Dear Jenn,
I noticed that after I eat bread or pasta I feel tired, bloated and out of sorts with myself. I am a bread, pasta, rice and potato guy—I love my starches! Could this be a gluten-related problem or something else? I never had food allergies. What do you think?
Sincerely,
Starch Lover
Dear Starch Lover,
It seems people are reacting negatively to gluten products more frequently. This requires study by both the American food industry and our farmers. Some scientists hypothesize that gluten-related problems may be due to the environment or changes in the food supply. Today, farmers use higher-gluten wheat varieties because of their natural insecticide qualities. Variables in food technology and modern-day processing might also be involved. There is a great deal to research on the cause(s) of gluten-related reactions, and much study is needed.
Definitions and General Information
1. Gluten is a group of seed-storage proteins found in certain grains.
2. The storage proteins are known as prolamins and are found naturally in wheat, barley and rye.
3. Prolamins fall under the gluten umbrella but are classified under specific grains in which they are found. On a molecular level these proteins have different configurations.
a. Gliadin and gluten are prolamins found in wheat.
b. Secalin is a prolamin found in rye.
c. Hordein is a prolamin found in barley.
What is the function of gluten? It acts like a binder holding starch together i.e., raw pizza dough is stretchy because of the gluten. Gluten traps gas bubbles during fermentation of breads, giving bread its unique texture. During heating, gluten hardens, allowing for a firm textured product.
Sources of Gluten and Derivatives
Sources—Wheat, spelt, rye, barley, beer and triticale (a hybrid of wheat and rye developed in the 19th century in Scotland and Germany. It is used commercially).
Derivatives—Durum, couscous, semolina, farina, kamut, einkorn, wheat-berries, bulgur, wheat bran, wheat starch, wheat germ, emmer, seitan, and graham flour.
Foods That Contain Gluten
Breads, pitas, bagels, rolls, pasta, cakes, cookies, crackers, biscuits, pies and pastry. Also, breakfast cereals, breadcrumbs, croutons and modified food starch. Malts such as; malt extracts, syrups, flavorings and brewer’s yeast, some beverages, hydrolyzed vegetable protein, hot dogs, ice cream, vegetable gum and many other products.
Alcoholic beverages that contain gluten are: beer, ales and lagers.
*Note: Wheat products have the highest amounts of gluten and are commonly added to commercial food products. If you are avoiding gluten, read labels for ingredients, and be familiar with gluten containing products.
*If you experience unpleasant symptoms after consuming gluten-rich food, it is important to explore the root cause of the gluten reaction. The correct diagnosis is essential to treatment of the condition.
Gluten-Related Conditions:
1. Celiac Disease, Celiac Sprue, Non-Tropical Sprue or Gluten Sensitive Enteropathy is a genetic auto-immune disorder. When gluten is consumed, the immune system reacts by causing cellular damage in the intestinal tract. Over time, the damaged intestinal tract becomes dysfunctional, causing malabsorption and eventually malnutrition. Symptoms of celiac disease include; diarrhea, vomiting, constipation, abdominal pain, bloating, gas, poor appetite and weight loss.
Celiac disease is a serious complex multi-organ disorder with highly variable extra-intestinal involvement. Other symptoms include: thinning hair, dull skin, itchy skin, rashes, headache, fatigue, brain fog, bone and joint pain, body inflammation, tingling of the hands and feet, anxiety, depression and mood changes.
People with celiac disease are more prone to: acid reflux, mouth ulcers, anemia, liver disease, hyposplenism (spleen dysfunction), osteoporosis, osteomalacia, damage to dental enamel, pneumococcal bacterial infections and herpes zoster. The central nervous system can be affected and seizures can result. In childhood, short statures may result. In women of childbearing age, irregular menstrual cycles and multiple miscarriages have been connected to celiac disease. In rare cases, lymphomas of the gastrointestinal tract have been seen.
Treatment: Medications may be prescribed by your doctor may help ease symptoms:
Corticosteroids suppress inflammation.
Immunosuppressants decrease attack on body tissue by the immune system.
Supplemental dietary enzymes taken before meals aid digestion.
Probiotics, e.g., lactobacillus and bifidobacteria aid digestion.
* The best way to prevent symptoms, side effects and control celiac disease is to completely remove gluten from the diet.
2. Gluten Intolerance is known as non-celiac gluten sensitivity. This is a disorder where a person cannot tolerate gluten. The symptoms are similar to celiac disease, however, antibodies do not attack and destroy normal body tissue. The ingested gluten causes short-term problems such as: diarrhea, constipation, stomach pain, bloating, nausea, flatulence, fatigue, brain fog, headache and joint pain. Additionally, the central nervous system may be affected with a reduction in serotonin (hormone involved with joyful feelings) causing anxiety, depression and mood change. Individual with gluten intolerance may find relief by:
Supplementing diet with digestive enzymes.
Reducing volume of dietary gluten
Eliminating gluten entirely from diet.
3. Wheat Allergy is an immune reaction to proteins in wheat. It is caused by consumption of wheat products or in some cases inhaling wheat flour. Wheat allergic reactions include: stomach cramps, nausea, vomiting, headache, nasal congestion and skin rash. More serious reactions may include difficulty breathing, wheezing, fast heartbeat, clammy skin, confusion, anxiety, losing consciousness and/or anaphylaxis.
Unlike celiac disease and gluten sensitivity, wheat allergy may be outgrown. Wheat allergy does not damage body tissue however, the risk of anaphylaxis should be taken seriously. Wheat allergy reactions are best dealt with by:
Avoiding wheat in the diet.
Using allergy medications at the time of a wheat-induced reaction.
Making a Diagnosis (Some Tests May Require Consumption of Gluten)
1. Celiac Disease:
Biopsy of the small intestine can identify celiac disease or another problem.
Blood tests identify elevated levels of certain antibody proteins indicating an immune reaction.
Genetic testing for human leukocyte antigens (HLA-DQ2 and HLA-DQ8).
Diagnostic “home tests” are available. Discuss with your physician or dietician.
2. Wheat Allergy:
Skin prick test.
Blood test.
Elimination diets remove gluten from the diet to determine if there are significant changes in your symptoms.
Oral Food Challenge: Under physician’s (allergist’s) care, a measured dosage of suspect food is ingested to study the body’s reaction. This should only be done at a medical facility capable of treating anaphylaxis.
3. Gluten Intolerance:
There is no specific test to determine gluten sensitivity. If you have celiac disease symptoms, see your doctor for diagnosis and testing.
Conclusion
Celiac disease, gluten intolerance and wheat allergy have similar symptoms, making it difficult to self-diagnose. The differences between these conditions lie in their root cause. It is extremely important to get an accurate diagnosis in order to properly treat the specific condition.
It seems logical to avoid any food product that does not agree with you. Beware: Gluten is in many commercial food items. Read labels carefully! There are many “gluten free” (GF) products on the market such as GF: challah, bread, pasta, pizza, etc. Some of these products are quite tasty, but caloric.
If you have been diagnosed with celiac disease, gluten intolerance, wheat allergy or any food related problem, Nutrition Transformations can recommend proper dietary choices, help you plan appropriate menus and help you maintain your health.
Yours in good health,
www.Jenn www.nu-tranform.com
718-644-1387
Zooms sessions available.
In-person appointments requires proof of vaccinations
By Jenn Chapler, MS, RD, CDN
