Let’s talk about gluten!
Gluten is a complex topic, first because there has been a recent media ‘demonization’ of it, causing substantial misconceptions among the population, and second, it’s known that its consumption can cause an autoimmune reaction known as celiac disease in genetically predisposed individuals.
Before I start talking about gluten, it’s important to understand some terms, for instance, prolamins. These are a group of low nutritional value plant proteins, which means that they lack essential amino acids. This group of proteins is found mainly in the seeds of cereal grain such as wheat, barley, rye, and oats. When flour made from these grains is mixed with water the combination of two proteins (glutenin and gliadin, part of the prolamin group) combine to form gluten during the kneading of the dough. To sum up, gluten is classified as a group of proteins and is formed by the combination of these with water, and kneading.
Now that you know how gluten is formed, let’s understand what is celiac disease (CD). CD is an inflammatory disorder of the small intestine produced by permanent intolerance to gluten proteins in predisposed individuals. Gliadins contain most of the toxic components to celiac individuals, it triggers an abnormal immune response that causes the typical celiac lesion in the small intestine characterized by villous atrophy, crypt hyperplasia, and increased numbers of intraepithelial and lamina propria lymphocytes¹. Symptoms can vary greatly, from malabsorption, abdominal distension, and pain, diarrhea, weight loss in the classical form of the disease to iron-deficiency anemia, chronic fatigue, vitamin deficiency, late menarche/early menopause, unexplained infertility, depression, and anxiety in the non-classical form. To make matters more complicated, there is also a silent form of celiac disease, which means that these patients won’t experience any symptoms, even if they’ll still suffer villous atrophy damage in their small intestine.
As for the diagnosis, the only way to confirm that a person has celiac disease is to have an intestinal biopsy, where a pathologist will assign a Marsh Type according to the histological changes. The only treatment available for celiac disease is lifelong adherence to a strict gluten-free diet.
Now that you understand how gluten is formed and what celiac disease is, let’s find out which foods contain gluten?
Besides baked goods made from the cereal grains mentioned above, gluten can be found in a wide variety of processed foods, this is because gluten has physico-chemical characteristics that induce substantial improvements in the products. For instance, it can improve the texture and shape due to its visco-elasticity, it can form emulsions, foams, gels, and serve as a vehicle for flavorings and colorants, as well as reducing production costs when used as a substitute for animal proteins. For this reason, it’s extremely important for those who have any sort of gluten intolerance to check the food package to certify that the product is indeed gluten-free.
Now that you have this information, I believe that many of you are wondering, should we all go gluten-free?
The short answer is NO, let’s understand why. According to the following study “Effects of a gluten-free diet on gut microbiota and immune function in healthy adult human subjects”, published by the British Journal of Nutrition in 2009, a gluten-free diet (GFD) led to reductions in beneficial gut bacteria populations and the ability of fecal samples to stimulate the host’s immunity, which means that GDF may influence the composition of immune function of the gut microbiota in healthy individuals, without the influence of any underlying disease. Moreover, it’s worth mentioning that gluten-free foods are more expensive and frequently contain a greater amount of fat and/or carbohydrates, and might lack vitamins and minerals because they aren’t fortified as they are not designed to be consumed by the general population.
As a dietitian, I don’t see any major benefit in adhering to a GFD if you DON’T have any type of gluten intolerance, and if you believe that you might have a gluten intolerance I would strongly suggest visiting a gastroenterologist before adhering to a GFD so you can be properly diagnosed and treated.
Author: RD. Thais Ribeiro
