Gluten, gluten intolerance and gluten-free diet

Many believe that gluten is a separate substance and are convinced that it is only found in flour products. Both of these views are wrong.

What is Gluten?

Gluten is the common name for wheat, rye, barley, and hybrid cereal proteins. Respectively, gluten is not a single substance, but a whole group of proteins found in wheat, rye, barley and spelt.

This group includes two proteins - glutenin and gliadin, which are the main cause of health problems in people with celiac disease.

Gluten, which causes health problems, is formed when wheat, rye, barley or spelled flour is mixed with water.

Wheat, rye, barley or spelt flour + water + mixing = gluten causing health problems.

When water is added to flours containing glutenin and gliadin, the starch molecules in the flour expand and the glutenin molecules combine to form long, interconnected chains.

Mixing, kneading and "resting" the dough contribute to the formation of these bonds, giving the dough elasticity.

Gliadin molecules, on the contrary, retain their compact shape in the presence of water. Essentially, they work like ball bearings, allowing the pieces of glutenin to slide over each other without joining together. This contributes to the extensibility of the dough, and the ability to form it and hold its shape during baking.

Respectively, gluten (glutenin and gliadin) gives the dough elasticity, helping it to rise and retain its shape during baking and creating a pleasant texture in the final product.

These properties are important for all types of dough, from handmade noodles to pancakes, baguettes, muffins…

To get a similar texture, to gluten-free flour dough, xanthan gum, guar gum or eggs are added.

 

Gluten - containing products

Gluten can be found in both whole grains and processed foods:

  • In grains - whole wheat, wheat bran, barley, rye, triticale, spelt, Kamut (Khorasan wheat), couscous, farro, semolina, bulgur, groats, eincorn wheat, durum wheat, wheat germ…
  • In processed cereal products - crackers, bread, breadcrumbs, pasta, seitan, wheat soba noodles, certain vegetarian products and meat substitutes, biscuits, confectionery…
  • In other foods and beverages like barley malt, malt vinegar, soy sauce, some kinds of ketchup, broths and salad dressings and sauces thickened with flour, some spice mixes, flavored chips, beer, some wines, and some processed meats.
 

It is not always clear whether a particular food contains gluten or not because:

  • Gluten is often used in food production as a thickener or stabilizer;
  • Many food producers use the same equipment to make gluten-containing and gluten-free products. Thus, even if food should not theoretically contain gluten, it can be "obtained" during processing.
 

Oats

Theoretically, oats do not contain gluten.

However, they are often transported and processed using equipment that is also used for wheat processing. Therefore, oat products often contain gluten, even if neither gluten nor wheat is mentioned on the product label.

Some experts claim that gluten-free oat products do not exist in principle (even if they are labeled gluten-free) because oats contain a protein called avenin , which is very similar in structure to gluten.

However, studies show that most people with gluten intolerance can consume gluten-free oat products without any problems.

In fact, gluten-free oat flour products are often recommended for use in gluten-free diets because oats are rich in fiber and essential nutrients.

 

Gluten intolerance

For most people, gluten is not a problem at all.

However, it can cause problems for people with celiac disease or who are allergic to wheat or hypersensitive to gluten.

Various degrees of gluten intolerance is present in 1-2% of the world's population.

 

Celiac disease

Celiac disease is the most common and severe form of gluten intolerance, affecting about 1% of the population.

Celiac disease is a serious genetic autoimmune disease. The immune system perceives gluten as a threat and, when it enters the gut, attacks it just like any other enemy. As a result, the small intestine is damaged, which interferes with the absorption of nutrients.

This, in turn, can lead to nutrient deficiencies, anemia, severe indigestion and an increased risk of many diseases.

The most common symptoms of celiac disease are:

  • Digestive disorders – diarrhea, bloating, abdominal pain, constipation, tissue damage in the small intestine, stool with a very unpleasant odor…
  • Skin health problems - rash, eczema, skin inflammation…
  • Neurological problems - confusion, headache, tiredness, anxiety, numbness, depression, difficulty concentrating…
  • Other health problems - unexplained weight loss, nutrient deficiency, weakened immune system, osteoporosis, headache, anemia…
 

However, some people with celiac disease may not have digestive symptoms but may have other problems such as fatigue or anemia.

For this reason, it is often difficult for doctors to diagnose celiac disease.

 

Increased sensitivity to gluten

There are people who do not have celiac disease, but still react negatively to gluten.

It is not known exactly how many such people exist, since the results of studies vary. The range is quite large - from 0.5% to 13%.

