Gluten is getting a bad rap across the globe! Awareness of the possible negative health consequences are fast becoming common knowledge with an estimated 30% of Americans trying to actively remove or cut down on their gluten consumption. Why is this happening compared to just a few short decades ago when most people didn’t even know what gluten was? Everywhere we look now the words ‘gluten-free’ come up in restaurants, cafes and on many food products and packages.
As a practitioner I have seen enormous benefits occur for some people when gluten has been removed from the diet in full, even while the patient has negative blood test results.
Let’s talk about the different types of gluten issues:
When people with Celiac Disease (CD) eat wheat, the immune system in the gut mistakenly assumes that the gluten proteins are foreign invaders and mounts an attack. The immune system doesn’t only attack the gluten proteins, it also attacks the gut lining itself, leading to degeneration of the intestinal lining, leaky gut, massive inflammation and various harmful effects. This is the most severely affected group and accounts for approximately 1% of the population, but it is on the rise particularly in the elderly. In one study after 45 years of follow-up, undiagnosed CD was associated with a nearly 4-fold increased risk of death. The prevalence of undiagnosed CD seems to have increased dramatically in the United States during the past 50 years. It is estimated that 80% of people with CD have no idea that they have it. Many people who have CD actually may not have any digestive or abdominal symptoms but suffer with anaemia, fatigue, muscle soreness or other associated symptoms.
It is recommended to be tested for CD if you have these health issues;
- Gastrointestinal and classical symptoms: diarrhea, weight loss, abdominal distention, failure to thrive
- Autoimmune diseases, type 1 diabetes, thyroid disorders, Sjögren’s syndrome, microscopic colitis, inflammatory bowel disease or any other autoimmune disease
- First-degree relatives of affected people
- Elevated liver enzymes
- Iron-deficiency anemia
- Delayed puberty
- Irritable bowel syndrome
The other group of people that may be affected by gluten are classified as non-celiac gluten sensitivity (NCGS). This is a new classification that some do not accept but studies are suggesting otherwise, interestingly Celiac Disease was not accepted 30 years ago by many professionals as being a legitimate disease. At this stage it is mostly diagnosed with the elimination of gluten where symptoms resolve with a subsequent reintroduction of gluten and the symptoms reoccur. It is estimated that NCGS accounts for approximately 6-8% of the population based on anti-gliadin antibodies in blood tests in some studies.
A review paper in The New England Journal of Medicine listed 55 diseases that can be caused by eating gluten. These included IBS, inflammatory bowel disease, cancer and autoimmune diseases. Gluten is also linked to many mood and neurological diseases, including anxiety, depression, schizophrenia, dementia, migraines and nerve damage.
About 40% of people carry the HLA-DQ2 and HLA-DQ8 genes, which make people susceptible to gluten sensitivity.
In the American Journal of Gastroenterology, one study concluded that gluten seems to be a trigger in people that did not have a diagnosed gluten disorder. This was a double blind placebo control study that demonstrated within 1 week there were more reports of tiredness, pain, discomfort, bloating, and poor stool consistency in the gluten group compared to the gluten free group.
Why Is This Happening?
There are a number of possible reasons why this may be happening and why gluten-related issues are on the rise:
- Newer wheat varieties such as the dwarf wheat have a higher gluten content to improve the consistency and sponginess of baked goods
- Gluten acts as a natural insecticide so farmers favor higher gluten varieties which are more likely to cause health problems
- Higher consumption over the years of wheat-based products
- Greater yield = less nutrition compared with more ancient varieties of wheat
- Lack of traditional preparations being used such as soaking, fermenting and sprouting of grain products; Correct preparation of grains reduces the lectin content and other anti-nutrients and allows the nutrients to be more bioavailable which also reduces some of the possible digestive issues that are implicated (traditionally all grains were prepared in this way)
- The newer breeds of wheat have a higher content of Glia-9 which is a type of gluten that is the most associated with health problems
- Dosing wheat in large farms with glycosphate (roundup) before harvesting called “desiccation,” to reduce the wear and tear on machinery allows for earlier harvesting but minute amounts are present in the grain.
- Wheat was introduced into Europe during the Middle Ages, and 30% of people of European descent carry the gene for celiac disease (HLA DQ2 or HLA DQ8), which increases susceptibility to health problems from eating gluten
In some cases gluten is blamed where FODMAPs are possibly causing gut issues particularly in cases of IBS. Interestingly some studies indicate einkorn and kamut which are older wheat grain varieties are implicated with less health problems and may not stimulate any health issues at all. These findings indicate that modern wheat has a unique ability to trigger an auto-immune reaction in the gut and is probably the main reason why celiac disease and gluten sensitivity are on the rise.