Gluten and Celiac Disease

What is Gluten?

Gluten is the term for a group of proteins found in a specific part of certain grains. It has qualities that help bread rise while baking and gives it its unique taste profile.

The specific part of the grain which contains gluten is called the endosperm. The endosperm is similar to the yolk of a chicken egg. The endosperm provides nutrients to the seed embryo during development, just like the yolk does for a chicken.

To take it a bit deeper, gluten is composed of two of the four proteins found in the endosperm: gliadins and glutenins (the other two are albumins and globulins).

Which foods contain gluten?

Foods, like breads and pastas, made with wheat, barley, or rye will usually contain gluten. However, many soups, sauces, salad dressings, and most types of beer also have gluten. In vegan and vegetarian circles, it's common to hear of a product called seitan. Seitan is also called wheat gluten. It can be thought of as "pure" gluten since it's made by removing the starch from wheat flour.

Cross-contamination can cause foods that don't naturally contain gluten (like oats) to end up containing gluten when it reaches the consumer's plate.

Which foods don't have gluten?

Gluten is specific to grains, so most other foods won't naturally contain gluten. Fruits and vegetables, meats (including poultry, fish, and seafood), dairy, and non-grain seeds (i.e., beans, legumes, and nuts) don't have gluten. Distilled liquor (as long as it doesn't contain gluten-containing flavorings) is also gluten-free.

The term "gluten-free" is regulated by the Food and Drug Administration in the United States. To be classified as gluten-free, a product cannot contain more than 20 milligrams (of gluten) per kilogram of food (20 parts per million).

Celiac disease

Celiac disease is an autoimmune disorder that's "the most common food intolerance in western society", some estimates suggest up to 1% of the population may have celiac disease.

If a person with celiac disease regularly consumes gluten-containing food they may show symptoms like fatigue, arthritis, anemia, diarrhea, depression, anxiety, and weight loss (among others). Other symptoms that one wouldn't typically associate with celiac disease, like pregnancy complications (e.g., miscarriages, preterm births, or underweight births), may also occur.

Some people, however, are asymptomatic, meaning there aren't obvious signs they have celiac disease. Due to the possibility that a person is asymptomatic and the difficulty of diagnosis, it's estimated that "about 83%... are undiagnosed or misdiagnosed with other conditions".

Individuals with inflammatory bowel disease, like Crohn's disease, are more likely than the general population to have celiac disease. Due to its hereditary nature, the close relatives (parents, siblings, and children) of a person with celiac disease are more likely to also have the disease.

The long-term problem facing individuals with celiac disease is damage to the small intestine. Thankfully, the best treatment for celiac disease, maintaining a strict gluten-free diet, is straightforward. In fact, the healing process begins when a person with celiac disease moves to a gluten-free diet and can have dramatic impacts to a person's quality of life.

Should a person avoid gluten if they don't have Celiac disease?

Recent trends in health and wellness have caused people to consider changing their diets to be healthier. Given the health benefits of a gluten-free diet for individuals with Celiac disease, a person may consider going gluten-free for the health benefits. Unfortunately, there's no evidence to suggest that going gluten-free is beneficial for people without celiac disease.

Whole grains provide nutrients and replacing those with more processed grains can lead to worse outcomes for the average person. Before a big change to one's diet, it's important to understand what the impact of those changes will be. Chasing fad diets or pursuing a way of eating that's only applicable to a subset of the population might lead to slower progress than other simple changes could provide.

Are you ready to make a change?

If you're considering changing your diet, you may benefit from Dr. Inman's nutritional counseling service. Dr. Inman approaches your health from a holistic and data-driven perspective; she'll take the time to understand your current health habits.

You may also benefit from genetic testing to determine if you're predisposed to gluten sensitivity and if that sensitivity makes you more likely to experience gastrointestinal inflammatory disease.

Her experience can help you avoid long-term experimentation and struggle. Top athletic performers have teams dedicated to managing their nutrition. While most of us can't afford to hire a staff, we can get affordable, personalized help.

Take the next step in your health journey and schedule a nutritional counseling appointment with Dr. Inman today. Click the button below and you'll be taken to JaneApp, Dr. Inman's online scheduling tool.