Possible symptoms of sensitivity to gluten are:

  • Diarrhea;
  • Stomach ache;
  • Fatigue;
  • Flatulence;
  • Depression.
 

There is no clear definition of increased sensitivity to gluten. The doctor will make this diagnosis if he has ruled out celiac disease and wheat allergy, but the person still reacts negatively to gluten.

There are also many cases of imagined/self-diagnosed gluten sensitivity.

For example, in one study involving 392 people with self-diagnosis of gluten intolerance, it was studied how and whether their health/well-being improves with a gluten-free diet.

The results showed that 26 people had celiac disease and two people were allergic to wheat.

Only 27 of the remaining 364 people were sensitive to gluten.

Accordingly, only 55 people (14%) had real problems with gluten, the rest had imaginary problems.

 

Wheat allergy

It is estimated that 0.2-1% of children are allergic to wheat, which can cause digestive problems. By the time they reach adulthood, about 65% of these problems disappear without treatment.

People with an allergy to wheat can still consume all other gluten-containing foods. Neither gluten nor barley or rye products cause them any adverse reactions.

 

Irritable Bowel Syndrome

Some people with irritable bowel syndrome are sensitive to wheat. Why wheat causes unpleasant symptoms in some but not in others is not yet clear.

Irritable bowel syndrome is a common indigestion that can cause the following symptoms:

 

Irritable bowel syndrome is a chronic condition, but it can be managed and symptoms reduced with diet and lifestyle changes.

Of course, if there is a desire to change something, not just to portray a martyr.

 

Gluten intolerance or just sensitivity?

Gastrointestinal discomfort is the most common sign of gluten intolerance.

However, there are many other possible causes for this discomfort. There is a big difference between being gluten intolerant and being sensitive to only certain foods. In the case of celiac disease, a gluten-free diet is practically the only way to improve your health. But if you're only sensitive to certain gluten-containing foods, like the avenin in oats, the problem is minor.

To determine the cause of the discomfort, you should first check if you have celiac disease.

There are two main ways to determine if a person has celiac disease:

  • Blood tests - which check for the presence of antibodies. A common one is the tTG-IgA test. If positive, the doctor will prescribe a tissue biopsy to confirm the results;
  • Small Intestine Biopsy - A small sample of tissue is taken from the small intestine and analyzed by a laboratory for damage.
 

In both of the above tests, a gluten-containing diet should be followed. If the tests are carried out while following a gluten-free diet, a false negative result will be obtained. If there is no gluten in the body, which causes the formation of antibodies, then they cannot be found.

If your celiac disease tests are negative, the best way to find out if you are gluten sensitive is:

  • First, follow a strict gluten-free diet for a few weeks and pay attention to the symptoms - whether they are decreasing or not;
  • Then start eating gluten again to see if your symptoms return.
 

If your symptoms do not improve with a gluten-free diet and do not get worse when you start taking gluten-containing products again, the problem may be with something other than gluten.

With the help of such a gluten-free diet test, it is impossible to diagnose celiac disease or gluten intolerance, because, as I said, there can be many other causes of symptoms.

But if the test is "positive" — this is a reason to seek medical advice and start a more serious examination.

 

FODMAP

FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols) are short-chain carbohydrates found in many foods, including wheat.

Many people cannot digest them. This can cause a variety of digestive symptoms that are similar to those of gluten intolerance.

That is, if wheat causes you unpleasant digestive symptoms, you may be sensitive to FODMAP and not to gluten.

 

Gluten free diet

Some people really need a gluten-free diet. If you have been diagnosed with celiac disease, there are virtually no other solutions.

There are also studies showing that a gluten-free diet may be helpful for some patients with schizophrenia. Others studies have shown potential benefits in autism and gluten ataxia .

However, a gluten-free diet has largely become a fad diet - people exclude traditional sources of gluten (wheat, rye, and barley flour products) from their diet.

5 to 10 years ago, most people didn't even know what gluten was.

Even today, many people don't know this (ask 10 random passers-by what gluten is and compare the answers), but they do know that gluten is harmful to health.

Why harmful?

Maybe it's because food manufacturers create gluten-free products and advertise them as "healthier"?

Because eating healthy is fashionable and after all - everyone takes care of their health…

And many people really believe that a gluten-free diet is healthier, that it will help them lose weight and feel more energetic.

