In Praise of Burgers

Burgers are my favourite. If I could get away with eating one every day and stay within my powerlifting weight class I would. There is nothing that satiates my combined love of protein and carbs more, several juicy patties of ground beef brisket, oozing with tangy blue cheese and sweet-salty bacon jam, sandwiched between 2 halves of a toasted brioche bun.

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A Perfect Example of a Burger

There is only one problem with this delicious picture. There’s a bun and I am a coeliac.

The advent of the gluten free menu is a relatively recent phenomenon. It wasn’t that long ago that eating out was a stressful and woefully disappointing experience. In the absence of a dedicated GF menu I’d ask the waitress if such and such item had gluten in it and she’d mumble a bit, look confused and shuffle off to the kitchen to ask the chef. If the chef didn’t know what gluten was I’d resign myself to a sad dinner, politely order a salad and sulk into my Hearts of Romaine while my more fortunate dining companions tucked into their plates of wheat-laden deliciousness.

These days you can’t move for free-from menus in every major high street restaurant chain and it’s as easy as gluten free pie to get a decent coeliac friendly meal. Gluten Free really has come a very long way in the 15 years since I was diagnosed, but one thing I have noticed in recent years, is the occasional raising of eyebrows and the almost imperceptible sardonic smirk when I ask for the Gluten Free menu, and I can just imagine the waiter thinking –

Here we go, another gluten free hipster.

 

The fitness industry is unfortunately for scaring people into self-diagnosing digestive issues, and attempting to fix it by avoiding bread and listening to self-appointed internet health experts (who incidentally tend to argue doctors don’t know what they’re doing).

Now I would absolutely love to be able to say that this is a phase that I’m going through, like my 12-month attempt at Paleo (apart from endless bacon it was horrible, life without cheese was painful) Atkins (worse than paleo, my breath stank and peeing on Keto-Stix daily to see if I was in ketosis got a bit tedious) clean eating (have you ever tried a sugar detox? There’s nothing left to eat except broccoli) and low carb (I was tired all the time, my lifting suffered and I cracked in the end and ate nothing but marshmallows for 2 days straight), but sadly it’s not.

Once a coeliac, always a coeliac

So what exactly is the difference between coeliac disease and gluten intolerance?

Why do so many people think that they have a problem with gluten?

Let’s get this straight from the get go, Coeliac disease is not an allergy, the clue is in the name.

Here’s a science bit:

Coeliac disease is an autoimmune disease: other examples include diabetes (type 1) and rheumatoid arthritis. Coeliac disease comes about from the body perceiving the proteins in gluten as an alien invader. As a result, it marshals its immune resources with an inflammatory reaction and immune cells (autoantibodies) to inappropriately attack its own cells.

The primary target of this reaction is the lining of the small intestine, which normally contains millions of tiny tube-shaped structures called villi. Imagine the insides of your intestines being like the fronds of an anemone. Villi enable food and nutrients to be digested into the body. In coeliac disease gluten causes the villi to become flattened and blunt, so food and nutrients pass over the villi, damaging the absorptive capacity.

 

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Healthy Villi on the left, blunted villi of a Coeliac Disease sufferer on the right.

If you can’t absorb nutrients from your small intestine, bad things happen: such as anemia or osteoporosis from iron and calcium malabsorption. Other symptoms include abdominal pain, excess wind (I wasn’t popular) bloating, diarrhea, chronic fatigue, weakness, mouth ulcers and bleeding gums.  Some coeliacs lose weight due to poor absorption of food. Some people with CD also get an itchy bumpy skin condition called dermatitis herpetiformis, usually on the backs of their arms.

If the symptoms described above develop, the diagnosis may be made quickly. However, common or typical symptoms do not always develop and Coeliac Disease antibody blood tests do not always give accurate results. Particularly in adults, the areas affected in the gut may be patchy. Symptoms may be mild, or atypical, and it may be quite a while before a diagnosis is made. Frustratingly, the average time from first symptoms to diagnosis is 13 years in the UK.

Often people with CD will just feel unwell and see their Doctor for a range of conditions and the trail of sickness crumbs don’t lead to a diagnosis. This was me. 15 years of mental fog, depression, periodontitis, anemia, IBS, hair loss, memory loss and eventually osteopenia, the precursor to osteoporosis. 2 blood tests over the years gave negative results, my GP clearly thought I was a hypochondriac and eventually I had to have a colonoscopy and endoscopy to get a diagnosis confirmedAfter being sick for over a decade, boy was I happy when I finally found out what was wrong with me!

Giving up gluten was a massive relief

There is no cure for Coeliac Disease, just a lifelong Gluten Free diet.

So it’s not something that David Avocado Wolfe or The Food Babe has recommended to me. I don’t actually have a choice. Neither do I preach gluten-free to anyone. That’s like somebody with a peanut allergy professing the benefits of peanut-free living to everybody.

