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What’s the Deal with Gluten? – Veestro

Introduction

Wheat gluten was one of the earliest proteins to be studied scientifically, by Jacopo Beccari (Professor of Chemistry at the University of Bologna) in his article “De Frumento” (Concerning Grain) in 1745 (1, 2). It has since been studied in great detail by cereal chemists, because of its role in underpinning the ability to make leavened bread, other baked goods, pasta, and noodles. These properties are only shared to a very limited extent by related cereals (barley and rye). Hence, gluten underpins the production of staple foods for a substantial proportion of the global population, particularly in temperate zones.

Although gluten was identified as the trigger for coeliac disease almost 70 years ago (3), interest in gluten outside the scientific community was limited to those unfortunate enough to suffer from coeliac disease until early in the present century, which has seen an explosion of interest, particularly in the popular press and social media. As an example, a “Google” search carried out in December 2018 gave almost 400 million hits in less than a minute. This interest relates, of course, to the proposed role of gluten in triggering a range of adverse reactions, with substantial proportions of the population in many countries choosing to adopt a gluten-free, or low-gluten, diet. However, despite this massive interest few people have a clear understanding of gluten itself: what is it, what is the origin, why is it special?

This article, which forms part of the Special Research Topic “Gluten, from Plant to Plate: Implications for People with Celiac Disease,” therefore, provides a broad account of wheat gluten including its synthesis and deposition in the developing grain, the structures, and evolutionary relationships of its component proteins, and its unique properties which are exploited in grain processing, focusing on features which are relevant to its role in triggering coeliac disease. It does not cover other impacts of wheat proteins on human health, notably allergy, and non-coeliac gluten sensitivity (NCGS) which are discussed in other recent review articles (4, 5).

Gluten Intolerance Symptoms

Damage done by gluten-related disorders, including celiac disease and NCGS, goes beyond just the gastrointestinal tract. Recent research over the past several decades suggests that gluten intolerance symptoms show up in almost every system within the body: the central nervous system (including the brain), endocrine system, cardiovascular system (including the health of the heart and blood vessels), reproductive system and skeletal system.

Because gluten intolerance can lead to autoimmune reactions and increased inflammation levels (the root of most diseases), it’s associated with numerous diseases. But the problem is that many people fail to attribute these symptoms to an undiagnosed food sensitivity. Gluten sensitivity symptoms also get ignored and they persist as no dietary changes are made by the person unknowingly suffering with a gluten sensitivity. What are the first signs of gluten intolerance? It’s time to take a look at this gluten intolerance symptoms checklist.

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What Foods Can You Eat on a Gluten Free Diet?

Eating a gluten-free diet may be easier than you think. The following foods are all naturally gluten free:

  • Fruits and veggies
  • Meat and fish
  • Beans and lentils
  • Nuts and seeds
  • Eggs and dairy
  • Healthy fats (i.e., coconut oil and olive oil)
  • Non-gluten grains (i.e., millet, quinoa, rice, amaranth, and corn)

Essentially, all whole, unprocessed foods except wheat, rye, and barley are naturally gluten free. Thus, the possibilities are endless!

7. Autoimmune Reactions in People Without Celiac Disease

Point #6 above gave a lot of reasons why celiac disease is associated with other autoimmune diseases, but it’s not limited to people with celiac disease. If you thought non-celiac gluten sensitivity was unrelated to autoimmune disease, you thought wrong! This study found that a lot of people with non-celiac gluten sensitivity have autoimmune markers in their blood, suggesting that the wheat exposure might be causing autoimmune issues even without celiac disease.

One interesting aspect of this is that patients with non-celiac gluten sensitivity may have a different type of autoimmune reaction, which just underlines that celiac disease and non-celiac gluten sensitivity are two different things. But the point is that both involve potentially serious autoimmune responses.

Conflict of Interest Statement

The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Gut-Brain Axis

But the potential effects of gluten don’t end there. The gut has its own nervous system and produces more neurotransmitters (i.e., serotonin) than your brain. This means the intestinal nervous system is in constant contact with the central nervous system.

Thus, if the gut is compromised, the brain may be negatively affected and vice versa. This explains why many brain-related symptoms and conditions (i.e., depression, anxiety, autism, and ADHD) are associated with digestive dysfunction.

