FODMAPS, Gluten, Nocebos, My Upper Arms, Knees, and Toes!

The haters of gluten-free living have been having a great month!

First, everyone reveled in showing those of us who have self-diagnosed as gluten-intolerant the following Jimmy Kimmel video:

Following the logic of this piece, if you don’t know what a carcinogen is, you would be immune to the cancer-causing effects of asbestos or plutonium! Ignorance truly would be bliss!! For the record, I DO know what gluten is (a composite protein of gliadin and glutenin that makes up the endosperm of grains in the family Triticeae, including wheat, barley, rye, and spelt).

A reason for the spike in gluten intolerance, and the rising numbers of people who choose to live gluten free may result form the fact that modern grains have been bred with much larger endosperms containing higher levels of gluten, and, thanks to the Farm Deal, we are being inundated with gluten in baked good, salad dressing, soy sauce, toothpaste and lipstick! I remember a woman who worked at the animal facility in grad school telling me that anyone who works there long enough will develop allergies to animal dander. In other words, anyone -ANYONE- who is exposed to artificially high levels of a potential allergen will develop an allergy to it. And when it comes to gluten, we are all that “anyone”. We are exposed to levels of gluten not seen in nature that we are just not meant to be consuming.

Gliadin

Glutenin

Also this week, the media picked up on a publication where it was shown that “gluten intolerance” may actually result from FODMAPS or “nocebos*.” In a nutshell, a scientist who had previously shown that non-celiac gluten insensitivity is responsible for certain digestive issues redesigned the study and determined that Fermentable, Oligo-, Di-, Mono-saccharides And Polyols, or FODMAPs may be the real culprit. I’m a little science-d out having worked overtime this weekend, so I’ll let wikipedia elaborate on what a FODMAP actually is.

The media jumped all over this report, and in its sadly characteristic modus operandi, distilled the report down into a simplistic talking point without doing any actual journalism, or having someone who understands science explain the study to them in the  monosyllabic words to which they appear to be restricted. First, I do want to reject the point that a lot of my friends on the gluten-is-evil team are saying. This study was well-designed, independently executed and properly peer-reviewed. It was not influenced by “Big Flour”.

However, there are still a couple of things to note about this study, or any scientific study you read. First, Professor Gibson is not the only person studying Gluten. The media has decided that his original paper showing gluten-sensitivity was the only paper ever demonstrating this phenomenon. It isn’t. Here’s a paper that Christina of BodyRebooted posted a couple of months ago. In this study the authors demonstrate that non-celiac subjects develop an immune response to gliadin (a component of gluten). In other words, these people were sensitive to, or intolerant of, gluten.

Another thing to note is that Professor Gibson’s study only looked at a specific set of issues related to gluten insensitivity, specifically digestive issues. He did not examine other issues such as skin health, inflammation-related pain, or longterm outcomes such as obesity, cancer, or autoimmune issues. And nor should he have. No one study can ever be expected to examine every single aspect of a complicated issue like gluten insensitivity. But the fact remains that if he didn’t look for these issues, he can’t make the claim that gluten doesn’t cause them. And to be fair to Professor Gibson, as a good scientist, he hasn’t been making these claims; it’s the media that has been overreaching and misinterpreting his data.

Journalists ≠ Scientists!

When we are trained in science, we are taught to scoff at people who say things like. “Well, I smoked my entire life/never wore a seatbelt/was spanked by my parents/never paid attention in science class, and I turned out fine,” because this is anecdotal evidence, and can be wildly unreliable. A good example of this is Winston Churchill, who smoked cigars every day and lived until he was 90. Based on that evidence you may think that you can smoke your way to longevity. However, if you look at a sample of 100 smokers, or 1000 smokers, or 1,000,000 smokers, you will see that the projected life expectancy for smokers is actually quite poor.

Your new Health Guru!

