Gluten – What We All Should Know

Dr. Rich Sheerin DC, CSCS

Adjunct Professor of Anatomy and Physiology – Monmouth University and Brookdale Community

College

What is Gluten? Gluten is a protein

located in the endosperm within grass-type grains such as wheat, barley and rye

It’s actually a combination of 2 proteins: Gliadin and Glutenin

Gluten is formed when agitation (pressure, kneading, etc.) causes Gliadin and Glutenin to combine.

The resulting protein - Gluten is thick and elastic (think “gooey”)

Gluten gives elasticity to dough and pasta, helps it rise and keep its shape and adds a chewy texture to the final product.

Gluten can be dried and broken down into a powder and added to baked goods and pasta to “improve” their texture

Gluten is also an ideal filler/thickener for processed foods as it is plentiful, cheap to produce and dense

This overuse of Gluten makes it very hard to eliminate or avoid Gluten, especially if one consumes prepared or processed foods

A Word on Fermentation

When yeast is added to dough, fermentation occurs and Gluten will trap the bubbles of Carbon Dioxide created – this makes dough lighter and “fluffier” (more on this later)

Where Do We Find Gluten?All grains theoretically contain it, but the

form of Gluten found in the following grains can be troublesome:Wheat – including spelt, kamut and triticale

Barley

Rye

Why These Grains?

Answer still unclear but these grains are all genetically related

Human intervention/farming practicesThe “original” GMOWheat has six sets of chromosomes

and 95,000 genes. In comparison, humans have just two sets of chromosomes and about 20,000 genes.

Gluten in the Body

In laboratory tests, wheat proteins have stimulated immune system cells, intestinal cells and neurological system cells to release inflammatory molecules called cytokines that can overexcite the immune system

Cytokines and InflammationCytokines are signals to the immune

system to send help ASAP – think of a flare gun to a shipwreck survivor

Upon “seeing the flare” the immune system sends its fighting cells to the rescue, causing inflammation

When we consume large amounts of Gluten, this inflammatory response can be magnified

Cytokines and Inflammation In some individuals, this response is

magnified and can cause local tissue destruction and illness

Further still, some individuals exhibit higher levels of inflammation and immune response when exposed to gluten

The above are the basis of Gluten Sensitivity and Gluten Allergy/Intolerance

Cytokines and InflammationStudies have also shown that breaking

down gliadin and glutenin produces even shorter chains of amino acids—the building blocks of proteins—some of which may behave like morphine and other opiates.

Perhaps these molecules explain some of the lethargy exhibited by people who do not have celiac disease but are nonetheless sensitive to wheat.

Gluten and IllnessWe are ALL sensitive to gluten on some

level. Too much of any substance can and

often will cause dysfunction in the body.

When gluten is digested in the GI tract, it splits back into Gliadin and Glutenin. In some people, Gliadin is treated a severely hostile invader and the body will go above and beyond to destroy it.

Gluten Intolerance and Celiac DiseaseNon-Celiac Gluten Sensitivity (NCGS)

More common (at least 6% of Americans) hard to definitively diagnose

Symptoms vary by patient and in severity and include:• Headache• Bloating• Fatigue• Skin rashes/sensitivity• Mouth ulcerations• Diarrhea/Constipation

Gluten Intolerance and Celiac DiseaseCeliac Disease

Much less common (1% of Americans)

Symptoms vary by patient and in severity and include:• Headache• Bloating• Fatigue• Skin rashes/sensitivity• Mouth ulcerations• Diarrhea/Constipation

Celiac Disease In true Celiac Disease, the immune

response is so severe that it can destroy the lining of the small intestine.

This disrupts normal nutrient absorption and can cause large molecules to “leak” into the bloodstream. (“Leaky Gut”)

The immune system then attacks these large, foreign molecules and the inflammation spreads throughout the body via the bloodstream

Symptoms of Celiac DiseaseThose as in NCGS as well as: Joint pain Increased lipids and glucose in blood

streamAnxiety/depressionMigranes/headacheTingling in hands/feet InfertilityAnemiaAnd many others…

Gluten Sensitivity and Celiac DiseaseCeliac Disease can be diagnosed via blood testingGluten Antibodies (the body’s self-made

recipe to destroy invaders) are present in your blood sample in high quantities

Endoscopy or biopsy of the small intestine can help confirm or rule out the diagnosis

How Can I Avoid Gluten?

Eliminate ALL wheat, kamut and rye intake

Limit oats, millet and teff as these are often processed in facilities that handle wheat

READ YOUR LABELS!!!

In the US, unlike other countries, the FDA does not require manufacturer’s to disclose whether or not a food product contains Gluten.

How Can I Avoid Gluten?Hidden sources/alternate names of Gluten include, but are not limited to: Durum/Semolina MSG Malto-dextrose, malt, malt vinegar Caramel color Hydrolyzed vegetable protein Modified food starch Bulgar Lecithins Triticale/triticum

How Can I Avoid Gluten?

Beer Breads Cakes and pies Candies Cereals Cookies and

crackers Croutons French fries

Gravies Matzo Pastas Processed

luncheon meats Salad dressings Sauces, including

soy sauce Seasoned rice

mixes

Seasoned snack foods, such as potato and tortilla chips

Self-basting poultry

Soups and soup bases

Vegetables in sauce

The best way to avoid Gluten is to avoid all PROCESSED/PREPARED/PACKAGED foods, unless they are specifically formulated to be Gluten-free.

Gluten Free Food Choices

BeansSeeds and Nuts (unprocessed and

unroasted)EggsRed and White meats (not battered or

breaded)All Fish (not battered or breaded)All Fruits and VegetablesMost Dairy Products

Gluten Free Grains/Cereals/StarchesRiceAmaranthArrowrootBuckwheatCorn and

cornmealFlaxGluten-free flours

(rice, almond, soy, corn, potato, bean)

Hominy (corn)MilletOatsQuinoaRiceSorghumSoyTapiocaTeff

Is Gluten Free Right For Me? If you’ve experienced a combination of gluten

sensitivity symptoms chronically or episodically over a greater than 6 month period.

If you have a familial history of Celiac Disease or NCGS

If you’re Diabetic (ID and NIDDM) If you’re being treated for CVD If you’ve been Dx with an autoimmune disease

(rheumatoid arthritis, psoriasis, fibromyalgia, Chron’s Dz, Lupus, Scleroderma, etc.)

If you has Colitis or another form of IBS

How Do I Implement Gluten Free Eating?Create a journal that records your

meals for 3-5 days and your how your body feels/symptoms at least 4x/day – approx. 30 minutes after meals is best. Record information on bowel movements (color, consistency, frequency) if an issue.

Eliminate ALL sources of Gluten in your diet for a minimum of 2-4 weeks while continuing to chronicle symptoms and bowel movements.

How Do I Implement Gluten Free Eating? If improvement is noted, continue on

for an additional 4 weeks and re-introduce gluten containing products ONE AT A TIME, recording your body’s reaction after each food.

A new gluten containing food every 48 hours should allow you to judge your tolerance.

If You’re Ready to Know

If you are considering a gluten elimination diet to help determine if you have a gluten intolerance of Celiac disease, speak to your doctor first.

Your doctor may ask you to wait until after testing, because celiac can only be detected if you have been eating gluten in your current diet.