What is gluten
Gluten is a protein found in commonly consumed grains such as wheat, barley, rye, kamut, spelt and oats (unless designated gluten-free). As these foods have long been considered dietary staples – the bottom section of the Food Pyramid, which we are encouraged to eat in abundance – it can come as a shock to many people to discover that gluten grains may be the cause of their ill health.
We are not genetically adapted to eat gluten, which was only introduced into Europe in the Middle Ages – a comparatively short time ago, in evolutionary terms. Thirty percent of people of European descent carry the gene for coeliac disease. In addition, gluten grains have been modified over the centuries, so they now contain a much higher proportion of gluten. This is bad news for anyone with gluten sensitivity.
Why Gluten Free?
It used to be thought that there was a clear distinction between people with full-blown coeliac disease, and the rest of the population. Traditionally, coeliac disease would be diagnosed in childhood as a result of gastrointestinal symptoms such as diarrhoea, and confirmed with an intestinal biopsy that showed damage to the gut lining.
However, these days it is recognised that gluten sensitivity conditions can range from mild intolerance to latent (and therefore undiagnosed) coeliac disease.
A groundbreaking study was published in the Journal of the American Medical Association (i). This study looked at almost 30,000 people from 1969 to 2008 and examined deaths in three groups – patients with full-blown coeliac disease, those with gluten-related inflammation of the intestine, and those with latent coeliac disease or gluten sensitivity, indicated by elevated gluten antibodies but a negative intestinal biopsy.
The research demonstrated that gluten sensitivity, whether overt or latent, carries with it an increased risk of death, particularly from heart disease or cancer. Risk of death increased by 39% in those with coeliac disease, 72% in those with gut inflammation, and 35% in those with non-coeliac gluten sensitivity.
The real problem here is that many people with gluten sensitivity do not realize what is causing their symptoms. A review paper in the New England Journal of Medicine (ii) listed 55 conditions that may be caused by gluten, including osteoporosis, irritable bowel disease, cancer, chronic fatigue, rheumatoid arthritis, multiple sclerosis, migraine, schizophrenia, depression, epilepsy and autism. Some forward-thinking clinicians now suggest eliminating gluten when any chronic disease is diagnosed. Autoimmune disease is the third greatest cause of morbidity and mortality in the western world, so detecting gluten sensitivity is of critical importance. However, in the UK for every one person diagnosed, there are at least eight that are not.
Gluten sensitivity is an autoimmune condition that causes inflammation throughout the body. This explains why it can be at the root of so many chronic illnesses that seem unconnected. Many people with gluten intolerance develop intestinal permeability (known as leaky gut), which leads to other allergies and intolerances. Symptoms can include digestive disturbances such as constipation, diarrhoea, bloating and pain, anxiety, fatigue, infertility, joint pain and poor blood sugar control.
Click HERE for a more in-depth explanation of coeliac disease, sub-clinical gluten intolerance and related health conditions.