That said, here’s my N=1 anecdotal evidence:

When I came to DDP Yoga, I was absolutely certain that I would never give up gluten. I was firmly in the you-either-have-celiac-disease-or-you-don’t camp, and I knew for a fact that I was not allergic to it, and that it wasn’t causing any of the lifelong issues I had. In fact, it had never been suggested to me that gluten could cause anything other than digestive problems, so its role in skin problems and my chronic knee pain wasn’t even on my radar. In other words, there definitely weren’t any psychosomatic effects (or “nocebos”) in my case.

I cut gluten during the course of my weight loss simply as a calorie-controlling mechanism, and I wasn’t expecting anything else in terms of benefits to my health. I have written about the benefits to my knee pain before, so I will be brief here. Cutting gluten prevented a large amount of knee pain that I had suffered with for years. Doing DDP Yoga certainly had a role in resolving this issue, but I have noticed that when I accidentally consume gluten or dairy, I have flair-ups of pain. I often don’t find out that I had consumed gluten until after the pain happens, and I retroactively investigate why it happened, so we can eliminate “nocebos” as the cause.

More recently, I had a amazing revelation of the power of GF living. For my entire life, I have had nasty, scaly, dry red bumps down the back of my upper arms and on my legs. I have tried everything to get rid of them. On the (lazy) advice of a doctor, I spent months at a time religiously moisturizing them. I tried exfoliating, I tried wrapping them at night, I tried old wives’ tales. Everything. And nothing worked so I just gave up trying. I completely gave up on trying to get rid of them over a decade ago. The other day, I was working on my computer, and crossed my arms as I thought about what I wanted to type. In doing so, I felt the skin on the back of my arms, and realized that it was completely soft and smooth! I couldn’t’ believe it. Some light Googling lead me to learn that gluten may cause dry scaly issues. This is yet another example of GF living resolving an issue that I didn’t even know gluten was causing! I have also written about the role of gluten in another skin issue here.

Photo on 5-19-14 at 8.46 AM

The bruise by my elbow is from running the Tough Mudder… DDP Yoga turned me into a M%^&*# F&^%$in’ Monster! But the rest is baby smooth!

I’d be remiss if I didn’t close by saying that as a scientist, I fully understand that FODMAPs may be responsible for the issues I had with both my skin and my knees (as well as digestive issues and weight, which I had but didn’t elaborate on in this piece). By excluding gluten from my diet, I will inadvertently remove FODMAPs from my diet too, and therefore experience the benefits of a FODMAP-free diet through GF living. If that is the case, great! I will continue to live GF, and I will continue to be healthy. I honestly don’t care which specific molecule was causing dry skin, chronic knee pain, acne, overweight and bloating/gas. I have found a healthy, whole-food diet through the DDP Yoga plan, and I am NEVER going back!

In all reality, humans are a heterogeneous bunch, and the answer may be “all of the above”. Some people may have celiac-based gluten intolerance, whereas others may have non-celiac sensitivity. Others still may be allergic to FODMAPs, and some people may have no issues with gluten or FODMAPs. I know this doesn’t fit the simplistic, one-size-fits-all talking points the media likes to use, but you shouldn’t be getting your scientific information from a journalist anymore than you should be expecting a professor of archeology to keep you up to speed on current world events!

I will make one last plug for the gluten-is-evil theory, and why I think gluten, and not FODMAPs, were responsible for my particular issues. The first time I went vegan back in 2009 (pre-DDP Yoga), I loved making Gluten Sausages. The main ingredient in these sausages is pure gluten, so we can eliminate FODMAPs as the culprit. I would make batches of 6 – 12 sausages at a time, and they never lasted very long. While they were delicious, over time I started noticing that if I ate them for more than 2 days in a row (which I often did), I became severely constipated for up to two weeks at a time and, well, this T-shirt explains the rest…

TMI, Darling!

 

Okay, so there was nothing in this piece about my toes. I just liked that song as a kid!

 
*This is an obnoxious neologism. We already had a term for this phenomenon; it’s called a psychosomatic response. And while you’re at it, take back “Aha moments” Oprah; the correct word for this is “epiphany”!
** Yeah, Dairy is bad too! 
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