Sunday, May 25, 2014

Gluten Sensitivity a Myth? Part 1

"So what we have here is s failure to communicate." BLUF: overly smug writer with limited understanding of the topic writes a cute story but misses the point.
"In one of the best examples of science working, a researcher who provided key evidence of (non-celiac disease) gluten sensitivity recently published follow-up papers that show the opposite."
"The first follow-up paper came out last year in the journal Gastroenterology. Here's the backstory that makes us cheer:
"The study was a follow up on a 2011 experiment in the lab of Peter Gibson at Monash University. The scientifically sound — but small — study found that gluten-containing diets can cause gastrointestinal distress in people without celiac disease, a well-known autoimmune disorder triggered by gluten.
"They called this non-celiac gluten sensitivity."
"For a follow-up paper, 37 self-identified gluten-sensitive patients were tested. According to Real Clear Science's Newton Blog, here's how the experiment went:
Subjects would be provided with every single meal for the duration of the trial. Any and all potential dietary triggers for gastrointestinal symptoms would be removed, including lactose (from milk products), certain preservatives like benzoates, propionate, sulfites, and nitrites, and fermentable, poorly absorbed short-chain carbohydrates, also known asFODMAPs. And last, but not least, nine days worth of urine and fecal matter would be collected. With this new study, Gibson wasn't messing around.
The subjects cycled through high-gluten, low-gluten, and no-gluten (placebo) diets, without knowing which diet plan they were on at any given time. In the end, all of the treatment diets — even the placebo diet — caused pain, bloating, nausea, and gas to a similar degree. It didn't matter if the diet contained gluten. (Read more about the study.)
The somewhat snarky conclusion:
"You can go ahead and smell your bread and eat it too. Science. It works."

But did it, in this case?  A better analysis follows in 2 days, or you can cruise over to and read his response. 

In my view, the weakness of the study is much like a study that tested what diets worked best for aviator performance - high fat, high carb or high protein.  The answer - high fat.  However, the findings would have been even stronger in that case had the high fat group been allowed to adapt to high fat for three weeks.  Instead they were cycled weekly or so through the different diets.

This group (in the gluten study) were handled likewise - but many folks with gluten issues will tell you it's not just the meal that leaves them feeling bad, it's a long hangover in the gut that lasts after gluten exposure.  This could be due to permeable gut issues or other issues with wheat/gluten ingestion.  The point to me is that it takes most folks 30 days of elimination to notice the difference after removing offensive foods, and this study seems not to have allowed for that.  (Minor grammar edits 5/26/2014).

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