The Whys of Gluten

From breads to cookies, pastas, and beers, countless foods contain gluten. But at the same time, countless gluten-free products have also emerged. As such, the role of gluten is unclear, and for many people, there are still several "whats" and "whys" to clarify: What is gluten? Why do some people benefit from reducing their consumption? Why aren't these benefits available to everyone? Am I one of those people?

What is gluten and how do we digest it?

Gluten is the name given to a group of proteins found in the seeds of cereals such as wheat, barley, rye, and malt. Unlike most proteins, this one is quite resistant to digestion! While some can be digested and absorbed, it's not surprising that most of the gluten consumed reaches the small intestine virtually intact. For people with a healthy intestinal tract, the presence of undigested gluten is harmless. [1]

But then... Why are there people who can't tolerate gluten?

There are, in fact, specific pathologies that lead to gluten tolerance. They are:

• Celiac Disease: In this case, the person has a compromised intestinal wall. This means that when consuming gluten-containing products, the poorly digested protein can interact with the intestinal wall, triggering an inflammatory response.
• Non-celiac gluten sensitivity: This is the case of people with symptoms similar to celiac disease after consuming gluten, but who do not experience an inflammatory response or damage to the intestine. [2]

Does this mean I should reduce my consumption of gluten-containing foods?

No! In fact, according to the Portuguese Celiac Association , only 1% of the Portuguese population has celiac disease. Therefore, most people will not benefit from reducing or eliminating gluten from their diet alone.

However, here are some guidelines in case you want to know how to proceed:

Have you been diagnosed with celiac disease or gluten sensitivity?

The recommended approach is to reduce or even eliminate gluten from the diet. However, this entire process should be established and monitored by a nutritionist, considering each case individually.

Have you not been diagnosed with any of the above conditions, but experience symptoms such as bloating, diarrhea, or cramps after eating foods containing gluten?

You should seek medical advice to determine the cause of your symptoms before making any changes to your eating habits.

Do you not experience any symptoms after consuming foods containing gluten?

For individuals who tolerate gluten but follow a gluten-restricted diet, there is no scientific evidence that indicates either improved health or increased disease prevention.[3] Therefore, there is no recommendation for you to reduce your gluten consumption.

In summary:

There are pathologies in which gluten consumption is not tolerated, and its exclusion (partial or total) is recommended. However, these cases do not reflect the majority of the population!

As such, there is no indication of any type of restriction on gluten consumption for the general population and, when doing so, it should always be under the supervision of a qualified health professional.

References

[1] J.L., M.L.K. & R. (2017) Krause's Food & the Nutrition Care Process . 14th Edition. St. Louis, MO: Elsevier.

[2] Leonard, M.M. et al. (2017) ‘Celiac disease and nonceliac gluten sensitivity’, JAMA , 318 (7), p. 647. doi:10.1001/jama.2017.9730.

[3] Gaesser, GA and Angadi, SS (2012) ‘Gluten-free diet: dietary advice applicable to the general population?’, Journal of the Academy of Nutrition and Dietetics , 112 (9), pp. 1330–1333. doi:10.1016/j.jand.2012.06.009.