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(HealthNewsDigest.com) – If you suffer any degree of gluten intolerance you need to avoid wheat, rye and barley. Gluten is a protein found in these grains. Currently, the market for gluten-free foods is exploding, expected to reach $2.6 billion by the end of 2012. Many people report feeling healthier when they go gluten-free. Yet, only 3 million Americans have celiac disease, the classic condition that benefits from a gluten-free diet, and the vast majority of these people have not been diagnosed. Who’s eating all these gluten-free foods?
Experts have speculated for a long time that there were other gluten-sensitive conditions but the lack of clear definitions and diagnostic criteria made it difficult to categorize these related conditions. People, however, who suffered unexplained behavioral changes, bone and joint pain, muscle cramps, leg numbness, weight loss, and chronic fatigue knew something was very wrong. And, when they stopped eating wheat their symptoms improved and they felt better.
To sort out the gluten puzzle a group of 15 experts met in London in early 2011. They combed the literature, debated their findings, and came to an agreement on definitions and classifications of gluten-related disorders. They divided the conditions into allergies, autoimmune diseases and sensitivity disorders. Their results and the new classification system were published in early 2012.
A decade ago, celiac disease, the classic autoimmune condition treated with a gluten-free diet, was rare. Today it is estimated that 1% of Americans has celiac disease and the incidence is rising worldwide. Onset occurs over time with continued exposure to gluten and results in severe damage to the intestinal tract.
Much of the world’s population eats wheat as bread, pasta, noodles, couscous, bulgur or baked goods. Some speculate that the introduction of wheat, 10,000 years ago at the dawn of agriculture, was an evolutionary challenge to humans and may have set the genetic foundation for gluten intolerance. The breeding of wheat varieties with higher gluten content, needed to produce excellent food products, has been continuous over time. For some humans, gluten becomes a toxic substance. With the worldwide exposure to wheat, almost every human has the potential to react to gluten during their lifetime. In some Asian countries, as less rice is eaten and wheat is becoming the preferred grain, the incidence of celiac disease is rising.
Dermatitis herpetiformis is the skin manifestation of celiac disease presenting with a blistering rash. It is more likely to occur in men at middle age. Why some people develop this form of celiac disease and how the intestines and skin are related is still unknown. The rash is gluten sensitive so a gluten-free diet is helpful with the condition. Gluten ataxia, another autoimmune condition, causes irreversible damage to the cerebellum section of the brain.
Wheat allergy or gluten sensitivity is not the same thing as celiac disease. Neither is an autoimmune disorder. Symptoms of a wheat allergy will appear within minutes or hours of eating wheat causing a rash, or GI and respiratory problems.
Gluten sensitivity is the toughest condition to diagnose. These are people who experience some type of distress when they eat gluten-containing foods and show improvement when they stop eating gluten. They are not allergic to wheat and they do not have an autoimmune disease. They are simply classified as non-celiac gluten sensitive or simply gluten sensitive. Their symptoms often overlap with those allergic to wheat and those that truly have celiac disease. Will their condition progress causing damage to the gut or evolve into celiac disease? We simply do not know. What we do know is that they respond to a gluten-free diet and once gluten is avoided their symptoms disappear.
Gluten-free diets have also been used to treat schizophrenia, multiple sclerosis, autism spectrum disorders, and dementia. Though some individuals report positive changes with gluten-free foods it has been impossible to separate the results from the placebo effect of a simple diet change. Much more research is needed before gluten-free diets can be recommended to treat these conditions.
Bottom line: If you suffer symptoms after eating wheat, barley or rye a gluten-free diet might be the right choice for you. If you have no symptoms, there is no benefit from removing these otherwise healthy foods from your meals.
For more information: Spectrum of gluten-related disorders: consensus on new nomenclature and classifications, BMC Medicine, 2012. (www.biomedcentral.com/1741-7015/10/13)
© NRH Nutrition Consultants, Inc.
Jo-Ann Heslin, MA, RD, CDN is a registered dietitian and the author of the nutrition counter series for Pocket Books with sales of more than 8.5 million books.
Look for:
The Complete Food Counter, 4th ed., 2012
The Diabetes Counter, 4th Ed., 2011
The Protein Counter, 3rd Ed., 2011
The Calorie Counter, 5th Ed., 2010
The Ultimate Carbohydrate Counter, 3rd Ed., 2010
The Fat Counter, 7th ed., 2009
The Healthy Wholefoods Counter, 2008
The Cholesterol Counter, 7th Ed., 2008
Your Complete Food Counter App: ClickHere
For more information on Jo-Ann and her books, go to: TheNutritionExperts
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