I hate to tell you, but there is no ‘one diet fits all’ with gluten sensitivity. In fact, I think the traditional gluten free diet has a lot to answer for.
As we said earlier, the majority of coeliacs are thought not to heal on a traditional GF diet. There are a few issues with the traditional gluten free diet given for coeliac disease.
First, it is only gliadin-free, not actually gluten free. Gliadin 33 mer is the one peptide that has been studied in relation to coeliac disease and, if you have a positive antibody to that, you then go through the coeliac diagnosis process and the treatment given for coeliacs is a gliadin free diet – avoiding wheat, rye and barley which have high levels of it. BUT, many people, as we said earlier, do not have an antibody to gliadin 33 mer and therefore fall through the diagnostic cracks. There are currently at least 60 different peptides and fractions of grains that can cause problems. What if your problem is with one of those?
The Problem of Cross-Reactive Foods
Additionally, there is a type of gluten in all grains. Sorry to tell you that, but it’s true. Many people who are not healing – and who are even misdiagnosed coeliacs – are not doing so because they are reacting to other fractions in grains. This is most likely because research is starting to show they cross-react with gluten and have the same effect on the body. In other words, if the food has a similar peptide structure to gluten or wheat etc, and the immune system reacts to it in the same way, you will get the same damage and symptoms as if you had eaten gluten. Not fair, is it?!
Prof Aristo Vojdani, an immunologist specialising in this area, explains:
“After establishing the patient on a gluten-free diet, many will return after adhering to this diet for months, and yet they still exhibit the same clinical complaints as they experienced with gluten-containing foods. Undoubtedly, these patients are having reactions to foods which cross-react with gluten antigens.”
“Complete normalization of gut lesions is very rare in adult patients with Celiac disease (8%), despite gluten-free diet compliance. Although a majority (65%) feels better, the ensuing inflammation in the gastrointestinal tract, due to cross-reactions with – and sensitization to – an array of food antigens, remains a cause for clinical concern.
There are even studies showing how corn and quinoa, to take just two examples, have a similar effect, sometimes worse, on the body as wheat. See these:
Corn Intolerance and
Here is a list of the known (so far) gluten cross-reactive foods and you can check for antibody reactions showing on these foods using the Cyrex Labs Cross-Reactive Foods Test on the shop here. Try and do this before giving any of them up for maximum info on results.
The Cross-Reactive Foods
If any of these are found positive, they need to be avoided for life in the same way as gluten.
Alpha-Casein & Beta-Casein
Chocolate (Milk) only milk chocolate is cross-reactive because, obviously, it contains milk. Cocoa itself is safe.
Yeast -a combination of brewer’s and baker’s yeasts is used in tests so could be both or either
So, some people may need to be grain free, not just traditional gluten free (ie. gliadin free) and I think you can see why. It very much depends how far the damage has got, how leaky a person is etc etc. By all means, start with the traditional GF diet, but, if you are not healing, use a grain free one. I invented the TrulyGlutenFree (grain and dairy free) diet to help, plus the Barrier Diet for people with multiple sensitivity, chronic inflammation and autoimmunity. Those are both included in the Gluten Plan for you.
Over the past few years, since I have specialised in gluten sensitivity, and in fact the past 20-odd, where I have specialised in food sensitivity generally, the vast majority of issues raised during healing have come down to someone reacting to something they didn’t know about. Not only is this nasty symptom-wise but it scuppers healing. Exactly what we don’t want.
I can’t give you a standard gluten healing diet: we have found everyone has to find their own way forward. It sucks, I know. Essentially, this step is all about finding where to start and then tweaking your chosen approach to fit what you need. That’s by far the biggest lesson we have learned over the last few years: the traditional gluten free diet is not enough and there is no one diet fits all in GRDs because most have developed other types of sensitivity, largely because of the leaky gut and other body barriers caused by the gluten-zonulin issue.
Gluten related disorders make you much more likely to increase zonulin production in the body because we know for a fact that gluten upregulates zonulin, so you have much more than normal. Zonulin controls the permeability of your body barriers including the gut, blood-brain, lungs, bladder, skin, eyes etc so making more of it means you are likely more ‘leaky’. This is the main reason why many people with gluten illnesses have multiple food and chemical sensitivities on top of the gluten problem.
Hyper-permeability puts you at risk of peptides getting through into the blood stream and sparking inflammatory, allergenic and autoimmune processes. These can take years to develop and show up as symptoms but the risk is most definitely there. If you have allergies or intolerances, you are already there. In fact, you can read an article I wrote about this here:
So, the first thing you need to establish when thinking about what diet you need to heal properly is how leaky are you? How far has the breach gone? We need a starting point to measure later so that you know when it is OK to start trying new foods.
Array 2 looks for antibodies to the main tight junctions and permeability structures and processes keeping your barriers strong. If they are positive, you are too permeable and the presence of antibodies shows there is an immune process going on. You can then take steps to remove the gluten which is triggering the zonulin and to re-heal the barriers. This is a useful progress test.
The Right Diet For You
Your job next is to use either just the Elimination & Challenge process or that AND lab testing combined to find out exactly what your body is up to food-wise. Then, you can make an intelligent and informed decision about the particular type of diet you need, not spend months (more often years) ping-ponging about not really knowing what to eat/what not to eat and whether it’s doing any real good. Once, you have that crucial info, you can design your own diet and use all the fabulous resources around to help you with recipes etc.
Here’s how to use lab testing and elimination & challenge to find your healing diet effectively:
2. If positive, avoid those foods, using an appropriate diet to help you.
If cross reactive foods antibodies are positive, you need to avoid for life in the same way as gluten.
If common food antibodies are positive, avoid for several months until your Array 2 permeability results are negative.
If any antibodies are negative, that’s a great sign, but do an elimination diet to double-check; your body doesn’t lie and you may not yet be as far on as producing an antibody reaction.
3. If you have already stopped eating one of the common foods and wish to check it, you can do Array 4 and check antibody levels, then eat the food for a month, wait 25 days to allow antibody production enough time and repeat the test. If the antibody to a food has risen, that food is not a good one for you. I wouldn’t recommend doing that with a cross-reactive food though because of the potential for triggering more damage.
4. If you suspect other foods, do the elimination process to identify them, extended antibody testing (Alletess) and non-antibody cellular testing (Genova’s FACT or ALCAT) to try and find them if you need to. You might find the free Allergy 101 Factsheet useful to help with this too.
The Different Diets
Obviously, the diet you need will be determined by your earlier tests, either lab or elimination and challenge, preferably both. There are several main diet types you can tap into. Here they are in a sort of ‘food removal’ order for you:
- Wheat Free (for wheat-sensitives only)
- Wheat and Dairy Free
- Traditional Gluten Free
- Traditional Gluten and Dairy Free
- Grain and Dairy Free (Truly Gluten Free)
- Barrier Diet
- Autoimmune Protocol (AIP)
Which diet you use will depend on what you need to eliminate, of course. I have gone through each one with links to resources etc in the Gluten Plan for you. To do that here would take a whole other website! The key message, though, is don’t assume a traditional gluten free diet is enough for you to heal. Because of the leaky body barriers making you more vulnerable to other food and environmental sensitivities and the problem of foods that cross-react with gluten, it probably isn’t. And the statistics suggest that, not just me.