Gluten: What’s The Truth?
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Gluten: What’s The Truth?
We asked you for your health-related view of gluten, and got the above spread of results. To put it simply:
Around 60% of voters voted for “Gluten is bad if you have an allergy/sensitivity; otherwise fine”
The rest of the votes were split fairly evenly between the other three options:
- Gluten is bad for everyone and we should avoid it
- Gluten is bad if (and only if) you have Celiac disease
- Gluten is fine for all, and going gluten-free is a modern fad
First, let’s define some terms so that we’re all on the same page:
What is gluten?
Gluten is a category of protein found in wheat, barley, rye, and triticale. As such, it’s not one single compound, but a little umbrella of similar compounds. However, for the sake of not making this article many times longer, we’re going to refer to “gluten” without further specification.
What is Celiac disease?
Celiac disease is an autoimmune disease. Like many autoimmune diseases, we don’t know for sure how/why it occurs, but a combination of genetic and environmental factors have been strongly implicated, with the latter putatively including overexposure to gluten.
It affects about 1% of the world’s population, and people with Celiac disease will tend to respond adversely to gluten, notably by inflammation of the small intestine and destruction of enterocytes (the cells that line the wall of the small intestine). This in turn causes all sorts of other problems, beyond the scope of today’s main feature, but suffice it to say, it’s not pleasant.
What is an allergy/intolerance/sensitivity?
This may seem basic, but a lot of people conflate allergy/intolerance/sensitivity, so:
- An allergy is when the body mistakes a harmless substance for something harmful, and responds inappropriately. This can be mild (e.g. allergic rhinitis, hayfever) or severe (e.g. peanut allergy), and as such, responses can vary from “sniffly nose” to “anaphylactic shock and death”.
- In the case of a wheat allergy (for example), this is usually somewhere between the two, and can for example cause breathing problems after ingesting wheat or inhaling wheat flour.
- An intolerance is when the body fails to correctly process something it should be able to process, and just ejects it half-processed instead.
- A common and easily demonstrable example is lactose intolerance. There isn’t a well-defined analog for gluten, but gluten intolerance is nonetheless a well-reported thing.
- A sensitivity is when none of the above apply, but the body nevertheless experiences unpleasant symptoms after exposure to a substance that should normally be safe.
- In the case of gluten, this is referred to as non-Celiac gluten sensitivity
A word on scientific objectivity: at 10almonds we try to report science as objectively as possible. Sometimes people have strong feelings on a topic, especially if it is polarizing.
Sometimes people with a certain condition feel constantly disbelieved and mocked; sometimes people without a certain condition think others are imagining problems for themselves where there are none.
We can’t diagnose anyone or validate either side of that, but what we can do is report the facts as objectively as science can lay them out.
Gluten is fine for all, and going gluten-free is a modern fad: True or False?
Definitely False, Celiac disease is a real autoimmune disease that cannot be faked, and allergies are also a real thing that people can have, and again can be validated in studies. Even intolerances have scientifically measurable symptoms and can be tested against nocebo.
See for example:
- Epidemiology and clinical presentations of Celiac disease
- Severe forms of food allergy that can precipitate allergic emergencies
- Properties of gluten intolerance: gluten structure, evolution, and pathogenicity
However! It may not be a modern fad, so much as a modern genuine increase in incidence.
Widespread varieties of wheat today contain a lot more gluten than wheat of ages past, and many other molecular changes mean there are other compounds in modern grains that never even existed before.
However, the health-related impact of these (novel proteins and carbohydrates) is currently still speculative, and we are not in the business of speculating, so we’ll leave that as a “this hasn’t been studied enough to comment yet but we recognize it could potentially be a thing” factor.
Gluten is bad if (and only if) you have Celiac disease: True or False?
Definitely False; allergies for example are well-evidenced as real; same facts as we discussed/linked just above.
Gluten is bad for everyone and we should avoid it: True or False?
False, tentatively and contingently.
First, as established, there are people with clinically-evidenced Celiac disease, wheat allergy, or similar. Obviously, they should avoid triggering those diseases.
What about the rest of us, and what about those who have non-Celiac gluten sensitivity?
Clinical testing has found that of those reporting non-Celiac gluten sensitivity, nocebo-controlled studies validate that diagnosis in only a minority of cases.
