• Cristina Montoya, RD

On Trend: Is There A Relationship Between Gluten And Inflammatory Arthritis?


With the growing popularity of the gluten-free diet as an anti-inflammatory aid and the increased availability of gluten-free products on your grocery store shelves, you might be wondering if cutting gluten from your diet will help to reduce your inflammatory arthritis symptoms. This week we are taking a closer look at the gluten-free diet to understand why there is so much hype about it and whether it can be helpful for those with autoimmune diseases. So, if you have been wondering about going gluten-free to help with your inflammatory symptoms and want to know if it could work for you, keep reading!

What exactly is gluten?

Grains contain four different proteins: prolamins, glutelins, albumins and globulins. The prolamin and glutelin proteins found in wheat, barley, and rye are what we refer to as "gluten."


The gluten proteins are what make your bread rise and have those delightful, spongey webs with a chewy texture. This occurs because gluten proteins form a mesh of elastic networks that trap gases and moisture during the cooking process, resulting in the rising of bread or the softening of pasta.



So, if gluten is responsible for all that amazing texture in our grain products, why would anyone want to avoid it? While gluten does not pose a risk to the majority of the population, there are people who need to avoid it for a variety of reasons such as having Celiac Disease, a Non-celiac Gluten Sensitivity or a Wheat Allergy.



Is there a relationship between gluten and Inflammatory Arthritis?


Considering many individuals can have a co-occurrence of multiple autoimmune diseases, it is unsurprising that there may be a link between the consumption of gluten-containing products and inflammatory diseases such as Rheumatoid Arthritis (RA). There has been some preliminary research that has shown that patients with Celiac disease may be at a higher risk of developing RA and inflammation of joint tissue.


People with Sjögren’s Syndrome are 10 times more likely to get CD than healthy individuals. The connection between gluten and Sjögren’s Syndrome is with the celiac gene HLA-DQ2, which binds to gluten peptides and creates autoimmune responses because this reacts with the t cells, specifically CD4+ T cells, which regulate or suppress immune responses. As well as, the protein BM180, found in gluten, helps regulate tear secretion- this may attract inflammatory cells and cause dry eyes.


What if you don’t have Celiac Disease? Will a gluten-free diet help to improve your inflammatory joint pain?


Currently, there is no definitive answer to this question as medical professionals continue to debate it. However, in those who may have a gluten sensitivity, consumption could cause an arthritic flare-up. This is due to the inflammatory response that may occur outside of the gut in those who have a sensitivity to the protein. If you think going gluten-free to help with your pain and inflammation, please speak with your healthcare provider to ensure that this is right for you.

What are some common foods containing gluten?


*Oats

While oats do not contain gluten, if the product is not labelled gluten-free, it may have cross-contamination from being grown close to a gluten-containing grain or being produced in a facility that also manufactures gluten-containing grains.


*Alcohol

Distilled liquors, wine and gluten-free ciders are safer bets, but malts, wheat and rye-based liquor that has not been distilled should be avoided.


It is important to understand that if any of these products are present in a food that is listed as gluten-free, then there has to be less than 20ppm in North American produced products. This is of particular importance for those who have Celiac Disease because a mere 1/8 of a tsp of a wheat product has enough gluten to damage the villi in the stomach! Therefore, it is important to use different preparation environments for gluten vs non-gluten containing products.


Do not start a gluten-free diet before determining a diagnosis for Celiac disease, as removing it could lead to inaccurate testing results. I hope this helps clear up any questions you may have about the gluten-free diet, happy eating!


Special thanks to Cheryl Anderson, a 4th-year nutrition student at Ryerson University who assisted with the research and writing for this post.


Do you feel you may benefit from removing gluten from your diet? Check out my let's get real anti-inflammatory nutritional coaching program: Apply here. I would love to hear from you.


See other posts on this series:


Helpful resources:


Gluten-Free: The Definitive Resource Guide by Shelley Case - Dietitian

Canadian Celiac Association

Celiac Disease Foundation

Gluten-Free Diet and Arthritis: Does It Help Improve Symptoms?