I’m Joining the Club!
When I found out a few weeks ago that I’m allergic to wheat, I jumped for joy. It was like my official invitation to the gluten-free club. I was no longer the “poser” I felt like up until that point. (Like: “Hi! I don’t eat gluten because… umm… it’s bad. Can I sit with you guys?”)
Indeed, the low-fat craze is slowly giving way to the gluten-free craze. But what exactly is gluten? It sounds so….nebulous. And what’s the difference between gluten sensitivity, allergies, and Celiac? What is happening? Is this a craze or a real thing? Let’s take a look.
WHAT IS GLUTEN?
Gluten is a large protein storage molecule found in grains. It is the main structural protein in wheat (the world’s most widely grown crop), but also makes appearances in other cereal grains such as rye and barley. Today’s wheat products have been technologically engineered to contain more protein, and thus more gluten along with it. Lovely.
Gluten also makes its way into most processed foods. Sneaky devil. Gluten gives bread extra chewiness, is used as a stabilizing agent, and serves as an additive for protein in processed foods. Basically, gluten is everywhere. “I didn’t know BBQ sauce would have gluten,” said my sister, when I offered her some gluten-free BBQ sauce. Yep. If it comes in a package and doesn’t say “gluten-free,” just assume a bit of gluten lurks inside.
Gluten is difficult for the body to digest, containing a toxic compound called gliadin. Gluten can yield digestive issues such as gas, bloating, and irritable bowel syndrome (IBS.) It can also create intestinal permeability, allowing food particles and toxins to leak into the bloodstream. (A condition known as “Leaky Guy”). Gluten easily sparks an immune response, causing the body to attack the gluten particles, and itself in the process. Associated issues from impaired digestion and/or Leaky Gut include digestive issues, skin problems and fatigue/irritability on the more benign end, to more serious conditions like rheumatoid arthritis, osteoporosis, and even cancer. Gluten has also been linked to psychiatric and neurological diseases such as depression, dementia, autism, and epilepsy.
The nomenclature regarding gluten issues is debated. I’ll break it down into 4 categories: Wheat Allergy, Celiac Disease, Gluten Sensitivity, and The Non-Sensitive. All share similar symptoms, although the mechanism of action, timing, and severity may differ.
1. WHEAT ALLERGY
For those allergic to wheat (i.e.: gluten), the body initiates an immune response, releasing IgE antibodies when in contact with wheat. Symptoms occur rather immediately (within minutes to hours). Wheat allergies may occur through food (dietary allergy), inhalation (“Baker’s asthma”), contact (“contact urticaria”), or even exercise after wheat consumption (“Wheat-dependent exercise-induced anaphylaxis“).
For those allergic to gluten, the immune response may lead to a variety of issues: skin (hives, rashes, eczema, dermatitis), gastrointestinal (digestive problems, gas, bloating, etc.), or respiratory (throat/voice issues, asthma). And in extreme cases: fatal anaphylaxis.
Population surveys are conflicting, but wheat allergies seem to occur more commonly in children (4-9%), and decrease with age (around .5-3% of adults).
2. CELIAC DISEASE
Beyond wheat allergy lies the darker, creme de-la-creme gluten reaction: Celiac Disease. With this autoimmune disease, the body mounts an intense immune response to gluten, ultimately resulting in enteropathy (inflammation of the intestine). It typically takes weeks to years after gluten exposure for the effects to become apparent, although some Celiac patients do react immediately with diarrhea, nausea, etc.
An inflamed intestine inhibits nutrient absorption and can result in intestinal problems like diarrhea, gas, bloating, vomiting, constipation, as well as extra-intestinal symptoms such as weight loss, malnutrition, fatigue, skin problems, anemia, osteoporosis, neurological disturbances, memory problems, infertility, cancer, and even death.
Approximately 1% of the population suffers from Celiac Disease, although recent studies indicate the percentage is rising, likely due to the global increase of wheat consumption. Sad day. (Although this encourages research on Celiac Disease, so that’s a silver lining)
3. GLUTEN SENSITIVITY
Approximately 10% of the population is estimated to be “Gluten Sensitive,” meaning they suffer an immune reaction to gluten, without an apparent allergic or autoimmune component. Those who are gluten sensitive may experience symptoms similar to those with a wheat allergy or Celiac disease, hours to days after exposure: digestive issues, abdominal pain, diarrhea, headache, bone or joint pain, muscle cramps, numbness, fatigue, “foggy mind,” depression, anemia, etc.
4. THE “NON-SENSITIVE”
Even if you’re not specifically sensitive to gluten, it’s still problematic. Gluten contains at least 50 “epitopes” which instigate T-cell responses (an immune reaction). The worst of these involves gliadin, which is completely resistant to digestion by the body’s enzymes. In vitro studies show gliadin wreaks havoc on cells, even before any allergic or immune response: it binds to them, inhibits cell growth, increases intestinal permeability, rearranges the cytoskeleton, alters enzymes in the esophagus, and instigates apoptosis (programmed cell death). As a 2011 gluten review notes, “All individuals, even those with a low degree of risk, are…susceptible to some form of gluten reaction during their life span.
WHAT TO DO???
Clearly, gluten is bad stuff. However, you don’t have to live in fear – you’re not alone! Whatever gluten clique you’re in (Wheat Allergy, Celiac, Gluten-Sensitive, or Non-Sensitive), a gluten-free diet is the way to go! (Of course, Paleo is, by nature Gluten-Free). Avoid the grains and bread at all cost, as well as processed foods. Look for “gluten-free” labels. Luckily, “gluten-free” is quite in vogue at the moment: in 2010, the gluten-free global market reached almost $2.5 billion (US) in sales. The current zeitgeist has also made it “cool” in a way to be gluten-free – a label “low carb” never seemed to achieved. Oh well, works for me.
So…which clique do you belong to?