“Can you please tell me why gluten is so bad for me? I’m hearing it everywhere, and I just don’t get it. My doctor told me to cut it out of my diet for a few months and it doesn’t seem to make any difference! I’m tired of staying away from all the foods that I love!” My patient--an athletic woman in her mid thirties--was clearly exasperated and searching for answers. She had suffered from mild to medium depression for the past five years, but otherwise enjoyed pretty good health. Going gluten-free has been a dramatically growing trend for the past several years, and it’s hard not to find Gluten-Free (GF) labeling on health food packaging anymore. But why? Many people who go gluten-free find miscellaneous health symptoms either improved or completely gone. Others, like my patient above, may not notice any difference at all. For those who notice a difference and can appreciate the health benefits, it may be an easy thing to avoid. But for others, it’s not so clear. So what’s the verdict: is gluten OK for some people and not for others? Gluten is the name for a group of proteins found in high amounts especially in wheat, but also barley, rye, spelt and kamut. Oats do not contain gluten, but are largely processed in facilities that also process wheat, and so almost always contain trace amounts of gluten. The latin name for “glue”, gluten proteins are what makes dough sticky, giving the airy quality to soft, chewy breads and baked goods we love so much. One of the first things to understand about gluten, is that it has been shown scientifically to contribute to leaky gut syndrome. This is particularly bad in individuals who are genetically or otherwise prone to leaky gut, but it can be potentially dangerous for everyone. Dr. Alessio Fasano, M.D., founder and director of the Center for Celiac Research at Massachusetts General Hospital and a professor at Harvard Medical School, has done leading research into gluten and leaky gut. He discovered that gluten triggers the production of a substance known as “zonulin”, which causes the tight junctions of the small intestine cell wall to loosen. In good health, the tight junctions soon close up again; but with overexposure, or in poor health, the tight junctions remain open. This allows not only the nutrients intended to pass through the small intestine and into your bloodstream, but also larger food particles not intended to pass through. Called “leaky gut”, this condition leads to an over-active immune system fighting food particles not meant to pass directly into circulation. If not resolved, in time this leads to autoimmune illness. Since we have a growing epidemic in autoimmune illness, this is very important to connection to make. The second thing to understand about gluten is that we are way more exposed to it than at any time in our human history. Why is this? Scientists figured out through a process called “deamination” that by removing one of the amino acids from the gluten proteins, gluten becomes water-soluble. This chemical “magic trick” transforms gluten into its nearly universal use as a preservative and a thickener. In its deaminated form, gluten is added to nearly all processed foods and to a vast majority of personal-care products as well, including toothpaste, shampoo and lotion. In fact, it is now such a common additive that our government does not require it to be labeled on packages. It’s often hidden under such names as “hydrolyzed vegetable protein”, “food starch”, or even “natural flavors”. This is very bad news if you happen to carry the gene for celiac disease, a serious autoimmune condition of the gut triggered by gluten exposure. As it turns out, an estimated thirty percent of people of European descent carry the gene for celiac disease, which either makes them highly susceptible to gluten, or downright sick. Significantly, an estimated 99 percent of the people who have celiac disease or gluten sensitivity are never diagnosed. Consider that even a tiny amount of gluten in a single dose can in many individuals trigger a significant inflammatory response in the gut that can last up to 3 months! Suddenly it is easy to understand why we are seeing growing explosions in digestive and autoimmune illness. But what if you don’t carry the gene? Even if you don’t carry the gene, you can put two and two together: between Dr. Fasano’s discovery that gluten opens up the cellular junctions in the small intestine, and the nearly universal exposure to gluten that most people experience on a daily basis--well, let’s just say it’s a recipe for widespread issues with leaky gut syndrome even in those who aren’t genetically predisposed. The third thing to understand about gluten is that it is, quite literally, not the same form of gluten that our ancestors consumed. In the quest for ever lighter, fluffier forms of bread and other baked goods, as well as in an effort to create hardier strains of wheat, farmers and corporations have developed new hybrids. Just as food growers figured out how to create a nectarine by crossing a peach with a plum, they have also developed new strains of wheat. The price? Hybridization created new forms of gluten--brand new proteins that our bodies do not recognize, and which are not found in either of the original strains. I should mention here, that most of these strains are grown and consumed in the United States. About eight years ago I traveled in Spain for a month. As an aside, I happen to be one of those not-so-fortunate people carrying the gene for celiac disease. I had figured out several years before this trip that not eating gluten saved me from a number of uncomfortable digestive complaints that had persisted for years through my twenties. During this trip, for some reason, I couldn’t stop eating bread. It was delicious; I ate it at least once or twice a day, piling on a variety of the tantalizing Spanish “tapas” of cheese and meats. And...I had absolutely no problems at all! When I got back the U.S., I decided to try wheat again. Hey, maybe I had outgrown my issue? Without missing a beat, I immediately reverted back to my original digestive “angst”, and this time much worse than before. So again, what’s the verdict on gluten? Here is my humble opinion: if you are anywhere on the spectrum of autoimmune illness, which includes suffering from chronic inflammatory conditions anywhere in the body, avoid gluten like the plague. Buy personal care products labeled gluten-free, avoid processed foods, and cook a lot at home. If you have a diagnosed digestive disease, including crohn’s, celiac, ulcerative colitis, or even GERDS (acid reflux), I would adopt the same approach. If you suffer from chronic neurological symptoms, such anxiety, depression, bipolar, OCD and so forth, I would still cut all gluten from your diet. This is because many neurological symptoms include chronic inflammation in the brain, which can be directly aggravated from components of gluten proteins that enter the bloodstream. IF you have no family history of any of the above, are healthy with a strong immune system and no digestive complaints: then, you can probably eat some gluten safely. I would still try and keep your overall daily exposures low though. And I would go for organic, non-hybridized strains of wheat, preferably sprouted or fermented--think sourdough bread as our ancestors prepared it. And finally: an apology to my patient mentioned above. I do not think I adequately explained the “whys” of keeping gluten out of her diet, due to time limitations. I hope she reads this article.