Gluten Disorder On The Rise

By Carol Chuang, MS, CNS, CMTA, CHC

A Minnesota study using frozen blood samples taken from Air Force recruits 50 years ago found that gluten disorder, a debilitating digestive condition, is four times more common today than it was in the 1950s. (Gluten is a protein composite found in grass-related grains such as wheat, rye, barley, spelt, and kamut.)

According to the Mayo Clinic gastroenterologist who led the study, he believed that the rising prevalence of gluten disorder is a result of the rapid changes in our eating habits and food processing over the last half century. Not only are we consuming much more bread, cereal, pasta, and pizza than previous generations, modern wheat is also very different from the wheat our ancestors ate.

Wheat breeding

Due to hybridization or crossbreeding, the proportion of gluten protein in wheat has increased enormously.

Yet, our genetics have changed very little since the days our hunter-gatherer ancestors roamed the planet. Our bodies have not developed the capacity to handle these "foreign" proteins. A modern diet that is heavily grain-based is dramatically different from what our stone-age ancestors used to eat - fresh-picked greens, berries, nuts, seeds, eggs and whatever they could catch or kill. For some of us, eating a diet that deviates from our evolutionary blueprint can lead to dire consequences.

Wheat Allergy, Celiac Disease, And Gluten Intolerance

The three common disorders that arise from gluten are wheat allergy, celiac disease, and gluten intolerance.

Wheat allergy is one of the top eight food allergies in America. The immune system releases histamine (IgE antibody) in response to the wheat that you consume, much like a peanut allergy. One molecule of allergic food can result in anaphylactic shock, a life-threatening type of allergic reaction that develops within seconds or minutes. 

Symptoms of wheat allergy may include tightening of the airway, rash, wheezing, lip swelling, abdominal pain, and diarrhea. People suffering from wheat allergy usually can identify it without testing. This is because the reaction occurs every time and shortly after they eat the allergic food.

Celiac disease, or celiac sprue occurs in people whose bodies cannot digest gluten. The undigested protein triggers the body's immune system to attack the tiny, finger-like protrusions called villi, which lines the small intestine. Normally, the villi allow nutrients from food to be absorbed through the walls of the small intestine into the bloodstream. But when the villi are damaged or flattened, a person is less able to absorb nutrients such as iron and calcium, which in turn may eventually lead to anemia, osteoporosis, infertility, and a whole host of other health issues.

Normal villi vs. Damaged villi

Additionally, celiac disease is associated with leaky gut syndrome, also known as permeable intestines. Undigested gluten moves through the damaged intestinal wall into the bloodstream, creating systemic inflammation throughout the body.

Symptoms of celiac disease vary from person to person. They may occur in the digestive system and/or other parts of the body. Common digestive symptoms include abdominal bloating and pain, diarrhea, vomiting, constipation, pale, foul-smelling, or fatty stool, and weight loss.  

Non-digestive symptoms include fatigue, bone or joint pain, arthritis, depression, anxiety, bipolar disorder, schizophrenia, ADHD, tingling numbness in the hands and feet, seizures, canker sores in mouth, and an itchy skin rash called dermatitis herpetiformis.

Currently, an estimated one out of 133 people suffer from this autoimmune disease. The number may be as high as one out of 33 in at-risk populations. You are more likely to have the disease if you have any of the following:

• a close relative with celiac disease
• European descent
• unexplained iron deficiency anemia
• premature osteoporosis and osteopenia
• unexplained reproductive disorders
• irritable bowel syndrome
• lupus
• type 1 diabetes mellitus
• rheumatoid arthritis
• autoimmune thyroid diseases (Hashimoto's, Grave's)
• microscopic colitis
• liver disease
• Down Syndrome

The onset of celiac disease can occur at any time in a person's life. Diagnosis of celiac disease includes antibody blood tests (IgA and IgG antibodies) for gluten and wheat, small intestinal biopsy (performed endoscopically), and genetic testing of the HLA DQ2/DQ8 genes.

