A few years ago it was only a few way out, wacky souls – Dr Peter Osborne and his Gluten Free Society in the US, Micki Rose and a handful of nutritional therapists in the UK – who were suggesting that maybe ‘classic’ coeliac disease (reacting only to the gluten in wheat, barley and rye) was not the whole answer. Could the many people with unresolved health issues, and those coeliacs who failed to get better on the standard gluten-free diet, have some sort of sensitivity or intolerance to all forms of gluten found in all grains, not just to the specific protein fraction, gliadin known to be implicated in classic coeliac disease?
Now, all of a sudden, this notion seems to have gone all but viral, thanks to a seminal paper published in October 2012 and involving virtually all of the great and the good in coeliac research – Spectrum of gluten-related disorders: consensus on new nomenclature and classification. By November even the august and far-from-far-out BMJ (British Medical Journal) had clambered aboard the bandwagon. Professors Imran Aziz and David Sanders are found combing the literature once again to discover whether ‘gluten sensitivity in the absence of coeliac disease exists’. (For a helpful comment on this research see Dr Briffa’s blog). On the same day a lengthy correspondence appeared between consultant physician Kamran Rostami and a patient who had finally resolved 20 years of ill health by excluding both gluten and lactose from his diet.
And more developments are expected soon as Dr Alessio Fassano, coeliac expert and leader in this area, told About.com just a few days ago. He hopes that a clinical trial now underway will identify some sort of biomarker for non-specific gluten sensitivity which will enable a diagnostic test and thereby much earlier intervention. As he goes on to say, this would not only have implications for those with physical health problems, but for those with behavioural conditions such as autism where a vocal minority have long claimed that gluten and casein were heavily implicated in breaching the blood brain barrier and causing the autistic disconnect.
(If you want to know more about autism and the gluten/casein-free diet see the free download page on the ESPA research site. For a ‘real life’ example of how it works see ‘The Story of Matthew, Luke, Joe and Ben’.)
It is, of course, no great surprise that it is the medical profession who are the last to catch on to the fact that gluten might have health implications outside coeliac disease. The nutritional therapy world, have long had their suspicious of gluten while, attributing their own ill health to an over consumption of gluten – and following in the footsteps of medical gurus such as Victoria Beckham, Gwyneth Paltrow and Novak Djokovich – the ‘eating public’ have been busily excluding it from their diets for some time.
Meanwhile, food manufacturers, seeing the way the wind was blowing, have put some serious work into developing wide ranges of excellent (sometime better than the originals) gluten-free foods which, in turn, have merely swelled the ranks of those eating them. Would-be gluten excluders can now get lots of tasty and delicious alternative gluten-free foods so going gluten-free is no longer even a penance.
In fact one has to wonder whether it is gluten sensitivity that is so much of an issue as gluten excess.
Over the last 50 years, wheat has been bred to include ever higher quantities of gluten as gluten is such a useful product in food manufacture. Since the invention of the Chorley Wood Bread Process in the 1960s, bread has been made with higher levels of high gluten, highly processed wheat which is never left to prove properly (thus leaving the gluten at least partially un-metabolised). And since the arrival of the ‘Mediterranean diet’ the average person’s daily diet includes high gluten wheat for virtually every meal: cereal and toast for breakfast, sweet biscuit with morning coffee, pizza for lunch, piece of cake or biscuit for tea and pasta for supper!! (Not, be it said, what a true Mediterranean would see as ‘their’ diet…)
Interestingly, even the medics have cottoned on to this one. This is the last paragraph of the seminal paper mentioned above:
‘Additionally, gluten is one of the most abundant and diffusely spread dietary components for most populations, particularly those of European origin. In Europe, the mean consumption of gluten is 10 g to 20 g per day, with segments of the general population consuming as much as 50 g of daily gluten or more. All individuals, even those with a low degree of risk, are therefore susceptible to some form of gluten reaction during their life span. Therefore, it is not surprising that during the past 50 years we have witnessed an ‘epidemic’ of CD and the surging of new gluten-related disorders, including the most recently described GS.’
I rest my case…
If you want to investigate the relationshiop between gluten and ill health in more detail, check out Micki Rose’s article, No grain, no pain, and all of the TrulyGlutenFree site, a good article on GreenMedInfo.com and material on the Gluten Free Society site. If you are interested in the gluten/casein-free diet for autism you might want to check in at Paul Whiteley’s Questioning Answers blog.