Gluten intolerance and Celiac primer

Gluten (from Latin gluten, "glue") is a group of proteins, called prolamins and glutelins, which occur with starch in the endosperm of various cereal grains. This protein complex supplies 75–85% of the total protein in  wheat bread. It is also found in related wheat species and hybrids, (such as spelt, khorasan, emmer, einkorn, and triticale), barley, rye, and oats,  as well as products derived from these grains, such as breads and malts, malt vinegars etc.

A gluten intolerance is the body’s inability to digest or break down the gluten protein. Gluten intolerance (also known as a gluten sensitivity) can range from a mild sensitivity to gluten to full-blown celiac disease.

If you have been suffering from symptoms after ingesting gluten, it may be possible that you have non-celiac gluten sensitivity (NCGS).

Gluten sensitivity is a disorder where one cannot tolerate gluten and experience symptoms similar to those with celiac disease yet lack the same antibodies and intestinal damage as seen in celiac disease.

A diagnosis distinguishing between celiac disease, a wheat allergy and gluten sensitivity is important, a fact highlighted in a recent study showing the impact correct diagnosis has on long-term treatment and future chronic disease prevention. Prior to testing, it’s important to not go gluten-free prior to laboratory tests, so that tests for celiac disease can be accurate.

Common symptoms of gluten intolerance or NCGS are:

• Bloating, gas or abdominal pain
• Diarrhea or constipation
• Nausea
• Headache
• Brain fog
• Joint pain
• Numbness in the legs, arms or fingers
• Fatigue
• Weight gain

Celiac disease a severe autoimmune disorder is triggered by gluten consumption that leads to damage in the small intestine, it can lead to many health disorders.

Symptoms can include one or more of the following:

• gastrointestinal symptoms e.g. diarrhoea, constipation, nausea, vomiting, flatulence, cramping, bloating, abdominal pain, steatorrhea
• fatigue, weakness and lethargy
• iron deficiency anaemia and/or other vitamin and mineral deficiencies
• failure to thrive or delayed puberty in children
• weight loss (although some people may gain weight)
• bone and joint pains
• recurrent mouth ulcers and/or swelling of mouth or tongue
• altered mental alertness and irritability
• skin rashes such as dermatitis herpetiformis
• easy bruising of the skin

People who experience any of the following should also be screened for coeliac disease

• early onset osteoporosis
• unexplained infertility
• family history of coeliac disease
• liver disease
• autoimmune disease e.g. type 1 diabetes, autoimmune thyroid condition
• Unexplained anaemia

Common foods that regularly contain ingredients with gluten include:

• pastas
• breads
• crackers
• seasonings and spice mixes

Outlook
If you have celiac disease, being gluten-free is essential for your health. If you have NCGS being gluten free will dramatically enhance your health. A gluten-free diet may seem challenging to deal with, but with time, my help and a bit of effort, it can become second nature.

If you can, start off gradually, so you can get used to going gluten-free it is easier. For example, you might try one completely gluten-free meal per day and gradually add more meals until gluten is completely out of your diet. If you want to guarantee that your food is gluten-free, cooking from scratch is the easiest way to avoid gluten. Patients will often have other food sensitivities especially dairy which may need to also be avoided.

Foods to avoid on a gluten free diet:

Wheat is one of the main staples of a Western diet and is considered the enemy, some doctors such as Dr William Davis M.D, cardiologist, diabetic specialist and author of Wheatbelly: https://www.wheatbellyblog.com, call it a perfect chronic poison for all people even those without a gluten intolerance or celiac.

In addition to pure wheat, all of its forms are also off-limits. This includes:

• wheat starch
• wheat bran
• wheat germ
• couscous
• cracked wheat
• durum
• einkorn
• emmer
• farina
• faro
• fu (common in Asian foods)
• gliadin
• graham flour
• kamut
• matzo
• semolina
• spelt

The list of gluten-containing grains doesn’t end at wheat. Other offenders are:

• barley
• bulgur
• oats (oats themselves don’t contain gluten, but are often processed in facilities that produce gluten containing grains and may be contaminated)
• rye
• seitan
• triticale and Mir (a cross between wheat and rye)
• Gluten may also show up as an ingredient in:
• barley malt
• chicken broth
• malt vinegar
• some salad dressings
• veggie burgers (if not specified gluten-free)
• soy sauce
• seasonings and spice mixes
• soba noodles
• condiments

Foods to eat -Foods without gluten

The list of off-limit items may seem daunting at first. Thankfully, there are plenty of replacements on the menu. Lots of foods are naturally gluten-free, including:
    •    fruits and vegetables
    •    beans
    •    seeds
    •    legumes
    •    nuts
    •    potatoes
    •    eggs
    •    dairy products
    •    oils and vinegars
    •    corn though this can often cross react with gluten.
    •    rice
    •    fish
    •    lean beef
    •    chicken
    •    seafood

Many other grains and foods are gluten-free as well. There's a plethora of options on Amazon:
    •    amaranth
    •    arrowroot
    •    buckwheat
    •    cassava
    •    millet
    •    quinoa
    •    rice
    •    sorghum
    •    soy
    •    tapioca

It may seem daunting to go gluten-free at first. But for many, the advantages far outweigh the inconvenience. Check out online options for pantry staples such as gluten-free breads, pasta, crackers, and cereals. For baking, use substitute flours.

These can include:

    •    buckwheat
    •    millet
    •    rice
    •    sorghum
    •    quinoa
    •    chickpea

Eating out

Eating at restaurants can be particularly challenging if you have a gluten intolerance, but this doesn’t mean you can’t ever dine out. You should be able to dodge the gluten bullet if you stick with the same types of items you eat at home, such as grilled meats and steamed vegetables. And always take protectzyme which helps break down gluten  and dairy by 90%

Foods to avoid in restaurants include fried foods, certain sauces, or anything that has been fried in the same pan with a gluten-containing food.

Celiac disease requires extra caution when eating out. Make sure that dietary restrictions are communicated to the chef in advance. Certain restaurants are almost certainly out of question for those on a gluten-free diet, including fast food restaurants, buffets, salad bars, and most bakeries. On the flipside, more and more establishments, cater to the gluten-free diet. Some restaurants also have dedicated gluten-free prep and cook areas, but calling ahead to confirm is always a good idea.

All people with celiac, NCGS can leave an active, healthy life free from future chromic disease, they just need to learn how!