Sunday, July 10, 2011

Gluten Intolerance, Celiac Disease, and The "Whole" Grain Story...


What's the deal with all the gluten/grain talk?  Many people have come to the realization that gluten and/or grains make them feel 'less than optimal' if not completely miserable.  But think back five to ten years ago.  Do you remember hearing much about 'celiac disease' or 'gluten intolerance'?  Ten years ago it was estimated that celiac disease incidence was about one case in every 2500 people.  Today, estimates are one case in every 133 people.  And although there is more awareness, only about one in every 4700 cases is actually diagnosed.  The undiagnosed individuals are unknowingly doing permanent intestinal, organ, and system wide damage every time they eat foods containing gluten and grains.  So, what is this gluten/grain stuff and why the heck have we gotten more intolerant?  Let's break it down piece by piece.
In order to better understand all of this (WARNING: it's going to get 'sciency' for a little while), it's important to look at and know what a grain is.


Whole Grain Definition & Illustration:
A Whole Grain is a cereal grain that contains cereal germ, endosperm, and bran, in contrast to refined grains, which retain only the endosperm.

The bran is the tough outside layer of the grain and has proteins, vitamins and minerals.  All 'whole grains' and whole grain products have the bran included, (brown rice, oats, quinoa, etc.)  The bran is where most of the lectins are.  A lectin is a protein that has a “key” that fits a “lock” of a specific carbohydrate.  All cell membranes contain carbohydrates.  If a lectin with the right “key” comes into contact with one of the carbohydrate “locks” in the gut, an artery, gland or organ, it ‘opens the lock’, disrupts, the cell membrane, and damages the cell.  The damage manifests as micro-perforations (tiny holes). These tiny holes let bacteria, intact proteins and other foreign substances escape the gut, gland, organ, etc.  Once free the escapees get into the blood stream, which signaling a series of immune and autoimmune responses to attack the foreign materials (NOT GOOD).  Additionally, lectins are resistant to stomach acid and digestive enzymes making them difficult or impossible to digest.


The endosperm or kernel of the grain is the inner portion and contains most of the complex carbohydrate and calories.  A perfect example of the kernel is a grain of white rice.


The germ is the embryo of the plant and the part that contains fatty acids.  It is the fatty acids that cause brown rice, and other "whole grains" to become rancid if kept too long.  The germ is also used to make vegetable oils.


Gluten Definition:
Gluten: (from Latin gluten "glue") is a protein in foods processed from wheat and related species, including barley, spelt, faro, kamut, and rye. 

There are two main classes of gluten: prolamines and glutelins. The prolamine gliadin is responsible for causing inflammation in gluten intolerance.  Additionally, gliadin catalyzes an immune response resulting in intestinal damage.  The difference between celiac disease and gluten intolerance is: celiac disease is an autoimmune reaction to gluten; gluten intolerance is simply the inability to digest gliadin. 
Now that you have a handle on grains, lectins, and gluten (or at least a rough idea of what they are and do...), let's look into why there has been such an increase in the prevalence of celiac disease and gluten intolerance. 

Better diagnostic tests are definitely part of it - although, these tests are not always accurate or sensitive enough to detect all cases.  Another commonly cited reason for the increase is the amount of publicity, products, and information we are exposed to regarding the subject.  Some so called 'experts' report concern that many people are 'missing out' on 'valuable nutrients' found in whole grains because they have self-diagnosed gluten intolerance or celiac disease.  Finally and not commonly mentioned are today's "hybrid grains".  Yep, go figure in order to make our crops bigger, stronger, and give better yields there have been some changes made.  The fact is - grains we eat today have significantly more gluten than those that were eaten by our ancestors.  In Paleolithic times eating grains was highly uncommon, suggesting that we are likely not set-up to tolerate the grains and gluten that are so easily accessible today.  Combine being somewhat susceptible to gluten intolerance with the higher amounts of gluten in hybrid grains - and lo and behold we've got an epidemic.

Still not sure what to think about gluten and grains?  Is your bagel really worth a lifetime of health problems that could be traced back to 'something you ate'? 

And now a message from your gut (and you should ALWAYS 'listen to your gut')...
"Please use your brains.  Stay away from the grains." 

Comments...

13 comments:

  1. Excellent piece! If I see one more article quoting a doctor who is worried about a nation full of alleged hypochondriacs "sabotaging their health" by cutting out gluten-containing grains, I'm going to scream.

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  2. this was awsome! im 16 and me and my dad and some of my coisins and aunts/uncles are self-diagnosed celiacs. This is helpfull in knowing what is going on in my body and makes explaining it a little easier to others:) i didnt know that there was a difference between celiac and gluten intolerance.

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  3. Thanks for the great comments! I really enjoy knowing that what I write helps people understand. And I hope you enjoy it and maybe even laugh a little at my attempts to be funny!
    -Amy

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  4. What are your thoughts on gluten free breads and other 'baked goods' that use ingredients like potato extract, rice flour, sorghum flour, rice flour, millet, etc. Almost feels like the equivalent of a reduced fat food that simply adds in more sugar and carbs to compensate.

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  5. I have replaced all wheat with potato and rice for over 5 years now.

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  6. From your post, it sounds like even the whole grains like quinoa and oats because of the damage from lectins in the bran. Yet you recommend quinoa and other gluten free grains. What am I missing? Almost sounds like processed (no bran) and gluten free is safer.

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  7. Zane,
    I do NOT recommend quinoa or oats!!! That was sarcasm!! In Robb's blog!!

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  8. Hi, Amy.

    I just heard about you for the first time on the Livin La Vida Low Carb Show. Since you're on the subject of gluten, would you consider reviewing the new book Wheat Belly for a future blog post?

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  9. Hitssquad!

    I would LOVE to review Wheat Belly! Send me an email at amyk.rd@gmail.com

    Thanks,
    -Amy

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