Considering a Gluten Free Diet?

Considering a Gluten Free Diet?

 What You Should Know

By Emily Fiorella Mulvehill 12/10/2013

            “Going gluten-free” is a very popular mantra lately. No differently than dietary fads of the past, the phrase “gluten free” commonly appears in health magazines, cooking shows, and on the shelves in our supermarkets. However, the difference between the present gluten-free dietary craze and fad diets of the past is that losing weight is not the end goal.  Instead, preventing and warding off disease and illness is. Perhaps for this reason, going gluten-free has gained global popularity and unparalleled support from the medical community. There are a number of unhealthy side effects that come from consuming gluten which is most commonly consumed in the form of wheat. While research on the issue is still inconclusive, we know there is something in the wheat plant that is making many of us sick. The purpose of this report is to examine the impact of gluten and the wheat grain on human health, the possible causes of a sudden manifestation of gluten-related disorders, and what, if anything, can be done to prevent gluten-related ailments.

            Gluten is the main structural protein found in wheat and other grains such as rye, barley, and oats. Wheat accounts for approximately seventy-five percent (75%) of all calories consumed from carbohydrates in the American diet. The gluten protein  found in wheat is what gives dough its elasticity and the ability to rise when combined with yeast. Traditional breads, baked goods, pasta, and pizza crust would have never been invented without gluten. It is used to thicken soups, sauces, and gravies. Gluten is also used as a valuable binding agent in processed food manufacturing. The more gluten used in baking, the more desirable the characteristics of that food becomes: fluffy, chewy, and springy. Could this be the reason that the amount of gluten contained in wheat has been increasing year after year? (Davis MD, 2011)

            Gluten is used, and is perhaps essential, in creating many delicious foods. Unfortunately, gluten related illnesses are becoming more common, and the only known treatment is to avoid the gluten containing foods altogether. Currently, experts know of at least three conditions that are related to the consumption of gluten. These are: celiac disease (CD), wheat allergy (WA), and gluten sensitivity (GS) ,which is also referred to as non-celiac gluten sensitivity (NCGS). In addition, recent research has found that a gluten-free diet is linked to reversing various chronic diseases such as obesity and diabetes.(Soares, 2013), (Spectrum of gluten-related disorders: consensus on new nomenclature and classification, 2012)

            Celiac disease is a genetic, autoimmune disease that damages the finger-like villi of the small intestines, disabling the body’s ability to absorb nutrients, leading to malnutrition. The only known treatment is to follow a gluten-free diet. Further complications can develop when celiac disease is left untreated, including: neurological disorders, osteoporosis, infertility, thyroid disease, some cancers, and other autoimmune diseases. Notably, the prevalence of celiac disease effects an estimated 1% of the population. It has increased dramatically in both the United States and in Europe over the past fifty (50) years, and as populations in the Middle East and Asia move towards a more Western style diet, cases of celiac disease are expected to increase in those locations as well. (Hischenhuber, et al., 2006)

            Wheat allergy, also known as baker’s asthma, is an allergic reaction caused by an antibody’s reaction to the proteins or other plant tissues found in wheat. Wheat allergy related reactions to consuming wheat range from sneezing, hives, and wheezing to diarrhea, and anaphylaxis.  Wheat allergy appears more frequently in Europe than the US. In parts of Europe, it has been found to represent 20% of food allergy cases; where as an American study found that wheat allergy represented only 2.5% of food allergy cases. The American figure may be underestimated as it accounts for only the most severe cases that ended up in hospitalization.(Hischenhuber, et al., 2006)

