What exactly is gluten?
And why is there so much buzz around gluten intolerance?
Is being intolerant to gluten even a real thing?
Even though a gluten-free diet is all the rage these days, there is legitimate research that stands behind the hype. Research that suggests yes, there are specific symptoms of gluten intolerance. And that gluten intolerance is a separate condition to celiac disease. But before we get into that, let’s start with the basics.
The word gluten is Latin and roughly translates to glue. Just like glue, gluten binds together whatever product it is added to. In baking, when gluten is activated with the addition of a liquid, it improves the product’s ability to rise and stay together.
Gluten is the magic ingredient that makes baking chewy and gooey instead of crumbly and messy. That fluffy, light yet kind-of gooey texture found in freshly baked bread, that’s gluten at work.
The best-known source of gluten is, of course, wheat flour. But gluten can also be found in:
- Soups and sauces, including soy sauce
- Alcohol, especially beer
- Salad dressings
- Imitation meats
- Candy and ice cream
- Cosmetics and hair products
- Medications and supplements
This list is by no means exhaustive. Gluten provides a reliable, smooth texture and is a dependable binding agent. Because of that, it is used in an enormous variety of everyday products.
However, as the use of gluten increases, so too does the incidence of celiac disease and gluten intolerance. As more people become aware of a potential gluten-related intolerance, the buzz around gluten and going gluten-free builds.
Is gluten intolerance real?
The best way to think of gluten-related illness is on a spectrum. At one end, you have celiac disease – an intense, autoimmune reaction that occurs when gluten is ingested. It is a genetically-linked illness with no cure. Fortunately, treatment is relatively straightforward – adopt a gluten-free diet. Approximately 1-3% of the population has celiac disease. (1)
At the other end of the spectrum, you have people who can tolerate gluten with no issues at all. Most of you will end up somewhere between the two extremes. Gluten won’t send you to the emergency room as it does to celiacs. But you probably won’t feel incredible after eating it either. Though you might not know that until you try a gluten-free diet for at least 30 days!
When you eat a protein, your body breaks it down into single amino acids. These amino acids are then easily absorbed through the small intestine. With wheat, the part of gluten that gives the human body so much trouble is a protein called gliadin. You can thank gliadins for their ability to help your loaf of bread rise.
But when it comes to digestion, gliadin doesn’t cooperate with your digestive tract. Gliadin is resistant to the enzymes your body uses to break down proteins. And after all the body’s digestive processes, gliadin remains intact.
It is this partial digestion that can alarm your immune system. With the immune system armed and attacking gliadin, inflammation results. This inflammation is thought to be behind both celiac disease and non-celiac gluten sensitivity.
Does everyone have a gluten intolerance?
At this point, you may be thinking, “If eating gluten causes inflammation, shouldn’t everyone avoid it?”
Not so fast. Inflammation due to an immune response is happening inside your body at all times.
Remember the last time you were sick?
Foreign invaders known as germs or pathogens made their way into your body. Your body’s immune system created antibodies to attack these pathogens. This inflammation then worked to clear the pathogens out of the body. The last time you exercised also created inflammation. Tiny tears in your muscles occur after exercise. Inflammation is needed to repair damaged muscle tissue.
These are healthy forms of inflammation. Inflammation becomes problematic when it continues without reprieve. Think of a celiac patient who still consumes gluten. This person’s immune system is continually creating inflammation in the small intestine. When inflammation runs out of control like this, damage to tissues or organs occurs. The activated immune system starts to inflame and destroy the intestinal villi and as a result, the body is unable to absorb nutrients. Common symptoms of celiac disease include:
- Weight loss
- Cramping and bloating
- Brain fog
- Itchy skin
For more information on symptoms of celiac disease, both common and hidden, check out this post.
Are you sufficiently confused at this point?
Keep reading, I’ll help you understand the difference between celiac disease and gluten intolerance!
The difference between celiac disease and gluten intolerance
Non-celiac gluten sensitivity (NCGS) is the name of the disorder where symptoms similar to celiac disease are experienced, yet all the tests for celiac disease are negative. While celiac disease affects 1-3% of the population, NCGS is estimated to affect a much greater percentage. (2)
Research into the prevalence of non-celiac gluten sensitivity still needs to be done. However, one early study done in New Zealand found that 5% of children avoided gluten even though they were not celiac. (3) This is suggested to be partially due to the prevalence of abdominal complaints.
