When Truckee contractor Dan Moore cut gluten from his diet, he didn’t do it for his health. Moore’s wife was going gluten-free, and he reasoned that shopping and cooking would be easier if he and Lisa were eating the same foods.
“I didn’t expect to feel any different,” he admitted. But within a few days, something unexpected happened. Moore had more energy and his moods felt even-keeled. And after meals, he no longer had the stomach cramps that had plagued him for years.
“Ever since I was a kid, my digestion’s been sensitive,” he said, “especially after eating something like pizza or pancakes.” Two years later, he’s still gluten-free.
Moore is one of a growing number of people who believes he has gluten “sensitivity,” a condition that, until recently, was not taken seriously by the medical community. But a study published in March by the University of Maryland’s Center for Celiac Research has proven not only that gluten sensitivity is real, but that it also elicits a completely different immune response in the body than either wheat allergy or celiac disease, the autoimmune disease caused by eating gluten.
This study came on the tails of a landmark consensus paper, published in BMC Medicine, which classified and named the entire range of known gluten-related disorders. The paper answered a question that’s been burning in the minds of many: How come everyone and their grandma is suddenly going gluten-free? It’s not just a fad, say the researchers; incidents of both celiac and gluten sensitivity are on the rise. People of European origin are most affected due to their genetic makeup. Currently, about 1 percent of Americans has celiac disease, but here and in other Western nations rates are doubling every 20 years. Cases of gluten sensitivity are even more prevalent; researchers estimate that as much as 10 percent of the population may be affected.
Gluten, a protein in wheat, barley, rye, and some oats, has been around for about 10,000 years, introduced when our ancestors began cultivating crops. So why are we so intolerant of it? One theory is that the varieties of wheat grown today contain higher levels of gluten than they used to, thanks to agricultural manipulation. Also, and perhaps most importantly, wheat makes up a huge part of the Western diet. It’s the primary ingredient in bread, bagels, crackers, pasta, cookies, and baked goods. If our bodies are genetically predisposed to react to gluten, and we bombard ourselves with wheat at every meal, we’re more likely to develop a gluten reaction over the course of our lives. That reaction can manifest in one of many ways, but the following are the most common:
• A wheat allergy is a negative immune response to either gluten or other proteins in wheat. It usually occurs minutes to hours after ingesting wheat and can manifest as a classic food allergy (hives, congestion, nausea, or more severe anaphylaxis), or a less common condition, such as baker’s asthma.
• Celiac disease is an autoimmune disease that develops after weeks or years of eating gluten. Symptoms include cramping, diarrhea, weight loss, bloating, muscle wasting, weakness, and fatigue. Some people develop celiac as children, others not until middle age or later. No one, however, is born with the disease.
When someone with celiac eats gluten, their immune system pumps out antibodies that damage the small intestine’s villi, the tiny fingers responsible for absorbing nutrients into the body. Without treatment, celiac disease can have devastating consequences, including malnutrition, osteoporosis, infertility, anemia, seizures, and even cancer. Some people with mild symptoms remain undiagnosed for years, attributing their discomfort to irritable bowel syndrome or chronic fatigue. But intestinal damage is occurring even when symptoms are mild.
If you suspect you have celiac disease, get a blood test before embarking on a gluten-free diet; otherwise, you’ll no longer make the antibodies necessary for accurate test results. If your blood test is positive, a small intestine biopsy will probably be done to confirm the disease. The good news is that the intestinal damage is almost always reversible. The bad news is that if you have celiac, there’s a one in 22 chance that your first-degree relatives will develop it too.
• Gluten sensitivity is now the official name for an intolerance to gluten that is neither celiac nor an allergy. Symptoms might mimic celiac disease, but can also include a high number of non-intestinal ailments including bone and joint pain, behavioral changes, depression, muscle cramps, eczema, weight loss, chronic fatigue, brain fog, and numbness in the extremities. Unlike celiac disease, gluten sensitivity does not damage the small intestine.
Currently, the only way to diagnose gluten sensitivity is to rule out celiac disease and wheat allergy through testing, and then embark on a gluten-free diet. If your symptoms return when you reintroduce gluten, you probably have gluten sensitivity.
The Gluten-Free Diet
Cutting out gluten takes effort, but it’s certainly easier today than it used to be. Health food stores carry the widest variety of gluten-free fare, but even mainstream grocery stores now carry gluten-free pasta, bread, crackers, and even frozen dinners. You’ll need to read ingredients carefully and search out gluten-free versions of your favorite foods and beverages.
People with celiac disease need to avoid every trace of gluten. Those with wheat allergy or gluten sensitivity can sometimes cheat a bit, depending on their level of tolerance.
If you have no symptoms of a gluten disorder, should you go gluten-free just to be “healthy”? Probably not. A gluten-free diet can be low in vitamin D, vitamin B12, magnesium, and iron because the grains are typically non-fortified. Also, many gluten-free products are lower in fiber and higher in sugar, sodium, fat, and carbs because manufacturers are trying to mimic the taste and texture of products made with gluten. It’s certainly possible to eat a healthy gluten-free diet, but it takes effort and intention. Unless medically necessary, you probably shouldn’t attempt the diet if you’re just going to fill your cupboards with gluten-free bread, cookies, and cinnamon rolls.
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