Gluten intolerance is on the rise, and ‘Non-Coeliac Gluten Disorder’ is a recognised condition, not a faddy diet option. Cyrex blood tests look at a multitude of wheat and gluten proteins capable of triggering an immune reaction, as well as a long list of foods with cross-reacting capabilities,i.e. foods whose proteins are similar enough in structure to mimic gliadin and glutenin. These can trick a reacting immune system into perpetuating the same response initiated by gluten. A common cross-reacting protein is casein, found in bovine milk (dairy). Studies show that about 50% of gluten sensitive patients have a problem with casein. Less common are reactions with proteins found in Whey, Soy, eggs and the other starch/grains typically used as replacements for wheat by patients following gluten-free diets.
A perfect example was the patient who substituted corn and millet products from the ‘gluten-free’ shelf in her local supermarket. She was studiously adhering to a strict gluten-free diet, but found her gut symptoms unchanged and gluten antibodies remained stubbornly present. On testing, she was found to have elevated antibodies resulting from a cross-reaction to Millet at a level of 4+. Only by testing, identifying, and removing cross-reacting foods, can gluten avoidance be really effective.
So what has changed in recent years to make us so reactive and intolerant to wheat?
Modern wheat crops are now complex configured hybrids, new to the human population, containing much higher levels of gluten, effectively increasing our exposure to the gliadin/glutenin proteins. The complexity of these newly configured wheat proteins makes it harder for our guts to digest, and with optimal digestion declining with advancing years, this could explain why intolerance is more common in the older age groups. If semi-digested peptides get absorbed the gut’s immune system is tasked with having to differentiate ‘friend from foe’. A mild food sensitivity can become a chronic intolerance, in conjunction with leaky gut syndrome, leading to a full blown immune reaction with the production of gluten antibodies.
Leaky gut – another modern phenomenon
Today, we eat on the run, and grab a bite between meetings. How often do we sit and focus mindfully on a meal? Efficient digestion needs relaxation to produce good levels of hydrochloric acid, which ensures good levels of intestinal and pancreatic enzymes to break foods down to their smallest constituent parts. Single amino acids – when absorbed – will not challenge the immune system. A healthy gut has a tricky job, it has to provide an effective barrier to the larger semi digested food particles, bacterial toxins and pathogens – a fine ‘cheesecloth’ barrier – whilst giving passage to the tiniest micronutrients. Why do so many people’s guts resemble a leaky ‘colander’?
The main ‘insults’ that commonly challenge and disrupt the integrity of the gut lining are:
- History of antibiotics (reducing the protection afforded by diverse gut flora).
- Use of NSAIDs (e.g. anti inflammatories like Ibuprofen, Asprin).
- Gastroenteritis or Bowel disease: Ulcerative Colitis, Crohn’s or Coeliac disease.
- Chronic stress, or chronic dietary imbalance (high sugar/alcohol consumption).
- High consumption of Wheat )Wheat lectins loosen gut cells called ‘tight junctions’)
- Chemical pesticides (Scientists are studying pesticides like Glyphosate, often sprayed on wheat crops prior to harvesting. Its mode of action is to destroy the guts of the insects regarded as pests by farmers who wish to maximise their crop yield.
The wheat-alcohol connection and leaky gut
Individuals who lack a certain enzyme (DPP IV) struggle to digest gluten proteins. For these people, consuming wheat-based foods together with alcoholic beverages can intensify the impact of these wheat/gluten antigens, because the alcohol makes them more soluble and more easily absorbed. In a recent study, researchers identified 150 different gluten peptides in beer. For a susceptible individual, consuming beer with a wheat product such as pizza overwhelms the digestive system with soluble, easily absorbed gluten peptides.
Worryingly, new research is showing that the immune system’s antibodies generated in response to wheat and gluten may also cross the blood-brain barrier. This may explain the typical ‘brain-fog’ and mood symptoms experienced by some people with gluten/wheat intolerance.
Adhering to a strict gluten-free diet is not easy. There may be more choice than ever before with food manufacturers responding to recent demand with a broader range of gluten free products, but unfortunately many manufacturers of processed foods and condiments actually add wheat starch and gluten to a whole host of unrelated foods like potato crisps, sauce thickeners, salad dressings, soy sauces, chilled ready meals, and even sushi, leading to many patients’ inadvertent gluten consumption. Painstaking scrutiny of all packaging small print is therefore a must for anyone needing to avoid it.
For someone with the autoimmune condition Coeliac Disease, accidental ingestion of just one molecule of gluten is serious as it can trigger an immune response that lasts for many weeks. To this end, it can be helpful for anyone with a gluten disorder to carry (emergency) digestive enzymes with them when eating out. Ignorance around gluten unfortunately prevails in many kitchens, both professional and domestic, with cooks and chefs often thinking a little teaspoon of flour won’t be noticed or felt. Taking a digestive enzyme supplement with a meal you don’t fully trust, can assist in the breakdown and digestion of those troublesome gluten peptides. This is not to say that gluten can return to the menu, simply that its risk of being absorbed undigested can be reduced.