They believe that gluten-free products are somehow healthier, but are unaware that:

  • Gluten as a thickener or stabilizer is widely used in the food industry, so gluten-free products are actually very few;
  • Gluten exclusion automatically excludes all traditional whole grain products. As a result, you are likely to consume less fiber, which can cause additional health problems;
  • Gluten exclusion increases the risk of developing type 2 diabetes - the more gluten in the diet, the lower the risk of diabetes;
  • The exclusion of gluten-containing foods can lead to a deficiency of vitamins and other nutrients, since most whole-grain foods contain large amounts of these nutrients.
  • Excluding products containing gluten can lead to weight gain, since the label "gluten-free" means only that the product does not contain gluten. But this does not mean that it is low in calories, fat, sugar, or salt... Also preservatives, emulsifiers, and flavor enhancers...
 

But if you feel psychologically better by including some gluten-free products in your diet - include them 😊.

In fact, the only reasons to exclude gluten from your diet are to treat celiac disease or to prevent the symptoms of a true wheat allergy.

People who voluntarily switch to a gluten-free diet give up food, which is an essential part of a balanced and healthy diet. This, in turn, increases various health and also beauty risks.

A real gluten-free diet is quite complicated.

Mainly because there are relatively few gluten-free substitutes for products made from wheat, barley and rye. Imagine your life without flour and all flour products. And all industrially processed products containing gluten as a thickener or stabilizer.

Following a gluten-free diet, you should:

  • Mostly choose fresh and unprocessed foods, as this is the best way to control the presence of gluten;
  • Avoid cereals and gluten-containing foods;
  • Diligently study the composition of products, because gluten as a thickener or stabilizer can be included in almost any industrially processed food.
 

Gluten - free grains

Several grains and seeds are naturally gluten-free:

  • Rice;
  • Oats (if not transported or processed by the same equipment as wheat, barley, rye…);
  • Buckwheat;
  • Quinoa;
  • Millet;
  • Corn;
  • Chia;
  • Flax seed;
  • Sunflower seeds;
  • Pumpkin seeds;
  • Teff;
  • Amaranth;
  • Sorghum;
  • Tapioca;
  • Arrowroot.
 

Gluten - free products

There are many healthy gluten-free foods:

  • Meat;
  • Fish and seafood;
  • Eggs;
  • Most dairy products;
  • Fruits;
  • Vegetables;
  • Legumes;
  • Nuts;
  • Tubers;
  • Fats such as oils and butter;
  • Most drinks.
 

High gluten products

The main sources of gluten in the diet are:

  • Wheat;
  • Rye;
  • Barley
  • Spelt;
  • Bread;
  • Pasta;
  • Whole grain products;
  • Beer;
  • Malt;
  • Cakes, biscuits, pies and other confectionery.

Many industrially processed foods, such as processed meat, french fries, sauce mixes, soy sauces, and ready-made desserts, can also contain gluten in a 'hidden' form. Therefore, anyone who wants to avoid it must read the labels (product composition) carefully.

 

There are also non-food items that may contain gluten, such as:

  • Lipstick, lip gloss and lip balm;
  • Medicines and food supplements;
  • Game mastic for children.
 

In conclusion

I repeat - varying degrees of gluten intolerance are ONLY in 1-2% of the population.

Almost all symptoms of gluten intolerance can occur for various reasons. Therefore, you should not engage in self-diagnosis, but consult a doctor in time. Because these symptoms may be a sign of another disease, which, with early diagnosis, can be quickly and successfully treated.

If you have not been diagnosed with celiac disease or wheat allergy, it is not necessary to exclude gluten from your diet. As I mentioned, a gluten-free diet is quite complicated and if you don't know how to make up for missing nutrients - it can do you more harm than good.

Instead, focus on choosing healthier foods. for example, instead of white bread, eat whole grain bread, which is an excellent source of fiber.

 

Eat delicious and be healthy!

 

Sources:

Health Benefits and Adverse Effects of a Gluten-Free Diet in Non-Celiac Disease Patients

Why Oats Are Safe and Healthy for Celiac Disease Patients

Definition & Facts for Celiac Disease

Prevalence and Morbidity of Undiagnosed Celiac Disease From a Community-Based Study

Wheat allergy: diagnosis and management

Properties of Gluten Intolerance: Gluten Structure, Evolution, Pathogenicity and Detoxification Capabilities

Fructan, Rather Than Gluten, Induces Symptoms in Patients With Self-Reported Non-Celiac Gluten Sensitivity

Long term gluten consumption in adults without celiac disease and risk of coronary heart disease

A Gluten-Free Diet, Not an Appropriate Choice Without a Medical Diagnosis

Gluten sensitivity

A Comprehensive Review of Celiac Disease / Gluten-Sensitive Enteropathies

Gluten free diet and nutrient deficiencies

Symptomatic improvement with gluten restriction in irritable bowel syndrome

Questions and Answers on the Gluten-Free Food Labeling Final Rule

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