Gluten free diet and foods, products, allergy by Ray Sahelian, M.D.
November 2, 2016

Gluten is a mixture of proteins or peptides found in some cereals, particularly wheat. It is the gliadin component of gluten which is responsible for celiac disease. A gluten-free diet is not the same as a wheat-free diet, and some gluten -free foods are not wheat free. Despite a good deal of research, it is unknown how or exactly why gluten harms the gut. It is now considered likely that celiac disease involves an abnormal immunologic response, rather than an enzyme deficiency as was suggested in the past.

A fad diet or real?
Gluten-free diets seem to be the latest fad, yet the number of people being diagnosed with celiac disease hasn't budged. People with celiac disease have no choice but to avoid gluten in their diet. If they don't, their small intestine is damaged every time they eat something with gluten. Gluten-free diets appear to have become a trendy way to address any sort of gastrointestinal problem.

Ann Nutr Metab. 2015. Adverse Effects of Wheat Gluten. Man began to consume cereals approximately 10,000 years ago when hunter-gatherers settled in the fertile golden crescent in the Middle East. Gluten has been an integral part of the Western type of diet ever since, and wheat consumption is also common in the Middle East, parts of India and China as well as Australia and Africa. In fact, the food supply in the world heavily depends on the availability of cereal-based food products, with wheat being one of the largest crops in the world. Part of this is due to the unique properties of wheat gluten, which has a high nutritional value and is crucial for the preparation of high-quality dough. In the last 10 years, however, wheat and gluten have received much negative attention. Many believe that it is inherently bad for our health and try to avoid consumption of gluten-containing cereals; a gluten-low lifestyle so to speak. This is fueled by a series of popular publications like Wheat Belly; Lose the Wheat, Lose the Weight, and Find Your Path Back to Health. However, in reality, there is only one condition where gluten is definitively the culprit: celiac disease, affecting approximately 1% of the population in the Western world.

Curr Allergy Asthma Rep. 2013 December. Is gluten a cause of gastrointestinal symptoms in people without celiac disease? The avoidance of wheat- and gluten-containing products is a worldwide phenomenon. While celiac disease is a well-established entity, the evidence base for gluten as a trigger of symptoms in patients without celiac disease (so-called 'non-celiac gluten sensitivity' or NCGS) is limited. The problems lie in the complexity of wheat and the ability of its carbohydrate as well as protein components to trigger gastrointestinal symptoms, the potentially false assumption that response to a gluten-free diet equates to an effect of gluten withdrawal, and diagnostic criteria for coeliac disease. Recent randomized controlled re-challenge trials have suggested that gluten may worsen gastrointestinal symptoms, but failed to confirm patients with self-perceived NCGS have specific gluten sensitivity. Furthermore, mechanisms by which gluten triggers symptoms have yet to be identified.

The grain quinoa appears to be safe for people with celiac disease.

Holidays and Thanksgiving
Many traditional Thanksgiving dishes -- such as turkey, corn, sweet potatoes and cranberry sauce -- are gluten-free, but when it comes to pies, stuffing, gravy, etc., gluten-free substitutes may need to be considered.

Non Celiac Gluten sensitivity
NCGS was originally described in the 1980s and recently a “re-discovered” disorder characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food, in subjects that are not affected with either celiac disease or wheat allergy. NCGS frequency is still unclear. Recent studies raised the possibility that, beside gluten, wheat amylase-trypsin inhibitors and low-fermentable, poorly-absorbed, short-chain carbohydrates can contribute to symptoms (at least those related to IBS, irritable bowel syndrome) experienced by NCGS patients.

Gluten sensitivity appears to be a real medical problem, and not a figment of the popular imagination conjured up by the gluten-free craze. Some people suffer changes within their bodies after eating gluten that are separate and distinct from those that accompany either celiac disease or wheat allergy. People with non-celiac wheat sensitivity appear to suffer from a weakened intestinal barrier, which leads to an immune response after they eat foods that contain the gluten protein -- typically wheat, rye or barley. Their symptoms involve bloating, abdominal pain and diarrhea, but also include fatigue, headache, anxiety, and problems with memory and thinking skills.

Prevalence
Approximately 3 to 5% of the population may have non-celiac gluten sensitivity. However, we are still challenged with finding stricter clinical criteria for the condition, developing a usable clinical approach for gluten challenge in these individuals, and understanding the pathogenesis of the condition.

Conditions that may be caused by gluten
Celiac disease is the prototype of an immune mediated response dominated by the activation of the adaptive immune system and in particular of CD4+ HLA class II restricted T cells. Patients with celiac's disease have an intolerance to the protein in gluten which damages their intestinal lining and makes it difficult to absorb nutrients. While there is a genetic predisposition for celiac disease, many people don't develop symptoms until later in life. Chemotherapy for certain forms of cancer can sometimes induce celiac disease.

A gluten free diet is worth a try in those with rheumatoid arthritis,

Some people with migraine do better by avoiding gluten. A few individuals with psoriasis may also benefit by reducing or avoiding gluten intake.

FDA gluten food standard
2007 - Makers of foods claiming to be free of gluten-containing grains such as wheat and barley face tighter standards under new FDA rules to help protect patients with a digestive disease that prevents them from absorbing the gluten protein. Under the new rules, foods claiming to be " gluten - free " must not contain any type of wheat, rye or barley, including hybrids. They also cannot use any ingredient made from such grains without having the gluten removed first.

Country Life Vitamins is Certified Gluten Free
2008 – The Gluten-Free Certification Organization (GFCO) announced today that it has certified Country Life Vitamins as certified gluten-free. Country Life has been producing a full line of vitamins and nutritional supplements since 1971. Country Life’s entire product line is gluten-free, allowing them to meet the needs of a growing market of persons following a gluten-free diet, who may not be able to meet all their nutritional needs from the foods they consume.

Questions
Q. I would like to order 3 products to help with insomnia, 5-Htp, L-tryptophan, and melatonin. I wanted to know if any of these 3 products at Physician Formulas contained wheat, rye or barley as I am sensitive to them.
   A. To the best of our knowledge, there is no gluten in these products.