Wander around your local Walmart or any other major supermarket and you will no doubt see aisles overflowing with gluten free products. Famous brands like Kellogg’s, Sara Lee, and Quaker have all jumped on the bandwagon and now make many gluten free alternatives. A recent survey by NPD research found that nearly one-third of Americans questioned planned to reduce or completely cut gluten from their diet.(1)
The gluten free diet may seem the latest in a long line of trendy diets like the Atkins diet, Paleo diet, or The F-Plan. For somebody who suffers from celiac disease or is non-celiac gluten sensitive, gluten free is not just a passing fad, it is an essential way of life. But what exactly is gluten and should we really be cutting it from our diet if we don’t suffer any medical intolerance it?
The Anatomy of Gluten
At its simplest form, gluten is the name given to a family of proteins found in grain like wheat, rye, barley and oats. Derived from the Latin word for glue, gluten proteins when mixed with water create a glue-like stickiness. This glue-like property gives elasticity to the dough and enables bread to rise when baked giving a satisfying chewy texture.(2)
Gluten protein is made up of two smaller proteins known as peptides. One of the peptides is glutenin and the other peptide is the harmful one responsible for the development of celiac symptoms. In wheat this harmful peptide is called gliadin, in rye it is secalin, hordein in barley, and in oats it is avenin. These grains are often referred to by the acronym WBRO in the order of their toxicity, as coined by the Celiac Sprue Association of the USA.
Celiac disease can be triggered by any of the four grains, but normally when referring to gluten, people most likely mean wheat gluten. Gluten makes up 80 percent of the protein in wheat. Gliadin, the harmful peptide found in wheat, is responsible for most of the negative health effects of gluten.(3)
The benefits of gluten in baking
Gluten is often called the building block of bread. As well as providing elasticity to bread dough, gluten also helps trap the oxygen released by rising agents like yeast or baking powder. When baking, the oven heat sets the gluten which ensures the product keeps it shape. That light airy texture to the bread is assisted by the gluten.
In addition to the gluten proteins found in the grain, extra gluten can sometimes be added. This extra gluten is obtained by washing the starch and bran out of a wheat flour dough until the water runs clear. This lump of 100 percent gluten can then be milled into a flour.
To a baker, additional gluten can supplement the gluten proteins already naturally present in wheat and add strength to a dough. Extra gluten can also increase oxygen retention and elasticity, which can help give breads a good structure and uniform shape. More gluten also improves water retention and absorption which can improve the softness and extend the shelf life of the bread.
Other uses of gluten in food
High quality pasta is normally made from just water and semolina flour produced by 100 percent durum wheat. A high protein and strong gluten count are required to make solid pasta. Sometimes gluten from other wheat flours is added to semolina to make a dough more suitable for pasta doughs.
Gluten is also used in many foods you wouldn’t expect. Often, sauces and gravies use the gluten in wheat flour to thicken them up.
Gluten is even used to enrich some processed meats. The binding and enrichment qualities of gluten are widely used in beef, pork, chicken and many pizza toppings.
Why is Gluten Bad for Some People?
Most of us love the effects of gluten without even realizing it. Bread without gluten can often be dense and more crumbly. It lacks that light airy texture we become accustomed to and often goes stale very quickly.
While most of our bodies can tolerate gluten, for some people with certain health conditions, gluten can cause major problems including celiac disease, gluten sensitivity, wheat allergies, and some other diseases.(4)
Celiac disease
Celiac disease, also known as celiac sprue is the most commonly known and most severe form of gluten intolerance. The most recent figures show that 0.71 percent of the US population are known to suffer from celiac disease but there is evidence that many cases are undiagnosed.(5)
Celiac is not just a severe allergy, it is an autoimmune disorder where the body treats gluten like an unwanted trespasser. In addition to attacking the gluten, the immune system also attacks the gut, flattening tiny protrusions called villi along the inner intestine wall. This damage to the gut can reduce the body’s ability to absorb important vitamins, proteins, sugars and other key nutrients. Long term effects can include intestinal cancer and diabetes.(6)
Common symptoms of celiac disease can include gastrointestinal problems like bloating or diarrhea as well as headaches, tiredness, skin rashes, and weight loss. Sometimes people with celiac disease do not show the digestive symptoms which can make it very hard to diagnose. A recent report stated up to 80 percent of people with celiac disease are not even aware they have it.(7)
Gluten Sensitivity
A few years ago, an international group of celiac experts declared that people can suffer from something other than celiac disease – Non-Celiac Gluten Sensitivity (also sometimes referred to as gluten sensitivity).