Easily contaminated foods:

  • Oats – look for oats that are specifically labeled gluten-free
  • Pizza – pizzerias that offer gluten-free crusts sometimes do not control for cross-contact with their wheat-based doughs
  • French fries
  • Non-certified baked goods – e.g., “gluten-free” goods from otherwise gluten-containing bakeries

3. Increased Intestinal Permeability

Inflammation in the gut contributes to a problem called intestinal permeability. The gut has a very complex system of “border control” that lets digested food into your bloodstream (this is how you get nutrients from it) while keeping everything else out. Every day, you swallow millions of random viruses, bacteria, indigestible molecules like dust, and other stuff that needs to go out the other end, not into your bloodstream.

Inflammation in the gut messes up that system of border control. It loosens the junctions between cells in the gut wall so too much stuff can pass through. This is often described as making the gut “leaky” (hence the popular name of “leaky gut”).

On top of inflammation leading to increased permeability, gluten accelerates this process by stimulating the release of a protein called zonulin. Zonulin independently contributes to loosening the junctions between cells in the gut. Add together the inflammation and the zonulin, and wheat has a powerful effect on gut permeability, which is really a problem.

Intestinal permeability is a big problem – most notably because it’s an essential factor in the development of autoimmune diseases.

Distilled Beverages And Vinegars

Most distilled alcoholic beverages and vinegars are gluten-free. These distilled products do not contain any harmful gluten peptides even if they are made from gluten-containing grains. Research indicates that the gluten peptide is too large to carry over in the distillation process, leaving the resulting liquid gluten-free. However, some types of alcoholic beverages do contain an unsafe amount of gluten for people with celiac disease, and include those with added color or flavoring such as dessert wines, and those made from barley malt, such as bottled wine coolers. For these, consumers should check the label, and if in doubt, contact the company. Beers, ales, lagers, malt beverages and malt vinegars that are made from gluten-containing grains are not distilled and therefore are not gluten-free. There are several brands of gluten-free beers available in the United States and abroad.

Interaction With Fat

In baking, fats interfere with gluten development process. Cookies are more crumbly than bread because they've got more fat in them. What happens is that the fat molecules surround and literally shorten the strands of gluten so that they can't stretch out as much. That's where we get the name "shortening" as well as shortbread cookies.

Gluten and Leaky Gut

If you’ve heard of leaky gut, you’ve likely heard it in connection with gluten. Leaky gut is a simple term that literally means that the gut allows potentially harmful substances to leak through it and enter the bloodstream. It has a more sophisticated name, which is intestinal permeability. 

In a healthy gut lining, there are tight junctions between the cells that prevent harmful substances from leaving the intestines. If these tight junctions get damaged, they leak bacteria and toxins into the blood, causing widespread inflammation.  

Gluten activates a protein called zonulin that regulates the tight junctions of the intestinal wall. Zonulin can increase the permeability or leaking of these tight junctions, but this may only be a problem for individuals with Celiac Disease or other intestinal issues like irritable bowel syndrome (4).

In a healthy person, it is questionable how much of an effect gluten has on leaky gut. Yet, it opens the question of whether or not you should avoid gluten. 

Problems with gluten digestion

Gluten-free diet is a diet in which gluten-free foods are consumed. This type of diet is not only part of the treatment for celiac disease, but it is related to several diseases and intolerances.

Celiac disease

Celiac disease is a serious autoimmune disease in which small intestine cells are invaded by the immune system. This reaction occurs in gluten digestion and affects approximately 1% of the world’s population. The cause of this disease is still unclear, but there is conclusive evidence of its genetic predisposition. [5]

In the US, about 1 in 133 people suffer from celiac disease,  representing approximately 2.5 million people of total population of 331 millions. The only way to treat celiac disease is a strict gluten-free diet. Celiac disease is not only a limitation in gluten consumption, but insufficient absorption of nutrients into the bloodstream leads to anemia, weight loss or delayed growth. Besides the irritation of the small intestine, gluten consumption in celiacs causes several other complications [8] [9]:

