Muscle for Life with Mike Matthews - Danny Lennon on Gluten Sensitivity, Leaky Gut, and More

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Starting point is 00:01:13 And if you're not in the United States, your order is going to ship free if it is over $99. So again, if you appreciate my work and if you want to see more of it, please do support me so I can keep doing what I love, like producing more podcasts like this. To shop and save now, head over to www.LegionAthletics.com and use the code FRIDAY19 at checkout and you'll save up to 30% on your entire order. Hello, this is Matthew Michaels. No, that's not right. I'm glad my name is not Matthew Michaels. That sounds like a porn star or a WWE wrestler or something. But no, I am Michael Matthews, a guy with two first names as names, a guy who often gets called Matthew.

Starting point is 00:02:09 Anyway, welcome to Muscle for Life, another episode. And this one is about gluten-free dieting, which is still going very strong these days. I was a little bit surprised when I looked at the Google Trends before deciding whether I wanted to do this episode, because I have produced some content on gluten-free dieting in the past. I've written an article. I believe I recorded a podcast around the time of publishing the article. And according to Google Trends, gluten-free, the gluten-free diet is just about as popular now as it was six years ago, which was its heyday, the peak of its popularity. It has maintained that more or less. And I guess we see that out in the world, right? Gluten-free foods are still packing the shelves of our grocery stores and coffee shops and bakeries and the like. And gluten-free options are available in most of the more health-conscious, hip restaurants that I've been to

Starting point is 00:03:14 in the last six months or so. And so really, gluten-free dieting, it's no longer just a fad among health bloggers and paleo fanatics. It really has successfully inserted itself into the current zeitgeist, that sounds sensual, and reached a comfortable cruising altitude. Despite this, though, gluten is still a hotly debated topic. And it's a polarizing little nutrient with some people claiming that it's literally poison and should be avoided by everyone at all costs and others saying that there is no good evidence that anyone but those with celiac disease should give any thought as to their gluten intake. So to help clear this up and

Starting point is 00:04:07 catch us up with the current state of the evidence and to present a fair and balanced take on the current weight of the evidence, I invited Danny Lennon to join me on the podcast. Now it's been a number of years since I last had him on the show, but it should have happened sooner because he's a great guest. He is a member of the scientific advisory board of my sports nutrition company, Legion Athletics, and he has a master's degree in nutritional sciences. And he also hosts his own very popular podcast called Sigma Nutrition Radio, which you should definitely check out. If you like my stuff, you're going to like his stuff. And if you like my stuff, you're going to

Starting point is 00:04:49 like this interview. And on his podcast, Danny interviews world-renowned experts from the fields of nutrition, medicine, and sports performance. And in this episode, in this interview, Danny and I discuss all things gluten, including what it is, because many people don't know actually what it is, what happens in our body when we eat it, the difference between celiac disease and gluten sensitivity. That's another commonly misunderstood nuance of gluten intake, whether leaky gut is a real thing and more. So I hope you like the discussion. Here it is. Hey, Danny, welcome to my podcast again. Hey, Mike, thanks for having me. Very much appreciate it. Yeah, yeah. It's been a while. I remember speaking to you, but I don't remember what even

Starting point is 00:05:39 the last interview was on. I'd have to look, but we're here today to talk about gluten and gluten free dieting, which again, when we were just talking about the, the, it's still very much a thing. If I went into Google trends for everybody listening and just put it in and it's having popularity spikes that just in the last six months or so that are right on par with 2014, which is when it seemed to really kind of kick into high gear. And so, you know, and I see it in just in my line of work, having, I hear from a lot of just kind of general population people, you know, normal everyday people who want to get into better shape and they want to look good, feel good. I am still asked fairly often about gluten.

Starting point is 00:06:25 Is it an issue? Should they be following gluten-free diet? How do they know if they have celiac disease and how do they know if they are gluten sensitive and so forth? And so you have produced some pretty in-depth content on this and done quite a bit of research. So I thought you'd be a great guy to just break it down for on this and done quite a bit of research. So I thought you'd be a great guy to just break it down for us because it's been a couple of years since I looked into it. And so that's why I thought, Hey, instead of going through the whole process again, I'm just going to find someone like Danny and let him explain everything and make me look good. Well, I can try my best. So hopefully I can give at least an insight into how I tend to think about

Starting point is 00:07:05 this and how I communicate that idea to people asking me about it. And then hopefully it seems useful to people. And so that's the goal. I like it. So why don't we start at the top, just for anyone who doesn't even know what gluten is, maybe we'll just start there. What is it? Sure. So gluten is at least typically tends to be thought of as a protein that's in certain grains. Although technically it's not really one single protein, it's a combination of various different proteins. And we usually most talk about gliadin and glutenin proteins.

Starting point is 00:07:40 And at least from the research that I'm familiar with, it seems that gliadin is the one that is probably doing most of the stuff that we refer to as the symptomology of celiac disease and non-cel others that is, again, contained in these foods. But for certain people, it may present an issue. And this is where most of the discussion then picks up from there. And why is that? Why is it an issue with some people, whereas I don't think there's such a thing as like a chicken sensitivity. Right. So it seems that for certain people, and again, there's definitely a genetic component to this. And so maybe one good way to start would be to look at this through the lens of celiac disease, which I think a lot of people will be familiar with. And with celiac disease, we know that from a dietary intervention perspective, the way we would tackle that is a strict gluten-free diet that is done for life. And in the case of celiac disease, we have, like I said, a genetic component. So we have a couple of these different antigens that are called DQ2 and DQ8, and those seem to be implicated in having