In the following study, for example, only 16% of those reporting symptoms showed them in the trials, and 40% of those also showed a nocebo response (i.e., like placebo, but a bad rather than good effect):
This one, on the other hand, found that positive validations of diagnoses were found to be between 7% and 77%, depending on the trial, with an average of 30%:
Re-challenge Studies in Non-celiac Gluten Sensitivity: A Systematic Review and Meta-Analysis
In other words: non-Celiac gluten sensitivity is a thing, and/but may be over-reported, and/but may be in some part exacerbated by psychosomatic effect.
Note: psychosomatic effect does not mean “imagining it” or “all in your head”. Indeed, the “soma” part of the word “psychosomatic” has to do with its measurable effect on the rest of the body.
For example, while pain can’t be easily objectively measured, other things, like inflammation, definitely can.
As for everyone else? If you’re enjoying your wheat (or similar) products, it’s well-established that they should be wholegrain for the best health impact (fiber, a positive for your health, rather than white flour’s super-fast metabolites padding the liver and causing metabolic problems).
Wheat itself may have other problems, for example FODMAPs, amylase trypsin inhibitors, and wheat germ agglutinins, but that’s “a wheat thing” rather than “a gluten thing”.
That’s beyond the scope of today’s main feature, but you might want to check out today’s featured book!
For a final scientific opinion on this last one, though, here’s what a respected academic journal of gastroenterology has to say:
From coeliac disease to noncoeliac gluten sensitivity; should everyone be gluten-free?
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Apples vs Bananas – Which is Healthier?
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Our Verdict
When comparing apples to bananas, we picked the bananas.
Why?
Both apples and bananas contain lots of vitamins, but bananas contain far more of Vitamins A, B, and C.
Apples beat bananas only for vitamins E and K.
This may seem like “well that’s 2 vs 3; that’s pretty close” until one remembers that vitamin B is actually eight vitamins in a trenchcoat. Bananas have more of vitamins B1, B2, B3, B5, B6, and B9.
If you’re wondering about the other numbers: neither fruit contains vitamins B7 (biotin) or B12 (cobalamins of various kinds). Vitamins B4, B8, B10, and B11 do not exist as such (due to changes in how vitamins are classified).
Both apples and bananas contain lots of minerals, but bananas contain far more of iron, magnesium, phosphorus, potassium, zinc, copper, manganese, and selenium.
Apples beat bananas only for calcium (and then, only very marginally)
Both apples and bananas have plenty of fiber.
Apples have marginally less sugar, but given the fiber content, this is pretty much moot when it comes to health considerations, and apples are higher in fructose in any case.
In short, both are wonderful fruits (and we encourage you to enjoy both!), and/but bananas beat apples healthwise in almost all measures.
PS: top tip if you find it challenging to get bananas at the right level of ripeness for eating… Try sun-dried! Not those hard chip kinds (those are mechanically and/or chemically dried, and usually have added sugar and preservatives), but sun-dried.
Here’s an example product on Amazon
Warning: since there aren’t many sun-dried bananas available on Amazon, double-check you haven’t been redirected to mechanically/chemically dried ones, as Amazon will try that sometimes!
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Blueberries vs Cranberries – Which is Healthier?
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Our Verdict
When comparing blueberries to cranberries, we picked the blueberries.
Why?
It’s close!
In terms of macros, blueberries have slightly more protein and carbs, while cranberries have slightly more fiber. We say the extra fiber’s more important than the (even more minimally) extra protein, so this is the slightest of marginal wins for cranberries in this category.
In the category of vitamins, blueberries have much more of vitamins B1, B2, B3, B9, K, and choline, while cranberries have slightly more of vitamins A, B5, B6, C, and E. That’s a 6:5 win for blueberries, and also, the margins of difference were much greater for blueberries’ vitamins, making this a clearer win for blueberries.
When it comes to minerals, blueberries have slightly more iron, manganese, phosphorus, and zinc, while cranberries have slightly more calcium. The margins of difference are small in both cases, but this is a 4:1 win for blueberries.
Both of these berries are famously full of antioxidants; blueberries have more antioxidant power overall, though cranberries have some specific benefits such as being better than antibiotics against UTIs—though there are some contraindications too; check out the link below for more on that!
All in all, meanwhile, we say that adding up the sections here makes for a win for blueberries, but by all means, enjoy either or both (unless one of the contraindications below applies to you).
Want to learn more?
You might like to read:
Health Benefits Of Cranberries (But: You’d Better Watch Out)
Take care!
