Gluten, a dietary protein, is problematic for people with celiac disease or gluten sensitivity. Celiac disease is a genetically determined lifelong and incurable condition affecting the intestines. Gluten sensitivity is not as severe but may warrant dietary changes. Elimination of gluten from your diet is imperative and lifesaving if you have celiac disease. Other gluten-related issues in the diet are not fully understood, and research is ongoing.
About Gluten
Gluten is found in wheat, barley and rye, which are culprits in causing digestive problems for the gluten-sensitive, but rice, corn and millet, which are considered safe foods, also contain gluten. All gluten is not the same, and the dietary problem of gluten comes from the type of protein molecules present in the composition of gluten. Gluten is made up of prolamin, an amino acid, and glutelin, a protein, which are located in the endosperm of grass-related grains. Gliadin is a molecule within prolamins and along with glutenin form the majority of protein in wheat seeds. Upon digesting a wheat product, the gliadin binds to cells in your body, and if you are gluten sensitive, as in the case of celiac disease, your body forms antibodies to the gliadin, causing an autoimmune response.
Celiac Disease
Diagnosis of celiac disease involves serologic tests to determine the presence of gliadin antibodies, in addition to symptom presentation, history and physical examination. Celiac disease is a genetic disorder with environmental triggers, specifically from dietary habits. In this digestive disease, the small intestines are damaged, and the body is not able to absorb nutrients from food in a normal manner. Consumption of foods containing gluten ignites an autoimmune response, causing your body to destroy the villi, protrusions lining the small intestines that aid in food absorption. This ultimately results in malnourishment no matter how much food you eat. The exact reason your body has an abnormal reaction to gluten is not fully understood, but eliminating this substance from the diet significantly impacts intestinal healing. The only treatment for celiac disease is the lifelong elimination of gluten from your diet.
Gluten Sensitivity
Gluten sensitivity occurs in some people when eating foods containing gluten but it is not the same as celiac disease. Gluten sensitivity is not linked to intestinal damage, and no research shows that it will lead to later development of celiac disease. No test medical test can confirm the presence of a gluten sensitivity, but medical testing can rule out a celiac disease diagnosis. The best way to determine if you have gluten sensitivity is to work with your physician on an elimination diet. This type of diet eliminates gluten products for a certain amount of time and then slowly reintroduces gluten-containing foods back into your diet. Your symptoms are monitored during reintroduction to determine if gluten is a factor in gastrointestinal distress. A low-gluten diet or gluten-free diet is the course of action for treating gluten sensitivity.
Gluten and Food
Celiac disease is prevalent in more than 2 million Americans. The Food Allergen Labeling and Consumer Protection Act of 2006 requires foods to be labeled with wheat or other common allergens and is in process of finalizing a gluten-free label as well. Choose your foods carefully to prevent consumption of gluten if you have issues in your diet. Avoid the ingredient wheat in any foods or ingredients lists. Bromated, enriched, graham, plain or semolina flours are all wheat products. Potato chips, cold cuts, soups, gravy and bouillon cubes may contain gluten. Corn, rice, arrowroot, quinoa and tapioca are gluten-free foods. Meat without breading, batter or marinade and that is not processed is gluten-free. Vegetables, fruits and most dairy foods are also gluten-free. Read product labels and consult your physician for dietary recommendations.
References
- Gluten Intolerance Group: Gluten Sensitivity; April 2009
- UNC Health Care: Should You Go Gluten Free?; December 2010
- MayoClinic.com: Gluten-Free Diet; Mayo Clinic Staff; January 29, 2010
- Celiac Sprue Association: Celiac Disease Defined
- National Digestive Diseases Information Clearinghouse: Celiac Disease
