Use Your Brain, Not Your Gut: Why the Evidence For and Against Gluten Sensitivity is Weak

gluten“Too many people rely on abstracts and ignore methodology, data, and other important information. The Pubmed abstract is not the final word.” – Examine.com

“I told you so!” has been the rallying cry on the internet the past few days as the anti-anti-gluten crowd (which is quickly becoming as annoying as the anti-gluten crowd) has spewed venom at every non-Celiac who thinks their tummy troubles stem from gluten.

Shock and awe spread across the internet when Peter Gibson, one of the researchers who pioneered the notion of gluten sensitivity, recanted his original findings after a follow-up study suggested that gluten sensitivity isn’t all it’s cracked up to be.

Note I say “suggested.”

Not “thoroughly shown,” as said in the Business Insider headline.

Not “confirms” that “gluten sensitivity doesn’t exist,” as written in the Guardian Liberty Voice headline.

And not “gluten free is dumb” as Gizmodo’s eloquently crafted headline proclaimed.

Not only is this irresponsible journalism, but it proves these journalists don’t know how to read research.

What the media and all the anti-anti-gluten bandwagon-hoppers forgot to do is actually read the studies. But rather than promote a rational understanding, they’re scratching and clawing for headlines.

HOW IT BEGAN

What’s so silly is that Gibson’s original study (the one that the RealClearScience.com article called “one of the strongest pieces of evidence to date that non-celiac gluten sensitivity … is a genuine condition”) wasn’t even that conclusive!

The study found that symptoms of gastrointestinal distress (i.e. tummy trouble) and control of these symptoms were significantly worse in subjects who consumed gluten compared to subjects who did not consume gluten. However, no findings indicated why the gluten eaters felt worse.

Let’s look at the good and the bad of the original 2011 study:

The Good

– Six weeks long (decent duration)
– Gluten intake was well controlled
– Double-blind (meaning neither the subjects nor the researchers knew who was eating what, which reduces biased conclusions)

The Bad

– Only 34 subjects (small sample size)
– Only four males (poor representation of males as a population)
– Besides gluten intake, rest of diet wasn’t well controlled (food diary was used, which traditionally sucks for accuracy)

The study even says that it’s not 100 percent conclusive! Straight from the “Conclusions” section of the abstract:

“Non-celiac gluten intolerance” may exist [my emphasis], but no clues to the mechanism were elucidated.

ROUND TWO

With weak findings like that, it’s no wonder Gibson and co. wanted to do another study. This one had different findings although was still ultimately inconclusive. But that didn’t stop the media from grabbing it by the balls, twisting it into something it’s not and running with it.

The new study, which had tighter controls (every patient was provided every meal by the researchers), looked at 37 subjects with non-celiac gluten sensitivity (NCGS) and irritable bowl syndrome (IBS). Subjects ate according to three different one-week diets (high-gluten, low-gluten and placebo), separated by a 2-week “washout” period to eliminate the effects of each diet “running into” each other. The researchers found that gluten has no significant effect on symptoms.

OK, that’s fine, but there are a few problems with the study:

– The duration lasted 8-17 months based on an endpoint of a change in overall symptom score (i.e. the subject felt better or worse). Why not run everyone the same length?
–  A 2-week washout may not be enough, as some research has shown that adults with Celiac Disease may need up to five years for their intestines to heal from the damage caused by gluten. We don’t know how long it takes for “sensitive” people to recover.
There was a “nocebo” effect, meaning patients expected to get worse (and some did) even if they received the placebo. That’s because the subjects had NCGS and IBS and had every reason to believe gluten will make them feel terrible. That’s a significant bias.

Still no earth-shattering evidence that gluten sensitivity isn’t real. From the “Conclusions” section:

“Gluten might be not be a specific trigger of functional gut symptoms once dietary FODMAPs are reduced.”

Notice the word “might”. Most researchers are smart enough not to make brash, sweeping statements when there’s still more research to be done. Facebook users aren’t always so smart.

Here’s the real kicker: they removed ALL other potential allergens from the diet, including dairy and FODMAPs (fructose, and some carbohydrates from certain vegetables and beans). Kudos for tight control.

Removal of FODMAPs seemed to make many of the subjects feel better. Might it be that FODMAPs – found prevalently in bread products – are the problem? And if removing gluten reduces ingestion of FODMAPs, is going gluten-free still “dumb”?

ROUND THREE – THE SURVEY

The Business Insider article pulled a big science no-no when it claimed that a survey (“a third, larger study”) “confirmed the findings” that gluten sensitivity doesn’t exist.
A survey? Yes, surveys are used in scientific literature, but when it comes to food journals, surveys are notorious for being a terrible way to collect objective data. People can’t remember what they ate for breakfast, let alone what they ate a week ago and how it made them feel.

Stating that this survey “confirmed” the findings of an inconclusive study is misleading. It’s practically a lie. And it’s a shame that the whole internet is in a tizzy about it.

THE BOTTOM LINE

The gluten and anti-gluten bashing has got to stop, because you’re all ridiculous. Eat what makes you feel healthy and energized, not what people on the internet say you should or shouldn’t eat. And stopping caring so much about what other people are eating. No one’s force-feeding you seitan or gluten-free pizza dough, are they?

To the anti-gluten crowd: it’s great that you’ve chosen to eliminate a non-essential food group that might make you feel lousy. You can get those nutrients elsewhere, like from fruits, veggies or potatoes. But stop being douchebags towards everyone you see chowing down on a sandwich or crackers. And stop claiming it’s “how our ancestors ate,” because it’s not.

To the anti-anti-gluten crowd: stop caring so much about what other people are doing. I know it gets annoying when a gluten-hater snarls at you at a restaurant, but let it slide. Just consider your well-developed intestinal fortitude a victory over the pretentious anti-gluten jerkoffs.

And to everyone who thinks it’s “cool” to always take the middle ground and cut down anyone who takes a stand or claims that something is “good” or “bad” (whether it’s gluten, sugar, carbs, fat, intermittent fasting, high-frequency eating, etc.), get over yourself. I’d rather be scientifically “wrong” and be 100 percent committed to my goals than be scientifically “right” but be totally wishy-washy. Constantly adopting the “yes and no” or the “it depends” attitude is a fast track to suboptimal results.

Whether gluten sensitivity actually exists in people without Celiac disease… who cares? Many gluten products are highly processed and contain FODMAPs, which seem to be problematic for some. Reduce your consumption of highly-processed foods (gluten included) in favor of more fresh, whole foods and you’ll probably feel better.

Oh, and learn to think for yourself the next time the internet explodes with faulty science.

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Posted in Nutrition, Rants
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