            Non-celiac gluten sensitivity is a more recent phenomenon. Gluten sensitivity is neither a disease nor an allergy,  and as of today’s date, there is no diagnostic way to test for it. That said, it shares the same extra-intestinal symptoms and treatment of celiac disease; thus, making the two disorders almost indistinguishable. The symptoms include and are not limited to: stomach pain, bloating, heartburn, joint pain, headache, behavioral changes, fatigue, insomnia, and brain fog. The appropriate treatment is to adhere to a strict gluten-free diet, and the symptoms will subside. However, gluten sensitivity is not an auto-immune disorder,  and it does not directly lead to damage in the small intestine.  Little is known about what causes gluten sensitivity and the idea that gluten can cause reactions outside of celiac disease or a wheat allergy is still new to most health care professionals.  Since there is no diagnosis for non-celiac gluten sensitivity, the immense growth in gluten related disorders is perhaps best evidenced by the increased demand for gluten free-foods. Global sales of gluten-free products reached a remarkable $2.5 billion in 2010, skyrocketed to more than $4 billion in 2012, and is expected to exceed more than $6 billion by year 2017.These numbers are perplexing when compared to the mere one percent 1% of Americans and Europeans that reportedly have celiac disease. This suggests that the effects of gluten are so obvious and disruptive that people are able to self-diagnose, adhere to a gluten free diet, and realize the health benefits. (Hischenhuber, et al., 2006), (Spectrum of gluten-related disorders: consensus on new nomenclature and classification, 2012), (HUFFPOST Healthy Living, 2012)

            Gluten may also contribute to the rise of obesity. Yet, many proponents of gluten argue that the relationship between the elimination of gluten and weight loss has been created by food manufacturers in order to capitalize on the “gluten-free diet” craze; which may have some merit.  Although, a recent study published in the Journal of Nutritional Biochemistry found supporting evidence that a gluten-free diet restricts the expansion of fat tissue, reduces inflammation, and curbs insulin resistance. It suggested that a gluten free diet is effective in preventing obesity and metabolic disorders.  Yet, despite the study, many gluten-free, pre-packaged foods are loaded with extra sugar and fat calories.  These processed, gluten-free food alternatives are a recipe for eight gain and would counteract any weight loss benefits from going gluten-free.(Soares, 2013)

            In response to the growing sphere of gluten-related disorders, a panel of fifteen(15) experts convened in London in February of 2011 to research and develop new classifications and terminology, such as gluten sensitivity. No classifications and/or medical terminology were approved until the panelists reached complete consensus. The panel reported their results in one of the most widely cited articles on gluten disorders, entitled “Spectrum of Gluten-Related Disorders: Consensus on New Nomenclature and Classification.” The conclusion of their research suggested that all individuals are susceptible to some form of gluten reaction, and that there is presently an “epidemic” of celiac disease as well as “gluten sensitivity.” (Spectrum of gluten-related disorders: consensus on new nomenclature and classification, 2012)

            How can a dietary protein, so widely consumed all over the world, be so toxic? As discussed below, celiac disease researchers have been exploring the possibilities by studying the evolution of wheat.

            Specifically, ancient varieties of wheat had twenty-eight chromosomes and stood four and a half feet tall compared to today’s forty-two chromosome, two (2) foot tall plant(that we still for some reason call wheat). Similar to the difference in genetic structure, celiac researchers found that the gluten content in the ancient varieties was much less, and it has been steadily increasing over the last 10,000 years. In the past, evidence indicates that wheat, while constantly changing, did so gradually. However, there has been a significant modification to wheat in the past century. The recent dramatic change in structure can be attributed to farmers who started, more than 100 years ago, cross breeding varieties of wheat to increase yields, tolerate drought, resist disease, and improve the wheat’s characteristics (by increasing the gluten content) which allows for better bread-making (Kasarda, 2013). In addition to the recent one-hundred plus years of genetic modification, advancements in fertilizers and pesticides have also influenced the plant. One can begin to understand what has led to the differences between wheat grown today and the wheat of  the past. Dr. William Davis, cardiologist and author of Wheat Belly so eloquently states:

Modern wheat no more resembles the wheat of Moses than a chimpanzee resembles a human - in fact, a chimpanzee is closer to a human than modern wheat is to ancient wheat. I would argue that the wheat we are being sold shouldn't even be called wheat. It is a geneticist-created artificial plant that is a far genetic and biochemical distance away from any wheat that ever existed in nature.(Davis MD, 2011)