Starting point is 00:08:59 a response to consumption of gluten. So it's this, essentially in the case of celiac disease, there's an autoimmune response that can be launched after gluten is in the system. However, as we'll probably talk about in a moment, that is not the only type of case. So an autoimmune reaction to gluten is not the only issue where someone can have a problem. And there's probably three main categories we should probably talk about. So to mention those from the first, let's say, issue or category would be those that are autoimmune in nature, which I just mentioned one example being celiac disease. We can also have other issues that are more on the allergic side. So this would be someone with things like a wheat allergy or

Starting point is 00:09:45 something called like baker's asthma and some other allergic reactions that can occur after consuming a gluten-containing grain. And then the third category is probably where I think most of our discussion is going to get into today and which is where most of the debates happen and what most people really want to know is there seems to be some people that can have an issue with gluten that is neither autoimmune or allergic in nature. So if it's non-autoimmune and non-allergic, we have this other category that we would typically call gluten sensitivity. Again, people have symptoms after consuming gluten, but do not have an autoimmune or allergic mechanism to that.

Starting point is 00:10:26 And so that's probably where most of the discussion lies. Right. And just so people understand maybe the high level mechanisms in each of these cases, maybe quickly, can you explain the autoimmunes? Like if somebody actually has celiac disease, what happens and why is it bad for them to eat gluten? So a few things happen after consuming gluten. And I think one that actually is going to show up in our discussion of non-celiac gluten sensitivity as well, it seems to be that after consuming gluten, we get the presence of something called zonulin. And zonulin can essentially cause an increase in intestinal permeability, which is one of the problems that occurs in non-celiac gluten sensitivity and otherwise. So that's one

Starting point is 00:11:14 potential component. Within something like celiac disease, we're looking at someone having a certain genetic predisposition. After the trigger of something like gluten in this case, they get intestinal damage. So that because it's an autoimmune response, as with any autoimmune disorder, you're getting the production of essentially antibodies that attack the body's own tissue. So in this case, the damage is done at the level of the intestine. So you're getting an autoimmune response that therefore causes destruction of intestinal tissue. And so the way to prevent that is obviously prevention of gluten getting into the system, and therefore we have a gluten-free diet. And that's in the small intestine, right? And over time, it impairs the intestine's ability

Starting point is 00:12:01 to absorb nutrients? Correct. Yes. And so that's why it can be super serious for anybody wondering that if there's too much damage, then you can get into a position where you might even be eating fairly well, but your body is simply not able to absorb enough nutrients from the food that you're getting to stay healthy. Right. Right. And that's why typically before someone has reached a diagnosis, not only may they have

Starting point is 00:12:24 symptoms of things like intestinal pain, but a lot of the time it can be a lot of lethargy. They probably will see weight loss in a lot of these cases. And again, that's down to this destruction of intestinal tissue, inability to absorb nutrients as they should do. And therefore, you can see problems such as weight loss despite them eating what they would see as a normal diet. And then you have this low energy and then other symptoms that then on examination, we see that we get a diagnosis of celiac disease. And you mentioned intestinal permeability. Can you explain quickly what that is? Because I'm just thinking that a number of people have probably heard of that and they might be thinking, oh, is that like leaky gut or something? Which is one of those buzzwords that goes around. Yeah. So that's typically what is being referred to when people colloquially use the term leaky gut,

Starting point is 00:13:14 this idea of increased intestinal permeability. So the best way to think of this is within the lining of the gut, we have cells that have these connections called tight junctions. So one way to think of this as an analogy would be almost like these shoelaces that are holding this connection between the cells that line the surface of the intestine. And so they have an important function that within the lining of the gut, what we actually want is to be able to let through beneficial molecules, i.e., in this case, nutrients, so that we are digesting in the gut. We want to be able to let them pass through into our system, into the bloodstream and so on. And we want to be able to keep out harmful ones. So for example, pathogenic bacteria. And so these tight junctions between these cells, like

Starting point is 00:14:04 I said, kind of act not directly, but an easy analogy might be to think of them that are like shoelaces that open and then close, depending on what we want to let pass through the cells of gluten is the release of a certain protein called zonulin. And zonulin seems to increase acutely intestinal permeability. So in other words, that gap between, let's say, two intestinal cells gets larger. So if that gap opens up and that gap is now wider than it otherwise is, now there is potential for certain molecules to be able to pass easily through the intestine. And this is why we think the term leaky gut gets used, right? More of these larger molecules are passing through. So the intestinal permeability is increased. So that's what we're really thinking about, the gap between the cells that line our intestine, and they can increase in size that gap between them.

Starting point is 00:15:06 And that's increased intestinal permeability. And why is it bad if, is that a matter of if the gaps get too large, or is it a matter of even a small increase over a longer period of time? Right. That's a good question. And so one way to think about this, of why increased intestinal permeability may be a problem, is if we think about what And we have these much smaller molecules now, right? We can pass these amino acids from the intestine out into the bloodstream. Now, what can happen is if we have full intact proteins, they're too large to pass through that gap. And we don't want that happening. We want to be able to digest them down into amino acids or

Starting point is 00:16:02 polypeptides. Now, if we have an increased intestinal permeability and we have this larger gap for larger molecules to pass through, and then we get these intact protein fragments being able to get into, say, the bloodstream, these protein fragments then can be essentially treated by our immune system in the same way that they would treat an invading pathogenic bacteria. They're noticing, hey, this is a molecule that shouldn't really be here. This isn't something we are expecting to see. So we are going to mount an immune response.

Starting point is 00:16:35 And this is, again, why we would start making antigens towards this. So one example would be the passing through of molecules into the bloodstream that we don't necessarily want to get through. And again, this is more when this happens chronically. So one of the issues, and we'll probably talk about this a bit more, I'm presuming, but one thing that we know about when people consume gluten, and then we get this release of zonulin that I just mentioned, is that that isn't restricted to people just with celiac disease. That happens in pretty much everyone that we get this release of zonulin. And at that time, we may see an increase in intestinal permeability. Now, the difference being is that isn't necessarily a problem for everyone.