Gluten intolerance, also called non-celiac gluten sensitivity, is very similar to celiac disease except that it is not immune-related. There is no clinical diagnostic test for gluten intolerance; however, if you go on a gluten-free diet and your symptoms disappear, you are likely to have gluten intolerance.

Going Gluten-Free

The only treatment for celiac disease and gluten intolerance is to abstain from any foods that contain gluten.

Grains to avoid:

• barley
• couscous
• farro
• kamut
• malt
• oats (unless labeled gluten-free)
• rye
• semolina
• spelt
• teff
• triticale
• wheat

Hidden sources of gluten:

• candies
• canned tuna fish
• cereals
• caramel coloring
• cold cuts
• coloring
• corn starch (may contain anti-caking ingredient)
• emulsifiers
• flavorings
• hydrolyzed plant protein (HPP)
• hydrolyzed vegetable protein (HVP)
• ketchup (vinegar may contain gluten)
• malt and barley malt
• maple syrup (unless labeled 100% pure)
• medications
• modified food starch
• preservatives
• rice syrup (unless labeled gluten-free)
• sauce mixes
• soy sauce
• soups, ready-made
• spices (may contain anti-caking ingredient)
• starches
• texturized vegetable protein (TVP)
• vegetable gum
• vinegar

Gluten-free grains, seeds, and flours:

• amaranth
• almond flour
• buckwheat
• coconut flour
• corn (only eat non-genetically modified corn)
• flax
• millet
• quinoa
• rice
• sorghum
• soy (not recommended as a health food)

Additional Tips

• Be patient. When you start out on a gluten-free diet, you may begin to feel better almost immediately. But for some people, it may take up to a month or two before the inflammation subsides. After all, it needs almost 9-12 months for the lining of your small intestine to heal.
• Probiotics. One way to expedite the healing process is to incorporate the use of probiotics, which are the beneficial bacteria that reside in your gut. Many people with leaky gut have a bacterial imbalance - too much of the "unfriendly" bacteria and too little of the "friendly" bacteria. Probiotics have also been shown to have anti-inflammatory potential and help alleviate the severity of celiac disease. Natural probiotics include fermented vegetables such as kimchee and sauerkraut, unsweetened kefir (fermented milk) and yogurt, and natto (fermented soybeans, a traditional Japanese food). Another option is to take a high quality probiotic supplement with your meal.
• L-glutamine. This amino acid is found in abundance in the entire gastrointestinal tract. It plays a key role in the metabolism, structure and functioning of the gut and its extensive immune system. Supplementation of L-glutamine will help promote intestinal healing. 
• Digestive enzymes help to break down food into their smallest molecules and enhance absorption of nutrients, which is a major problem for people with celiac disease.
• Omega-3 fatty acids help to promote intestinal healing, support the immune system, and reduce inflammation. Good sources of omega-3 are found in cold water fish such as wild Alaskan salmon, sardines, and herrings. Another alternative is to take a high quality omega-3 supplement derived from mercury-free fish.
• Last but not least, when you go gluten-free, make sure you are not swapping whole grains for refined, processed foods. One study of people with celiac disease who followed a gluten-free diet found that over 80% gained weight after two years. Just because a food is gluten-free doesn't automatically make it healthy or promote weight loss. Instead, substitute your gluten grains with lots of vegetables and avoid gluten-free foods that are refined, processed, or loaded with sugar.

© Carol Chuang 2012

About the Author

Carol Chuang earned a Master of Science degree in Nutrition from Huntington College of Health Sciences. She is a Certified Nutrition Specialist from the American College of Nutrition, a Certified Health Counselor from the Institute for Integrative Nutrition, a Certified Metabolic Typing Advisor, and a Certified Functional Diagnostic Nutritionist. She is also board certified by the American Association of Drugless Practitioners.

Carol is a Professional Member of the American College of Nutrition and the Price-Pottenger Nutrition Foundation. Apart from having her private practice counseling individual clients, she writes a monthly nutrition newsletter, and conducts regular seminars on various topics of nutrition and wellness.