What's Wheatin’ You? Dietary Advice for People with Celiac Disease and Gluten Intolerance

Lewis Chan, HK BioTek Intern

Gluten is a protein found in wheat, barley and rye-based products. It gives foods like bread, pasta and most baked goods their chewy, stretchy texture.

While the majority of people can consume gluten freely, around 0.7 to 1% of people in the U.S. are affected by Celiac disease, a condition where gluten triggers an immune response that damages the small intestine’s lining over time. This causes malabsorption, which can lead to symptoms like diarrhoea, fatigue, weight loss, bloating and anaemia and could lead to more serious complications. In children, malabsorption caused by Celiac disease affects growth and development.

People without Celiac disease who suffer negative reactions from consuming gluten may suffer from gluten sensitivity or gluten intolerance, both of which are not currently well-defined within the medical community.

Gluten sensitivity (also known as non-celiac gluten sensitivity) often refers to milder reactions to gluten that resolve quickly. On the other hand, gluten intolerance may incite more serious symptoms that last for a longer period of time. Neither of them are an autoimmune reaction like Celiac disease or an allergic reaction where the immune system produces antibodies to bind onto foreign substances.

Diagnosing gluten sensitivity and gluten intolerance happens by ruling out Celiac disease and wheat allergy as there are no tests or biomarkers that can identify this condition.

At this point of time, no cure for Celiac disease or of gluten sensitivity have been identified yet. The most common method to prevent symptoms is by replacing gluten-containing grains with gluten-free options, such as rice, potatoes, corn, peas, lentils, quinoa, millet, soy and sorghum. Following a gluten-free diet allows intestinal damage to heal and prevents further damage.

Pure, uncontaminated oats are also gluten-free, but most commercially sold oats are often contaminated with gluten as they may be processed in the same facilities as gluten-containing grains. Look for oat products at specialty food stores that are certified gluten-free and claim not to have gluten cross-contact.

References

1. https://www.beyondceliac.org/gluten-free-diet/overview/

2. https://www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220

3. https://rarediseases.info.nih.gov/diseases/11998/celiac-disease/cases/50559

4. https://www.schaer.com/en-us/a/celiac-vs-gluten-intolerance

5. https://www.verywellfit.com/is-oatmeal-gluten-free-562847