Gluten, the ‘glue’ of many grains
by Sara J. Pluta
Gluten is a protein consisting of a mixture of glutelin and gliadin, present in cereal grains, notably wheat, rye, barley, and sometimes oats. Gluten adds texture and elasticity to baked goods and is often used as thickener and binder in a variety of foods, as a flavor enhancer, and even for further protein supplementation as a meat substitute in vegan diets. Seitan is a popular meat alternative derived from concentrated gluten. It has a chewy, meaty texture that absorbs flavors well.
Most of the protein found in wheat, up to 80%, is made up of the proteins glutein and gliadin. When these two molecules are joined together in a chemical reaction such as kneading and heating, they stretch and harden, allowing dough to form a light, airy, and somewhat chewy texture that we are all so familiar with. What could be better than a warm, crusty loaf of bread right out of the oven? Delicious.
The amount of gluten in a flour determines the final product. Bread flour needs more of these proteins to produce a loaf that is light, not dense, and chewy, not crumbly. Pastry flour, which should be flaky instead of chewy, has less gluten.
In addition to the common grains mentioned above, other cereal grains that contain gluten are durum, spelt, einkorn, farro, graham, kamut, and semolina. The obvious use of these grains is in breakfast cereals and baked goods. The more hidden use is as a thickener. Gluten can be found in soups and broths, gravies, sauces, salad dressings, bouillon, even spice blends, coffees, dairy products, vinegars, and liquors.
As you can see, gluten is found in a wide array of common food items from the obvious, to the outright invisible. So what happens when you have gluten sensitivity, an increasingly common medical problem afflicting people? Research shows that gluten sensitivity in some form (from more severe celiac disease to mild gluten intolerance), affects approximately 15% of the U.S. population. As gluten becomes more of a health concern, how can you determine if you are gluten intolerant or suffering from full-blown celiac disease? What are the signs and symptoms?
To begin, let’s classify both celiac disease and gluten intolerance. Celiac disease is an immune reaction, an autoimmune disease, in which the body reacts to the protein gluten. If a person with celiac disease eats gluten, the lining of their small intestine becomes inflamed and damaged. The damaged intestine is then less able to absorb nutrients, which can lead to malnutrition and weight loss. Celiac patients also suffer from distressing symptoms such as diarrhea, stomach upset, abdominal pain, and bloating. Over time, severe malabsorption can occur, causing wasting, bone and teeth problems. It can have an effect on everything from energy to brain function.
In a study published in BMC Medicine, researchers described gluten sensitivity as a disorder distinct from celiac disease, in part because the intestines don’t appear damaged. About 1% of the population has celiac disease; the remaining 10-15% are gluten-reactive. “Still, doctors don’t have an accepted definition, nor do they fully understand the cause. Gluten sensitivity is basically a bit unknown. It’s everything that is not wheat allergy or celiac disease, and yet these individuals experience adverse events when they ingest gluten,” says Stefano Guandalini, M.D., director of the University of Chicago Celiac Disease Center.
Besides gastrointestinal symptoms such as bloating, gas, constipation, and diarrhea, gluten-sensitive people often complain of fatigue, headaches, depression, aching joints, eczema, irritability and behavioral changes, irregular menstrual cycles, and overall exhaustion.
Daniel Leffler, M.D., an assistant professor of medicine at Harvard Medical School and a gastroenterologist at Beth Israel Deaconess Medical Center in Boston, estimates that half of approximately 60 million people in the US who suffer from irritable bowel syndrome (IBS) are probably sensitive to gluten. Gluten intolerance of any kind is often under-diagnosed or misdiagnosed because it manifests itself in obscure ways that can baffle doctors.
Celiac disease can be definitely diagnosed using a two-stop process. The patient’s blood is tested for the presence of intestine-attacking antibodies activated by gluten. If the tests come back positive, a biopsy is ordered to look for intestinal damage, any evidence of which confirms the diagnosis.
Gluten-sensitivity, however, is more ambiguous and lacks any defining medical tests. These individuals exhibit classic symptoms of celiac disease yet have no detectable intestinal damage and test negative for certain antibodies. Although they show no signs of erosion or other damage, a recent study by Alessio Fasano, M.D., medical director of the University of Maryland Center for Celiac Research in Baltimore, and his colleagues, found that the intestines of gluten-sensitive patients contain proteins that contribute to a harmful immune response. This response resembles, but is distinct, from the progression of true celiac disease.
What are the Risks?
So how much gluten is okay? The answer depends on a person’s diagnosis and range of sensitivity. People with celiac disease must commit to an absolutely gluten-free diet. Eating gluten can over time, increase a person’s risk for osteoporosis, infertility, and certain cancers, in addition to worsening the immediate symptoms.
“You’re going to be on this diet for life, and it has to be extremely strict. Even crumbs can turn on the autoimmune process typical of celiac disease,” Fasano says. “If you make a mistake with celiac disease, you pay the price on the spot, but there can be a cumulative price, too.”
For those with gluten-sensitivity, it all depends on their reaction to the protein. Some experts say that people on the less severe end of the spectrum should feel comfortable eating as much gluten as they can handle without feeling sick. To some this could be a pizza, to others it might be better to avoid gluten entirely. Most people improve on the diet so it’s advisable to stick with it as much as possible.
The good news is, the gluten-free industry is booming, growing 27 percent since 2009. Exceeding $6 billion in 2011, it’s fueled by an abundance of new products in 2010 and 2011 that bear a gluten-free claim. According to Mintel Menu Insights, gluten-free menu items have increased 280 percent from 2008-2011. Meanwhile, product launches with a gluten-free claim nearly tripled in 2011 to roughly 1,700 products as compared to 2007.
As awareness increases and more and more palatable, tasty gluten-free foods find their way on the grocery store shelves and in restaurants around the country, it is becoming easier to follow and adapt to a gluten-free diet. For those in need, and those looking to experiment, the options are out there. Go for it, gluten-free has never been so easy!
Sara J. Pluta
A keen interest in food and nutrition led Sara to pursue a culinary degree in health-supportive cuisine and then go on to study nutrition extensively, as she earned a BS, MS, and completed coursework for her doctorate in Holistic Nutrition. Sara has been in the Natural Products Industry for over 15 years where she enjoys empowering people through education and enthusiasm. Sara is a passionate speaker and a natural teacher who blends modern science, ancient wisdom, and human interest to connect with her audience.