What to do with gluten? Can we live without it? Should you? These are a few of the questions that I ponder. As with any decision, it is best to collect as much data as possible before choosing a path.

Since we know that a loss of immune tolerance predates food- related disease onset, it would behoove us to know that we have a dysfunctional micro biome, leaky gut or intestinal permeability. Knowing this will likely help us make a better decision regarding whether gluten should be avoided.

As discussed in previous newsletters, gluten proteins appear to be an irritant to all, however, only certain populations clinically suffer disease by consuming it. People with the genotype for HLA DQ2/8 are at the highest risk for gluten sensitivity or worse yet, celiac disease. I am sure that time will show us other genotype associations that provide an advanced warning.

Let’s look at another study from Italy. In 2012 Dr. F. Russo performed a double blind crossover study of 20 young healthy Italian men where the outcome studied was signs of intestinal permeability following the consumption of wheat pasta versus wheat pasta with 11 percent chicory root. Chicory is a strong inulin prebiotic, a food for our gut bacteria. What they wanted to know was: does a prebiotic food added to wheat pasta prevent some of the gluten induced damage of the intestinal lining?

They found that both groups had decreased intestinal permeability when they were on the inulin crossover arm. This is to say that the prebiotic inulin helped to prevent gluten damage of the gut by feeding the beneficial bacteria that protect us. This is based on the science that the healthy beneficial bacterial types release chemicals that close the tight junctions that protect against the zonulin released by consuming gluten. This is well known to occur in animals based on the research of Dr. Patrice Cani at the prestigious Université Catholique de Louvain in Belgium.

Knowing that the function of the gut micro biome is a major determinant to the tolerance of food proteins including gluten means that we need to understand what disturbs the micro flora in a negative way. Here is the main list again (not in order of importance):

1) Caesarian delivery

2) Formula feeding with cow based milk

3) Recurrent antibiotic exposure

4) High refined flour, high refined sugar diet, low fiber diet

5) Chronic drug use: antacids, non steroidal anti inflammatories, steroids

6) Chronic consumption of non nutritive sweeteners like saccharin

7) Chronic alcohol use

8) Chronic stress

9) Exposure to bacteria from the environment

Of these, the current research shows us that the consumption of food types dictates the long term function of the gut more than anything else. We also know that if we have a stable gut micro biome that contains beneficial bacteria, we will not suffer food reactions. These bacteria are producing signals that increase the claudin and occluding proteins thereby keeping our intestinal tight junctions strong which is key to an intact tolerant intestine.

In a perfect world, we are all born vaginally, nurse from the breast of our mother who consumes a perfect whole foods chemical free diet, are exposed to dirt, never consume drugs or alcohol, are unstressed and eat a perfect diet as children and adults.

Unfortunately, Modern American life has set some of us up to not handle gluten proteins appropriately as we have too many of the risk factors checked for gut dysfunction (see last week’s column).

Coming full circle to my story, I am confident that gluten is no longer good for me. As a scientist, while I cannot say that gluten is the primary cause based on the science, I am sure that it has played a large role in the inflammation of my coronary arteries, my gut lining, my skin and joints. Having no desire to have coronary artery disease, arthritis or any autoimmune disease, I made major changes to my lifestyle that science has shown to be beneficial.

In my N of 1 study, these are the changes that I made to live longer with less disease:

1) Eliminate gluten 100 percent

2) Eat a clean, whole foods Paleo style diet that is mostly organic and predominantly based on vegetables and fruits, more than 12 servings a day.

3) Consume little to no refined flour or sugar. All flour- and sugar-based foods, regardless of source, are high glycemic and thus an inflammatory food.

4) Intermittent fasting. See nnewsletter at http://www.salisburypediatrics.com/patient-education/dr-magryta-s-newsletter/220-intermittent-fasting

5) Reduce stress through meditation and prayer.

Bottom line is this: You are you and I am me, therefore, you see what you can do for you as I have done for me!

Be aggressive against disease,

Dr. M

Dr. Chris Magryta is a physician at Salisbury Pediatric Associates. Contact him at  newsletter@salisburypediatrics.com