MSBites
Living with MS is challenging enough without turning mealtime into an overwhelming obstacle course of dos and don'ts. Am I right?
Here's the thing: we live in a challenging information environment where people with MS have become a marketing demographic. The wellness industry exists to sell us products, services, and diets promising to heal, beat, or reverse this complex disease we live with. To put it bluntly, we all have targets on our backs.
I'm Mona - a registered dietitian, MS Certified Specialist, and someone who's been living with MS since 2008. I get it. I know what it feels like when that diagnosis blows up your life, when MS shows up uninvited to disrupt plans big and small, and when every day feels like a different new normal.
I created MSBites because the loudest voices discussing nutrition and MS often promote "alternative approaches," while the conventional nutrition perspective has been notably absent from the conversation. Until now.
On MSBites, I bring context, clarity, and compassionate skepticism to help you distinguish reliable information from wellness woo. We'll explore the science of nutrition and MS, bust myths, answer your questions, and share practical tips to help you eat well - without fear that you're doing it "wrong."
My mission? Unbiased, engaging conversations about nutrition and MS that help you make informed decisions, free from fear, confusion, or overwhelm.
Let's take the overwhelm out of eating with MS. One bite at a time.
MSBites
Is gluten really the villain it's made out to be?
Is gluten really the villain it's made out to be? In this episode, I will dive deep into the science behind gluten - what it actually is, who truly needs to avoid it, and whether people with multiple sclerosis should be concerned. We'll explore the difference between celiac disease, wheat allergy, and non-celiac gluten sensitivity, debunk common myths about gluten being universally inflammatory, and examine what the research actually says about gluten and MS.
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Did you ever notice how gluten went from being just a thing in bread to apparently becoming the root of all evil? And if you have MS, you've probably wondered if you should be avoiding gluten too. Today we're getting to the bottom of whether gluten is actually the problem or if we are all just caught up in drama. Started by the wellness world. I am Mona, your host, a registered dietician, MS. Certified specialist, and someone who's been living with MS. Myself since 2008. And today we're talking about gluten. you've probably heard someone say that they're going gluten free. Maybe you have too. Maybe it's for health, for digestion or just because a wellness influencer said that gluten is the root cause of every health problem known to man, but is gluten really as bad as it's made out to be? And what about those of us with multiple sclerosis? Should we be worried about gluten? In this episode, we're gonna unpack what gluten actually is, why it's in more than just bread, and whether it deserves the bad reputation it often gets, especially for the MS community. So let's get started. What is gluten? Gluten is a protein composite, which means a group of proteins found in wheat, barley, and rye. It's made up of two main proteins, glutenin and gliadin, and when flour is mixed with water, these proteins link together to form a sticky, stretchy network that gives bread it's chewy texture and structure. Gluten is like the scaffolding of the culinary world. It holds everything together. In bread. It helps dough rise and maintain its shape. If you've ever tried gluten-free bread, you're likely familiar with the difference. But you might be surprised to know that gluten is in far more than just bread. If you live with Celiac, you already know this, but for those of us who are new to the gluten-free conversation, you'll also find it in things like soy sauce, salad dressings, gravy, beer, and even some unexpected places like supplements over the counter, as well as prescription medications. In food. Gluten is beloved by Bakers. There's a reason why it gives dough that elasticity. It helps it trap air during fermentation, and it contributes to that satisfying, springy texture in baked goods. I remember a well, I'd like to say it was a funny story, but I remember when I worked inpatient at a hospital, myself and my colleagues, the other dieticians on staff, we had to taste roughly 10 different versions of gluten-free breads as a part of determining which one would be used by the kitchen. None of them were what I would call delicious. I'm hoping that these options have, have improved over time. But if, again, if you've been trying gluten-free breads, you probably know there's a difference in the taste and texture, but in medications and supplements, gluten can also be used as a binder or filler. Technically, when this is done, it's called an excipient, which basically means that gluten helps to hold the contents of the pill together. you'll find gluten listed under inactive ingredients if it's listed. This seems like a really good time to remind you that because supplements are not regulated, there's no guarantee that the ingredients listed on the label are actually in the bottle or in the supplement, in the advertised amounts and. Unlisted ingredients may also be present. To avoid gluten, check the ingredient lists for wheat or gluten containing grains and choose supplements labeled gluten-free, meaning that they contain less than 20 parts per million of gluten, that's per FDA guidelines. I also recommend consumer labs.com. They're a, an independent third party that tests supplements for various contaminants, including gluten. They're a great resource and I'll include a link to their website in the show notes. For the general population, trace gluten in, uh, medications and supplements is not a big deal, but if you are living with celiac disease, you'll know it can trigger a serious reaction. And we'll come back to that in just a minute, But when it comes to gluten and human health at large, who actually needs to avoid gluten, there's you choosing to avoid it, but who really absolutely needs to avoid it. For starters, there's folks with celiac disease. Celiac is an autoimmune condition, and when somebody with celiac disease eats gluten, it causes their immune system to attack the lining of the small intestine, it damages and flattens the villi which are responsible for nutrient absorption. Over time. This can cause serious health issues such as anemia, osteoporosis, nutrient deficiencies, and other complications. Celiac disease, affects roughly 1% of the population. And then there's a wheat allergy, which is different from celiac disease. It's an IgE mediated allergic reaction, which is quite rare, and it affects an estimated 0.4% of adults and around 0.5% of children. If folks with a wheat allergy ingest wheat, it can lead to anaphylaxis, which is a life-threatening allergic condition. Finally, we have something called non-celiac gluten sensitivity. This is a controversial concept and it's hard to diagnose. That's because currently there is no sensitive or reproducible blood or tissue test that uniquely identifies non-celiac gluten sensitivity, making exclusion