Unfortunately for some of us, we can no longer enjoy our favorite
foods because of gluten. Yes, I am one of those poor souls. “Why?!” is a
question I frequently ask when I see warm fresh bread, or when my friends want
to go to Oktoberfest while I can’t drink any of the beer. Gluten sensitivity is
a complex problem, and relates to the way our bodies react to the proteins in
food, which continue to change and evolve as a result of industrialization.
What is gluten?
Gluten may have gotten a bad rap recently, but what exactly is it? Gluten is what gives dough its elasticity and helps it keeps its shape. It is a protein composite, meaning it is made of two proteins that are conjoined. These proteins are gliadin and glutenin. When gluten is digested, it splits back apart.
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Gluten is found mainly in wheat, but also in other grains like barley and rye. Because of its elastic and thickening properties, it is often found in imitation meats, some ice cream, and condiments like ketchup, and soy sauce. This often leaves us gluten-challenged people feeling discouraged in restaurants and grocery stores.
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What are celiac
disease, gluten intolerance, and wheat allergy?
Gluten sensitivity is a blanket term that covers a broad
range of conditions. Celiac disease is the most severe sensitivity and is more
rare than gluten intolerance. Most people who have gluten sensitivity have
gastrointestinal symptoms, particularly those with celiac disease. However,
some people have non-digestive symptoms like fatigue, headaches, eczema, and
depression. The chart below shows the range of symptoms reported from
gluten-sensitive patients.
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| Figure taken from Nature Reviews paper |
Many of these symptoms have traditionally been diagnosed as
irritable bowel syndrome, thyroid issues, or other autoimmune disorders.
Recently as more research has been done, doctors have realized a diet high in
gluten is part of some of the medical problems that have been on the rise.
Celiac disease, gluten intolerance, and wheat allergy are
characterized by two different responses to gluten. People with celiac disease
have an autoimmune reaction to the gliadin protein, meaning their bodies tell
the immune system to attack itself. In the case of celiac disease, it targets the
lining of the small intestine (villi). This can cause unpleasant digestive
systems and may even lead to malnutrition and cancer. Celiac disease is
diagnosed through an intestinal biopsy that shows damage done to the villi.
About 1 in 133 people have celiac disease, but many have not yet been diagnosed.
Celiac disease is a permanent condition, and gluten must be strictly avoided
for those who have it in order to reduce its effects.
Non-celiac gluten sensitivity, or gluten intolerance, is a
relatively new diagnosis. Causes and symptoms are still being researched. It is
hypothesized that gluten intolerant people have an immune response to gluten in
contrast to an autoimmune response like those with celiac disease.
This means that the body attacks the gluten protein (or one of the components),
the way that it would attack a bacteria or virus if you had a cold or infection.
The result is inflammation inside and outside of the digestive tract, which
explains why people who are gluten intolerant tend to have more non-digestive
symptoms (rashes, headaches, and depression). It is estimated that about 5-10%
of the population has gluten intolerance and it is not known if it is permanent
or not. Typically, non-celiac gluten sensitive people should not eat gluten
containing products, but do not need to be as cautious about cross-contamination
with gluten.
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Having an allergy to wheat is not a form of gluten
sensitivity, but exhibits some of the same symptoms. It is a reaction to one of
the proteins found in wheat. An allergy is a
different type of immune response to a protein. The gliadin protein is not one
of the common allergenic proteins, so one of the other
components in wheat generally causes an allergic response. The body identifies the protein as harmful and sends an
increased amount of white blood cells into the body to fight it, which is what
triggers the reaction. Food allergies
are usually more severe than sensitivities, and contact with wheat should be
avoided, but other gluten containing grains are okay.
Going gluten free simply for weight-loss is not generally
recommended. A gluten-free diet can leave people nutrient-deficient, especially
if they only substitute gluten-free products for regular ones. More likely,
people who experience weight loss on a gluten-free diet, do because they are
cutting excess calories from complex carbohydrates. This article originally posted on LiveScience goes over the reasons gluten
free dieting can be problematic, and ways to diagnose celiac disease and gluten
intolerance.
Why wasn’t gluten a
problem 100 years ago?
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As we know, the way that we grow and process food has
dramatically changed over the course of several decades. New variants of wheat,
however, have been produced as a product of selective breeding with a process
called hybridization that has been used for hundreds of years, which is
discussed in my GMO post. This has resulted a different wheat structure
than 100 years ago. Farming using machines and increased use of pesticides and
fertilizers may also be the cause of some adverse reactions.
In addition, people are consuming more gluten today. To
increase output, the process of bread leavening has become shorter, which
increases the concentration of gluten proteins in many bread products.
Additionally, there has been an increase in the amount of wheat and gluten that
people are consuming because of an increase in consumption of processed foods. This
factor, along with a greater understanding and ability to diagnose gluten
sensitivity has contributed to the increased number of cases in recent years.
If you find that you have gluten sensitivity, there are many
recipes and products available for gluten free living to make the transition
easier. And lucky for me, I live in a city with many gluten-free options for
foods I used to love like pizza. I have even come across some pretty good
gluten-free beers! I’ll cheers to that!
References:
Volta, Umberto, and Roberto De Giorgio. "New understanding of gluten sensitivity." Nature Reviews Gastroenterology and Hepatology 9.5 (2012): 295-299.
