Gluten allergy and gluten free diet

What is gluten?

Gluten refers to the combined gliadin (prolamin) and glutenin (glutelin) fraction of wheat. The gluten protein fraction displays unique structure building properties that are used in food processing. These structure building properties are also reflected in the terminology, as gluten is essentially the Latin translation of “glue”. Gluten in wheat flour forms a three-dimensional protein network upon proper hydration and mixing. These network-forming properties are utilized in baking applications to create viscoelastic dough matrices. Besides network formation, gluten functionality in food includes water binding and viscosity yielding, which make gluten a widely used food additive.

What is the effect of gluten allergy or sensitivity?

Gluten allergy or sensitivity can cause several medical problems which include but not limited to celiac disease (CD), non-celiac gluten sensitivity (NCGS), gluten ataxia (GA), wheat allergy and dermatitis herpetiformis (DH). A wide range of extra-intestinal symptoms have been associated with non-celiac gluten/wheat sensitivity, from headache and fatigue to depression and dermatitis, suggesting systemic manifestations of the disease. NCGS is considered an immune system–related disease, and its link to autoimmune diseases has been hypothesized and investigated. The most common autoimmune disorder that’s genetically linked to coeliac disease is type 1 diabetes, with the common denominators in both conditions being the HLA DQ2 and HLA DQ8 genes. Celiac disease is also more common in people with rheumatoid arthritis, multiple sclerosis (MS), Hashimoto’s thyroiditis, Addison’s disease, autoimmune hepatitis, and a few other disorders.

What is benefit of gluten free diet (GFD)?

The origin of the gluten-free diet dates back to 1941, when it made its debut in a report on the dietary treatment of CD by pediatrician and scientist Willem Karl Dicke. Today, the diet continues to be applied and investigated for a variety of additional health purposes, including the management of NCGS, irritable bowel syndrome (IBS), diabetes, DH, inflammation, and obesity.

Expected health benefits of the gluten-free diet also influence dietary decisions. Although beneficial effects of the diet have yet to be demonstrated in healthy individuals, consumer market survey data demonstrate that 33% and 26% of Canadians and Americans, respectively, believe gluten-free products are healthier.

What are the sources of gluten?

Following are the major sources of gluten:

· Wheat

· Barley

· Rye

· Triticale — a cross between wheat and rye

· Oats, in some cases

While oats are naturally gluten-free, they may be contaminated during production with wheat, barley, or rye. Oats and oat products labeled gluten-free have not been cross-contaminated. Some people with celiac disease, however, cannot tolerate the gluten-free-labeled oats.

There are different varieties of wheat as below, all of which contain wheat gluten: Durum, Einkorn, Emmer, Kamut and Spelt.

Wheat flours have different names based on how the wheat is milled or the flour is processed. All the following flours have gluten:

· Enriched flour with added vitamins and minerals

· Farina, milled wheat usually used in hot cereals

· Graham flour, a course whole-wheat flour

· Self-rising flour, also called phosphate flour

· Semolina, the part of milled wheat used in pasta and couscous

What is gluten free diet (GFD)

Gluten-free products share a common composition of raw ingredients, including corn, rice, soy, cassava, and potato. These ingredients replace gluten-containing grains like wheat, rye, and barley in regular products. Overall, gluten-free items are higher in fat, sugar, and sodium compared to regular products, though compositional trends may vary by product type. Studies have shown that the total fat content of gluten-free breads is at least twice the amount found in their gluten-containing counterparts, contributing to the improved mouthfeel of these products.

Conversely, many gluten-free pasta products appear to have significantly higher carbohydrate and sodium contents. Gluten-free products are generally inferior sources of protein and dietary fiber as well. The glycemic index (GI) of gluten-free products varies based on the type and quality of ingredients used, as well as the food-processing procedures performed to manufacture them. Since gluten-free items are not typically fortified or enriched in the way that many regular products are, they are also generally lower in folate, iron, niacin, thiamin, and riboflavin. Efforts have been made to improve the formulation of these products without compromising their sensory appeal.

For people with celiac disease in particular, it is important to avoid exposure to gluten. The following tips can help you prevent cross-contamination in your own food preparations at home and avoid gluten-containing food when you eat out:

· Store gluten-free and gluten-containing foods in different places.

· Keep cooking surfaces and food storage areas clean.

· Wash dishes and cooking equipment thoroughly.

· Toast bread in the oven — or consider separate toasters — to avoid cross-contamination.

· Read restaurant menus online ahead of time, if possible, to be sure there are options for you.

· Eat out early or late when a restaurant is less busy and better able to address your needs.