Food sensitivities and allergies have become increasingly prevalent in recent times, with people reporting intolerance to various foods like dairy, lactose, wheat, yeast, sugar, additives, and gluten, among others. The reasons behind this surge in sensitivities are a combination of heightened awareness and a genuine increase in the incidence of these conditions.
Our Shifting Relationship with Grains
Our dietary patterns have evolved significantly throughout human history. While primates thrive on carbohydrates and have a natural preference for sweetness, humans have learned to isolate and concentrate sweetness from food, altering our bodies' response to certain foods.
Grains, particularly wheat, have become a staple in the modern diet. However, recent research indicates that sensitivities to gluten, a protein composite found in wheat and related cereals like barley and rye, are more common than previously thought. Approximately 1 in 10 people are affected by gluten sensitivity, while nearly 1 in 100 people suffer from coeliac disease, a more severe autoimmune disorder triggered by gluten intolerance.
Why the Prevalence of Gluten Sensitivity and Coeliac Disease?
One reason for the rise in gluten-related conditions could be our genetic adaptation to grains. Our ancestors consumed minimal gluten as grain cultivation began only about 10,000 years ago, a relatively short period in evolutionary terms. Additionally, modern wheat has a much higher gluten content, making up as much as 78% of its total protein. Gliadin, a gluten protein, has been identified as both an intestinal irritant and a cause of allergic reactions.
Identifying the Problem
Diagnosing gluten sensitivity and coeliac disease can be challenging, as both conditions can present with ambiguous symptoms that are often similar. Moreover, some individuals with gluten sensitivity experience no digestive symptoms at all, leading to under-diagnosis. Studies suggest that around 500,000 people in the UK have yet to be diagnosed with coeliac disease. Encouragingly, awareness campaigns have led to increased education for healthcare professionals, and improved food labelling standards and the "free from" food industry have made gluten-free options more accessible.
Understanding Gluten Intolerance
Gluten intolerance can produce gut symptoms similar to those of coeliac disease but does not involve the production of associated antibodies by the immune system. It may present with symptoms like fatigue, upper respiratory tract issues, nutrient absorption problems, and digestive disorders. Recent research indicates that a group of short-chain carbohydrates known as FODMAPs may also contribute to these symptoms, and they are abundant in gluten-containing grains.
Coeliac disease is an autoimmune disorder in which the immune system reacts to gluten, leading to inflammation and long-term damage to the lining of the small intestine. This damage can result in reduced nutrient absorption, leading to malnutrition, deficiencies, weight loss, fatigue, digestive issues, and a weakened immune system. Coeliac disease may be triggered by a combination of genetic susceptibility, exposure to gluten, and an unusually permeable gut lining.
Living with Gluten Sensitivity or Coeliac Disease
While there is no known cure for these conditions, adopting a gluten-free diet is the primary and successful treatment. It is essential to remove all sources of gluten from the diet, which may require patience and time for improvement, especially if the gut has experienced prolonged irritation and inflammation.
A gluten-free diet is a lifelong commitment, but with careful planning, it is possible to maintain a healthy, well-balanced, and varied diet. Gluten-free supplements, such as nutrient-fortified meal replacements, can provide excellent support and ensure access to a broad spectrum of nutrients without gluten exposure.