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Sugar Blues – by William Dufty
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This is a “read it cover to cover” book. It charts the rise of sugar’s place in world diets in general and the American diet in particular, and draws many conclusions about the effect this has had on us.
This book will challenge you. Sometimes, it will change your mind. Sometimes, you’ll go “no, I’m sure that’s not right”, and you’ll go Googling. Either way, you’ll learn something.
And that, for us, is the most important measure of any informational book: did we gain something from it? In Sugar Blues, perhaps the single biggest “gain” for the reader is that it’s an eye-opener and a call-to-arms—the extent to which you heed that is up to you, but it sure is good to at least be familiar with the battlefield.
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A new government inquiry will examine women’s pain and treatment. How and why is it different?
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The Victorian government has announced an inquiry into women’s pain. Given women are disproportionately affected by pain, such a thorough investigation is long overdue.
The inquiry, the first of its kind in Australia and the first we’re aware of internationally, is expected to take a year. It aims to improve care and services for Victorian girls and women experiencing pain in the future.
The gender pain gap
Globally, more women report chronic pain than men do. A survey of over 1,750 Victorian women found 40% are living with chronic pain.
Approximately half of chronic pain conditions have a higher prevalence in women compared to men, including low back pain and osteoarthritis. And female-specific pain conditions, such as endometriosis, are much more common than male-specific pain conditions such as chronic prostatitis/chronic pelvic pain syndrome.
These statistics are seen across the lifespan, with higher rates of chronic pain being reported in females as young as two years old. This discrepancy increases with age, with 28% of Australian women aged over 85 experiencing chronic pain compared to 18% of men.
It feels worse
Women also experience pain differently to men. There is some evidence to suggest that when diagnosed with the same condition, women are more likely to report higher pain scores than men.
Similarly, there is some evidence to suggest women are also more likely to report higher pain scores during experimental trials where the same painful pressure stimulus is applied to both women and men.
Pain is also more burdensome for women. Depression is twice as prevalent in women with chronic pain than men with chronic pain. Women are also more likely to report more health care use and be hospitalised due to their pain than men.
Women seem to feel pain more acutely and often feel ignored by doctors.
ShutterstockMedical misogyny
Women in pain are viewed and treated differently to men. Women are more likely to be told their pain is psychological and dismissed as not being real or “all in their head”.
Hollywood actor Selma Blair recently shared her experience of having her symptoms repeatedly dismissed by doctors and put down to “menstrual issues”, before being diagnosed with multiple sclerosis in 2018.
It’s an experience familiar to many women in Australia, where medical misogyny still runs deep. Our research has repeatedly shown Australian women with pelvic pain are similarly dismissed, leading to lengthy diagnostic delays and serious impacts on their quality of life.
Misogyny exists in research too
Historically, misogyny has also run deep in medical research, including pain research. Women have been viewed as smaller bodied men with different reproductive functions. As a result, most pre-clinical pain research has used male rodents as the default research subject. Some researchers say the menstrual cycle in female rodents adds additional variability and therefore uncertainty to experiments. And while variability due to the menstrual cycle may be true, it may be no greater than male-specific sources of variability (such as within-cage aggression and dominance) that can also influence research findings.
The exclusion of female subjects in pre-clinical studies has hindered our understanding of sex differences in pain and of response to treatment. Only recently have we begun to understand various genetic, neurochemical, and neuroimmune factors contribute to sex differences in pain prevalence and sensitivity. And sex differences exist in pain processing itself. For instance, in the spinal cord, male and female rodents process potentially painful stimuli through entirely different immune cells.
These differences have relevance for how pain should be treated in women, yet many of the existing pharmacological treatments for pain, including opioids, are largely or solely based upon research completed on male rodents.
When women seek care, their pain is also treated differently. Studies show women receive less pain medication after surgery compared to men. In fact, one study found while men were prescribed opioids after joint surgery, women were more likely to be prescribed antidepressants. In another study, women were more likely to receive sedatives for pain relief following surgery, while men were more likely to receive pain medication.
So, women are disproportionately affected by pain in terms of how common it is and sensitivity, but also in how their pain is viewed, treated, and even researched. Women continue to be excluded, dismissed, and receive sub-optimal care, and the recently announced inquiry aims to improve this.
What will the inquiry involve?
Consumers, health-care professionals and health-care organisations will be invited to share their experiences of treatment services for women’s pain in Victoria as part of the year-long inquiry. These experiences will be used to describe the current service delivery system available to Victorian women with pain, and to plan more appropriate services to be delivered in the future.
