Dispelling the myths of a gluten free diet
The rise of the gluten free diet… This is not a fad diet, it does not cause weight loss and is not necessarily healthier. It is required when a physical condition in your gut has a reaction to gluten.
Undigested gluten proteins (prevalent in wheat and other grains) enter the intestines and are treated by the body as a foreign invader, irritating the gut and flattening the microvilli along the small intestine wall. Without those microvilli, there is considerably less surface area with which to absorb nutrients from ingested food.
People aren’t born with this condition; something triggers it and with the dramatic increase of this condition in all ages, it must be something pervasive in the environment.
Coeliac disease and gluten sensitivity/intolerance
At one time the terms were used interchangeably however emerging research is discovering that there is a difference between them…
Although symptoms (principally gastrointestinal) of gluten sensitivity are not dissimilar to those of celiac disease, the overall clinical picture is less severe. Recent research explains how gluten sensitivity is a different clinical entity, in that it does not result in the intestinal inflammation that leads to a flattening of the villi of the small intestine that characterizes celiac disease. The development of tissue transglutaminase (tTG) autoantibodies, used to diagnose celiac disease, is not present in gluten sensitivity[i].
Gluten sensitivity/intolerance otherwise known as Non-Celiac Gluten Sensitive (NCGS) is where there is an adverse effect on the body without the allergenic and autoimmune condition; but it does produce symptoms. These individuals can tolerate small amounts of gluten.
Gluten sensitivity presents a different immune mechanism, the innate immune response, as opposed to the long-term adaptive immune response that arises in celiac disease. It is believed that gluten sensitive reactions do not engender the same long-term damage to the intestine that untreated celiac disease can cause.
It is also important to note that there are individuals allergic to wheat, however this is spurred by an IgE allergic response instead of an autoimmune (coeliac) or immune mediated (gluten sensitivity) reaction.
Coeliac disease is a lifelong autoimmune condition characterised by the chronic inflammation of the intestine. In genetically predisposed individuals, the intake of foods containing gluten leads to an immune response in the small intestine. This can lead to nutritional deficiencies and associated long-term complications.
In Coeliac Disease the lining of the small bowel is damaged by a protein in food called gluten. When gluten is ingested by a coeliac it damages the finger-like projections (called ‘villi’) in the small bowel. The inflammation caused by gluten makes the villi flat, which can lead to poor absorption of the nutrients in food.
- Weight Loss (in some cases this may be the opposite)
- Iron Deficiency Anaemia (easy bruising of the skin)
- Vitamin & Mineral Deficiencies
- Gastrointestinal Symptoms such as: abdominal pain, diarrhoea, constipation, flatulence, cramping, vomiting, nausea, bloating
- Muscle wasting
- Autoimmune Disease
- Failure to thrive in children or delayed growth or delayed puberty in children
- Fatigue, weakness and lethargy
- Skin rashes such as dermatitis
- Mouth ulcers and/or swelling of mouth or tongue that reoccur
- Altered mental alertness and irritability
Keep a look out for our next Gluten Free blog instalment (next week) where we will discuss which foods contain gluten and which foods are naturally gluten free.
[i] Sapone et al (2012) Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Medicine;10:13.