and challenge central to diagnosis difficult. Self-diagnosed and self-reported cases are substantially higher than challenge confirmed cases. Some people report symptoms like bloating or brain fog after eating gluten, but they don't test positive for celiac or wheat allergy. And this may be due to, an overlap of symptoms. These GI symptoms overlap with IBS as well as other disorders and the non-gluten components of wheat such as FODMAPs, sometimes these symptoms are incorrectly attributed to gluten. In other words, it makes it really tough to know which food or food component, assuming there is one that's causing the problem. Which is why the science here is murky your gi pain and discomfort. It could be gluten, it could be FODMAPs and FODMAPs. If you've not, heard this phrase, they're fermentable carbohydrates. They ferment in your GI tract, which is what they're supposed to do. but that fermenting can create gas and pain and bloating and discomfort that is separate and apart and has nothing to do with gluten. And here's where the myths originate. Many influencers label gluten as universally inflammatory. This is a vast overgeneralization because outside of the three groups I just reviewed there's no compelling evidence that gluten is harmful for the average person. And gluten-free does not automatically mean healthy. I feel compelled at this time to mention that since so many of the same voices who demonize gluten also suggest that it's imperative that you avoid all processed foods. It's important to remember that removing gluten from gluten containing grains requires. A process. In fact, lots of processes, Many gluten-free packaged foods are considered highly processed. Which means that it may be free from gluten, but it might also be free from any, any other nutrients that would be there to support your health. So. What about gluten and multiple sclerosis? What does the evidence say about that? Should people with MS avoid gluten? It's an increasingly common belief in wellness circles that gluten is inflammatory, and I'm doing that as air quote and may worsen your health broadly and MS specifically. But what does the evidence say? Multiple sclerosis. Is a chronic disabling disease of the central nervous system and damages the protective covering of the nerves. The myelin, the exact cause of MS is unknown, but it's thought to be a mix of genetics, immune dysfunction, and environmental factors, including potentially. Diet compared to the amount of research investigating the role of nutrition in human health, the study of nutrition in MS is still relatively new though at present, there is limited evidence of the role that diet plays in MS, and there's certainly no consensus. Despite the buzz, there's no strong evidence linking gluten to MS onset or progression. In fact, several recent reviews highlight that healthy balanced eating patterns, which often includes whole grains with gluten, are associated with improved quality of life and reduced symptoMS in multiple sclerosis patients. Yes, some people with MS report feeling better on a gluten-free diet That could be due to a, a variety of factors, including the impact of FODMAPs, which I described a moment ago. But it's not clear whether the absence of gluten or the overall shift towards healthier eating that is making the difference, and that's the key. Gluten may have nothing to do with the fact that you're feeling better. And it's important to identify the actual problem, food or component of the food incorrectly. Blaming gluten for a symptom or something that's kind of intangible. prevents us from finding out what's really causing the issue and it may unwittingly contribute to nutrient deficiencies and that muddies the waters even more. So should people with MS avoid gluten? Before I answer that question, I want to say flat out that MS. Bites in every sense of that phrase. It's unpredictable, disruptive, painful, and exhausting. Who amongst us wouldn't at least consider eliminating an ingredient from our eating pattern? If. Doing so truly would make an enormous difference, right? The fear and angst around the unpredictability of MS is precisely what leaves us all vulnerable to the promise that a diet, a supplement, or a food restriction will heal, beat or reverse multiple sclerosis. But here's the deal, unless you've been diagnosed with celiac disease, which is rare, even among people with MS, there's no medical reason to avoid gluten, and it's unlikely that doing so will have an impact on multiple sclerosis. A better approach would be to focus on The overall quality of your diet or eating pattern, and for most of us, that means addition rather than subtraction, adding more colorful fruits and vegetables, whole grains, Omega-3 fats, and increased variety. So we are exposed to the greatest diversity of nutrients, nutrients, our bodies need to function their best, especially when we're living with MS. studies suggest that building and eating pattern around those factors matter far more than whether your eating pattern contains gluten or doesn't. If you're unsure whether gluten is affecting you, I totally get that, which is why I recommend talking to a registered dietician before you make any changes, before you remove large swaths of food choices from your eating pattern. Preferably reaching out to a dietician that understands multiple sclerosis and practices from a conventional as opposed to an alternative medicine perspective, at least to start with. This is important because unfortunately, many of these alternative medicine and alternative nutrition providers are the ones who are urging us to avoid gluten along with other foods. Cutting out gluten unnecessarily could lead to nutrient deficiencies. Nutrients like fiber, B vitamins and iron, which have some pretty important roles in brain health and brain function. Fiber supports the microbiome and helps with bowel regularity. B vitamins, particularly B12 is involved in myelin repair, brain function, and energy metabolism. While iron supports oxygen transport and neurotransmitter production and myelin formation, gluten containing whole grains are often rich in all of these nutrients. So avoiding them without a medical necessity could compromise your body's ability to support brain health, gut health, and immune function. And there would be no reason to do so. So is gluten the villain it's made out to be? For most people, the answer is no. It has numerous culinary functions, and unless you have a specific medical condition, it's unlikely to be impacting your health at all. For people with MS, there's no solid evidence that gluten is driving inflammation or disease progression. Instead, the focus should be on a balanced, varied, and flexible eating pattern to support overall health. Well, I do hope that this, answers a few of your questions about gluten. You can use the link in the show notes to let me know how I did. If there are questions you still have around this topic or around anything related to nutrition and MS, let me know. I'm happy to answer questions. Thank you so much for tuning in. I'm really glad you're here. Let's take the overwhelm out of eating with MS. One Bite at a time. You can subscribe to MS. Bites wherever you listen to podcasts. Take care y'all.