Monday, March 14, 2016

Gluten

Let's start with the most basic of questions. What exactly is gluten? 
Gluten is a mix of proteins in wheat and related grains including spelt, barley and rye. Wheat gluten consists of two major componts, gliadin and glutenin. Glutenin is responsible for the elasticity and strength of dough. Essentially, it's a naturally occurring, and normal protein in many of the foods we eat.

Given the fact that it is "all natural" in this first world climate of cleansing and clean eating, it's mind boggling how a naturally occurring plant protein is being avoided to the extend that gluten has been and continues to be. 

Obviously those with CD need to avoid gluten, all gluten, and all the time, because it elicits an immune response in them which destroys their gut lining, leading to other long term complications. But this does not make gluten a bad substance for the majority of the population.

The prevalence of Celiac disease (CD) in the USA was 0.71% according to a 2012 study. (1)


There is some evidence to suggest certain non-celiacs do suffer a type of non-celiac gluten sensitivity. This is an area that needs a lot more study. Non-celiac gluten sensitivity has been reported at 6% of the population.

A 2016 study provided some evidence towards this. Of 140 subjects enrolled in the study, 101 experienced improvement on a GF diet and of those subjects, 14% were found to have a NCGS. Limitations of the trial include the low subject numbers and self-reporting. (2)

Many people who avoid gluten do so without any real professional advice, and in a lot of cases, any real understanding of why they are doing so. It may be that they legitimately do suffer side effects from the food they eat, but health professionals are best at isolating the true cause of the gastrointestinal disturbances.

What could be worth investigating further in many of these NCGS individuals is FODMAPs as a cause of their symptoms and discomfort. This does not rule out wheat as a cause (which would still support the use of a GF diet (for simplicity sake). But it could actually identify other or alternative factors too. 

FODMAPs is the accronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols and I will discuss these as a future topic.


1. Am J Gastroenterol. 2012 Oct;107(10):1538-44; quiz 1537, 1545. doi: 10.1038/ajg.2012.219. Epub 2012 Jul 31.
The prevalence of celiac disease in the United States.
Rubio-Tapia A1, Ludvigsson JF, Brantner TL, Murray JA, Everhart JE.



2. PMID:
 
26867199
 
[PubMed - in process] 
PMCID:
 
PMC4772047

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