Thursday, June 5, 2014

Gluten Freedom: Everything you wanted to know about gluten from the leading expert

I was recently looking for a new book to purchase when I came upon the book Gluten Freedom by Dr. Alessio Fasano.  Dr. Fasano is considered the expert when it comes to Celiac disease, gluten sensitivity, and gluten research.  I'm sure Cameron Diaz's new diet book will sell more copies which is kind of sad, but this book is not only solid on information, but it manages to do so while also being engaging.  I have followed Dr. Fasano's work and thought this book would provide me with the most up to date information on gluten and how it affects human health since it was just published late last month.  I wasn't wrong.

It's hard to come across a good reference book that is also easy to read on a topic as complex and scientific as this.  For the most part they are loaded with jargon and provide scientific facts with little practical information.  This book literally should be called Everything you Ever Wanted to Know About Gluten but Were Afraid to Ask.  The book is broken up in to 4 parts and each part has quite a bit to offer.

The first part, called Gluten Enters the Picture, goes over the history of gluten: what it is, and why it's problematic.  I don't want to give out a ton of the book since it's so good, but let's just say there are several reasons why most people should pay attention to gluten.  He begins by discussing the three gluten related disorders: wheat allergy, gluten sensitivity, Celiac disease, and the way each condition causes problems.  If you think this is primarily a genetic problem, think again.  The gene variants that cause Celiac disease can be found in 30% of Caucasians and Celiac disease is literally exploding everywhere from Asia to Europe to all around the globe.  Even so, you don't need these genetic variants to become sensitive to gluten and just because you have them doesn't mean that you will get Celiac disease.  Despite the gene being so common in Caucasians, Celiac disease currently affects only 1% of them which points to the environment being as important in its development as having the gene variants. One of the more troubling aspects of this disease is that studies show that as many as 3,000,000 Americans likely have Celiac disease, but only around 200,000 have been diagnosed.

Even if you don't get Celiac disease, you can become sensitive to gluten.  This is because no human has the enzymes necessary to break it down and it causes an immune everybody.  Now, this doesn't mean everyone should avoid gluten and Dr. Fasano states this emphatically.  Many things we eat initiate an immune response, whether they become an issue is based on many things including age, health, and the microbiome.  Given the history of Celiac disease, looking at blood samples from every decade shows that it doubles in occurrence every decade, it's becoming a growing problem heavily influenced by our environment.  Dr. Fasano also discusses whether GMOs could be to blame(Unlikely), things that likely contribute to it, and even diagrams the specific components of gluten that are problematic for people and the responses they elicit.

Probably the most interesting part of this section was that while most people think of Celiac disease and other gluten related conditions as specific to the digestive tract, most people who get diagnosed with Celiac disease present with neurological symptoms, not digestive symptoms.  Many people never even experience digestive disturbances making the disease a chameleon.  There is a lot more to this section including leaky gut and zonulin, the brain, and autoimunity.

Part two is called Learning to Live Without Gluten and goes through most of the diet stuff: what to avoid, what you can eat, and provides a basic template for developing gluten free meals.  Part 3 is called Gluten-Free Life and goes over many of the trappings of trying to live in society gluten free, discusses pregnancy and gluten, and provides a chronological guide to living gluten free.  This is important because gluten related disorders, including Celiac disease, can strike people at any age with no history of issues with gluten containing foods in the past.  This is a drastic change from the early days of research where it was considered a solely pediatric condition that wasn't even present in the US.

There are quite a few stories of people coming down with the disease and the years of misdiagnosis that most people experienced during the early stages of Celiac research.  Despite many advances thanks to the research, many people still wait to get a proper diagnosis.  There are also quite a few tips given by people who have learned to live a gluten free lifestyle the hard way: by being diagnosed at a time when no one knew what gluten was and when availability of gluten-free food was scarce at best.

Part four is one of the primary reasons I bought the book.  It's called Going Beyond Gluten and covers what is currently going on in gluten research including the environmental factors at play(Aka the microbiome) and therapeutic interventions that could possibly lead to the previously unthinkable: worry free consumption of gluten by people with Celiac disease and gluten sensitivity.  As Dr. Fasano points out in the book, throughout the history of gluten and Celiac disease research, many things that were once held as gospel were eventually overturned as the science clarified the picture.  This includes existence of the disease in the US and Asian populations, it's prevalence, when it can afflict you, and how to successfully diagnosis the condition.

Overall this is an amazing book that clarifies quite a few things that I was uncertain about with regard to gluten.  It thoroughly goes over the research on gluten to date and also gives a glimpse at what we can expect to see come out in the future.  For someone with a gluten related disorder, it provides quite a bit of insight from people who have personal experience in dealing with a diagnosed gluten related disorder.  It contains recipes as well as helpful tips in navigating society while going gluten free, whether you are doing it for yourself or your family.  In addition, there are several resources in the back that provide help to people who may be having a difficult time going gluten free on their own.  This book should be required reading for anyone with a gluten related condition as well as people who work with them who wants to know the science behind gluten as well as how to successfully live a gluten free life.

Gluten Freedom by Dr. Alessio Fasano