Gluten and gluten sensitivity continue to be a very controversial subject these days. While some health experts believe that gluten is harmful for a fairly high percentage of people, others claim that its severity is simply over-stated and in most cases gluten seems to be perfectly safe for the vast majority of the population.
Despite this, because of all the “buzz” about gluten’s harmful effect, more than 30 percent of the American population is now actively trying to avoid eating it.
First…what exactly is Gluten?
Gluten is a small class of proteins found in grains, particularly wheat, rye, and barley, which have very low nutritional and biological values to the human body.
The two main proteins in gluten are gliadin and glutenin. However, according to studies, gliadin seems to be the biggest coeliac toxicity offender of the two. (1)
The origin of gluten is actually derived from Latin “meaning” glue or sticky substance.
When flour is mixed with water, these insoluble gluten proteins bond to form a sticky grid that has a “glue like” consistency. This gluten bond makes the dough elastic, giving bread the ability to rise when heated, while also providing its satisfying, chewy texture. (2)
So…what’s all the hype?
Most people can actually tolerate gluten rather well. However, it has been shown, for a small percentage of society that gluten can become problematic. Particularly for those who seem to suffer from gluten sensitivity and/or wheat allergy, and alarmingly dangerous or even fatal for those who suffer from the digestive, autoimmune disorder, celiac. (3, 4)
It is well documented that celiac disease is the most severe form of gluten intolerance. This autoimmune disorder affects about 0.7–1% of the population and involves the body treating gluten as a foreign toxic invader, thus the immune system attacks the gluten, as well as the lining of the gut. (5, 6)
This “so called” protective attack ends up damaging the gut wall, which can result in major nutrient deficiencies, severe digestive issues, and an increased risk of other major chronic malfunctions ranging from anemia and osteoporosis to secondary autoimmunity and malignancy. (7)
The most common symptoms of celiac disease are digestive discomfort, tissue damage in the small intestines, bloating, diarrhea, constipation, headache, tiredness, skin rashes, depression, and even weight loss. However, some people with celiac disease do not have digestive symptoms, but may have other symptoms like low energy, weakness or blood deficiencies including low iron. (8, 9, 10)
And for this reason, celiac disease is commonly difficult to diagnose, even for specialists. In fact, nearly 80 percent of people with this autoimmune disorder don’t even realize that they have it. (11)
Non-Celiac Gluten Sensitivity
There is another spectrum of people who do not fit the protocols that fall under the class for having celiac disease, but still seem to react negatively to gluten. This highly controversial condition is what’s known as non-celiac gluten sensitivity (NCGS). And although the current exact percentage of the population that is seemingly affected by this condition is unknown, the estimated range resides around 6 to 7 percent. (12)
Some of the common symptoms that seem to be associated with NCGS include diarrhea, stomach pain, fatigue, and bloating. And although there is no clear definition for non-celiac gluten sensitivity or any reliable lab test established, the diagnosis is usually made when a patient reacts negatively to gluten, but celiac disease and allergies have been ruled out. (13, 14, 15)
To date, there are still many experts who believe that NCGS isn’t a real condition and therefore a manifestation of some other underlying condition ignited by substances other than gluten. In fact, one study looked at nearly 400 people with self-diagnosed gluten intolerance, and investigated whether they improved on a gluten-free diet. (16)
The results from this study showed that only 26 people had celiac disease, while 2 had a wheat allergy. This left only 27 of the remaining 364 who actually fell under the category of being sensitive to gluten.
What this tells us is that of the 400 who thought they were gluten intolerant, only 55 people or a mere 14.5 percent actually had an issue with gluten. Therefore, further reinforcing the fact that many people who think they’re gluten intolerant actually have other causes for their symptoms.
However, if you do believe you may be one of the few who suffer from gluten sensitivity here are the proposed diagnostic criteria to help establish if you may have non-celiac gluten sensitivity: (17)
- Gluten ingestion leads to rapid digestive or non-digestive issues.
- Symptoms disappear quickly on a gluten-free diet.
- Reintroducing gluten causes the symptoms to appear again.
- Celiac disease and wheat allergy have been ruled out.
If these criteria have all been confirmed then a blinded gluten challenge test should be done to fully confirm the diagnosis. (18)
Could there be something other than gluten behind the helm?
What if there was actually a deeper underlying issue behind many of the problems people seem to be experiencing with gluten?
One new study done on gluten sensitivity took 37 individuals who were experiencing NCGS and irritable bowel syndrome. However, this study did something different than other double-blind cross-over trials performed. They placed the participants on a diet low in FODMAPs. They then gave the participants isolated gluten instead of a gluten-containing grain, like wheat.
The conclusion of the study was that isolated gluten bared no cause for concern in these individuals, and that the self-reported non-celiac gluten sensitivity was indeed the result of being sensitivity to FODMAPs and not gluten at all. (19)
So…what are FODMAPs?
FODMAP is an acronym that stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols which are all short-chained carbohydrates, or in simple terms (sugars). These short-chain carbohydrates are incompletely absorbed in the gastrointestinal tract and can be easily fermented by gut bacteria. (20)
These sugars travel through literally untouched, increasing fluid movement into the large intestines. And the cross-over and fermentation caused by these undigested sugars then become a major contributor to things such as gas, pain, and diarrhea, which are all closely related to non-celiac gluten sensitivity and irritable bowel syndrome. (21)
Wheat just so happens to be highly active in FODMAPs and it is well established that these short-chain carbs are some of the worst offenders in functional gut symptoms associated with food intolerances. (22, 23, 24)
This is one of the many reasons why non-celiac gluten sensitivity is a highly controversial subject that is discounted by many experts. In fact NCGS is so hard to pin-point or diagnose that it has led many researchers to speculate that perhaps wheat sensitivity or wheat intolerance syndrome are more appropriate labels than gluten sensitivity (25)
Unfortunately, as you can see, NCGS is much more incredibly complicated than most people can comprehend, and very few clear answers have been discovered as of yet.
Like all other things, gluten and wheat may be absolutely fine for some people, while not so good for others. So, if you are personally convinced that wheat or gluten causes you problems, then there’s no reason to sit around and wait for the research to come in. If its discomforting and makes you feel bad, just avoid it “PERIOD.”
But, just remember, if you are jumping on the gluten-free bandwagon because it’s the “latest health trend” understand that Gluten-free muffins, crackers, cookies, cakes, and pie are just the newest rendition of junk food, so let’s try to avoid turning this into a repeat of the fat-free craze.