Gluten Problems in Non-Celiacs

Is Gluten giving me pains and bloating?

Gluten can cause digestive problems in non Celiacs as well as those with Celiac Disease. Although gluten is well known to cause the serious and debilitating symptoms of Celiac Disease and affected people have four different types of antibodies, many others have gluten sensitivity. Many of us, who suffer from considerable discomfort, receive an unhelpful descriptive ‘diagnosis’ such as ‘Irritable Bowel’, which tells us nothing that we didn’t know already!

In 2004, a research group from Monash University published research about FODMAPS (Fermentable Oligosaccharides, Monosaccharides and Polyols) that are common constituents of many fruits and vegetables. The research has now been refined and the results have been widely applied since 2007. This helpful research describes which foods contain moderate or high amounts of FODMAPS. Use of the APPS that are now available, allows affected people to choose small or no exposures to a large range of fruit and vegetables that might cause them discomfort.

Avoiding FODMAPS helps me greatly, but despite this, I was still experiencing considerable discomfort at night and decided to change to a different type of bread. The sough dough bread I chose reduced my discomfort further but I still had some discomfort until by chance I changed the Soy Sauce I was using most nights to a gluten-free Soy Sauce. Suddenly I seemed to be completely cured!

I’m not suggesting that removing gluten will compensate for FODMAP issues but rather that it might be one more thing to consider for those who are still experiencing some discomfort.

Gluten

From an evolutionary perspective, humans have only recently been exposed to grains and gluten. Our human ancestors existed about 2.5 million years ago, yet wheat and grains were only introduced into our diets about 10,000 years ago! Rice, by contrast is a common carbohydrate staple for more than half of the world’s population and does not contain gluten. Rice was grown in India as early as 5000 BC.

Gluten is a protein that is found in most grains, especially wheat, barley, and rye so in most modern, western diets it’s commonly consumed in foods such as bread, biscuits, cereal, pasta, and pizza.

Since the two world wars, agronomists have developed grains that have much higher amounts of gluten than the original strains. Furthermore, since the misguided advice from 1970’s research that urged us to eat more and more grains, there has been a huge increase in the consumption of grains and gluten. For these two reasons, many people are now consuming very high amounts of gluten, and this might not be advisable.

Gluten – a gut antagonist?

Some people cannot tolerate any gluten and if they do, develop an autoimmune disease known as Celiac Disease. But many people have a condition diagnosed as Non-Celiac Gluten Sensitivity where they may have antibodies to Gliadin but not the other three antibodies that are also diagnostic of Celiac Disease. Nevertheless, only about 50% of people who have Gluten Sensitivity have any positive antibodies.

Celiac Disease versus Gluten Sensitivity

Celiac Disease is a serious ‘autoimmune’ disease that has a genetic predisposition. Approximately one in 10 people with an affected relative, develop Celiac Disease. Celiac Disease doesn’t have simple inheritance in the same way as most other genes, but identical twins show abut 75-80% concordance. When a person with Celiac Disease eats food containing the grain-derived protein ‘gluten’, they suffer serious intestinal problems and damage to the cells of the small intestine. If this is untreated, Celiac Disease can lead to other serious health problems. However, since it’s thought that either early exposure to gluten and/or an exceptionally clean early home environment might increase the risk of a susceptible person developing the disease, identical twins would be particularly at risk.

Celiac Disease only occurs if a susceptible person ingests gluten so in countries like Japan and sub-Saharan Africa, where gluten consumption is very low, the incidence of Celiac Disease is also very low. In many other countries, however, and especially the USA, the rate of Celiac Disease is rising quite rapidly. It is thought that this might be due to absence of exposures to bacteria in early childhood, but it might also be caused by the current increased likelihood of exposure to gluten.

What foods should I avoid if I am gluten sensitive?

Take care with all leavened foods. These are made by fermenting yeast with the purpose of creating a light, slightly honeycombed dough. Gluten is used to create elasticity, which enables the bread or other baked food to retain its shape. Gluten is the Latin word for ‘glue’, but gluten is usually made from two proteins named glutenin and gliadin that are blended together.

Different types of flour have different amounts of gluten. Low gluten cake flour is about 7-8%, pastry flour is 8-9%, all purpose flour is 11-12% and bread flour is about 13% gluten.

The way a bread is made also changes the final gluten content. Most sour dough breads have almost zero gluten and are often tolerated well by people with gluten sensitivity – probably the 50% without positive antibodies.

If you are gluten sensitive you should avoid wheat (including varieties like spelt and durum as well as wheat products like semolina), barley, rye, triticale and possibly oats. I find that I can eat a very small amount of oats but am more comfortable without them. Oats contain another protein called Avenin that causes a cross-reaction: one in five people with Celiac Disease reacts to oats. Compounds in Barley and Rye, called Hordein and Secalin respectively cause reactions in people with Celiac Disease but can be tolerated by some people with gluten sensitivity.

Grains that are gluten-free and can be safely eaten are corn, millet, rice, and sorghum while cereals that are safe include amaranth, buckwheat, and quinoa.

Food Standards and Labels

It is common now to buy food in supermarkets that is clearly labelled ‘gluten free’. Similarly, it is not uncommon to find a menu that allows the customer to choose a gluten-free meal, even if that meal contains foods such as pasta or pizza. In Australia and New Zealand, foods such as oats cannot be labelled or promoted as gluten free. This is because current tests can only measure Gliadin, Hordein and Secalin but not Avenin.

If ‘oats’ claim to be ‘gluten-free’ it means that they are not contaminated with grains other than oats. It does not mean that they do not contain Avenin.

For all other breads, cakes, biscuits, and pastries, we should assume that they DO contain gluten unless they have an authentic label stating that they are gluten free.

If I can help?

If I can help you with advice or perhaps give a talk, or write something for your organisation, please contact me.