The Problem with Gluten

Could gluten be wreaking havoc in your gut?

Lately you may have noticed a surge of gluten-free products showing up on store shelves -- gluten-free breads, cookies and crackers, gluten-free vitamins, and even gluten-free body care products. There are also books, cookbooks, and magazines dedicated to the gluten-free lifestyle. "Gluten-free" has quickly become a buzzword in the health food vernacular. So what's up with the gluten-free craze? Why are these products becoming so prevalent? And are they really necessary?

For more than 2 million Americans, these products are indeed necessary. These 2 million plus Americans suffer from celiac disease (also called celiac sprue), a chronic digestive disorder that is caused by a hereditary intolerance to gluten, a protein found in wheat, rye, spelt, kamut, and barley. When a person with celiac disease eats a gluten-containing food, their immune system mistakes the gluten proteins as foreign invaders and, in essence, attacks the small intestine causing serious inflammation. The inflammation damages or destroys the intestinal villi, the tiny hair-like protrusions that line the walls of the intestine. These villi normally allow nutrients from food to be absorbed into the bloodstream, but without healthy villi, people with celiac disease cannot absorb the nutrients their bodies need to stay healthy. Malabsorption becomes a serious problem and if left unchecked can lead to malnutrition, despite a nutritious diet. If left untreated, celiac disease can lead to serious health issues such as osteoporosis, central and peripheral nervous system impairment, seizures, internal hemorrhaging, pancreatic disease, infertility, miscarriages, and birth defects.

Another significant health issue associated with celiac disease is leaky gut syndrome, which is increased permeability of the intestinal lining. Gluten increases the production of a protein that opens up the tight seams between the cells in the intestinal walls, allowing partially digested food molecules and microorganisms to enter the blood stream, triggering an immune response which can eventually lead to other autoimmune and/or neurological disorders. Additionally, gluten can trigger leaky gut in the intestine of non-celiac gluten sensitive people (more on that later) and can be an early sign of celiac disease.

Celiac, once considered a rare childhood disease, is now recognized as one of the most common genetically-based diseases in the country, and the most under-diagnosed. Researchers at the University of Minnesota and the Mayo Clinic recently found that gluten intolerance is four times more common today than it was fifty years ago, leading the researchers to raise questions about whether dramatic changes in the American diet have played a role. Many believe that our bodies were not designed to handle the quantity of gluten that is found in today's typical diet, which is full of processed and refined high-gluten carbohydrates.

Even more worrisome, the researchers also found that those who have celiac disease that goes undiagnosed have a four-time increase in the risk of death compared to those without the disease.

How do you know if you have celiac disease? The first signs of celiac are usually diarrhea, weight loss, and nutritional deficiencies. Other symptoms can include nausea, abdominal swelling, depression, fatigue, irritability, muscle cramps and joint and/or bone pain. Celiac disease is often difficult to diagnose because the symptoms are so similar to those of other diseases like irritable bowel syndrome, gastric ulcers, and anemia. In fact, the average time it takes for a person to be diagnosed with celiac is eleven years. Blood tests are often the first step in determining if you have celiac disease, followed by a biopsy of intestinal tissue. Because it is hereditary, if one family member is diagnosed, other family members should also be tested.

Celiac vs. non-celiac gluten sensitivity

Celiac disease is not a food allergy, but rather a hereditary autoimmune disorder with no known cure other than complete and permanent elimination of all forms of gluten. However, people can also be sensitive to gluten without developing celiac; gluten-sensitive individuals are often referred to as non-celiac gluten sensitive. Like celiac, non-celiac gluten sensitivity can lead to very serious health consequences, including leaky gut syndrome. If celiac disease has been ruled out, but you still think you have gluten sensitivity, try eliminating all gluten for at least two weeks and up to six weeks. If your symptoms improve, you most likely have gluten sensitivity and you may want to consider further medical testing to confirm gluten sensitivity. A confirmation is often important to encourage you to make the commitment to a gluten-free diet.

Adopting a gluten-free diet

If you are diagnosed with celiac disease or nonceliac gluten sensitivity it is extremely important that you follow a gluten-free diet. Just reducing gluten is not enough—even small amounts of gluten can set off an autoimmune response and cause intestinal damage, including damaged villi and leaky gut. The gut must be allowed to fully heal to restore proper nutrient absorption and optimal immune health.

Adopting a gluten-free diet may be challenging at first, but once you learn to design menus around nutritious whole foods minus the grains, it can be easy and satisfying. Remember, you're only giving up grains, you can still eat animal products, including meat, cheese, eggs, and milk; vegetables and fruit; nuts and seeds; and non-gluten grains and their flours such as rice, corn, quinoa, amaranth, buckwheat, millet, and teff.

In the beginning, you may find it easier to replace those gluten-containing foods you love with gluten-free versions. It is important to remember, though, that just because a food is labeled "gluten-free" does not mean it is a health food. Gluten-free breads, cakes, crackers, and cookies are no healthier than their traditional counterparts. Additionally, if you eat processed foods (typically found in boxes, bags, and cans) you must learn to carefully read ingredient lists since gluten is often "hidden" in ingredients with names like "hydrolyzed vegetable protein" (HVP), "maltodextrin," "modified food starch," and "natural flavorings."

As awareness and prevalence of celiac disease and gluten sensitivity grows, manufacturers of all sorts are responding with a plethora of gluten-free products; many restaurants are also responding to the demand, adding gluten-free options to menus; and there are many gluten-free cookbooks to help you create your own gluten-free dishes. Additionally, naturally gluten-free foods -- meat, eggs, dairy products, fruits and vegetables, nuts and seeds—abound. So even though celiac and gluten sensitivity are serious conditions, once you make the commitment toward a natural foods diet and learn to eliminate gluten from your diet, it is possible to live a very healthy (and satisfying!) life without the gluten.

Read More: Gluten-Free Alternatives: Grains and Flours

For more information, visit these websites:
www.csaceliacs.org
www.celiac.com
www.celiac.org
www.gluten.net

References available on request.