Gluten - NutraPedia

Back to Table of Contents

Gluten: An Overview of Health Implications

1) Conditions Studied

Gluten has been studied in relation to various health conditions, particularly:

  • Celiac Disease
  • Non-Celiac Gluten Sensitivity
  • Wheat Allergy
  • Irritable Bowel Syndrome (IBS)
  • Autism Spectrum Disorders (in some studies)

2) Efficacy in Treating Conditions

For treating the above conditions, the efficacy of a gluten-free diet is as follows:

  • Celiac Disease: A gluten-free diet is the primary treatment and is highly effective.
  • Non-Celiac Gluten Sensitivity: Symptoms may improve on a gluten-free diet, but more research is needed.
  • Wheat Allergy: Avoiding gluten can prevent allergic reactions.
  • Irritable Bowel Syndrome (IBS): Some patients report symptom relief when following a gluten-free diet.
  • Autism Spectrum Disorders: Evidence does not support a significant impact from gluten-free diets.

3) Health Benefits

Health benefits of a gluten-free diet are primarily seen in individuals with gluten-related disorders, including:

  • Improved gastrointestinal health
  • Reduction in chronic inflammation in those with celiac disease
  • Alleviation of symptoms such as bloating, gas, and diarrhea
  • Enhanced nutrient absorption after intestinal healing in celiac patients

4) Downsides

There are potential downsides to a gluten-free diet, especially if not medically necessary, such as:

  • Potential for nutritional deficiencies (fiber, iron, B vitamins)
  • Increased risk of exposure to heavy metals (from consuming more rice products)
  • Higher costs and less availability of gluten-free products
  • Social and psychological challenges of diet maintenance

5) Impact on Genetic Variations

Gluten's impact can vary based on genetic makeup, particularly:

  • Celiac Disease: Individuals with HLA-DQ2 or HLA-DQ8 genetic variations are at a higher risk and thus may benefit from avoiding gluten.
  • Non-Celiac Gluten Sensitivity: There's no specific genetic marker known, but it may be associated with other immune-related genes.
  • For the general population without such genetic variations, there is no clear evidence that gluten is either beneficial or harmful.

Summary on Gluten's Role in Breadmaking and Celiac Disease

Gluten's Role in Breadmaking

  • Gluten proteins, particularly high molecular weight (HMW) subunits, are vital for the visco-elastic properties of wheat dough, crucial for making leavened bread.
  • HMW subunits contribute significantly to dough's elasticity, forming polymers stabilized by disulphide bonds.
  • Variations in the amount and composition of HMW subunits affect dough elasticity and wheat quality.
  • Genetic engineering could enhance wheat quality by altering the quantity and composition of gluten proteins.

Celiac Disease and Gluten

  • Celiac disease (CD) is characterized by an intolerance to gluten proteins, leading to damage in the small intestine.
  • Most CD patients carry HLA-DQ2 or HLA-DQ8 molecules, critical for presenting gluten peptides to T cells.
  • Tissue transglutaminase (tTG) modifies gluten peptides, enhancing their recognition by T cells and contributing to CD.
  • The only current treatment for CD is a strict lifelong gluten-free diet, with potential alternative treatments under study.

Non-Celiac Gluten Sensitivity and Dietary Considerations

  • Non-celiac wheat sensitivity (NCGS) is a genuine clinical condition, distinct from CD and wheat allergy (WA).
  • Gluten can cause gastrointestinal symptoms in individuals without celiac disease, especially those with irritable bowel syndrome (IBS).
  • Dietary adjustments, like a low FODMAP diet, can be an effective treatment strategy for functional gut symptoms.

Research on Gluten and Celiac Disease

  • Genetic factors contribute to CD, with non-HLA genetic factors also playing a significant role.
  • Diagnosis of CD has shifted towards fewer symptomatic cases and more asymptomatic adult cases identified through screening.
  • Familial forms of CD are associated with higher risk among first-degree relatives, especially siblings.
  • Seronegative CD, lacking typical antibodies, presents with classical symptoms of malabsorption and severe villous atrophy.
  • Early diagnosis and strict adherence to a gluten-free diet are crucial in reducing mortality risk for CD patients.

References:


  1. Biotechnology of breadmaking: unraveling and manipulating the multi-protein gluten complex
  2. Wheat gluten: high molecular weight glutenin subunits--structure, genetics, and relation to dough elasticity
  3. The structure and properties of gluten: an elastic protein from wheat grain
  4. The intestinal T cell response to alpha-gliadin in adult celiac disease is focused on a single deamidated glutamine targeted by tissue transglutaminase
  5. Celiac disease: prevalence, diagnosis, pathogenesis and treatment
  6. Ingestion of oats and barley in patients with celiac disease mobilizes cross-reactive T cells activated by avenin peptides and immuno-dominant hordein peptides
  7. The molecular basis for oat intolerance in patients with celiac disease
  8. Non-celiac wheat sensitivity diagnosed by double-blind placebo-controlled challenge: exploring a new clinical entity
  9. Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial
  10. Non-Celiac Gluten Sensitivity among Patients Perceiving Gluten-Related Symptoms
  11. Non-Celiac Gluten Sensitivity Has Narrowed the Spectrum of Irritable Bowel Syndrome: A Double-Blind Randomized Placebo-Controlled Trial
  12. Evidence for the Presence of Non-Celiac Gluten Sensitivity in Patients with Functional Gastrointestinal Symptoms: Results from a Multicenter Randomized Double-Blind Placebo-Controlled Gluten Challenge
  13. Food choice as a key management strategy for functional gastrointestinal symptoms
  14. No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates
  15. A major non-HLA locus in celiac disease maps to chromosome 19
  16. Trends in the presentation of celiac disease
  17. Current approaches to diagnosis and treatment of celiac disease: an evolving spectrum
  18. Risk factors in familial forms of celiac disease
  19. Challenges in the celiac disease diagnosis; Prague consensus
  20. Serological markers for coeliac disease: is it time to change?
  21. A Prospective Study on the Usefulness of Duodenal Bulb Biopsies in Celiac Disease Diagnosis in Children: Urging Caution
  22. Seronegative celiac disease: Shedding light on an obscure clinical entity
  23. Mortality in patients with coeliac disease and their relatives: a cohort study
  24. Molecular basis of celiac disease


Upload Whole Genome Sequencing (WGS) raw DNA data today and take a deep dive into your genome!

Or if you only have standard microarray data currently, upload raw DNA data to get started with your free DNA raw data analysis today!