The Health Sciences Institute is intended to provide cutting-edge health information.
Nothing on this site should be interpreted as personal medical advice. Always consult with your doctor before changing anything related to your healthcare.

Bringing in the sheaves

Gluten is a typical component of several different grains. As a primary ingredient of flour, gluten delivers protein and gives bread a higher rise. The problem with gluten is that many people don’t tolerate it well – complicated by the fact that a good number of them aren’t even aware of their sensitivity.

Last week I received an e-mail with questions about gluten on the very same day I came across a new study about celiac disease (CD), a digestive disorder triggered by gluten intake. The e-mail offered a personal experience that demonstrates how profoundly gluten can affect our diet, while the study showed that far more people are susceptible to celiac disease than previously thought – a very troublesome finding, given how damaging the disease can be.

Furrowed BROW 

The e-mail comes from an HSI member named Jerry who has some important questions about gluten.

“I decided to go on a gluten free diet based on the information I found on gluten intolerance. Since then there have been changes, the most surprising being weight loss. I’m 62, 6’1″ and my weight dropped from 170 to 140, so the weight loss was substantial for me. I’m taking in about the same amount of carbs (I simply switched to gluten free grains) and more calories in the form of extra meat. I’m beginning to think gluten is a health hazard. What is your opinion on gluten foods? Is there a link between gluten and weight loss, or weight gain?”

To answer Jerry’s questions, I asked HSI Panelist Allan Spreen, M.D., for his insights on gluten basics, and here’s what he had to say:

“The high-gluten grains are within the mnemonic BROW (Barley, Rye, Oat, Wheat). When completely unrefined these grains in and of themselves are not the problem. It’s when sensitive individuals run into them that trouble can occur (not counting the dangers of refining them into low-nutrient, low-fiber, high-starch blood sugar stressors). Most often, reactions can involve swings in blood sugar, which can manifest as irritability, headache, difficulty concentrating, fatigue, increased appetite, and subsequently weight problems.

“Constant exposure to one food can cause a person to become ‘sensitized’. This is most common in the case of wheat, since wheat is absolutely everywhere. If a person craves grains, cereals, breads, etc., or eats them every day, I often test them by avoiding the potential offending agent for 7 days (21 for dairy). Sometimes the results are remarkable.”

Greater dangers

While sensitivity to gluten can create a variety of health problems, far more worrisome is celiac disease. CD is an auto-immune disorder in which gluten creates an obstruction to the absorption of nutrients in the small intestine. When CD goes untreated, malnutrition develops, followed by a chronic condition that may trigger other dangerous ailments, including gastrointestinal cancer.

Last week the Archives of Internal Medicine published the report of a large celiac disease study conducted in several different medical centers throughout the U.S. Knowing that CD is often genetically inherited, the researchers set out to compare the prevalence of CD in an at-risk group to a not-at-risk group.

The scientists took blood samples from more than 13,000 adults and children. Almost 75 percent of the subjects were thought to be at risk for CD because of family history or prior symptoms. In this at-risk group, celiac disease proved to be present in almost 4 of every 100 subjects. In the not-at-risk group, one in every 133 subjects was shown to have CD.

These results suggest the possibility that more than one and a half million people in the U.S. have celiac disease – far more than previously believed. But there is some good news: Given the knowledge that this is not as rare a disease as previously thought, the researchers hope that doctors will be more inclined to test for it, increasing the possibility that a greater number of cases will be caught in the early stages.

A tough call 

The problem with diagnosis of CD is that the symptoms are sometimes directly related to digestion (as with abdominal cramping, unexplained weight loss, and chronic diarrhea), but sometimes not (as with osteoporosis, joint pain, and depression). If any of these symptoms occur in a patient with family history of CD, this should stand out as a red flag for any physician.

The primary treatment for celiac disease is adherence to a strict non-gluten diet – but this is easier said than done. As Dr. Spreen has pointed out, refined “BROW” grains are the primary culprits and should be completely avoided. But gluten may be hidden in some foods such as soups, soy sauce, low-fat or non-fat products, and even in candies such as jelly beans. Some common food ingredients that may contain gluten include: modified food starch, hydrolyzed vegetable or plant protein, and some binders and fillers, as well as malt and natural flavorings.

Fortunately, if diagnosed early and addressed before it has a chance to do serious damage, celiac disease is relatively easy to treat. If you believe that you may be experiencing symptoms of celiac disease (especially if the family history is there), ask your doctor or dietician to provide you with specific strategies for recognizing and avoiding hidden gluten in your diet.

In addition, a number of studies have shown that a plant-based enzyme called Aspergillus oryzae may be effective in protecting the intestine from the effects of gluten. Enzyme formulas containing Aspergillus oryzae (such as Similase and Zest for Life Enzyme Boost Formula) are available from sources on the Internet. However, anyone with celiac disease or other serious digestive problems should first discuss the use of enzyme supplements with a health care provider.



To Your Good Health,

Jenny Thompson
Health Sciences Institute

“Gluten Disorder More Common Than Thought” Lindsey Tanner, Associated Press, 2/10/03
“Prevalence of Celiac Disease in At-Risk and Not-At-Risk Groups in the United States” Archives of Internal Medicine, Vol. 163, No. 3, 2/10/03
“About Celiac Disease” Celiac Disease Foundation