Starting point is 00:17:21 And I think in some of those pieces I wrote, I refer to some of the work of Dr. Alessio Fasano, who is one of the leading researchers in this field of gluten sensitivity and celiac disease. The way he put it was something along the lines of not everyone will lose this battle, right? That once, let's say a gluten protein is able to pass through the intestinal tract and into the bloodstream, and we have to, let's say, mount this immune response, that for most people, that's a pretty easy thing to do. And when we think about it, every single day, we come in to contact with thousands of different bacteria that we have to essentially deal with, and that's not necessarily a problem. And so in the same way,

Starting point is 00:18:07 for most people, it may not necessarily be a problem, but for some people who have an issue with gluten, it could be, and we'll certainly circle back to that. So again, kind of circle back all the way to your question, this increased intestinal permeability, if that's a chronic issue, is problematic because it can allow the movement of certain molecules from the gut into the bloodstream that we don't necessarily want passing through. Yeah, that makes sense. What about a gluten allergy? How does that differ from the autoimmune response that you just detailed and then the sensitivity that we'll get to? Sure. So with something like an allergy, this would kind of mirror the way most people think about a lot of true food allergies, where there's an immediate and obvious response off the back of

Starting point is 00:18:58 consuming that food. So someone with, let's say, a wheat allergy may have a response where they immediately get breathing difficulties or nausea, or they start breaking out in hives, things like this. Typically, what we would think of with someone who has an immediate allergic reaction to a certain food. So this is an allergy, so therefore an immediate allergic reaction with these kind of designated symptoms, which is kind of distinct from this gradual destruction of intestinal tissue over time with some of the autoimmune mechanisms we mentioned earlier, and is also distinct from what we would see in non-celiac gluten sensitivity, which is probably what most people end up discussing if they feel they're sensitive to gluten. So they would probably know if they have a true allergy, like a wheat allergy or similar. Yeah. Yeah. And that's the point, right? Like you eat it and something clearly bad happens soon after.

Starting point is 00:19:52 Right. And the same way, like any type of disorder where someone has an anaphylactic reaction to food, it's an immediate and obvious reaction that you see. So quite different from the sensitivities we'll probably discuss. Yeah. So let's go there now. Let's talk about sensitivity and how that differs from the autoimmune and the allergy. And then just some of the, I guess that's where we'll get into a lot of the things that people hear about why they should avoid gluten purportedly or why, should avoid gluten purportedly or why or how do they know if they do indeed have a gluten sensitivity are there any risks of going gluten free and so forth sure so i think the first place that i definitely start is we should probably make it clear because i do still sometimes see people out there that kind of throw out this easy line of the only people that need to worry about gluten are people with celiac disease. And I think based on all the literature we have right now,

Starting point is 00:20:50 that is clearly not the case, that there are certainly people that still seem to have symptoms on consuming gluten-containing grains that don't have celiac disease, that don't have an autoimmune issue with that, that don't have a wheat allergy per se. And so this is this area that we've mentioned quite a few times now already of non-celiac gluten sensitivity. Now, because of that categorization I gave earlier of these three categories of autoimmune, allergic, and then non-autoimmune, non-allergic, that is essentially where we're at with diagnosis of non-C-LK gluten sensitivity, unfortunately, in that it's based off a diagnosis based on exclusion criteria. So it's someone that is having symptoms after consuming gluten that we've already ruled out

Starting point is 00:21:40 allergic and autoimmune mechanisms. So unfortunately, what we don't have with something like non-celiac gluten sensitivity is a concrete validated test that you can go down to your doctor and get, and then confirm you have non-celiac gluten sensitivity based on this. But there are tests that I hear about them. I think it's, I don't know how many medical doctors are giving them, but I believe chiropractors, it's, they're kind of popular in the chiropractic world where they claim like, oh, you can take this test and then we can see if you're sensitive to gluten. I've had people ask me about it.

Starting point is 00:22:16 Yeah. And so you're right. There are several labs that I have seen again from when we look at what is, and again, I know depending on someone's perspective of how they look at these things, they may think of what is accepted within conventional medicine differently. But to me, within the consensus within conventional medicine, we don't have a validated test that you can go and say this specific biomarker tells you this person definitely has non-C-lead gluten sensitivity and this person does not. There are some of the labs that have developed various different tests, like you mentioned. I think there are some that test anti-gliadin, IgA antibodies in the feces,

Starting point is 00:22:57 for example, and there are others. But to my knowledge, at least, and I'm happy to be correct, But to my knowledge, at least, and I'm happy to be correct, this is different now, but these are still mainly unver test, is that there's at least some research that I've read into this that indicates that maybe up to like half of the people who would have a diagnosis of gluten sensitivity test negative for those antibodies anyway. And so you have this issue of, in some cases, it could give a false positive. There's other cases where it's going to give a false negative. So it's really not telling us all that much. The other problem is with a lot of antibody testing is it could just be indicating that someone has had an exposure to this type of protein that has got into their bloodstream

Starting point is 00:23:59 and they've mounted that immune response. And as we mentioned earlier, this can happen, right? You get exposure to that gliadin protein that slips through from the intestine into the bloodstream. You mount a response to that, and then you're going to produce certain antibodies to that protein. And so the presence of having those antibodies doesn't tell you that you have an issue that you must avoid gluten or gliadin for the rest of your life. It could just be indicating that you've had exposure to it. So I think, yeah, it's just the rest of your life. It could just be indicating that you've had exposure to it. So I think, yeah, it's just the legitimacy of some of those tests right now are

Starting point is 00:24:30 a bit off, to my knowledge, being what are accepted within medical practice. And as far as repeated exposure to gluten, again, just for anybody wondering that, because you had mentioned that it can become a problem in the case of intestinal permeability when it's a chronic thing, but it doesn't necessarily become a problem. Is that my understanding? So for example, somebody could eat gluten every day of their life and actually have, yes, there might be a small immune response, but our immune systems are always fighting off things. And it's not like you would add some great load to the immune system or disorder the immune system. Somehow it would just happen a little bit every day and it wouldn't otherwise impact their health or wellbeing.

