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What's the deal with Gluten?
 Consumers unfamiliar with gluten may have wondered why there has been an explosion of gluten-free products in recent years. What began as a trickle of products in natural food stores such as Whole Foods has cascaded into a flood of choices saturating larger mainstream grocers like King Soopers. The gluten-free revolution has not only marched into supermarkets, but has also taken a foot-hold in more and more restaurants.
What is gluten? According to Meriam-Webster’s Medical Dictionary, it is “a gluey protein substance, especially of wheat flour, that causes dough to be sticky.” The Collins English Dictionary describes it as “a protein consisting of a mixture of glutelin and gliadin, present in cereal grains, especially wheat.” Dictionary.com defines gluten as “The tough, viscid, nitrogenous substance remaining when the flour of wheat or other grain is washed to remove the starch.”
People with limited knowledge may simply associate gluten with bread or wheat. While this is the primary source, gluten can be found in a bewildering amount of items. It is found in sodas, sauces, marinades, salad dressings, juices, and even vitamins. Some of the lunch meats in the supermarket use small amounts of gluten as preservatives.
One of the reasons for the rising popularity of gluten-free diets is the emergence of Celiac Disease (CD). Celiac Disease is not a food allergy. This is how the Celiac Disease Foundation website describes it: “Celiac Disease (CD) is unique in that a specific food component, gluten, has been identified as the trigger. When individuals with CD eat gluten, the villi (tiny hair-like projections in the small intestine that absorb nutrients from food) are damaged. This is due to an autoimmune reaction to gluten. Damaged villi do not effectively absorb basic nutrients – proteins, carbohydrates, fats, vitamins, minerals, and, in some cases, water and bile salts. If CD is left untreated, damage to the small bowel can be chronic and life threatening, causing an increased risk of associated disorders – both nutritional and immune related.” Even tiny amounts of gluten in foods can cause serious health issues to those affected by the disease.
According to the University of Chicago’s Celiac Disease Center, 3 million Americans are affected by Celiac Disease, roughly the same amount as those living with Type-1 diabetes. 97% of them are undiagnosed. 1 in 133 average healthy individuals has Celiac Disease. In those with first-degree family members (parent, child, sibling) the rate is 1 in 22. The symptoms of CD vary greatly, and include abdominal cramps, bloating, diarrhea, nausea, vomiting, anemia, osteoporosis, extreme weight-loss, and vitamin deficiencies, among many others.
Celiac Disease causes more than just digestive problems. Studies have shown that CD also affects fertility, and can significantly increase a woman’s risk of miscarriage during pregnancy. This is especially true for undiagnosed individuals. The National Foundation for Celiac Awareness website illustrates these issues. “It appears from numerous studies on women suffering from unexplained infertility that the incidence of undiagnosed celiac disease in this population is somewhere between 1-3%. Some studies even have found the prevalence to be as high as 8%...Miscarriage occurs 31% more in undiagnosed CD patients than the normal population...In addition, a recent study has shown that the anti-TTG antibody produced in response to gluten exposure in CD actually binds to the placenta. This may compromise placental function putting patients at higher risk for pregnancy loss and problems with the fetus.”
Eating gluten-free is more than a diet, for some it is a lifestyle and a matter of life or death. Imagine going to a restaurant like Chipotle and having to ask the person preparing your meal to change their gloves before they handle your order, so you don’t get gluten contamination with a tortilla or tostada shell. Have you ever had to spend five minutes with the person checking bags at the Pepsi Center explaining that the only reason you are bringing in your own food is because while watching the event, you want to snack like everybody else, and anything you could buy short of bottled water would send you to the hospital? Most people at a tailgate don’t have to keep an eagle-eye on the dip they brought, making sure that someone doesn’t contaminate it with a glutinous chip, or grill on tinfoil for fear of gluten transferral from buns, seasoning, or other ingredients from whatever was cooked before.
Luckily, food-service establishments are starting to catch up as well. Restaurants are educating their employees on the importance of devoting special attention to customers with gluten-free diets. Some are beginning to make recipes and ingredients more readily accessible to customers with special needs. The strengthening awareness and understanding of Celiac Disease is causing restaurants to adapt to the illness, similar to when the low-carb diet fad was at its peak and seemingly every establishment catered to this preference. More and more pizza chains are starting to carry gluten-free pizza dough. Red Robin has a deep-fryer dedicated solely to fries, so they are not cooked in oil contaminated by other breaded items such as onion rings and chicken strips. It is important to note, however, that even though something on the menu claims to be gluten-free, it’s wise to double check with your service, as there may be a tiny fraction of gluten in it. This is severely alarming, as people (much less restaurants) uneducated about the disease may be unaware that the tiny fraction of gluten in the meal may as well be rat poison, and could send someone to the hospital.
Those newly diagnosed with Celiac Disease may not be aware of all the options available to them now, and not solely regarding food options. Life-threatening illnesses such as cancer, diabetes, or kidney failure need a variety of treatments which are commonly covered by health insurance companies. With celiac disease, the “treatment” is the consumption of products that cost significantly more than their glutinous counterparts. If you were to triple or quadruple your food budget every month, because you would die if you didn’t, what would that do to your quality of living? What would you have to give up in order to simply eat to survive? There are now tax credits to help off-set this cost, as it becomes more widely accepted and acknowledged that for some people, eating gluten-free is not a matter of choice, but a necessity for living.
It is incredible that of a disease that affects roughly 1% of Americans, over 2.9 of the 3 million people affected are undiagnosed. The number and quality of resources available to people seeking information about celiac diseases continues to rise. Slowly, so is the awareness and understanding of it also.
Some outlaw motorcycle groups identify themselves with a patch that says “1%ers.” They are proud to separate themselves from the rest of the law-abiding motorcycle clubs. While those affected by celiac disease aren’t necessarily lawbreakers, they are renegades when it comes to the lifestyle they live. The vastly improving network of resources and products makes it much easier for them to blend into society. Hopefully, with the increasing knowledge, awareness and understanding of the disease, those with CD will feel like their condition is less of a stigma and more a healthy badge of honor.
Resources to acquire more information about celiac disease include:
National Foundation for Celiac Awareness
Celiac Disease Foundation
University of Chicago Celiac Disease Center
Source
MINES & Associates HealthPsychology Team
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