  • osteoporosis
  • multiple sclerosis
  • sterility
  • thyroiditis

Non-celiac gluten sensitivity

It is a manifestation of increased sensitivity to gluten, which has several negative manifestations similar to celiac disease, but the test results did not show celiac disease or wheat allergy. For this type of sensitivity, the abbreviated name NCGS (non-celiac gluten sensitivity) is used. The discovery of NCGS occurred in the 1980s, and its findings can be compared to the knowledge of celiac disease 40 years ago. There is currently very little information about this type of intolerance and the only way to eliminate sensitivity is to completely eliminate gluten from the diet. Clinical presentation can be multisystemic and there is a wide variety of NCGS-related manifestations. For better orientation, we present a chart of some manifestations of non-celiac gluten sensitivity according to their frequency [5] [10]:

Frequency
Intestinal manifestations
Extraintestinal manifestations
very common
bloating
 
abdominal pain
lack of well-being fatigue
common
diarrhea epigastric pain (upper abdomen below ribs) nausea constipation
Headache anxiety foggy mind joint and muscle pain
unspecified
weight loss anemia depression rhinitis / asthma

Approximately 18 million Americans suffer from one form of gluten intolerance or non-celiac gluten sensitivity. Symptoms of intolerance include bloating and flatulence, diarrhea, fatigue, rashes and so called brain fog. [9] 

Wheat allergy

Wheat allergy is not directly about gluten intolerance , although it is a very similar condition. It’s an allergy to wheat itself, not just gluten proteins. The difference from celiac disease is in the explicit problem with wheat, where the allergic person can consume gluten from other sources such as barley. Gluten-free diet is a possible way of eating in these difficulties because wheat is one of the most common sources of gluten. [5] [11]

How do you recognize gluten intolerance?

Gluten intolerance brings with it a wide range of manifestations. Digestive problems are the most common manifestation and include: [22]:

  • bloating
  • flatulence
  • stomachache
  • constipation
  • diarrhea
  • gastric reflux

Gluten intolerance is an inflammatory reaction of the organism to digestion of this protein. In addition to digestive problems, symptoms that are not directly associated with digestion appear with intolerance [22]:

  • weight gain or loss
  • joint pain
  • anxiety, depression, irritability and other behavioral changes
  • eczema
  • Headache
  • energy loss and frequent fatigue
  • asthma and allergies
  • convulsions, numbness and tingling (associated with poor absorption of B12)

Frequent difficulties following gluten consumption may indicate some form of intolerance. Problems with gluten digestion may not directly indicate that you are suffering from celiac disease, it may also be non-celiac gluten sensitivity. In the event of recurrence of these symptoms, it is wise to consult a specialist and, if necessary, undergo tests to confirm this 100%.

If it’s not gluten, what can it be? (FODMAP Carbohydrates)

Gluten is one of the first things that people think of in connection with digestive problems. After omission of wheat from the diet, they start to feel better, but not always it means a problem with gluten per se. Many people also have trouble digesting carbohydrates, which are commonly referred to as FODMAP. The abbreviation refers to Fermentable Oligosaccharides Disaccharides Monosaccharides and Polyols. Said carbohydrates are fermented in the intestine and cause digestive problems and a number of symptoms that are associated with irritable bowel syndrome. Foods high in FODMAP include [23]:

  • wheat
  • milk products
  • avocado, apricot
  • leguminous plants

There is a difference between difficulties in digesting gluten and FODMAP carbohydrates. In the case of wheat, FODMAP’s “malice” is an oligosaccharide fructan, not gluten. Similarly with milk, because it contains lactose, which also belongs to FODMAP carbohydrates. If you have trouble digesting these foods, the best solution is to find out if you are having problems with gluten or FODMAP carbohydrates. [23]

Flours Containing the Most Gluten

There are different varieties of wheat, each with its own gluten content. Flours made from high-gluten wheat are called strong flours and are used for making bread, bagels, pasta, and pizza crusts. Flours made from softer, low-gluten wheat are called weak flours and are used for making cakes and delicate pastries.

All-purpose flour is formulated to have a medium gluten content of around 12 percent or so. This makes it a good middle-of-the-road flour that can be used for a whole range of baking.

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