I’ve been interested in gluten intolerance ever since I was diagnosed with gluten sensitivity, and more so since I started Food for Normal People. And since I’m always eager to learn more about the condition, I thought it would be a good idea to speak to my friend Priyanka Banerjee who is a research scientist and lecturer at the Institute of Physiology, Charite, Berlin.
Priyanka has been researching on food allergies for some time and offers a scientist’s perspective on gluten and food sensitivity in general. So if you’re a science buff, here are some facts you may be interested in.
What is gluten?
Gluten is a family of proteins found in grains like wheat, rye, spelt and barley. Gluten proteins can be divided into two main fractions according to their solubility in aqueous alcohols: the soluble gliadins and the insoluble glutenins. Gliadin is responsible for most of the negative health effects.
What does Ayurveda have to say about gluten intolerance? Click here to read more.
How does gluten intolerance manifest in a person who is sensitive to the protein?
An individual with gluten intolerance will develop symptoms after consuming foods containing wheat, barley, or rye. Gluten intolerance or non-Celiac gluten sensitivity, as it is also known, shares some of the same symptoms of Celiac disease, but is a less severe condition.
Gluten intolerance is often mistaken for Celiac disease, but they are separate conditions. Celiac disease is a severe autoimmune disease and it can damage a person’s digestive system.
Symptoms of gluten intolerance include, diarrhea and constipation, bloating, abdominal pain, fatigue, nausea, headaches, anxiety and body pain.
People with gluten-intolerance are generally considered to have Celiac disease, but doctors are now accepting the fact that some patients may be gluten-intolerant but not have Celiac disease. Could you explain?
People with Celiac disease can’t tolerate gluten, not even small amounts. Just 50 milligrams of the protein – about the amount in one small crouton – is enough to cause trouble. For Celiac patients, gluten triggers an immune response that damages the lining of the small intestine.
This can interfere with the absorption of nutrients from food, cause a host of symptoms and even lead to other problems like osteoporosis, infertility, nerve damage, and seizures. A related condition called gluten-sensitivity or non-Celiac gluten sensitivity can generate symptoms similar to Celiac disease, but without the intestinal damage.
Want to know more about food sensitivity? Here’s a list of websites.
Non-celiac gluten sensitivity (NCGS) is a term that is used to describe individuals who are not affected by Celiac disease or wheat allergy, yet they have intestinal and/or extra-intestinal symptoms related to gluten ingestion and their symptoms improve upon eliminating gluten from their diet.
Gluten-related disorder groups are manifested by symptoms of gastrointestinal tract disorders, as well as those of the hematological, dermatological, endocrinological, gynecological, rheumatological and nervous systems.
It is believed that NCGS represents heterogeneous groups with different subgroups characterized by different etiologies, clinical histories and clinical courses. There also appears to be an overlap between NCGS and irritable bowel syndrome (IBS).
There is a need for establishing strict criteria for diagnosing NCGS and the absence of validated biomarkers remains a significant limitation for research studies on NCGS.
New evidence shows that a gluten-free diet may be beneficial for some patients with gastrointestinal symptoms, such as those commonly found in patients with IBS. Prevalence studies of NCGS pose a challenge due to the absence of a specific diagnostic marker and a standardized diagnostic procedure.
I am allergic to wheat, but can eat other gluten-containing grains. Is there a reason why?
Celiac disease, wheat allergy and non-Celiac gluten sensitivity represent different gluten-related disorders. Similar clinical manifestations can be observed in these disorders, yet there are peculiar pathogenetic pathways involved in their development.
Celiac disease and wheat allergy have been extensively studied, while non-Celiac gluten sensitivity is a relatively novel clinical entity, believed to be closely related to other gastrointestinal functional syndromes.
Wheat allergy (WA) represents another type of adverse immunologic reaction to proteins contained in wheat and related grains, with different clinical presentations depending on the route of exposure. In this setting, Immunoglobulin E (IgE) antibodies mediate the inflammatory response to several allergenic proteins (like alpha-amylase/trypsin inhibitor, non-specific lipid transfer protein (nsLTP), gliadins, HMW glutenins).
Wheat allergy is triggered by an immunoglobulin E (IgE)-dependent mechanism; its prevalence varies according to the age and region, and in Europe has been estimated to be lower than 1%. Many studies have investigated the potential role of several external factors that can influence the risk to developing wheat allergy, but results are still inconclusive. Wheat could be responsible for several clinical manifestations depending on the route of allergen exposure: food-dependent exercise-induced anaphylaxis (FDEIA), occupational rhinitis or asthma (also known as baker’s asthma), and contact urticaria.
Nowadays, oral immunotherapy has been proposed for wheat allergy with promising results, even if further studies are necessary to establish the best protocol in order to promote tolerance in children allergic to wheat.
Could our lifestyle nowadays have something to do with these problems?
It’s hard to say. Since there are no proper diagnostic/biomarkers for gluten-insensitivity, we don’t really know whether poor lifestyle choices or genetic factors are responsible for such conditions.
Sources:
https://www.ncbi.nlm.nih.gov/pubmed/26109797
https://www.ncbi.nlm.nih.gov/pubmed/31340608
https://www.ncbi.nlm.nih.gov/pubmed/22345659
https://www.wjgnet.com/1007-9327/full/v21/i23/7110.htm
https://www.ncbi.nlm.nih.gov/pubmed/31986568
https://www.ncbi.nlm.nih.gov/pubmed/32026861
https://www.ncbi.nlm.nih.gov/pubmed/17008153