GLUTEN. Once a relatively unknown term only briefly discussed in medical school, it is now a household term.
Whether you've noticed "Gluten Free" on food packaging or have heard about restaurants offering "Gluten Free" menus, you've likely become familiar with this term. But do you know exactly what "gluten-free" means -- and why so many people are trying to avoid gluten?
Let's start with what gluten is and where it is found...
Gluten is a protein found in certain grains: wheat, rye, and barley, to be exact. It is literally the "glue" that holds baked goods together, giving them their elasticity. Because it is found in wheat, gluten is extremely prevalent in most people's wheat-heavy diets. Just think about it: gluten is in bread, crackers, pasta, cakes, cookies, and almost all baked goods. It's hard to avoid, and most people don't think twice about eating it.
The problem is, our bodies weren't necessarily meant to eat grains like wheat. And in fact, wheat didn't enter the human diet until about ten thousand years ago, making it a relatively new food for our bodies. We are not able to fully digest wheat and gluten, and to make matters worse, recent strains of wheat have actually been genetically modified to contain MORE gluten. Many experts theorize that this could be one reason more and more people are having negative reactions to wheat and gluten.
Adverse reactions to wheat and gluten have taken many forms, from wheat allergies to gluten intolerance/sensitivity, to full-blown Celiac Disease (also known as Celiac Sprue, Coeliac Disease, non-tropical sprue, and gluten-sensitive enteropathy).
Just how prevalent are these negative reactions to gluten?
Well, according to a well-known study conducted by Dr. Alessio Fasano in 2003 1, Celiac Disease affects 1 in 133 people in the United States, almost 1% of the population. It is the most common genetic disorder in North America and Europe and is found in populations all over the world. (Other countries, such as Ireland, have even higher rates: 2%.)
To make matters worse, only about 10-20% of those people with full-blown Celiac Disease in the U.S. have been correctly diagnosed. This arguably makes it the most under-diagnosed disease in the country, with close to 3 million people remaining undiagnosed. That means there are A LOT of very sick people living their lives with stubborn symptoms that have likely resulted in many visits to multiple specialists without a proper diagnosis.
That's because, even now, there are many doctors who know very little about Celiac (again, it's barely discussed in medical school and had always been considered extremely rare). And doctors don't always know what to look for. While Celiac Disease often results in gastrointestinal symptoms, it's technically an auto-immune disease that can result in patients presenting with a wide range of symptoms. People with Celiac Disease may have unexplained anemia, migraines, osteoporosis, or skin rashes -- conditions doctors are likely to treat with iron, prescriptions, or creams without even considering what might be the "root cause" of the problem.
Even more eye-opening is a paper published in March 2011 by Dr. Alessio Fasano and his colleagues at the University of Maryland's Center for Celiac Research 2 that proved that gluten sensitivity, as distinguished from Celiac Disease, exists -- and that it affects anywhere from 6% to 7% of the population. (Others in the medical community estimate that number could be as anywhere from 10% to as high as 40%.) We'll discuss the differences between Celiac Disease and gluten sensitivity in another section, but the outcome is essentially the same. Gluten makes both of these groups of people very sick, and a gluten-free diet is currently the only treatment and path to better health.