What exactly is gluten and why is there so much buzz around going gluten-free? Is it the latest fad diet or is there legitimate research backing up the claims to ditch the wheat?
Let’s start with the basics. The word gluten is Latin and translates to “glue”. Just like glue, it 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 and makes it chewy instead of crumbly. Think of taking a bite of a slice of freshly baked bread. That fluffy, light texture – that’s gluten at work.
The best-known source of gluten is baked goods, but gluten can also be found in:
- Soups and sauces, including soy sauce;
- Alcohol, including 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 sensitivity, the buzz around gluten and going gluten free builds.
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 or treatment other than to completely avoid gluten. Approximately 1%-3% of the population has celiac disease.
At the other end of the spectrum, you have people who can tolerate gluten with no issues at all.
Most of us lie somewhere between the two extremes.
When we eat a protein, our body breaks it down into single amino acids. These amino acids are then easily absorbed into the small intestine. In wheat, the most commonly ingested source of gluten, the part of gluten that gives the body so much trouble is a protein called gliadin. Gliadin is resistant to the enzymes our body uses to break down proteins, and after all the body’s digestive processes, gliadin remains intact.
It is this partial digestion that alarms our immune system. With the immune system armed and attacking gliadin, inflammation results. This inflammation is thought to cause celiac disease and non-celiac gluten sensitivity.
At this point, you may be thinking, “If eating gluten causes inflammation, shouldn’t everyone avoid it?”
However, inflammation due to an immune response is happening inside our 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 the damaged muscle tissue.
Inflammation becomes problematic when it continues without reprieve. Think of a celiac patient who still consumes gluten. The patient’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,
- Cramps and bloating.
There can also be a wide range of other, less common symptoms including:
- Brain fog,
- Itchy skin,
For more information on symptoms of celiac disease, both common and hidden, check out this post.
Non-celiac gluten sensitivity (NCGS) is the name of the disorder where symptoms similar to celiac disease are experienced, yet all testing for celiac is negative. While celiac disease affects between 1-3% of the population, NCGS is estimated to affect a much greater percentage. (1)
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. (2) 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. (3) 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. (4, 5)
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 the body can react to. Gluten is considered a storage protein and is a complex mixture of distinct proteins. (6) At the time of this writing, researchers have yet to uncover methods for testing the body’s reaction to all the gluten proteins. The majority of research looks specifically at the gliadin protein.
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. This was a time when our human civilization transitioned from the Paleolithic era (where we were hunters and gatherers) to a model that more resembles what see today. More specifically, we 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 two hundred thousand years ago. From that time they are thought to have been primarily hunter-gatherers – eating a varied diet of fruits, vegetables, and meats. Throughout that time our bodies – and the bacteria inside our guts – adapted to these food groups.
To contrast, wheat and other industrialized products have been in our diet for less than 1% of our existence on this planet.
This is one current hypothesis as to why we are collectively having challenges with wheat in our diets – our digestive tracts have not yet caught up (in an evolutionary sense) to the foods we eat in the modern world. Our bodies are only set up to digest fruit, vegetables, and meat.
2. The hygiene hypothesis
The hygiene hypothesis was first proposed by Dr. David Strachan in 1989 in an article in the British Medical Journal. (7) 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. In Finland, the prevalence of celiac disease was 1 in 107. (8) Both cultures shared similarities in genetic predispositions and consumption of grain products. The largest variable between the two cultures was the level of hygiene.
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.
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;
- Unexplained symptoms (for more detail please see this post).
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!
Do you follow a gluten-free diet?
How did your health change after going gluten-free?
Also published on Medium.