Most health crazes aren’t backed by research. And if research does exist, suggesting that a new craze, such as a certain diet, might actually provide health benefits, such research is often flawed—observational, nonrandomized, and biased—and can leave us scratching our heads as to how the craze become so popular, in the absence of good science.
We saw this with the low-fat craze, which was predicated on poorly designed studies of insignificant sample size that were funded by the food industry. We saw this again with the processed food craze, which was the result of effective food industry propaganda that hypnotized everyone into believing that convenience should be prioritized over healthfulness. The gluten-free craze, seemingly just as manic, might be easy to dismiss as just another craze that will soon reveal itself to be complete nonsense, at which point we can all go back to shamelessly eating sandwiches and bagels and pizza and pasta and cookies.
But let’s not get ahead of ourselves, in assuming that gluten-free will ultimately meet the same fate as low-fat, because the gluten-free movement has what the other crazes, since debunked, never had: incontrovertible research.
What the research indicates
The gluten protein—present in wheat, barley, and rye—has been studied for decades, and is universally recognized as the cause of celiac disease, which affects 1% of the American population.1 People with celiac disease experience an autoimmune reaction to gluten in which their immune system inappropriately targets and causes damage to the intestinal barrier, which causes digestive dysfunction and nutrient malabsorption, which, in turn, causes further immune dysregulation and manifests as diarrhea, abdominal pain, bloating, fatigue, joint pain, and innumerable other chronic symptoms. Such an extreme reaction to gluten requires that people with celiac disease adhere strictly to a gluten-free diet, to decrease the potential for damaging the intestinal barrier, and to increase the potential for allowing the intestinal barrier to heal.
More recently, the degree to which gluten can cause damage to the intestinal barrier in the 99% of people who don’t have celiac disease has been investigated, and the findings, quite alarmingly, indicate that gluten actually causes intestinal damage in everyone, though not to the same degree, and not in the same way, as those with celiac disease. Gluten, it turns out, causes the activation of zonulin (a protein responsible for regulating intestinal barrier function) in everyone who consumes gluten, which then leads to increased intestinal permeability, or, more colloquially, leaky gut.2
What leaky gut is
To understand what leaky gut is, and why it’s important, let’s start with an overview of the digestive system.
The digestive system has two major functions: to absorb nutrients (useful substances), and to protect the body from pathogens, toxins, and antigens (harmful substances). The small and large intestines, the primary organs responsible for performing these two functions, are lined with a single layer of cells—intestinal epithelial cells—that provide a selective barrier to control what substances can and cannot enter the bloodstream.
If the junctions between intestinal epithelial cells are intact, intestinal permeability is normal, and useful substances will be absorbed, and harmful substances will not be absorbed. If the junctions between intestinal epithelial cells become compromised and widen, however, intestinal permeability is increased, and harmful substances will be absorbed into circulation. Certain stressors, such as gluten, can cause these junctions to widen, which results in increased exposure to harmful substances that can cause or contribute to various chronic conditions.3
Leaky gut doesn’t necessarily cause symptoms, which is why many people who consume gluten regularly don’t notice any adverse effects that are obviously attributed to gluten. If left unchecked, however, leaky gut can wreak havoc on the body, by allowing pathogens, toxins, and antigens to enter the bloodstream that otherwise wouldn’t.
Autoimmune diseases, for example, are significantly more likely to develop in people with leaky gut, due to the increased exposure to harmful substances that can cause or contribute to immune dysregulation.4 Impaired immune function is also more likely, due to the increased demand of the immune system to mitigate damage, which can lead to chronic infections. Food sensitivities are more likely to develop, as well, due to the increased exposure to food antigens that can cause an abnormal immune reaction. These and other conditions often cause chronic symptoms, but leaky gut is often the cause of these conditions, which makes intestinal barrier integrity an important focus for anyone seeking to recover from chronic illness.
How to test for leaky gut
To test for leaky gut, you can conduct a quantitative polymerase chain reaction (qPCR) stool analysis, which involves collecting a stool sample, at home, with a container included in the qPCR stool analysis test kit, and sending to the lab for analysis. The qPCR stool analysis measures zonulin, a marker of intestinal permeability, and also tests for parasites, bacteria, fungi, and viruses that are often implicated in the development of chronic symptoms, making the test a great starting point for many people with chronic illness who have yet to identify the causes of their symptoms.
How to address leaky gut
If the results of your qPCR stool analysis show abnormally high zonulin, indicating leaky gut, there are certain supplements that can be taken to facilitate healing of the intestinal epithelial barrier, such as slippery elm, marshmallow root, licorice root, and ginger. But the most important strategy, of course, is to address the causes of leaky gut. And if you haven’t yet eliminated gluten from your diet, then gluten is almost certainly a cause, if not the primary cause, and making the transition to a gluten-free diet would thus be warranted.
That’s not to say that going gluten-free requires that you do a qPCR stool analysis and receive results that indicate leaky gut. If you have chronic symptoms, and you’re committed to resolving them, there’s no downside in joining the gluten-free movement, without test results, whereas the upside potential is limitless, given that gluten is now recognized as a food antigen that causes leaky gut in everyone, and not just those with celiac disease. Restoring normal intestinal permeability is often a precondition to recovery from chronic illness, due to its significant influence on immune function and overall health, and eliminating gluten from your diet, to improve intestinal integrity, can be an important step on your journey to better health.
How to transition to a gluten-free diet
If you’ve attempted to make the transition to gluten-free, but ultimately gave in to the unrelenting craving for some gluten-containing food you found yourself in front of days or weeks or months later, you’re certainly not alone.
Gluten doesn’t just affect your intestines. It also affects your brain.
And it does so in a way that distinguishes it from other compounds in the foods that we consume, in that it doesn’t just activate dopamine, but also acts on opioid receptors, which causes a highly addictive feel-good response.5 Gluten is thus addictive in the same way that opiates are addictive, and just as opiates can cause debilitating withdrawal symptoms, attempting to stop eating gluten can cause withdrawal symptoms via the same mechanism.
It’s no wonder, then, that only a subset of those who attempt to go gluten-free actually stick with it for the long-term, despite having the intention to. The cravings, for many, are overwhelming, and relying on willpower alone often isn’t enough to push through.
You’re more likely to succeed by relying on accountability, rather than willpower, and specifically the accountability from working closely with a health coach, who knows what you’re going through, who can help you to stay committed to the process, and who can walk with you every step of the way. Eliminating gluten from your diet could be the most difficult dietary change you ever make, but if you’re able to maintain your commitment, and get through the discomfort, it could also be the most important.