DOCTORS’ NOTES

Reducing carbs will help you feel better. But does that mean you’re sensitive to gluten? A researcher explains,

Gluten-free is one of the biggest nutritional crazes in the world right now. It’s become a greater enemy than fat and carbohydrates, with many people reporting they lose weight, gain energy and feel better without it. The fad has taken nutritional scientists like me by surprise, because most people don’t have any gluten problems that we can find.

So far, we can’t find evidence of gluten sensitivity in people’s genes, aside from the one per cent of the population with celiac disease, which is a very serious intolerance to gluten.

In fact, 70 per cent of people don’t even carry the gene required to develop celiac disease, and most of those with the gene never develop the condition. Then why do so many people swear by swearing off gluten? That’s what we’re trying to find out in my laboratory.

We’ve finally landed on a possible clue: eating a lot of gluten may cause small amounts of inflammation in some people without celiac disease. We found those who eat the most gluten experience a rise in blood levels of alpha-2 macroglobulin, which indicates inflammation and is also a sign that your immune system is working to clear something. For that marker to be visible, people had to be eating roughly five slices of bread a day or two full plates of pasta.

We’re still not sure whether the gluten actually causes the inflammation. And for most people, this inflammation probably won’t lead to symptoms. But it gives us a hint into why some people might feel worse eating gluten, even though they don’t have celiac disease.

For now, the jury’s still out on the possibility non-celiac sufferers could have their own gluten sensitivities.

In the meantime, I’ve got some theories of my own. I suspect many people feel great when they cut out gluten simply because they reduced excess carbohydrates — something many of us probably should do. Bread and pasta weigh you down because each gram of starch from these foods is stored with 3 grams of water in your muscles and liver. Simply by shedding that water, you can look and feel leaner in less than a day.

Carbs are also packed with calories. Cut those out and you’ll likely drop weight and feel better.

I’m a gluten researcher and I don’t avoid gluten — although I do cut back on most carbs when I want to drop a few pounds. I’ve had myself tested genetically and I don’t carry the gene for celiac disease. But I’m also wary of the substitutes. Many of those gluten-free breads and pastas cost double, are of poor nutritional quality and don’t taste as good.

Also, new research shows that eating a lot of these gluten-free foods might lead to unfavourable changes in the bacteria lining our gut.

If you’re worried about gluten sensitivity, ask your health provider for a celiac test. Most people with celiac disease are still undiagnosed. Don’t give up gluten until after the blood test, otherwise the test may show inaccurate results.

Even if you don’t have celiac disease, there’s no harm in trying to cut out gluten as an experiment, as part of an “elimination diet” to identify what food substances may be disagreeing with your personal physiology. If you do, it’s best to work with a dietitian who can make sure you’re still getting enough B vitamins, fibre and other nutrients found in grains.

The best way to eat is often very personal to your own digestive system, tastes and energy needs. Paying close attention to how you feel after eating certain foods is one of the best ways to piece together your own nutritional puzzle. Dr. Ahmed El-Sohemy is an associate professor of nutritional sciences at U of T. Doctors’ Notes is a weekly column by members of the University of Toronto’s faculty of medicine. Email doctorsnotes@thestar.ca.