Starting point is 00:25:13 Whereas in some people, it actually would. And the same scenario just plays out differently in their physiology. Yes. And that's what we're trying to get at with this predisposition to a non-C-declin sensitivity that some people would be predisposed to problems off the back of that, others would not. And then it comes down to an issue of prevalence, which we can certainly get into. And that's probably the place where most people tend to go on hearing that. Yeah. What are some of the common symptoms of legitimate cases of the non-autoimmune and non-allergic sensitivity? And how does that play out? Because obviously it's not an allergic reaction. So, you know, they're not going to eat a bread roll and have their face puff up, you know, like they've just

Starting point is 00:25:58 gotten beaten or something. It's going to be probably more subtle than that, right? And come out over time. Right. And one of the issues with trying to get a real number one an accurate diagnosis for someone but two when we look at the prevalence rates discussed in different research papers on non-celiac gluten sensitivity you see quite a range and variance in reported figures for prevalence and some of that comes down to exactly the issues we have with trying to diagnose it. If we're doing it on exclusion criteria, with regard to symptoms, there is a variation in different symptoms that are reported by people. So it's not one exact set of symptoms that everyone experiences. They can be different from person to person. And also a lot of those

Starting point is 00:26:42 symptoms are, I would say not quite generic, isn't the right way to think of it, but are certainly symptoms that could have many, many different causes, right? So some people have bloating, some people have intestinal pain, some people have what they will refer to as like foggy thinking, right? Or brain fog. Some people get really low energy and are very lethargic. Some have a combination of those. Some report breakouts in their skin. So the different symptoms that we've seen reported in different case studies of people partly having a gluten sensitivity are quite wide ranging, and they're not the exact same in all cases, which again makes this a bit

Starting point is 00:27:23 more tricky to try and drill down to exactly what's going on. But there are at least some of the common ones that are most often reported, I would say. And as far as prevalence goes, what are those? What do those numbers look like? And like you said, it ranges quite a bit, but- Sure. So again, this will depend on what research paper you look at, but at least from those that I have read, we see in a lot of the cases, a variance between anywhere between like half

Starting point is 00:27:50 a percent up to maybe five or 6% of the population. Now, there have been papers that I've seen that have reported much higher figures. I believe there was one paper, and I can't exactly remember the lead author, so forgive me. I think it came out in the UK, though, a few years back, that had a figure up around 12%, 13%. But at least most of the papers I see are probably between half a percent to 6% of the population.

Starting point is 00:28:17 So it's certainly much higher, perhaps, than the prevalence of celiac disease, which is probably around 1%. So it could be a bit higher than that. And therefore, the number of people who may have an issue with gluten-containing grains is a relatively significant number of people. However, the big takeaway is it still is a minority and is probably certainly not reflective of the number of people who have embarked on a gluten-free diet, the amount of marketing of gluten-free foods that you see in any supermarket, and generally the concerns many people have around the population tends to outweigh the figures that most research papers are putting prevalence at.

Starting point is 00:29:00 So if we say maybe around 5-ish percent, and it could be a bit above or below that, depending on what research paper you look at. Okay. And there's also the point of you have many people who are experiencing symptoms that could be attributed to a gluten sensitivity, but may be something else altogether. Like they sleep like shit and that's why they feel like shit actually. Right. And this is an interesting one. And it's something I kind of alluded to in one of those pieces I wrote, God, it must be five years ago now. One of the pieces, at least, was, I think I called it something to the effect of, is gluten a straw or a dagger?

Starting point is 00:29:37 And in that analogy, the dagger would be something that would cause actual harm to anyone who was faced with it. First, the straw would be the straw that breaks the camel's back. And so one kind of thought experiment I thought about is, is it really fair to compare two different situations? And we took the same individual in two parallel universes, where in one they eat a diet of really nutrient-dense foods, high in fiber, lots of vegetables, an adequate amount of protein. They're a really active person. They walk outside regularly. They train a few times a week. They get like eight

Starting point is 00:30:10 hours of sleep each night. They have really good sleep hygiene. They have optimal vitamin D status. They're not on any medication. Things like they're breastfed as a child. They have low stress. They're lean versus- I love it. The Ubermensch, you've just outlined it. Yeah, right? So literally a list of everything you could do, right? Versus someone who, let's say, does the opposite of all that, a really highly refined processed food diet, low in protein, low in fiber, really high in sugar and calories, really sedentary. Let's say they do shift work and sleep four hours a night, deficient in vitamin D, really highly stressed, extremely obese,

Starting point is 00:30:51 all the opposite of those. In those two cases, would we see the same symptomology after eating certain foods? Or even like you said, could some of the symptoms be confused for something that may be because they're just in a poor health position? So maybe indeed people would get a benefit from using acutely a gluten free diet for several reasons, which you can explore. But then over time, they actually might be perfectly fine with it once their health actually improves. Hey, if you like what I am doing here on the podcast and elsewhere, and if you want to help me help more people get into the best shape of their lives, please do consider supporting my sports nutrition company, Legion Athletics, which produces 100% natural evidence-based health and fitness supplements, including protein powders and bars, pre-workout and post-workout supplements, fat burners, multivitamins, joint support, and more. Every ingredient and every dose in every product is backed by peer-reviewed scientific research.

