What is gluten and should it be avoided?

The word ‘gluten’ is derived from the Latin word for glue. Gluten is a combination of grain-based proteins called glutelins and prolamins. These proteins can stretch under high cooking temperatures, giving a chewy texture to baked foods.

Coeliac disease

A genetic condition known as coeliac disease (CD) is typified mostly by severe intolerance to gliadins in wheat gluten, with chronic diarrhoea, abdominal distension, fatigue, intestinal pain, hypoproteinemia (low blood protein) and so on.

The non-classic CD has indeterminate symptoms such as chronic migraine, infertility, teeth enamel defects and depression; and a variant called asymptomatic CD, where no obvious symptoms are evident even though sufferers have characteristic intestinal lesions.

All proteins are made up of linked chains of amino acids – therefore, CD is a genetically-based autoimmune response triggered by certain amino acid chains in wheat gliadin (and probably other gluten proteins).

An intriguing 2017 paper indicated that CD can be caused by certain human reovirus strains, particularly one called Type 1 Lang (T1L), which is known to infect intestines and disrupt their functions.

In experiments, healthy mice infected by these reovirus strains developed CD. A reovirus is based exclusively on ribonucleic acid (RNA) while a virus can have both deoxyribonucleic acid (DNA) and RNA as its infection vectors.

However, there are no human epidemiology studies linking T1L to CD, so this remains an interesting theory.

Consumption of gluten-free foods

Statistically, CD affects around 1 per cent of the population in most developed nations. Yet the gluten-free food business in the United States grew by 136 per cent from 2013 to 2015 and is currently estimated to be more than US$17 billion annually.

One reason for the huge growth in gluten-free was that initial research supported the idea that non-CD gluten sensitivity (NCGS) is a real condition – and people with NCGS can recover from gastrointestinal issues by avoiding gluten.

A study in 2013 by Monash University could find no link between gluten and gastrointestinal problems, but they did establish a link between NCGS and a class of food compounds called FODMAPs (acronym for fermentable, oligo-, di-, mono-saccharides and polyols).

Needless to say, FODMAPs are usually present in foods that contain gluten – a detailed analysis follows later. The study also identified that some people were sensitive to foods which have no gluten or FODMAPs – and which may be attributable to other allergies such as nut and lactose intolerance.

So if gluten is not the real gastrointestinal culprit, then why is a large percentage of the developed world going gluten-free?

It is partly because gluten-free became a fad, heavily promoted by countless “alternative health/medicine/cure” websites, magazines, videos and books. It is also highly probable people are ascribing other allergic reactions to gluten. Gluten-free is also lumped in with general but technically vague trends such as “healthy living” and “better eating/living”.

A pretty complex subject

To reflect the complexity of the subject, gluten is possibly not off the hook entirely, according to some recent hypotheses – one claim is that NCGS may be due to metabolites (or intermediate digestion products) created during the processing of gluten by the digestive system.

Other research also linked NCGS with other afflictions such as postural tachycardia syndrome (abnormal heart rate/blood flow issues caused by changes in posture) and Histamine Intolerance, again, is inconclusive whether gluten is the sole culprit and not FODMAPs or other food compounds. And as mentioned, it is entirely feasible that other allergic reactions may be classed incorrectly as NCGS.

Another possible factor is the complexity of the genes in bread wheat – the biggest source of gluten and FODMAPs in human diets.

Bread wheat is a complex hybrid, with 17 billion base-pairs of DNA (compared with only three billion for humans), derived from 42 chromosomes (compared with 46 for humans).

It may be one DNA pair, many DNA pairs, certain permutations of genes or all three – we do not know for certain which combinations of wheat genes trigger negative reactions in humans.

Regardless of all the above, NCGS remains mostly a self-diagnosed syndrome and is seldom based on medical assessments.

Gluten-free is now therefore mostly a lifestyle choice and not conclusively linked to any real gastrointestinal issues to do with gluten itself – unless, of course, you actually have CD. It is similar to fat-free foods, where some people choose to ingest sugar-laden foods textured by synthetic emulsifiers, conditioners and additives, just to avoid the natural fats in, for example, yogurt.

As with many “lifestyle choices”, the food industry is delighted to offer another range of premium-priced consumables.

Love of bread

Since wheat flour is involved in all cases, what might be the problem issue?

Frankly, there is no defini­tive answer – human digestive systems are too complicated for that, especially its obscure, largely unexplored and often perplexing interactions with modern food ingredients and additives.

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Category: Features, Health alert