Dear Mark: Gluten

Dear Mark,

You talk a lot about the evils of grains. I follow your logic on why a grain free diet is best, and I have seen weight loss and just feel better overall since heeding your advice. But there is one thing (well, more than one) that I don’t understand but hear about often. Could you explain what gluten is and why it should be avoided?

Gluten is a large, water-soluble protein that creates the elasticity in dough. It’s found in grains such as wheat, rye, barley, triticale, and oats. These days it’s also found in additives like thickeners and fillers used in everything from lunch meat to soup to candy.

Gluten sensitivity or intolerance, once thought to be rare, is now believed to affect a third of the population. (Some believe this number is substantially higher.) It’s considered a genetically influenced, life-long autoimmune disease, but it sometimes doesn’t manifest itself until a person is in their thirties or even forties. When an affected person eats or drinks something containing gluten, the protein initiates a kind of allergic reaction in the body, resulting in some level of inflammatory reaction. The reaction can vary significantly from person to person and can manifest itself in a wide variety of initial symptoms that include: dermatitis, fatigue, joint pain, acid reflux, abnormal menses, and infertility. Some gluten sensitive people are asymptomatic, at least for a certain period of their lives.

In serious cases, gluten intolerance causes intestinal atrophy known as Celiac disease. The Gluten Intolerance Group of North America reports that 1 in 133 people have Celiac disease. Unfortunately, not everyone who develops Celiac disease will have recognizable symptoms before the condition has wreaked serious havoc in the intestinal system by flattening of the villus epithelium and subsequently decreasing the area for nutrient absorption. For these people, Celiac disease often isn’t diagnosed until after effects of malnutrition have set in (lack of growth in children, diarrhea, stomach pain and/or bloating, vomiting, behavioral changes, etc.). In these cases, biopsies are often taken to assess the extent of damage and to aid diagnosis. Even if biopsies are normal, there is still the chance that nutrient absorption is impaired.

Thankfully, methods for diagnosing gluten sensitivity and related Celiac disease have improved in recent years as awareness has increased and more research has been done. Blood tests for specific antibodies have allowed physicians to diagnose the disease in many cases before much if any damage has occurred. Researchers are also beginning to test for antibodies in the intestinal tract, which may promise an even earlier diagnosis in at-risk individuals.

Given my stance on grains, I obviously suggest avoiding gluten. As mentioned, gluten intolerance is a very common condition and may be underestimated still. Given the relatively recent introduction of gluten (and all grains) into the human diet, gluten intolerance and the related Celiac disease are very unfortunate but not very surprising conditions. In addition to omitting grains from your diet (especially those listed above), it’s important to avoid processed foods, which likely contain trace amounts in forms like hydrolyzed proteins, starch/modified starch, malt, binders, and natural flavorings. If anyone in your family has been diagnosed with Celiac disease or gluten intolerance, it’s a wise idea to talk to your doctor about testing options.

Whatshername? Flickr Photo (CC)

Further Reading:

Simple vs. Complex Carbs

Gluten-Free Girl

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Posted By: Mark Sisson

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