Coeliac UK describes the differences between CD, wheat allergy & gluten intolerance as follows:

Coeliac disease is a well-defined, serious illness where the body’s immune system attacks itself when gluten is eaten. This causes damage to the lining of the gut and means that the body cannot properly absorb nutrients from food. Coeliac disease is not a food allergy or intolerance, it is an autoimmune disease.

Wheat allergy is a reaction to proteins found in wheat, triggered by the immune system and usually occurs within seconds or minutes of eating.

Non coeliac gluten sensitivity is when symptoms similar to coeliac disease are experienced, but there are no associated antibodies and no damage to the lining of the gut.”

The problem with non-coeliac gluten sensitivity is that there are no bio-markers for the condition and contrary to popular belief, there are no tests available, only a total elimination diet would enable a sufferer to ascertain whether gluten was the actual culprit for their reported symptoms.

The typical argument that gluten-free fanatics like to push is that gluten damages everybody’s intestinal walls, causing malabsorption (puzzlingly, some even blame gluten for making you fat by this mechanism). The problem here is that there is no evidence to support that even the small number of people that claim non-coeliac gluten sensitivity experience any damage to the intestinal lining. Gut damage is a pest reserved only for the true coeliacs.

So why the gluten free diet trend explosion?

According to one recent study, an incredible 29% of US citizens said that they were trying to give up Gluten, which amounts to over 70 million people. UK Poll company YouGov reported last year that 60% of adults had bought a Gluten Free product in the previous 12 months and that 1 in 10 households contained someone adversely effected by gluten.

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Interestingly, a delve into internet searches over the last few years would suggest that this meteoric rise in interest in Gluten Free diets has a lot less to do with a growing awareness of coeliac disease and a lot more to do with the popularity of Gluten Free celebrities such as Gwyneth Paltrow, Oprah, Victoria Beckham, Tennis Player Novak Djokovic (none of whom are diagnosed coeliacs) and the rise of the Paleo Diet.  Paleo just happens to be gluten free, a diet which returns us to the stone ages as far as food choices are concerned, but relies heavily on such mod cons as the Nutri-bullet to whip up the much loved kale smoothie, just like the cavemen did.

Many other claims – with no actual evidence basis – have also been attributed to gluten: autism and brain fog and Alzheimer’s to name a few. Gluten scaremongering along with its celebrity following have been the main 2 factors driving the trend & so the gluten Free diet cult has quickly snowballed into the mainstream.

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Source – Google Trends/BBC

But, I hear you cry, I gave up gluten and I feel so much better than when I was eating bread and cake and pasta!

Since gluten is found in the vast majority of junk food and beer, it goes without saying that cutting out over processed and low nutrient carbohydrates, often sugar and additive laden, replacing them with wholefoods and cooking more at home, would tend to reduce most people’s calories by proxy and make them feel better. Someone also might typically drop gluten while also taking up yoga, eating more vegetables, diving into a bunch of health activities and magically feeling better. Hmm, must have been the gluten.

Alan Levinovitz, Author of The Gluten Lie and other myths about what you eat, has the following to say on that.

The Placebo Effect, combined with the fact they are not drinking 5 beers a night, makes them feel better and they think it was the gluten.

But what about the studies that say gluten intolerance is a real thing?

Of the clinical studies indicating that non-coeliac gluten sensitivity does exist, these have recently been refuted by one of the very scientists who made the claims in the first place.

Peter Gibson, the research scientist who wrote this paper wasn’t happy with his original findings. Gluten is present in nearly every standard diet world-wide, could it really be such a problem? So he went back and did more in-depth research. For his follow up paper, 37 self-identified subjects with non-coeliac gluten sensitivity were studied. At the end of the study Gibson stated:

In contrast to our first study… we could find absolutely no specific response to gluten

Full study here.

One thing is for certain, even if Gluten Sensitivity doesn’t actually exist, the growth of the gluten free market shows no sign of abating, and for this we coeliacs have a lot to be grateful. 15 years ago, before GF was a thing, before the world and his dog suddenly started having problems with bread and pasta and cake and everything delicious, gluten free food items were only available on prescription from a GP and they weren’t exactly the best thing since, well, sliced bread. Since they were purely prescription items, the manufacturers didn’t go out of their way to make them palatable or even similar in taste and texture to their gluten-laden equivalent. Think dry, think sawdust, think chemical shit- storm that remained edible for 24 hours once opened. If you were lucky.

How times have changed! Thanks to the gluten free trend, me & my fellow coeliacs have never had so many decent tasting GF options available to us in supermarkets and restaurants. The UK Gluten-Free Market has been forecast to grow by 46% to £561M by 2017 and has already seen double digit growth annually since 2008. One company alone launched 15 new Gluten Free products in 2015. This growth has not simply been fueled by a rise in the diagnosis in CD, but by the overwhelming demand from those following the GF Trend.

Gluten Free is now literally everywhere.

So as I bite gratefully into my Blue Cheese burger with an extra patty, bacon jam and extra jalapeños, complete with a gluten-free bun, I doff my imaginary cap as I say a silent thank you.

GF Hipsters, I salute you.

References

The gluten Lie and other myths about what you eat 

 

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