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Starting point is 00:32:52 What's science's just collectively the best guesses as to the reason why some people are sensitive to gluten? And is it, I was going to get at what you're just saying, is a theory that, well, you have people whose immune systems are already kind of overloaded and compromised for all these other reasons, and simply adding this additional stressor is the straw that breaks the camel's back? Yeah, I think there's definitely a genetic component that even if you take someone who has healthy behaviors regardless can probably still have a gluten sensitivity at least some research seems to suggest that kind of genetic component i mentioned earlier around celiac disease where we have like if you take patients with celiac disease like 97 of them or something like that have genes encoding for that human leukocyte antigen dq2 or

Starting point is 00:33:46 dq8 and some of the research suggests that people with non-cdl sensitivity about 50 percent of them seem to have that same genetic predisposition so there could be something going on that there's like even if you do everything else right you could still have issues with gluten but it was more of a thought experiment i I do think certain people may experience symptoms because their overall health and their gut function could be compromised and we're adding fuel to the fire. And if we were to alleviate some of those other health concerns and they restored some gut function that they could probably consume gluten-containing foods and deal with them effectively and not have any issues. And as far as a gluten-free diet goes,

Starting point is 00:34:30 so you have, might be worth just commenting on, you have people out there who claim to feel a lot better after eliminating gluten. And what are your thoughts on what can that be attributed to? Now, there could be be as simple as they have celiac disease. Maybe they don't know it, but they have been experiencing this autoimmune response. And eventually it has gotten to the point where now they notice a big difference whether they eat or not. An allergy would be obvious, or maybe they have a sensitivity, but there are other factors that where it may not be the elimination of gluten per se, but maybe certain foods, right? Or they make other changes that kind of go along with the normal ways of, or at least the most popular kind of mainstream gluten-free diets out there. Right. And that's a really good question because I think it would be foolish for anyone to ignore the anecdotal reports of people who have embarked on gluten-free diets and seen improvements. And the thing we have to work out, was that down to the element of gluten per se, or is it down to something else that happened when going on a gluten-free diet, which is exactly what you bring up, Mike.

Starting point is 00:35:51 And when I've tended to think through this, there's kind of four or five main answers or reasons you could give as to why someone improved their symptoms or felt better after giving up gluten. One is, of course, that they just actually do have an issue with gluten. They do have a non-select gluten sensitivity. And so removing that caused a problem. Sorry to interject, but just quickly, it's kind of tough to know that because if you can't get a blood test done and just have someone point and be like, yeah, there's the bacteria, there's the problem. Of course, in this case, not bacteria, but I'm thinking of like Lyme disease is something I thought of earlier when you were mentioning symptoms that where it's one of these situations where if you have it, there's a bacteria, you can get tested and they go, yes, there it is. Here's some antibiotics. You are now cured. But then you have

Starting point is 00:36:28 a lot of weird cases where there is no such bacteria present, but people have the symptoms and whatever, right? So in the case of celiac disease, you can get that test done, right? They can be like, here it is. We know for a fact, this is the problem, right? But you can't do that for sensitivity. So does it really just come down to paying attention to the symptoms? And basically you have to kind of go, yeah, I check a number of these boxes and I've been eating gluten regularly. I'm going to try cutting it out and just see what happens. Right. So I think there's a few ways to go. Sure. And I think the first port of call is if someone, let's say, has had ongoing symptoms

Starting point is 00:37:05 and they go on a gluten-free diet and they see alleviation of those symptoms. That, of course, is a great start saying, okay, something I've done has actually helped me. I actually feel a lot better. Then the next they can do is start working through to work out, is it actually down to gluten or not? Now, some people might not care, right? They might say,

Starting point is 00:37:30 look, I've started this diet. I think I could do it. It's no real issue to me and I feel better, so I'm just going to stay doing it. I don't really care the exact reason why. And if they want to do that, that is fair enough. But other people I'm sure would want to work out, hey, maybe if it's not the gluten, I'd kind of want to know that because then there are foods I can probably eat if it's something else that made me feel better. So I think understanding what other things happen when you go on a gluten-free diet and thinking about is that them can help work out the sensor. And so I'll probably work through those. You can also then use like an elimination diet, which is kind of our gold standard with a lot of food intolerances of now you have these foods gone, your symptoms have alleviated, and now you can gradually reintroduce specific foods and see if it's

Starting point is 00:38:12 a certain food that you took out that's causing the issue, if it's a certain group of foods, if it's only gluten-containing foods, or if it's others. And so we can definitely circle back to that. But to kind of cover those areas people should be aware of, why they may have seen improvements in symptoms or why they just generally felt better. Or you see a lot of people just try a gluten-free diet and say, I've got a lot more energy or I just feel healthier or my skin improved. A lot of these anecdotal reports, there's beyond gluten being the issue, one could just be a placebo effect and or a nocebo effect.

Starting point is 00:38:46 So if someone is told, hey, you've got to try this gluten-free diet, as soon as you start eating it, like within a day or two, you're going to feel amazing. And so if they do that and the placebo effect kicks in, they may actually start feeling really good after doing that diet. So that can certainly be a role. Similarly, if someone says, hey, anytime you eat that food that has that gluten in it, or you eat bread or you eat pasta, do you not feel that your gut really is in a bad way and you feel bloated and you feel terrible? And then people start noticing these things, even though it may not be an issue.

