Gluten-free has become the way to be. The gluten-free market has boomed, in 2010 annual sales of gluten-free food products were estimated  to be $2.5 billion in the United State alone. It seems like everyone is talking about gluten and even worrying whether it is in their toiletries and cosmetics. Perhaps it’s because of the recent trend to “go green” and eat “organic”, that many people think that eating gluten is inherently bad for you. However, a gluten-free diet may not be necessary for you at all.

What is Gluten?

Gluten is a general name for a mixture of storage proteins found in wheat, rye, and barley. The group comprises of two types of protein; Glutenins (alcohol-insoluble) and Prolamins (alcohol-soluble). Prolamins are a group of proline and glutamine (amino acids) rich proteins that resist digestion in the stomach and intestine. The prolamins found in wheat, rye, and barley are gliadin, secalin, and hordein respectively.

History of Gluten Intolerance

Wheat is the primary source of food in industrialized and developing countries, and is the main source of gluten in today’s food. Wheat is commonly used to make breads, pastas, and cereals among other food products. Historically, celiac disease was considered a rare disorder(about 2 decades ago).  A genetic predisposition in some individuals caused them to become ill when they consumed food containing wheat. Gluten was found to be the culprit in wheat that was responsible for triggering celiac disease in a small portion of the population. These people were required to adhere to a strict gluten-free diet. As  a result, gluten free foods were produced and marketed targeting this populations. As knowledge that something in wheat could make someone sick spread, people began to associate gluten with being unhealthy or unsafe to consume. So much so that recently, the amount of people consuming gluten-free products has greatly  outnumbered the amount of patients affected by celiac disease.

The reason for this is, there are a number of gluten intolerances  that fall under the branch of Gluten-related disorders.  Among them are Celiac disease, Gluten Ataxia, Dermatitis herpetiformis, Wheat allergy, and Gluten sensitivity.

Celiac Disease, Gluten Ataxia, Dermatitis Herpetiformis

Celiac disease (CD), Gluten Ataxia (GA), and Dermatitis Herpetiformis (DH) are all autoimmune diseases triggered specifically by gluten. CD is characterized by an inappropriate T-cell mediated immune response that causes inflammation within the small intestine causing injury to the lining of the bowels. There can be no symptoms at all or gastrointestinal symptoms such as, chronic diarrhea, abdominal pain, weight loss, abdominal distention, and constipation. Symptoms can also occur in other parts of the body, causing fatigue, anemia, joint/muscle pain, epilepsy, and reduced bone mineral density. CD is detected by looking for certain biomarkers (specific indicators) in blood and by histological imaging of the small intestine to look for disorders in the appearance of tissue that signify injury.

Gluten Ataxia  involves the brain as well as the gastrointestinal system (stomach + intestines). Patients with this disorder will have cerebellar dysfunction, problems with gait, tremor, and shrinkage of the small bowel lining.

DH is a skin disease characterized by a blistering rash and deposits in the skin of the IgA antibody. Symptoms include blisters, papules, redness and swelling, followed by erosion of the skin and hyperpigmentation. Gastrointestinal symptoms are uncommon but can occur along with iron deficiency.

Wheat Allergy

Wheat allergy  is not an autoimmune response, but an allergic reaction. Unlike the three autoimmune gluten-related disorders it does not cause permanent G.I. damage. In persons with WA proteins in wheat can cause a food allergy,  respiratory allergy, or dermal allergy. Eating wheat can cause itching and swelling  in the mouth and throat, as well as life threatening anaphylaxis. Cramps, bloating, and diarrhea make up the G.I symptoms. Inhaling wheat dust  can cause wheezing and itching of the eyes, nose, and throat ( baker’s asthma/bakers rhinitis). Skin contact with wheat can cause a rash or swelling of the skin, but this is rare.

Gluten Sensitivity

Gluten sensitivity is better described as Non-celiac gluten sensitivity and  Non-celiac wheat sensitivity. This is the growing form of gluten-related disorder that is  defined as intolerance to gluten in the absence of celiac disease or wheat allergy. There are no biomarkers and therefore no  test to diagnose it. The only way to tell if you have it is, if your symptoms go away when you stop eating foods that contain gluten. There is no immune or allergic reaction associated with gluten sensitivity. Some researchers suspect that other components of cereals (wheat, barley, rye) like fermentable complex sugar may be the cause of intestinal and other symptoms.

Gluten-free diet

Gluten-free foods are made with starches or  refined flours (outer layer of grain is removed) and often have a low content of fiber, but high level of sugars, salts and trans-fat.

Wheat germ, wheat bran, whole wheat, cracked wheat, semolina, spelt, and triticate should be avoided. Any foods derived from gluten containing cereals (wheat, barley, rye) such as pasta, breads, crackers, malt, malt syrup, malt extract, malt flavoring, and beer should also be avoided.

Some naturally  gluten free foods that can also be used to substitute wheat, barely, and rye are; soybean, rice, millet, corn, buckwheat, and oats.  Since many people with gluten-related disorders also have vitamin deficiencies due to poor absorption of nutrients from the intestine, a balanced diets should be taken seriously. Potatoes, root crops, plain meat, fish, eggs, butter, milk, nuts, fruits, vegetables, seeds, and legumes are all permissible and necessary to maintain good nutrition in a gluten-free diet.

Summary

Gluten is  harmful to you only if you have a Gluten related disorder. Celiac disease is most harmful as damage is permanent, but symptoms of Gluten Sensitivity rapidly disappear once gluten is removed from the diet.  A gluten free diet is the only form of treatment for celiac disease and therefore lifelong adherence is necessary for those people. It is not possible for all gluten to be removed from some food products, but there are some foods that are naturally gluten free. A gluten-free diet should not be used as part of a fad or a get slim quick scheme. Being gluten-free has nothing to do with “going green” or eating organic. If you suspect that you have a gluten-related disorder you should consult with a doctor before removing gluten containing foods from your diet; this may make it difficult for your doctor to determine the cause of your symptoms.