Gluten

Gluten 101

What is gluten?

Gluten is a collection of proteins (namely the long amino-acid chains gliadins and glutenins) that make bread rise and give the delectable texture to so many processed and baked foods. Wheat contains the most gluten, and the closer a grain is in relation to wheat, the greater its ability to cause trouble.2 This includes rye, barley, triticale (a wheat-rye hybrid), and oats. On the other hand, rice and corn are further removed from wheat and do not cause problems for those sensitive to gluten.1,2 Other gluten-free grains and flours include sorghum (millet-like grain), amaranth, quinoa, almond, arrowroot, flax, potato, and tapioca (although some sources suggest avoiding amaranth and quinoa). See Gluten-Free GrainsCLF for more info.

Why are gluten grains causing so much trouble?

One idea is that our bodies were not designed to handle the quantity of gluten that is found in today’s foods. From the beginning, the majority of mankind did not thrive on gluten-containing grains. Our bodies have not been able to adapt to these dietary changes efficiently. Although there are some people who can tolerate gluten, they may be in the minority.

Gluten and the digestive system

There is evidence that high-gluten diets alter the normal lining of the small intestine in healthy people,3which opens up the possibility that gluten, particularly in large amounts, is not suited for many of us. Luckily, just as the high-gluten diet can damage intestinal tissues, a gluten-free diet consistently reverses this damage.7 For people with celiac disease, the most well-known gluten-sensitive condition, consumption of gluten causes inflammation and damage to the lining of the small intestine – specifically the tiny hair-like projections called villi. The villi improve the absorptive efficiency of the intestine by increasing the surface area through which nutrients can be absorbed. The flattening of the villi reduces this surface area to a fraction of that of a healthy intestine. Thus, malabsorption becomes a serious problem, and the loss of vitamins, minerals and calories often result in malnutrition despite an adequate diet.6

Possible reactions to gluten

A wide variety of reactions can occur in response to gluten. The main issue is that when consumed, gluten frequently causes the immune system to react as if the gluten was an invader, something the body must rid itself of. Another possibility is for the body to have an autoimmune response, which is when the body is unable to distinguish gluten from normal body tissues. The health effects of gluten are compounded by its ability to compromise the digestive system, and thus nutrient absorption and assimilation, which then go on to impact the entire body – such as the liver, skin, glandular system, and brain.4,7

Most common symptoms

Celiac disease affects both adults and children (mostly Caucasians or European descent), and can appear at any age. It often appears when a child is first introduced to cereal foods or can be triggered by emotional stress or physical trauma (such as surgery or pregnancy). The first signs are diarrhea; weight loss; nausea; abdominal swelling; large and frequently pale and/or light-yellow-colored, foul-smelling stools that float; depression; fatigue; irritability; muscle cramps; and joint and/or bone pain.7,5,6

Over 150 medical conditions and symptoms have now been linked to gluten-sensitivity

7 Dr. Braly, co-author of Dangerous Grains, believes that undiagnosed sensitivities to gluten and other grain proteins contribute to many autoimmune and neurological conditions, bone loss, chronic pain, learning problems, fatigue, intestinal complaints and more.7,9

Types of sensitivities

Interestingly, celiac is found in 1 in every 167 healthy children in the United States and 1 in every 111 healthy adults.8 It is now understood that there are variations of this condition that blur its prevalence. The term silent celiac disease is when the same damage is seen in the small intestines as found in classic celiac disease but without any obvious symptoms. Latentceliac disease is when a person tests positive for antibodies but has a negative biopsy and goes on to develop celiac disease months or years later.7,9 Moreover, research in human genes now reveals that non-celiac gluten sensitivity, or immune reactions to gluten, may affect as many as 90 million Americans.7 Kenneth Fine, M.D., director of the Intestinal Health Institute in Dallas, Texas believes 60% to 70% of the population possesses the genes that make a person susceptible to developing gluten sensitivity.9

Determining your risk

Gluten intolerance and celiac disease are more common than once believed. Here are some signs to listen to and ways to determine if you may be at risk:

Are you in the high-risk group?

First degree family members with gluten sensitivity or celiac disease; suffer from insulin-dependent diabetes or first degree relatives with condition; autoimmune disorders; chronic neurologic or neuromuscular conditions; osteoporosis (especially in children); allergies; bowel disease; learning disorders; reproductive problems; chronic severe headaches.

Consider filling out the self-test questionnaires in Going Against the Grain by Melissa Diane Smith or Dangerous Grains by James Braley.

Elimination trial

Try eliminating all gluten for at least two and up to six weeks. If symptoms improve, you most likely have a gluten sensitivity and it may be best to stick with the diet. After gluten has been eliminated for a period of time, a small amount of an avoided grain can be added back into your diet to see your reaction. Of course, those with celiac disease must avoid all intake of gluten to prevent severe health consequences; therefore, this condition should be ruled out before performing this experiment.7,9

Testing/Screens

This includes small intestinal biopsy, blood tests, and stool tests.

Other food sensitivities

Due to compromised digestive function, those with any level of gluten sensitivity may be intolerant to other foods as well, particularly cows’milk10 and soy.11,12,13 Therefore, if symptoms do not improve with the elimination of gluten, the presence of other food sensitivities should be determined.

Possible contributors

Digestive enzyme deficiencies, a leaky gut wall, and overworked liver detoxification system or immune system are all-important factors in the development of food sensitivities. While some people may be more genetically at risk than others, modern-day contributing factors, such as the use of many common drugs or exposure to chemicals such as pesticides, overexposure to such environmental factors as stress, viruses, chemicals, drugs, alcohol, or surgery; and an excess consumption of gluten leaves us all susceptible to developing food sensitivities.9

Because of the complexity of this condition and the multiple nutritional factors involved, people with celiac disease should be under the care of a doctor.

References available upon request.