Okay, so raise your hand if you know someone on a gluten-free diet. I would imagine nearly everyone’s hand went up. Okay, you can put your hand down now... seriously, people are starting to look at you funny.
So, maybe you’re wondering (or perhaps not) why all of a sudden everyone is on this whole gluten-free kick. Is it the newest fad diet? Is it because all the cool kids are doing it? Truthfully, that might account for some of this phenomenon but for the most part, this thing is legit. More and more people are discovering that they are, in fact, intolerant to wheat and other gluten containing grains.
What the Heck is this Gluten Stuff Anyway?
Let me back up for a second explain exactly what gluten is. Gluten is an elastic, sticky protein that’s found in lots of grains but mainly in Barley, Rye, Oats and Wheat (or B.R.O.W. to help you remember). It’s what gives your bread that spongy chewiness and what allows pizza makers to toss dough around. The problem is, we humans aren’t too adept at digesting this stuff and this can cause some serious health issues.
The Gut Landscape.
To explain why this is problematic, I’ll need to briefly explain what the terrain is like inside our digestive system- in particular, the small intestine. Don’t worry, this will only be a lot boring. Here goes: Lining the small intestine has a thin layer of cells called enterocytes. This is your first line of defense against anything allergenic, pathogenic or otherwise nasty from getting into your blood stream where it doesn’t belong. The function of this thin, protective layer is to let only very tiny nutrients into the blood stream to be used for various purposes throughout the body. Are you with me so far? Good. Next we have little finger-like protrusions that line the intestine called villi. Think of those as a shag carpet (for those of you born before 1980). These villi create a massive surface area that helps the absorption of these nutrients. This surface area is so huge that, if you were to iron it out, could cover a tennis court. On top of those villi are even tinier villi which are called, of all things, microvilli. The job of the microvilli is to produce
enzymes. For example; they produce lactase to digest lactose, the sugar found in milk. This helps breakdown food into small particles that will then be allowed to pass through the enterocytes. See that... full circle of small intestinal digestion and absorption in one simple paragraph.
The Gluten Reaction
When gluten is ingested and begins to breakdown, it creates other proteins, or prolamins. One of those proteins is called gliadin. Gliadin interacts with an enzyme called tissue Transglutaminase (tTG) which, in folks that are sensitive to gluten, activates the immune system causing inflammation in the gut. This leads to the destruction of those villi and microvilli I told you about earlier. (Side Note: While Gliadin is the common prolamin that causes this problem, there are over 60 other substrates of gluten that may cause similar reactions. We’re just beginning to understand how many ways gluten can cause problems). Remember, those villi create a huge surface area to help absorb nutrients and the microvilli help break food down into those nutrients. As you might imagine, if the villi and microvilli are completely destroyed by the immune system, then absorbing nutrients becomes extremely difficult or impossible. This is classic Celiac Disease but we also have a condition known as Non Celiac Gluten Sensitivity (NCGS) which can be described as the process of becoming Celiac. Celiac disease is defined by the complete destruction of the villi, while in NCGS we observe only partial villous atrophy, or partial blunting of the villi. In other words, if a normal gut looks like that shag carpet, and Celiac disease look like a concrete floor, then NCGS is somewhere between the two. It looks more like a commercial or berber carpeting. This can create a lot of the same symptoms as classic celiac disease both within the gut and outside of the gut.
A Fourfold Increase. Why?
There are a few possible reasons why Celiac Disease has increased fourfold over the last 40 years or so. For one, there is clearly more awareness of the disease and if more screening is being done then, naturally, the more it’s being diagnosed. The problem is that tests are not always accurate especially at detecting NCGS. If the patient is in that transition stage (berber carpet) then the test may only be accurate about 30% of the time whereas it’s 97% accurate in the case of full blown Celiac Disease (concrete floor). We are just starting to see much more sensitive and accurate tests come out so it’s unlikely that improved testing could account for much of the increase.
The most likely factor is that the wheat plant itself has changed. Back in the ‘50s and ‘60s there was increasing fear that, as the world’s population exploded, we would not be able to feed everyone. Thus, the semi-dwarf, high yield wheat plant was developed by the American Agronomist, Dr. Norman Borlaug. This increased yields by up to ten times the amount of previous harvests. This actually won him the Nobel Peace Price in 1970.
Through techniques like hybridization, backcrossing, mutation induction and chemical manipulation the agriculture industry was able to tease out certain “desirable” traits in the plant. One of the other changes in the plant happened to be the increase in gluten. In fact, there is 50% more gluten in wheat today then there was 50 years ago. Remember that gluten (which comes from the Latin word meaning “glue”) is a sticky, elastic protein. As you might imagine, the extra gluten has helped the food industry create more processed food than ever before. So not only has the plant itself changed dramatically, we’re eating way more of the stuff than ever before in the form of highly processed and refined foods that are largely devoid of nutrients. Through all of these drastic changes in proteins, genes and chromosomes not once has anyone tested this basically new food to see if it was still safe for human consumption. It should not come as a shock that we have a tremendous increase in not just Celiac Disease but other diseases that stem from a dysfunctional gut.
It’s estimated that about 1 in 100 people have diagnosed CD and as many as 7 out of 10 people have some range of gluten sensitivity. Countless people go undiagnosed both because screening methods are not always accurate but also because, for most folks, the symptoms actually manifest outside of the digestive tract. In the next part of this series, I’ll explain how gluten can cause problems nearly anywhere in the body before it effects the digestive tract.
If you or someone you know has tried a gluten free diet, let me know in the comment section below. How did the diet effect them? Did they see an improvement in health?
Also, we’ll be starting the Wellness Punks podcast very soon. If you have any questions regarding health or nutrition please email us at email@example.com and we’ll try to answer your questions on an upcoming episode.
Joe Rignola is a Certified Holistic Health Coach, Functional Diagnostic Nutritionist and founder of Wellness Punks, Mobile Health and Nutrition Coaching. He helps people achieve their highest level of health by teaching them not just what foods to eat, but why we should eat them. He also focuses on the many lifestyle factors that effect our health and well being. Clients have experienced improvements in weight, cholesterol levels, pain and inflammation, blood sugar, autoimmune problems and more. For more information please go to www.wellnesspunks.com or call 888-955-0002.
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