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Gluten-Tag: A Day Without Gluten May Be The Best Medicine

By Dr. Ivan Harris-Janz, B.Sc., N.D.


Introduction:

We are increasingly aware of nutritional advice touting the merits of a whole food diet, especially its impact on the major diseases particularly cardiovascular health, diabetes, and cancer prevention. Consuming grains in their natural and unprocessed form maintains their vitamin, mineral and fiber content, thus maximizing their benefit. But for some people, eating a diet including these grains may cause severe illness, resulting from the misunderstood and unrecognized constituent gluten. In fact, gluten-related illness has been estimated to affect 1 in 200 people in most parts of the world, making it a notable cause of disease especially relating to the gastrointestinal system. Additionally, it may be a substantial hidden contributor to numerous conditions including osteoporosis, anxiety and depression, heart disease, arthritis, neurological disease, and other common illnesses.

What is Gluten?

Gluten is a category of proteins derived from the starchy aspect of certain grains such as wheat. There are two groups, the glutelins and the prolamines. Some common prolamines include gliadin (wheat), secalinin (rye), avenin (oats), hordein (barley), panicin (millet), zien (corn), and orzenin (rice). Glutenins include glutenin from wheat and orycenin from rice. The major contributor to gluten-based disease is the prolamine gliadin found in wheat. Additional grains that contribute to gluten immunological reactions include rye, barley and the other grains outlined in table 1. Those grains which do not cause illness in gluten-sensitive individuals include corn, rice and buckwheat (table 2).

Table 1 Grains inducing gluten illness

GLUTEN-CONTAINING INGREDIENTS
Barley
Graham Flour
Rye
Bulgar
Kamut
Semolina
Cereal Binding
Malt
Spelt
Couscous
Malt Extract
Triticale
Durum
Malt Flavouring
Wheat
Einkorn
Malt Syrup
Wheat Bran
Emmer
Oats*
Wheat Germ
Filler
Oat Bran
Wheat Starch
Farro
Oat Syrup
* Oats contains gluten, however, many people with celiac disease are not susceptible to the protein found in oats. Caution is urged because oats may be contaminated by other grains such as wheat during processing.

Are oats safe?

Many people with gluten-related disease are able to tolerate oats without adverse effects. However, there are people that do react to oats; therefore it must not be assumed that oats are completely acceptable and safe. In general, oats are recommended for re-introduction after a gluten-free diet has been maintained for 2-3 months. An alternative to oats are rice based cereals, due to the fact that orzenin in rice does not cause immunological reactions.

How does gluten cause problems?

Most of the adverse effects from gluten are due to the prolamine, gliadin. There are several ways that gluten-intolerance is induced in susceptible individuals, mainly acting through an immunological process by a genetic pre-disposition. The process of gluten-related bowel dysfunction includes:

    1. Inability to break-down gluten due to the lack of the digestive enzyme intestinal glutaminase.
    2. The production of antibodies against the prolamine and its fragments.
    3. Increased bowel permeability to small molecules including gluten proteins and their fragments.
    4. Increased inflammation due to the accumulation of mediators such as histamine, prostaglandins, interleukins and other inflammatory triggers.
The end result is an immunological and inflammatory process that disrupts the small intestine surface, reducing digestion, decreasing absorption of key vitamins and nutrients, and contributing to inflammation throughout the body. This process extends to the cardiovascular, musculoskeletal and neurological systems.  

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