Understanding gluten sensitivity
There’s a lot of emotion surrounding the gluten free movement these days and it’s definitely not joy. Over dinner last week, a friend brought to my attention a news article she read in her local newspaper that has caused quite an uproar in the gluten free community. A chef at a popular restaurant in Minneapolis, MN was quoted as saying “Gluten free is the one that kills me, “ when asked what culinary trend he would like to see die. Another chef in Colorado recently posted on Facebook that “Gluten free is bulls***” and that “people who claim to be gluten intolerant don’t realize that it’s all in their disturbed little heads”. Most shocking, however, was that this chef went on to say that he purposely serves regular, high gluten pasta to customers that request gluten free. For those individuals with celiac disease, this type of practice can come with serious consequences.
In defense of the chef from MN, his comment was based on observations that many of the customers that request gluten free meals in his restaurant have been known to eat the bread (not gluten free) or later indulge in a non-gluten free dessert at the end of the meal. This type of behavior creates two problems:
1. It creates understandable frustration to any food service provider who has taken the time to accommodate a gluten free request.
2. It creates confusion and lack of awareness surrounding the necessity for some individuals to maintain a gluten free diet.
It is imperative to point out that being gluten intolerant/sensitive is a physical condition (that is not in a “disturbed little head”) and does create adverse effects in the body. Furthermore, gluten sensitivity exists on a spectrum of sorts with gluten sensitivity lying on one end of the spectrum and Celiac disease on another. Thus, how and why a person chooses to maintain a gluten free diet may appear very different depending on whether or not a person is gluten sensitive or celiac.
For both gluten sensitivity and celiac disease, the culprit is a reaction to ingesting gluten, which is found in wheat, barley and rye. Symptoms of gluten sensitivity and celiac disease can overlap and include gastrointestinal symptoms such as diarrhea, bloating, cramping, abdominal pain and constipation. Behavioral symptoms can include “foggy mind,” depression and ADHD-like behavior. Other symptoms include anemia, joint pain, osteoporosis, and leg numbness. For a gluten sensitive individual such as myself, I find my main symptom to be painful cystic acne that flares with gluten exposure, an overall feeling of sluggishness, and itchy skin.
Although symptoms (particularly gastrointestinal) are often similar to those of celiac disease, the overall clinical picture of gluten sensitivity is less severe. Recent research at the University of Maryland Center for Celiac Research shows that gluten sensitivity is a different clinical entity that does not result in the intestinal inflammation that leads to a flattening of the villi of the small intestine that characterizes celiac disease. The development of tissue transglutaminase (tTG) autoantibodies, used to diagnose celiac disease, is not present in gluten sensitivity.
A different immune mechanism, the innate immune response, comes into play in reactions of gluten sensitivity, as opposed to the long-term adaptive immune response that arises in celiac disease. Researchers believe that gluten sensitive reactions do not engender the same long-term damage to the intestine that untreated celiac disease can cause.
The only treatment for celiac disease is the complete elimination of gluten from the diet. If untreated, Celiac disease has been shown to contribute to osteoporosis, tooth enamel defects, gallbladder, liver, and spleen disease, and an increase risk of certain types of cancer, especially intestinal lymphoma. Understandably, one can see the outrage that comes from individuals affected by celiac disease based on the comment from the Colorado chef who admits to purposely exposing his customers to gluten. This type of practice is a true concern and a serious detriment to the health of any individual with celiac disease.
Those of us who are lucky enough to only be gluten sensitive still find it necessary to remove gluten from our diets. When I make the choice to have gluten, I can definitely feel a difference in the way I feel (which is not good) and my zits are the proof in the pudding. So, while many may believe that the gluten free diet is just a health trend or fad, research (and the clinical picture) has clearly proven otherwise.
For more information on gluten sensitivity, celiac disease, and some awesome gluten free recipes, click below.