Starting point is 00:39:20 There could be a placebo slash nocebo effect taking place, at least in some cases. It's theoretically possible. Another one that's related to that could be someone's baseline gluten intake. And by that, I would mean, let's say someone has been eating a particular type of way for a considerable period of time. It might have been a gluten-free diet. It could have been a paleo diet. It could have been a ketogenic diet. It could have been ketogenic diet, some type of variation of the diet that either intentionally or unintentionally, they were actually on very little to no gluten within that diet. And then they say, okay, I'm going to go and test to see if I can tolerate gluten or not. And then they go and have a meal, a large amount of gluten

Starting point is 00:40:01 containing grains. And then they suddenly suddenly they feel not so great afterwards after eating this big pizza or a lot of bread or something to that effect. It couldn't be almost this self-fulfilling prophecy of just consuming foods they're not used to consuming for months and months. There possibly could be a case for that to be made. I think what's probably most likely in a lot of cases if people are experiencing particularly gastrointestinal distress, is that there could be other non-gluten issues that occur when they consume certain grains or wheat. So when we think about what could cause issues after consuming, let's say, wheat. It could be gluten, but it also could be certain additives or preservatives in food that a small number of people have an issue with. It could be

Starting point is 00:40:51 a specific issue with the wheat itself. Or probably what looks like, for the most people in this position, could be a real issue, and there's been a number of papers published on this, is the presence of FODMAPs, which are certain types of carbohydrates, which can be, people can have problems digesting and these carbohydrates can then essentially ferment in the gut and cause particular issues. And so people would get very similar symptoms that they would be expecting from if they had a gluten sensitivity, but it's probably down to the FODMAPs. The FODMAPs are in a lot of different foods, right? If somebody has never heard of it before, it can be confusing to them. Like I eat mushrooms and I feel off. I eat broccoli,

Starting point is 00:41:35 I feel off. I eat apples and I feel off where those things are actually connected. Yes. And so those FODMAPs, we all have these different types of carbohydrates. And like you say, it could be in things like wheat and rye and barley, where we also have gluten, hence where we have this confusion about what could be causing it. And there's certain types of carbohydrates and fructans, which could be included in those, but it could also be lactose that we see in milk. It could be the fructose that's found in certain fruits and certain vegetables even. It could be polyols like xylitol or maltitol or others that have been used as sweeteners. So there's these different types of carbohydrates that, again, people can have an issue with. And this is one of the most researched areas

Starting point is 00:42:19 within dietary interventions for irritable bowel syndrome. So people with IBS, one of the standard dietary interventions that can be used would be a low FODMAP diet. So looking at those different foods that contain these different types of carbohydrates and going on a low FODMAP diet. And so if you think about what happens when someone goes on a gluten-free diet, they're actually cutting out a considerable chunk of foods that actually also have a high amount of FODMAPs. And so if their issue actually was the FODMAPs, and particularly the fructans, then they would see an improvement in symptoms because they've reduced the amount of FODMAPs in their diet, but they think it's down to reducing gluten

Starting point is 00:43:00 specifically. And so that is one thing worth considering. And it seems that people that do perhaps have an issue with certain foods with a high amount of FODMAPs in them, it can vary from person to person which types of carbohydrate and therefore which foods is the main driver. And so over time, after symptoms have alleviated, they can start reintroducing certain foods, and they might be fine with some and not with others. So they might be fine with, let's say wheat, but they find they get real bad symptoms after consuming onions, for example. Again, you would do a reintroduction as is the case with a lot of elimination diets followed by a reintroduction, which is common in the food intolerance. And so that could be

Starting point is 00:43:42 a predominant issue. And it looks like, at least for people who are reporting symptoms of IBS, that could be a big player and is probably more likely in a lot of cases than gluten specifically. And then the final thing I would mention is that for a lot of people who have, let's say, been eating a very suboptimal or generally unhealthy diet, that if they switch over to a gluten-free diet, in most cases, people's food quality overall improves and their diet quality improves overall. So if they're no longer eating gluten, for example, the foods that most of us tend to be able to over-consume very easily on, so pizzas, donuts, breads, et cetera, all of them are suddenly off the menu in most cases, unless someone goes out and just replaces them all with gluten-free versions,

Starting point is 00:44:31 which is another problem we can definitely address. But it's certainly that for a lot of people, I would say that are going from, let's say a poor, let's say standard Western diet with lots of processed foods and very low diet quality to then starting to try and improve their diet via gluten-free diet sure they might still feeling better but it could be because now they're including just more vegetables and lean meats just a generally healthier diet which also can lead to weight loss too or a lot of people mix that up they think that oh it's oh they got rid of the gluten and they're losing weight well it's also because their calorie intake dropped by 500 calories a day because they can no longer eat all the tasty stuff that they

Starting point is 00:45:09 like to eat too much of. Right. And I mean, we see this across many other different types of diets, right? It doesn't just occur with gluten-free diets that people make a certain change to a specific diet they've heard about. And for one reason or other, that leads to a reduced caloric intake. People end up losing weight on that diet. And if they are or other, that leads to a reduced caloric intake. People end up losing weight on that diet. And if they are in a position where their health actually improves from that weight loss, which is quite common, then people obviously feel better. They start noticing that they are more confident, they look a bit better, but they just feel better because their health has improved. And even in clinical issues, weight loss is going to help with that. So this is not unique to gluten-free diets. Many diets and most of the even fad diets out there tend to work for the same reason. It's a way of packaging it up that it's doing something magical when really it's, because many people don't want to hear about calories and macronutrients and kind of dry, boring things.