Non-Celiac Gluten Sensitivity isn’t well-understood, other than the fact that a reaction can occur nearly 48 hours after consuming gluten. It’s not an autoimmune reaction or an allergy, it doesn’t damage the small intestine, and there’s really no solid test that can prove its existence.
To be diagnosed with NCGS, a person has tested negative for celiac disease and a wheat allergy, but they still experience a reaction after consuming gluten. When gluten is removed from the diet completely and improvement is seen, a person can then be diagnosed with gluten sensitivity.
A lot of people realize that once they cut out gluten-containing foods from their diet, a lot of their uncomfortable symptoms improve. This could include anything such as recurrent abdominal pain, bloating, constipation, diarrhea, chronic fatigue, painful joints, skin rashes, or more.
Despite this little protein being so popular (or unpopular), there just isn’t an abundance of research about it at this point in time.
When Did Gluten Become Such a Major Issue?
The Greek physician Aretaeus of Cappadocia was found to have written about “The Coeliac Affection” as early as 250 AD.(8) Insufficient access to many foods, especially wheat, after World War II caused a Dutch pediatrician to notice that fewer children were suffering symptoms with celiac disease.
When Dr. Willem-Karel Dicke published his paper in 1941 observing the effects of a wheat-free diet in celiacs, many doctors started to link gluten to the various symptoms of celiac disease.(9)
Celiac disease was still thought of as a food allergy until the 1970s when scientists realized it was an autoimmune disorder, causing the immune system to attack its own intestines upon gluten entering the body.(10) It was still though at this stage that only the health of a person with celiac disease could be impacted by gluten.
The 1980s saw research published on the more controversial condition of gluten sensitivity, often referred to as non-celiac gluten sensitivity. Although having many of the same symptoms as celiac disease, gluten sensitivity doesn’t internally attack the body’s own organs. Many researchers have argued that this could be something other than gluten as following a gluten free diet may have cut out other proteins from wheat which may be the problem.(11)
Gluten in the US Today
As late as the mid 1990s, many doctors and researchers still didn’t recognize a significant amount of celiac cases in the US. In 2003, a study by Alessio Fasano, the director of Celiac Research and Treatment at Massachusetts General, showed celiac disease to affect one percent of the US population.(12) This figure was ten times higher than previously thought and sent the medical research into overdrive in the US.
Every week seemed to produce a new study on gluten sensitivity suggesting that a gluten-free diet may benefit many patients with various health issues. Studies showed there was maybe a link between gluten and schizophrenia (13) with other reports showing an association between gluten and autism (14). Gluten-free diets were said to benefit many patients from diabetics and multiple sclerosis sufferers to individuals who showed signs of autism and schizophrenia.
As medical research preached of the benefits of gluten-free diets, gluten gained its own celebrity status with many Hollywood stars and entertainers starting to extol the virtues of cutting gluten from their lifestyles.
Gluten and its Celebrity Status
Singer and actress Miley Cyrus was one of the first celebrities to jump aboard the gluten-free train that was hurling through the celebrity world. In 2012 she tweeted “Gluten is crappp anyway” and how she had lost weight from following a gluten-free and lactose-free diet.(15)
Many other celebrities including Victoria Beckham, Lady GaGa, Katy Perry and Kourtney Kardashian, to name but a few, have all come out as following a gluten-free diet.
For some like Victoria Beckham, the choice to go gluten-free is an attempt to lose weight and stay in shape but for others like New Girl star Zooey Deschanel, it is a health choice as she suffers from celiac disease.
Gwyneth Paltrow who has openly admitted to always being into the latest health kicks and cleanses (16) has even published a collection of gluten-free recipes in her new cookbook, It’s All Good.
It would be easy to dismiss the growing popularity and increasing numbers of gluten sensitivity on a fad caused by popular culture, but for people who are diagnosed as celiac disease sufferers, a gluten-free diet is essential. Some experts argue that changes in wheat can explain the rise of celiac disease and gluten sensitivity, but this view is not shared by a majority of doctors.
Gluten + Modern Wheat
William Davis, a cardiologist from Milwaukee, released the best selling book Wheat Belly described wheat as:
“The most destructive thing you could put on your plate, no question.” (17)
Davis goes on to explain his theory that modern varieties of wheat are to blame for the doubled number of cases in celiac disease in the last 20 years.
While it is true that in the last 40 years, breeders have created new varieties of wheat to increase a farmer’s grain yields, research has found no evidence of higher levels of gluten in wheat from the latter part of the 20th century. (18) Although wheat is definitely different nowadays, it may be other factors like the amount of wheat vital gluten per capita intake or variations in diets that have led to an increase in gluten intolerance.
