Hi, there! No blog post yesterday because work ran late and I had a couple of mini school-related fires that needed putting out all afternoon. Also, I was working on my difficult assignment. Not difficult in terms of understanding or content but tricky in terms of time committment and mandatory synthesis of our knowledge. We had to read an article full of bunk science (promoted by Dr. Oz, of course!) and identify statements that were incorrect and then explain both why the statements were incorrect and identify the correct statements that the author misconstrued to reach his conclusion. The assignment required the upper levels of Bloom’s taxonomy but was also a lot of fun. And it sparked this blog post.
Notes – this post is not in response to any one person, blog, topic, or product, but is my general PSA to the world, aka my readers, friends, coworkers, and acquaintances. Also, I am not claiming to know it all. I am in no way purporting to fully cover the topics, I’m just covering a few of the facts.
Some Facts on Gluten, Gluten Intolerance, and Gluten-free Diets
Gluten is a protein found in wheat, barley, and rye.
Gluten is resistant to complete digestion by GI enzymes and often travels to the small intestine of healthy individuals partially or fully intact. This is not a problem. Gluten does don’t cause inflammation in healthy individuals.
Individuals with Celiac disease (an immune-mediated disorder) suffer damage to their intestinal tracts that can compromise digestive and absorptive functions over time. In individuals with CD, undigested gluten peptides travel from the intestinal lumen, across the intestinal epithelium, and into the lamina propria; basically, through the intestinal cavity and into the intestinal linings. Because of the immune component of CD, these individuals have antibodies which react to the specific dietary protein fractions and cause inflammation.
Gluten sensitivity is used to describe individuals with nonspecific symptoms who lack the immune response found in CD. The term gluten intolerance describes individuals who have symptoms and may or may not have CD. These GI symptoms include cramping, bloating, nausea, and/or diarrhea.
This next part is so often misunderstood in the healthy living community that I’m actually going to quote straight from Krause – “Patients who experience these symptoms [i.e. may have gluten sensitivity or intolerance] should generally be advised against following a gluten-free diet without having a workup to exclude or confirm a diagnosis of CD.” This is because there may be an underlying condition for which a gluten-free diet is not the treatment and because following a gluten-free diet for several months or years may make it more difficult to accurately diagnose CD.
A gluten-free diet is regarded by medical practitioners as being generally healthy but it can be very expensive and/or restrictive.
A combination of clinical, laboratory, histologic evaluations is used to diagnose CD. The gold standard for diagnosis is a small intestine biopsy.
source – Mahan KL, Escott-Stump S, Raymond JL. Krause’s Food and Nutrition Care Process. 13th ed. St. Louis, Missouri: Elsevier Saunders; 2012.
Do you know anyone who follows a gluten-free diet? What is their reasoning for doing so?