Starting point is 00:46:10 I think of Stephen Gundry's lectin craze now. If you can say, oh, here's the new boogeyman, this is the thing, it gets people's attention. attention. And even if in the end, what it really comes down to is just your standard restrictive diet that forces you to eat the stuff that your mom always told you to eat. It's one of those, and I'm assuming people like him, and I'm sure he knows that there's no real good science behind how he's presenting lectins and the problems that he's claiming that lectins are causing in many people. It actually kind of reminds me of how the gluten craze has gone. lectins are causing in many people, it actually kind of reminds me of how the gluten craze has gone. It's like, oh, well, the ends justify the means type of thinking where it's like, well, behind the scenes, like, yeah, I mean, the science is not

Starting point is 00:46:57 exactly there, but hey, the end result is good. We're getting people to do the right thing, even if it's for the wrong reason. But is that really wrong? Yeah, I've seen very similar lines of thinking to that and an argument to the effect of, well, look, maybe even if you're unsure, even if someone goes on a gluten-free diet, we can get lots of healthy food in the diet. There's no real downside, right? Even if there's no inherent risk to being on a gluten-free diet. So why not just hedge your bets and do that just in case? And I think that is kind of short-sighted because it presumes that there's no downside to not being gluten-free. I think there are considerable benefits to someone who, let's say, has no issues with gluten being able to consume a diet with lots of gluten-containing

Starting point is 00:47:39 foods, never mind just the enjoyment that we get from many of the foods that contain gluten, never mind just the enjoyment that we get from many of the foods that contain gluten, but what we know about the overall health of whole grains in general and other foods that contain gluten, being able to include them in the diet, being able to have more variety in your diet, to be able to make less decisions and a less restrictive diet based on this idea that you need to be gluten-free. So I think there's very much so downsides to being on a gluten-free diet, both a lot psychological, but you could probably make a case for some physiological as well, depending on how it impacts someone. Especially if, like you mentioned, if that just means like, oh, cool. So if all I have to do is eliminate gluten, if that's the thing I should be focusing on the most, then I'm going to have these gluten-free pastries every day. And I'm going to have

Starting point is 00:48:28 gluten-free cookie at lunch every day. And I'm going to eat these gluten-free Cheez-Its every day. You know what I mean? Where then the quality of the diet has actually, maybe it hasn't declined from where it was previously, but maybe it hasn't improved either. And calories can even go up because a lot of these gluten-free foods are made to be tasty. And that often means some sort of fat and often sugar as well. And so by going gluten-free, really many people, depending on how they do it, can be accomplishing very little. Exactly. And I think that goes for pretty much any diet that just a descriptive label tells you almost nothing about the healthfulness of that diet. So sure, you can set your diet up in a way

Starting point is 00:49:15 that is extremely healthful overall, and it just happens to be gluten-free. You can also have a diet almost completely of processed foods that's also gluten free. And the same thing you could say about a vegan diet. You can have an extremely healthy vegan diet with lots of vegetables and fruits and nuts. You can also have a vegan diet that's just a processed food diet, but you just don't have animal products in there. The same thing with whether a diet is low carb, high carb, medium carb, it tells me nothing about the actual healthfulness of the diet until we look at the overall dietary pattern. And so that certainly applies in this case. And then there's other potential downsides depending on people's changes. If they just say, gluten is the only thing I need to worry about, that's the problem,

Starting point is 00:49:58 just cut gluten out and I'm good. Then maybe they start taking out foods and depending on what they place on, maybe their fiber intake drops considerably. Maybe they're an athlete and now their carbohydrate intake has dropped considerably. So there are knock-on issues that people should probably be aware about that are a few like that. And then there's also the, like I say, the psychological ones that would tie into long term adherence to. Oh yeah, that's a good point.

Starting point is 00:50:25 With fiber intake, something that many people don't pay attention to, that it's obviously a very important nutrient. And if you don't eat well, you don't get enough of it, or at least you don't get enough of it, particularly the soluble fiber, right? And then that point with athletes too, where accidentally cutting their carb intake or unwittingly cutting their carb intake in half, for example, can markedly reduce performance. They may think that it's the gluten-free diet, that they need gluten or something. It could go the other way. Or they think bread is the key to

Starting point is 00:50:57 their endurance or whatever. They have to eat that huge bowl of pasta or their performance is going to plummet right yeah that's what we need to start pushing next we need to put it as a performance sensor ergogenic aid oh i like that gluten supplements next get some fake research done you know if if you fund it we'll find it we'll hit up jacob wilson we need a study that shows that gluten is a basically an anabolic steroid Can you take care of that, Jacob? So anyways, to summarize, I think that those are all the key points.

Starting point is 00:51:30 And to summarize for anybody listening who is wondering if they have an issue with gluten, if there's an autoimmune issue, they can get tested for that. And probably if they were me, I would go about like, I'll just summarize. Here's how I would go about it. And Danny, you can jump in and correct me if you disagree with anything. But generally I would get

Starting point is 00:51:48 most of my calories from nutritious foods. It would include some gluten containing foods. Like I like oatmeal, for example, and I like to eat some pita bread with dinner, whatever. Right. But most of my calories would come from, from relatively unprocessed, nutritious foods, lean protein, fruits, vegetables, legumes, and so forth. And if I were to notice that I was regularly experiencing symptoms that are in line with some sort of gluten-related issue, then I would get tested to see if I have celiac disease. And if I don't, then would go through the process of an elimination diet. That's what I would do personally, just to see what is it that is causing this. Is it gluten? Is it FODMAPs? Is it something else? And through that process, probably get a pretty good idea of what is

Starting point is 00:52:33 causing issues. Now, where I'm actually at is I eat the way I just outlined and I don't have any symptoms related to gluten sensitivity. And so I just don't worry about it. Basically, I don't go out of my way to avoid gluten. My gluten intake is relatively low. Again, it would be some oatmeal, some pita bread, and there'd be some instances like if I go out to a dinner or to a restaurant and they have really good bread, then I'm going to eat some bread where I wouldn't normally eat like five rolls of bread or something for dinner, but there'll be acute dramatic increases in gluten intake. But just, I think if you do eat a pretty good diet, your gluten intake is, it shouldn't be too high unless maybe you're like lean bulking and you need to eat a lot of food and you need

Starting point is 00:53:20 a lot of carbs in particular. And so you're, for example, eating a fair amount of bread because it's an easy source of carbs with no fat. I could see that. Or pasta can be a good source of carbs if you use a low-fat sauce, if you're trying to keep your calories under control. But if you are eating well and having no issues, then you have nothing to worry about, really. I mean, do you agree with all that? Yeah, for sure.