Recent thinking correlates irritable bowel syndrome (IBS) with non-celiac gluten sensitivity. In Canada, there are more than 5 million people with IBS. (4) Two studies examined whether those diagnosed with irritable bowel syndrome had non-celiac gluten sensitivity. Between 28-30% of participants with IBS-like symptoms suffered from gluten sensitivity or hypersensitivities to multiple foods, including wheat. (5, 6)
This preliminary research suggests that non-celiac gluten sensitivity is far more prevalent than celiac disease.
To further complicate the study of gluten-related illnesses, there are more proteins than just gliadin that your body can react to. Gluten is considered a storage protein because it is a complex mixture of distinct proteins. (6) At the time of this writing, researchers have yet to uncover methods for testing your body’s reaction to all the proteins found in gluten. The majority of research looks specifically at the gliadin protein.
Why is it that gluten causes so many issues to the human gut?
Why humans develop gluten intolerances
We do not know why gluten affects us the way it does. There are theories, but these have yet to be conclusively proven. For a deep dive into why gluten affects so many people, please see this post. Two of the more promising theories are explored below.
1. The human digestive tract has not evolved to consume wheat and grains
If we turn to our evolutionary heritage, it paints an interesting picture of wheat in the context of the human diet. The agricultural revolution occurred from 1750 to the 19th century. (7) This was a time when human civilization transitioned from the Paleolithic era (where we were hunters and gatherers) to an environment that more closely resembles modern society. More specifically, humans transitioned from eating seasonal fruits/vegetables and meat to agricultural crops – specifically wheat and wheat-related products.
It is currently estimated that Homo Sapiens (the modern form of humans) evolved some three hundred thousand years ago. (8) For the majority of human history, Homo Sapiens are thought to have been primarily hunter-gatherers. Your ancient ancestors likely ate a varied diet of seasonal fruits, vegetables, and meats. Throughout that time, the human body and the bacteria inside the human digestive tract adapted and evolved to flourish on these food types.
To contrast, wheat and other industrialized products have been in the diet of Homo Sapiens for less than 1% of human existence on this planet.
This is one current hypothesis as to why wheat continues to create so many issues in the human GI tract. The digestive tracts of Homo Sapiens have not yet caught up – in an evolutionary sense – to the foods consumed in modern times. There is intense evolutionary pressure to consume foods humans ate for the majority of their existence on this planet. There’s relatively no time – from an evolutionary sense – that humans have had to learn to digest foods like Jujubes.
2. The hygiene hypothesis
The hygiene hypothesis was first proposed by Dr. David Strachan in 1989 in an article in the British Medical Journal. (8) He suggested that exposure to infections and/or unhygienic conditions early in life conveyed protection against the development of allergies.
The original hypothesis has been expanded in recent years. Some researchers feel that the modern household’s commitment to sanitation and cleanliness plays a role in the increase in allergic reactions. A Finnish study compared the prevalence of celiac disease in a poorly developed town in Russia to an adjacent, modern Finnish community.
In Russia, the prevalence of celiac disease was 1 in 496. That’s only 0.2% – far less than the global average of 1-3% In Finland, the prevalence of celiac disease was 1 in 107. (9) That’s just shy of 1%. Or, right in line with the global average.
Both cultures shared similarities in genetic predispositions and consumption of grain products. The largest variable between the two cultures was the level of hygiene. Finland is thought to have much higher levels of excessive cleanliness than Russia.
While the hygiene hypothesis seems like it may play a role, most researchers feel this explanation is far too simplistic. The development of both celiac disease and gluten sensitivity involves many genetic and environmental factors. It is unlikely both are caused solely by hygiene.
Are you gluten intolerant?
So, should you avoid gluten?
Absolutely – if you have:
- A family history of celiac disease.
- A family history of autoimmune disease.
- Symptoms of or a diagnosis of irritable bowel syndrome.
- Strange, unexplained symptoms or conditions like chronic fatigue or fibromyalgia.
If you don’t fall into the above categories but still feel that gluten is affecting you, try a gluten-free diet for 30-60 days. Please keep in mind that during this time you will need to be 100% diligent at removing gluten from your diet. For a detailed list of all the foods/places gluten hides, please see this post.
Ok, now that you know the gluten basics I want to hear from you!
How did your health change after going gluten-free? What symptoms made you suspect you had a gluten intolerance?
Leave your answers in the comments section below!
Also published on Medium.