Inquiry submissions are now open until March 12 2024. If you are a Victorian woman living with pain, or provide care to Victorian women with pain, we encourage you to submit.
The state has an excellent track record of improving women’s health in many areas, including heart, sexual, and reproductive health, but clearly, we have a way to go with women’s pain. We wait with bated breath to see the results of this much-needed investigation, and encourage other states and territories to take note of the findings.
Jane Chalmers, Senior Lecturer in Pain Sciences, University of South Australia and Amelia Mardon, PhD Candidate, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Thai Green Curry With Crispy Tofu Balls
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Diversity is key here, with a wide range of mostly plants, offering an even wider range of phytochemical benefits:
You will need
- 7 oz firm tofu
- 1 oz cashew nuts (don’t soak them)
- 1 tbsp nutritional yeast
- 1 tsp turmeric
- 4 scallions, sliced
- 7 oz mangetout
- 7 oz fermented red cabbage (i.e., from a jar)
- 1 cup coconut milk
- Juice of ½ lime
- 2 tsp light soy sauce
- 1 handful fresh cilantro, or if you have the “cilantro tastes like soap” gene, then parsley
- 1 handful fresh basil
- 1 green chili, chopped (multiply per heat preference)
- 1″ piece fresh ginger, roughly chopped
- ¼ bulb garlic, crushed
- 1 tsp red chili flakes
- 1 tsp black pepper, coarse ground
- ½ tsp MSG or 1 tsp low-sodium salt
- Avocado oil for frying
- Recommended, to serve: lime wedges
- Recommended, to serve: your carbohydrate of choice, such as soba noodles or perhaps our Tasty Versatile Rice.
Method
(we suggest you read everything at least once before doing anything)
1) Heat the oven to 350℉ / 180℃, and bake the cashews on a baking tray for about 8 minutes until lightly toasted. Remove from the oven and allow to cool a little.
2) Combine the nuts, tofu, nutritional yeast, turmeric, and scallions in a food processor, and process until the ingredients begin to clump together. Shape into about 20 small balls.
3) Heat some oil in a skillet and fry the tofu balls, jiggling frequently to get all sides; it should take about 5 minutes to see them lightly browned. Set aside.
4) Combine the coconut milk, lime juice, soy sauce, cilantro/parsley, basil, scallions, green chili, ginger, garlic, and MSG/salt in a high-speed blender, and blend until a smooth liquid.
5) Transfer the liquid to a saucepan, and bring to the boil. Reduce the heat, add the mangetout, and simmer for about 5 minutes to reduce slightly. Stir in the red chili flakes and black pepper.
6) Serve with your preferred carbohydrate, adding the fermented red cabbage and the crispy tofu balls you set aside, along with any garnish you might like to add.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Capsaicin For Weight Loss And Against Inflammation
- Ginger Does A Lot More Than You Think
- Why Curcumin (Turmeric) Is Worth Its Weight In Gold
- The Many Health Benefits Of Garlic
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- Making Friends With Your Gut (You Can Thank Us Later)
- What’s Your Plant Diversity Score? ← a score of 8.25 for this dish, not counting whatever carbs you might add. Remember, herbs/spices* count for ¼ of a point each!
*but not MSG or salt, as while they may in culinary terms get lumped in with spices, they are of course not plants. Nor is nutritional yeast (nor any other yeast, for that matter). However, mushrooms (not seen in this recipe, though to be honest they would be a respectable addition) would get included for a whole point per mushroom type, since while they are not technically plants but fungi, the nutritional profile is plantlike.
Take care!
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Healthy Habits For Your Heart – by Monique Tello
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Did you guess we’d review this one today? Well, you’ve already had a taste of what Dr. Tello has to offer, but if you want to take your heart health seriously, this incredibly accessible guide is excellent.
Because Dr. Tello doesn’t assume prior knowledge, the first part of the book (the first three chapters) are given over to “heart and habit basics”—heart science, the effect your lifestyle can have on such, and how to change your habits.
The second part of the book is rather larger, and addresses changing foundational habits, nutrition habits, weight loss/maintenance, healthy activity habits, and specifically addressing heart-harmful habits (especially drinking, smoking, and the like).
She then follows up with a section of recipes, references, and other useful informational appendices.
The writing style throughout is super simple and clear, even when giving detailed clinical information. This isn’t a dusty old doctor who loves the sound of their own jargon, this is good heart health rendered as easy and accessible as possible to all.
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