            Dr. Davis agrees with other celiac researchers that the gluten proteins found in wheat have contributed to the rise of celiac disease, although he is not convinced that our “non-celiac gluten-sensitive” health issues are solely related to gluten.  Instead, he believes they are also affected by other modified, non-gluten proteins found in wheat. For example, in May of 2013, a field in Eastern Oregon was found growing genetically modified, (glyphosate-resistant) “Roundup Ready” wheat.  Roundup Ready crops are genetically bred to resist the poison in weed killer. The wheat was developed by Monsanto, the world's largest producer of genetically modified seeds and supplier of weed killer. The mysterious discovery caused Japan and South Korea to temporarily suspend imports of western white wheat and leads one to the question, “How many more fields of this genetically modified organism (GMO) wheat are out there?” Furthermore, could cross pollination have contaminated neighboring fields? Roundup Ready is approved and used in growing soybeans, corn, cotton, canola, alfalfa, and sugar beets. However, it is not yet approved for growing wheat.  According to Nebraska’s Public Broadcasting Station, the US has not approved Roundup Ready wheat due to the fear of losing its overseas customers, at which point it wouldn’t be worth growing at all. But, this raises a few questions, “Why would Japan and South Korea be so quick to halt importing wheat from the US for the chance it contained the GMO?”  and “What do our overseas customers know about “Round Up Ready wheat that we do not know?”  As far as safety, there are not many studies published on the topic. However,  a 2008 article titled, “Risk Assessment of Genetically Modified Crops for Nutrition and Health,” shed some light on the issue in concluding that animals who were fed glyphosate-resistant soybeans versus conventional soybeans developed abnormalities in their organ tissue.(Magaña-Gómez JA, 2009), (Barnard, 2013), (Gerlock, 2013)

            Wheat has been evolving since the beginning of agriculture. One would think that humans would have adapted to this evolution and be able to tolerate this modified wheat by now, since it has long been a staple in our diet. However, over the last 50 years, wheat has endured more changes than ever from selective breeding and experimenting with GMO’s.  And, this coincides with the same time period whereby cases of celiac disease and gluten sensitivity have increased by 400%. (Gannon, 2012)

            Research is still underway to better understand how wheat affects people.  Scientists are attempting to discover a minimum threshold for gluten and wheat consumption that can safely be consumed by those who are affected by it. (Spectrum of gluten-related disorders: consensus on new nomenclature and classification, 2012)

Works Cited

Barnard, J. (2013, August 30). Source of GMO Wheat In Oregon Remains Mystery. Retrieved from Associated Press: http://bigstory.ap.org/article/source-gmo-wheat-oregon-remains-mystery

Davis MD, W. (2011). Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back To Health (p.213). Rodale.

Gannon, P. (2012, July 13). Gluten-Intolerant: Myth, Meme or Epidemic? Retrieved from greenmedinfo.com: http://www.greenmedinfo.com/blog/gluten-intolerant-myth-meme-or-epidemic

Gerlock, G. (2013, June 28). Farmers Ready To Grow Biotech Wheat Face Consumer Scrutiny. Retrieved from netnebraska.org: http://netnebraska.org/article/news/farmers-ready-grow-biotech-wheat-face-consumer-scrutiny

Hischenhuber, C., Crevel, R., Jarry, B., MÄki, M., Moneret-Vautrin, D. A., Romano, A., . . . Ward, R. (2006, March). Review article: safe amounts of gluten for patients with wheat allergy or coeliac disease. Alimentary Pharmacology & Therapeutics, pp. 23(5), 559-575. doi:10.1111/j.1365-2036.2006.02768.x.

HUFFPOST Healthy Living. (2012, October 22). Gluten-Free Foods Market To Hit $4.2 Billion This Year: Report. Retrieved from huffingtonpost.com: http://www.huffingtonpost.com/2012/10/22/gluten-free-foods-market-42-billion-dollars_n_2003721.html?view=print&comm_ref=false

Kasarda, D. D. (2013). Can an Increase in Celiac Disease Be Attributed to an Increase in the Gluten Content of Wheat as a Consequence of Wheat Breeding? Journal of Agricultural and Food Chemistry, 61 (6), 1155-1159.

Magaña-Gómez JA, d. l. (2009). Risk assessment of genetically modified crops for nutrition and health. PubMed - indexed for MEDLINE.

Soares, F. d.-L. (2013). Gluten-free diet reduces adiposity, inflammation and insulin resistance associated with the induction of PPAR-alpha and PPAR-gamma expression. Journal of Nutritional Biochemistry, 24(6), 1105-1111.

Spectrum of gluten-related disorders: consensus on new nomenclature and classification. (2012). BMC Medicine, 10(1), 13-24. doi:10.1186/1741-7015-10-13.