Gluten-related diseases are becoming more and more present - a growing number of people are consciously eating without gluten. You can buy gluten-free products in any well-stocked supermarket. Furthermore the topic is being discussed in the media. But what is gluten intolerance? Why do people renounce gluten?
Gluten - the miracle product of the food industry
Gluten is naturally present in many cereals. It is composed of various protein groups that form long strands when combined with moisture in dough made of grain. This property ensures a light, fluffy consistence and ensures that bread, rolls and all other bakery products are easy to cut.
However, gluten is not only a natural component of cereal products: it is used as a thickening and gelling agent, as a flavour carrier, as an aroma and colouring agent and as a stabiliser. Nowadays gluten is contained in almost every industrially produced food and is also used in medicines, cosmetics and hygiene products such as toothpaste.
What is harmful about gluten?
Gluten enters the intestines through digestion from the stomach, where gluten components can trigger harmful reactions, such as an increase in the permeability of the intestinal walls or inflammation of the intestinal mucosa. Serious diseases such as multiple sclerosis, type 1 diabetes and rheumatoid arthritis can be caused by such inflammations.
Different diseases: Gluten sensitivity, wheat allergy and celiac disease
There is not only one kind of disease called "gluten intolerance". Rather, there are three different variants: the autoimmune disease celiac disease, wheat allergy and gluten sensitivity. The diseases have similar symptoms, so a precise diagnosis is often difficult to make:
Celiac disease is an autoimmune disease. The human body produces antibodies which not only act against gluten components but also against the body's own antigens which are located in the intestinal villi. Consuming gluten can cause an inflammation of the intestinal mucosa and the recede of the intestinal villi. This reduces the intestinal absorption surface so the body can take in less nutrients.
Symptoms vary between children and adults. Children suffer from digestive disorders, loss of appetite, vomiting, and growth problems. The symptoms are less severe in adults and adolescents. The disease is often accompanied by migraine, chronic fatigue, depression, bone pain and powerlessness. If you suspect that you are suffering from celiac disease, a doctor can determine this through various tests.
Children or adults between the ages of 30 and 40 are usually affected. In general, more women than men suffer from this autoimmune disease. It is estimated that 1 out of 130 to 270 people worldwide have been diagnosed with the disease. The figures vary considerably and the number of undetected cases or false diagnoses is probably considerably higher than these values. In addition, it's difficult to distinguish between celiac disease and gluten sensitivity.
If you have a wheat allergy, your body will be allergic to even the tiniest amounts of wheat and wheat-like grains such as spelt. Similar to celiac disease, digestion in the small intestine produces antibodies and causes inflammation. The symptoms of wheat allergy occur much faster than in celiac disease. In some cases you will notice the effects immediately in others it takes a few hours or days. You can feel the symptoms especially on your skin and as complaints in the gastrointestinal tract. Itching, swelling, neurodermatitis, vomiting and digestive problems are common results, but asthmatic complaints can occur as well.
In order to diagnose a wheat allergy, the first step is to rule out celiac disease. Afterwards, a wheat allergy can be diagnosed by evaluating symptom diaries, which you should keep for several weeks, as well as a test for certain antibodies. Wheat allergy is very rare for adults and more common in children. Experts estimate that the prevalence of wheat allergy is less than one percent of the population.
In people who are gluten-sensitive, the symptoms are almost identical to those of celiac disease. However, it is not an autoimmune disease or allergy, but a dysfunction that occurs when gluten is consumed. However, the intestinal villi are not damaged.
Gluten sensitivity can only be determined indirectly by an exclusion procedure. If the tests for celiac disease and wheat allergy are negative, but the symptoms disappear with a gluten-free diet, it is probably gluten sensitivity. However, the exclusion procedure does not provide actual proof of gluten sensitivity. Instead of gluten sensitivity, irritable bowel syndrome is often diagnosed, as the symptoms are similar here as well.
The frequency of gluten sensitivity can only be estimated so far since no comprehensive and meaningful studies are available. It is believed that one to six percent of all people are affected. Similar to celiac disease, the number of unreported cases will be much higher. Gluten sensitivity is more common than celiac disease or wheat allergy.
Treatment with a gluten-free or wheat-free diet
All three diseases must be treated differently. If you are allergic to wheat, it is often enough to remove wheat and wheat-like grains from your diet. Gluten sensitive people should limit the consumption of gluten, but a complete renunciation is not necessary because the intestines are not damaged. If you have celiac disease, you should renounce gluten completely for the rest of your life, as otherwise your intestines will be damaged in the long term and other serious diseases might follow. Your intestine can only recover slowly. If you renounce gluten you can reduce the risk of long-term consequences. In order to prevent deficiency symptoms you should pay attention to an increased nutrient intake in addition to the gluten-free diet, since a damaged intestine can use the important nutrients less well and therefore needs more.
So what do you have to forgo? Here is an overview of gluten-containing and gluten-free foods:
Food containing gluten
Grains such as wheat, oats, rye, barley, spelt, kamut, einkorn, wild emmer and green spelt contain gluten. You should also avoid all products made from these cereals. This includes noodles, gnocchi, dumplings, bread and rolls as well as sweets such as cakes, tarts and biscuits. Also breadcrumb coating and breaded cheese, meat, fish, starch, semolina, pearl barley, cereal flakes and muesli should be avoided. Products made from minced meat also contain gluten. The vegan meat substitute Seitan even consists completely of gluten. Products made from minced meat also contain gluten, the vegan meat substitute Seitan consists exclusively of gluten. Gluten can also be found in many ready meals and snacks such as pizza, salt sticks and conventional cereal bars. Even beer is not gluten-free.
As already mentioned, gluten is the "miracle product" of the food industry and is contained in many products from which you would not expect it. For example, ready-made sauces, soy and fish sauces, ketchup, mustard, ready-made dressings and soups. Gluten is also used in chips and other ready-made potato products. Dairy products with fruit preparations, some fat-reduced products, cream cheese, pudding, ice cream, chocolate, chips and other snacks are also added with gluten. It is also found in many beverages: Lemonades, cocoa powder, flavoured tea and coffee. Gluten can also be found in sausages and scrambled eggs made from egg powder.
There are also gluten-free (pseudo-)grains that you can continue to eat as usual. These include rice, corn, millet, buckwheat, amaranth and quinoa. Nuts, kernels, pulses, vegetables, fruit and unprocessed animal products can also be eaten without hesitation. In general, unprocessed foods that do not naturally contain gluten are suitable for a gluten-free diet. This includes pure juices, non-aromatized tea and coffee, wine and sparkling wine. Potato starch, rice flour, maize starch and locust bean gum are suitable substitutes for binding agents. Meanwhile, many foods are also available in a version that is "gluten-free".
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