this point she can tolerate those 3 food items in small amounts and cooked. She had challenged dairy and eggs (not at same time) and couldn’t tolerate either, even in small amounts. Pretty much everything we eat is made from scratch at home. I have looked into some of these other diets, but each one has a food item that she cannot tolerate.

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8 Jill September 10, 2012 at 12:07 pm

Hi Mary,
Yes, for so many people there will be certain foods that are “legal” on a diet but they still cannot tolerate them. You have to tweek the diet to fit where you are at any one time.

I’m not in favor of soy unless it is fermented and corn unless it is organic. These can be irritating to a sensitive individual. Also, some are OK with egg yolks and not the whites which is the protein part and harder for allergic people.

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9 Lyza@ Chic Shades of Green September 16, 2012 at 3:33 pm

Hi Jill,

Do you think this is true for all auto-immune diseases/disorders or just for celiac? Has your research gone beyond celiac, which is what i assume is your reason behind all of your research? I don’t really notice a difference no matter what foods I eat, so it’s hard to imagine making an extreme change and challenging my family to do the same. very interesting information here.

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10 Jill September 16, 2012 at 8:14 pm

HI Lyza,
My personal opinion is that anyone facing an autoimmune issue would be better off without grains. They could try it for a set amount of time and see how they feel — but it has to be done with fanatic adherence otherwise it may not work. However, it doesn’t have to be a life sentence — many people heal their gut and move on and can then eat some of the previously prohibited foods and still be well.

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11 Lyza@ Chic Shades of Green September 16, 2012 at 9:01 pm

Thanks, it might be the next step I take. It’s a very extreme diet change for me, so I don’t want to take it lightly. I will check out the Dr you mention above.

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12 amber September 18, 2012 at 12:28 am

Hi Jill,

Thank you for this post!!

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13 Jyran October 26, 2012 at 6:18 pm

Would soaking and sprouting also get rid of the prolamins in grains? If so, wouldnt that make gluten free grains digestible by celiacs? Or is there something else besides phytates, lectins, and prolamines that isn’t digestible?

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14 Jill October 26, 2012 at 8:48 pm

Hi Jyran,
It is much more than just digestibility. The prolamins cause an immunological reaction in a susceptible person and this causes the inflammatory cascade. Soaking and sprouting has nothing to do with this type of reaction.

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