Starting point is 00:53:44 And I think that's the way i conclude on a lot of things if you aren't experiencing symptoms after consuming these foods and your overall diet is pretty good then there's no need to worry in my opinion if you are experiencing symptoms that you suspect is down to gluten then then like you said, Mike, the first port of call is go and get checked for celiac disease. We have tests to an extremely high degree of accuracy now. And if celiac disease is present but undetected, then that's a very serious issue and can increase your risk of many other chronic illnesses, nevermind the direct effects of that. So please, first of all, go and rule that out at the very least. If you rule that out and are still suspecting that it's causing issues, then again, as you said, Mike, you can take those foods out. You can do a reintroduction to see if there's specific foods you're having an issue with,

Starting point is 00:54:40 or if it's only after consuming gluten containingcontaining grains, for example. And then from there, you can work out what is best for you. But if you're not experiencing any negative symptoms and you include those foods in your diet, then you don't have any need to worry, in my opinion. And then the only other thing I would say is that as with a lot of things in nutrition, the worst stance to have is one that's an absolutist stance. So as I mentioned in our discussion earlier, saying that the only people that need to think about gluten are people with Z-dex disease, I think is not correct. And I think most of the science now would show that many other people can have an issue with it. So I think that end of the extreme is not accurate.

Starting point is 00:55:19 Similarly, the other end of the extreme, that gluten is this inherently dangerous thing that everyone should avoid and everyone should be gluten-free is ridiculous also. And so I think it comes down to that kind of happy medium as is most often the case. And then the final thing is, as we mentioned through our conversation, that there's a couple of different ways you can have a gluten-free diet. You can just end up naturally at a gluten-free diet or like you, a diet very low in gluten because most of your food intake is vegetables and fruit and meat and seafood and nuts and dairy and so on. That isn't a fad. That's just a diet that you've based around whole foods that you enjoy. And that is one way that you end up with a relatively low gluten

Starting point is 00:56:02 intake. But if you are eating a really poor diet full of just gluten-free cake and gluten-free pizzas, then that's probably not a good diet regardless of how much gluten is in it or not in it. But the pizza has tomato sauce. I mean, it's tomato. There you go. You're getting one of your five a day, right? Yeah, no, that makes perfect sense. And that is everything that I had on my outline of what I wanted to pick your brain on. So I really appreciate you coming on to break everything down. And let's wrap up with letting everybody know where they can find you

Starting point is 00:56:37 and your work and telling people about certainly your podcast. People should definitely, if they liked this discussion, they're going to like your podcast. So they should know about that and anything else that you want them to know about. Sure. So I think the easiest place is just to go to sigmanutrition.com. Everything is linked up there. More about me and what we offer. So sigmanutrition.com. If they like listening to podcasts, which presumably they do, they're listening to this, then they can just search for Sigma Nutrition Radio in any podcast app and they'll be able to find it. And then if they're listening to this, then they can just search for Sigma Nutrition Radio in any podcast app and they'll be able to find it. And then if they're looking for me on social media, then just putting in my name, Danny Lennon should pop up fairly easily. Instagram is DannyLennon underscore Sigma. And then I'm in all the other usual places as well.

Starting point is 00:57:18 So any of those, I'm happy to take any questions, feedback, or indeed criticism. Awesome, Danny. Well, thanks again for taking the time. I really appreciate it. I look forward to the next one. Yeah. Thanks for having me, Mike. or indeed criticism. Awesome, Danny. Well, thanks again for taking the time. I really appreciate it. I look forward to the next one. Yeah. Thanks for having me, Mike. I appreciate it. If you like what I'm doing here on the podcast and elsewhere, and if you want to help me do more of it, if you want to help me help more people get into the best shape of their lives too, please do consider supporting my sports nutrition company, Legion Athletics, which is currently holding its biggest sale of the year for Black

Starting point is 00:57:53 Friday and Cyber Monday. Now that means that for the next few days, you can save up to 30% on everything in our store over at www.legionathletics.com. That's L-E-G-I-O-N athletics.com, including our protein powders and our protein bars, our famous pre-workout supplement pulse and our post-workout supplement recharge, our fat burners, our multivitamins, joint support, fish oil, and more. And as you'll see, when you head over to the website, everything in the store is currently marked down five to 15%. And when you enter the

Starting point is 00:58:31 code BRIDAY19, numerals one nine at checkout, you'll save another 15%. And even better, if you're in the United States, your order is going to ship free. And if you're not in the United States, your order is going to ship free if it is over $99. So again, if you appreciate my work and if you want to see more of it, please do support me so I can keep doing what I love, like producing more podcasts like this. To shop and save now, head over to www.legionathletics.com, L-E-G-I-O-N athletics.com and use the code Friday19, numerals one nine at checkout, and you'll save up to 30% on your entire order. All right. Well, that's it for today's episode. I hope you found it interesting and helpful. And if you did, and you don't mind doing me a favor, could you their way to me and to the podcast

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Muscle for Life with Mike Matthews - Danny Lennon on Gluten Sensitivity, Leaky Gut, and More

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