What is gluten?
Gluten is a protein found in wheat, barley, rye, spelt, kamut, and oats. It is found in bread, pasta, wraps, bread rolls, pizza, biscuits, crackers, pastries, cereals and most processed foods. These foods are considered a staple in many people’s diet.
It is said that research for gluten sensitivities is where celiac research was 30 years ago. Research into non-celiac gluten sensitivity, also known as gluten intolerance, has increasingly been proving that you can get serious symptoms from gluten ingestion without having celiac disease. We now have the existence of a spectrum of gluten-related disorders. Research into this condition is in its infancy and not all doctors and other health professionals have accepted it as a real condition. The prevalence of gluten-sensitivity is estimated to be approximately 6% of the general population (six-fold more common than celiac disease).
Gluten Sensitivity (GS) refers to an adverse reaction to eating gluten that usually does not lead to damage of the small intestine. Only in the last few years have researchers verified and isolated the existence of a non-celiac gluten sensitivity.
There is no test for gluten sensitivity other then eliminating it for a period of time and re-introducing it back into the diet and observing any changes. Dr. Fasano hopes to eventually discover a biomarker specifically for gluten sensitivity. If you suspect you may be negatively affected by gluten it is recommended to have the appropriate tests to confirm that you don’t have celiac’s disease or a wheat allergy. If these are both negative then the elimination and re-entry of gluten test is recommended.
Here is more on the differences of Celiac Disease, Gluten Intolerance and Wheat Allergy.
What are symptoms of GS?
Many people associate gluten sensitivities with only IBS like symptoms such as bloating, flatulence, intestinal pain, discomfort, constipation and/or diarrhea. However, gluten has also been shown to cause many non-gastrointestinal symptoms.
The symptoms observed in gluten sensitivities may resemble those associated with celiac disease but with a prevalence of non-intestinal symptoms, such as bone and joint pain, muscle cramps, numbness, chronic fatigue, eczema, skin rashes such as hives, psoriasis, headaches/migraines, iron deficiency anaemia, other vitamin & mineral deficiencies, infertility, teeth enamel irregularities, ulcers, lactose intolerance, early onset osteoporosis, hair loss (alopecia), bruising easily, nosebleeds and night blindness.
Behavioural changes can also occur such as irritability, listlessness, mood disorders, poor concentration, foggy mind, depression and clumsiness (ataxia).
How a reaction to gluten could cause such a wide range of symptoms also remains unproven. Dr. Fasano and other experts speculate that once immune cells are mistakenly primed to attack gluten, they can migrate and spread inflammation, even to the brain. In some individuals, gluten sensitivity was shown to present only neurological dysfunction.
Dr. Fasano says he sees headaches and migraines and brain fog in about one-third of the people he has diagnosed with non-celiac gluten sensitivity (far more than in celiac disease).
Can gluten cause diseases?
A review paper in The New England Journal of Medicine listed 55 diseases that can be caused by eating gluten. These included IBS, inflammatory bowel disease, cancer and autoimmune diseases. Gluten is also linked to many mood and neurological diseases, including anxiety, depression, schizophrenia,dementia, migraines and nerve damage. Children can also be very easily affected by gluten causing the same symptoms as listed above. Gluten has even been implicated with worsening of autistic spectrum disorders symptoms in a small study but many parents have found a significant improvement following a gluten and casein free diet.
Gluten can cause health complications for many and you may be at risk even if you don’t have celiac disease. A large study in the Journal of the American Medical Association found that people with celiac disease or gluten sensitivity had a higher risk of death, mostly from heart disease and cancer. There was a 39% increased risk of death in those with celiac disease, 72% increased risk of death in those with gut inflammation related to gluten (but not celiac’s), and 35% increased risk in those with gluten sensitivity.
Why are so many people suffering with gluten intolerances and feeling better for eliminating gluten based products?
There are a few theories, one being that wheat today contains more gluten than it ever has previously in history and this is having a negative impact on our health. Gluten is a natural insecticide so farmers prefer super gluten strains of wheat as it requires less pest control and gives a higher yield at a lower cost. Gluten also gives baked goods their light fluffy, chewy texture and also contributes to its elasticity so the baked goods retain their shape well and provide a strong structure so the super gluten strains of wheat are popular with the food manufacturers and bakers. We are also eating more wheat based products than ever before, so many foods that we have been encouraged to consume are full of wheat and it is often used as a filler in soups, sauces and other food products so we are literally eating it all day in some cases. Here is a complete list of gluten containing foods on www.celiac.com.
Some grains such as spelt, rye and barley have lower levels of gluten and this can be why some people feel better for these alternate grains over wheat.