“Is it gluten-free?”

If you live in the Bay Area like I do, you probably hear this question at least once a day. In some places, “gluten” has almost become a bad word. But what is it exactly, and why has it gotten such a bad rap? Let’s take a look.

Gluten is a protein complex found in certain starches such as wheat, rye, and barley. It is created when the two proteins gliadin and glutenin mix with water. Gluten is responsible for giving baked goods their chewiness and volume, which is why it can be so hard to bake without it.

When considering whether you might have a reaction to gluten, there are two conditions to be aware of: celiac disease and gluten sensitivity.

Celiac disease is an autoimmune disorder and one of the most common genetic diseases in the world, affecting approximately 1% of the worldwide population. Unlike allergies, which are mediated by the immune factor IgE, celiac symptoms are caused by the activity of immune factors IgG and IgA. When people with celiac disease eat gluten, their bodies mount an attack that ultimately damages the small intestine and can lead to symptoms such as pain, malabsorption, and weight loss. Celiac disease has also been associated with non-digestive symptoms such as fatigue, depression, irritability, and “brain fog.” It is diagnosed using an intestinal biopsy and the only current treatment is a strict gluten-free diet.

Gluten sensitivity, or non-celiac wheat sensitivity, is a little more complex. Some individuals experience celiac-like symptoms after eating wheat or other gluten-containing products, such as digestive issues, behavioral disturbances, and pain. However, they do not have the hallmark antibodies and intestinal damage of those with celiac disease. Gluten sensitivity is a controversial condition because we don’t know exactly what causes the reaction; it could be a gluten constituent protein, a gluten contaminant, or even a compound in wheat unrelated to gluten whatsoever (hence the popularity of the alternate term non-celiac wheat sensitivity).

The domestication of wheat approximately 10,000 years ago was a significant turning point in human civilization, and mankind has been eating gluten for thousands of years. So why does gluten seem to only be becoming a problem now? There are several hypotheses. Some blame agricultural technological developments such as genetic modification for triggering some of the reactions that we see today. Another idea is that this phenomenon actually isn’t anything new. The symptoms reported by people with so-called gluten sensitivity– gastrointestinal discomfort, fatigue, and pain– are vague. It’s possible that people have been suffering from gluten sensitivity for a while but just haven’t known what to call it.

At the end of the day, gluten sensitivity is still a gray area and there’s a lot more we have to discover. While celiac disease is an autoimmune disorder with clearly defined diagnostic criteria, we’re just not sure yet why some people without this condition are sensitive to wheat and other gluten-containing crops. Luckily, there are many alternatives to wheat and gluten-containing products: here are a few ideas to get you started:

Meal Ideas

Breakfast

Lunch

Dinner

Snacks

  • Apple with almond butter
  • Carrots and hummus

References

Brown, Lisa. “Gluten Intolerance: Celiac Disease and Nonceliac Gluten Sensitivity.” Food Science: An Ecological Approach, edited by Sari Edelstein, Jones & Bartlett Learning, 2014, 353-353.

De Punder, Karin, and Leo Pruimboom. “The dietary intake of wheat and other cereal grains and their role in inflammation.” Nutrients 5.3 (2013): 771-787.

Eckardt, Nancy A. “Evolution of domesticated bread wheat.” The Plant Cell 22:993 (2010): 993-993.

Mansueto, Pasquale, et al. “Non-celiac gluten sensitivity: literature review.” Journal of the American College of Nutrition 33.1 (2014): 39-54.

Shewry, Peter R. “Wheat.” Journal of Experimental Botany 60.6 (2009):1537-1553.

“What is Celiac Disease?” Celiac Disease Foundation. Accessed 15 November 2017.

What’s the Deal with Gluten?
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