Other factors which could explain the growing intolerance of gluten could be better awareness and diagnosis or other proteins and carbohydrates in wheat which are also removed from your diet when going gluten-free. One popular theory is the hygiene hypothesis which states that because our environment has become so clean and sterile, our immune system has weakened. Often the body can overreact to many things which should be harmless including peanuts or wheat.
Should We All Go Gluten Free?
The avoidance of gluten is big business in the US. A survey by the Mayo Clinic found nearly 3.1 million people across the United States follow a gluten-free diet with 72 percent of them having never being diagnosed with celiac disease. Sales of gluten-free foods reached an estimated $11.6 in the US in 2015 with over 10 percent of restaurants offering gluten-free options.(19)
If you want to try a gluten-free diet there are certainly plenty of options available. Although cutting out gluten is the only known treatment for celiac disease, for the 99 percent of us who can tolerate gluten, going gluten-free could be an unnecessary and expensive exercise. Researchers who compared the price of 56 standard grocery products with their gluten-free alternatives, found the gluten-free products to be an average 242 percent more expensive.(20)
Cutting gluten from your diet could actually cause weight gain rather than loss as many products add extra fats or sugars to compensate for the missing elasticity and binding qualities of the missing gluten.
A gluten-free diet can also be lower in many essential nutrients and fibers and can lead to deficiencies in Vitamin B, folic acid and iron. The lack of fiber so prevalent in grains could lead to an increased chance of heart disease.(21) Gluten-free diets can also feature large amounts of rice and rice flour which can increase toxic metals in your digestive system, as rice often absorbs arsenic and serum mercury from the soil.(22)
Gluten: Friend or Foe?
For somebody who suffer from celiac disease, gluten is definitely a foe. Following a gluten-free diet is as important for a celiac sufferer as insulin is to many diabetics. Unlike most drugs in other diseases, cutting out gluten can have a 100 percent success rate with celiac disease.
Gluten may not contain unique nutrients we cannot get from other sources, but for those of us not intolerant, gluten be a useful part of our diet. The fibers and amino acids provided can help with digestive functions and can improve cardiovascular health. Going gluten-free may not cause you major health issues, but as with all major dietary changes it is advisable to check with your doctor first. In the case of a gluten-free diet, it may also be worth checking with your bank manager too!
Sources:
- https://www.npd.com/perspectives/food-for-thought/gluten-free-2012.html
- https://www.ncbi.nlm.nih.gov/pubmed/11368646
- https://www.ncbi.nlm.nih.gov/pubmed/8783747
- https://www.ncbi.nlm.nih.gov/pubmed/22313950
- https://www.ncbi.nlm.nih.gov/pubmed/22850429
- https://www.ncbi.nlm.nih.gov/pubmed/25702766
- https://www.ncbi.nlm.nih.gov/pubmed/22850429
- https://www.cureceliacdisease.org/wp-content/uploads/SU07CeliacCtr.News_.pdf
- http://i2.cdn.turner.com/cnn/2017/images/02/28/williamdickeglutenfree.pdf
- https://www.ncbi.nlm.nih.gov/pubmed/346327
- https://celiac.org/celiac-disease/understanding-celiac-disease-2/non-celiac-gluten-sensitivity-2/
- https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/215079
- https://www.ncbi.nlm.nih.gov/pubmed/16423158
- https://www.ncbi.nlm.nih.gov/pubmed/22564339
- https://twitter.com/MileyCyrus/status/189209905415192578
- http://okmagazine.com/get-scoop/gwyneth-paltrow-shares-how-going-gluten-free-changed-life-her-family/
- http://www.npr.org/sections/thesalt/2013/09/26/226510988/doctors-say-changes-in-wheat-do-not-explain-rise-of-celiac-disease
- http://pubs.acs.org/doi/full/10.1021/jf305122s
- http://www.mintel.com/press-centre/food-and-drink/half-of-americans-think-gluten-free-diets-are-a-fad-while-25-eat-gluten-free-foods
- https://www.ncbi.nlm.nih.gov/pubmed/18783640
- http://www.bmj.com/content/357/bmj.j1892?gclid=Cj0KCQjwvOzOBRDGARIsAICjxodVZSVT475pITmcQfjiNvVjUWJ_bZusviFYxR92cyRV6-uM3gsFgfQaAvcqEALw_wcB
- https://www.ncbi.nlm.nih.gov/pubmed/28223206
This is one section of our gluten free guide. Check out the other installments below:
- The Ultimate Guide To A Gluten Free Diet
- Gluten Intolerance vs. Celiac (What’s the Difference?)
- Gluten Free Food List
- What Does Gluten Free Mean?
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