Digestion Q&A by Dr. Lee on Gluten Free Diets
Medical Author Dr. Dennis Lee
Viewer Question: Do you know if oat bran contains gluten? And is it OK to eat if I have celiac sprue?
Dietician's Response: A Gluten is the protein fraction of wheat, rye, and barley. Gluten
contains several different types of protein, each with a different
arrangement of amino acids. (Proteins are chains of amino acids
hooked together.) It is believed that several of these proteins are
responsible for the inflammation that causes celiac disease (also known as sprue or
Quick GuideGluten-Free Diet: Popular Gluten-Free Foods in Pictures
What is a gluten-free diet?
Anyone who has had to follow a gluten-free diet has seen a huge change in the
availability of these foods. What was once only found in specialty stores and
known by very few people has now become a very popular diet trend. Products and
restaurants are proudly displaying their gluten-free status. Many now see this
as the latest "diet fad." Gluten is the protein found in wheat, rye, barley, and
triticale. A gluten-free diet excludes all of these, along with anything that
could have come in contact with them. Does everyone need this or only people
with specific diseases? This article with provide you with that answer and guide
you on how to follow this diet, if in fact, you do need to.
Who needs to follow a gluten-free diet?
People have been following a gluten-free diet for many reasons, but not all
are medically necessary. There are some conditions and diseases that do require
that you follow a gluten-free diet.
Probably the most well-known disease that requires a gluten-free diet is
celiac disease. Celiac disease is also known as celiac sprue, nontropical sprue,
and gluten-sensitive enteropathy. The exact cause of celiac disease is not
clear, but it known to have a genetic (inherited) component. Celiac disease
affects approximately 1% of the population, but this may increase as there has
been a rise in the incidence of celiac disease over the past decade.
Celiac disease is an autoimmune disease, where the immune system starts
attacking normal tissue, particularly the inner lining tissue of the small
intestine, in response to eating gluten. The specific reaction that leads to
inflammation is to proteins called prolamins found in certain grains; gliadin
found in wheat, secalin found in rye, horedin found in barley, and for some
avenin found in oats. Although only some react to the prolamins in oats,
everyone who has celiac and lives in North America is instructed to avoid oats.
This is due to the cross contamination caused by the crop being rotated and
milled with wheat.
A gluten-free diet is not optional for people with celiac disease. It is
considered a necessary
medical nutrition therapy. When you have celiac disease
your body reacts to gluten as if it were toxic. This reaction occurs in the
small intestine and ends up damaging the inner lining of the small intestine
(mucosal surface). When the mucosal surface is damaged the small intestine is
not able to absorb nutrients properly leaving people at risk for nutritional
deficiencies including protein, fat, iron, calcium, and fat soluble vitamins (A,
D, E, and K). It can also result in anemia, diarrhea, abdominal cramping,
vomiting, failure to thrive, osteoporosis,
and delayed growth. When gluten is removed from the diet there are clinical
improvements to the small intestines. Getting diagnosed as early as possible and
sticking with a gluten-free diet is key to avoid intestinal damage and long-term consequences of