While there is no uniform consensus on whether the incidence of gluten-related health problems is on the rise, advances in screening and testing methods, coupled with a growing public awareness of celiac disease and gluten sensitivity, have brought gluten into the spotlight. There are currently three main schools of thought on the relationship between gluten and health problems.
Genetics & Overconsumption
Celiac disease tends to occur in families and therefore individuals with family members who have CD are at increased risk of developing the disease. Genetic susceptibility is related to specific HLA markers. More than 97% of individuals with CD in the United States have DQ2 and/or DQ8 HLA markers. Some of these HLA genes can be tested for using a sample of blood or cells taken from your mouth by swabbing the inside of your cheek.
Tests that detect HLA DQ2 and DQ8 genes can suggest a diagnosis of CD, but they cannot confirm a diagnosis, since 35 percent to 40 percent of the overall American population carries these genes but only a small population of people with these genes will ever get the disease.
Research at the Mayo Clinic shows that the prevalence of CD is four times more common in all age groups now than 60 years ago.
Also, our bodies were not designed to digest the overwhelming quantity of gluten found in wheat products and the Standard American Diet. Grains were only introduced around 8,000 years ago. Originally, our ancestors knew these grains were difficult to digest so they were commonly soaked or sprouted which begins the enzymatic action that starts to break down the gluten into peptides and even amino acids making it easier to digest (though not eradicating the gluten content). In the 18th century, with the advent of the mechanical grain reaper, wheat became widely available and also highly processed, making its way into every meal. Americans now commonly eat wheat and/or gluten 3-6 times every day. The body may become sensitized to foods that are eaten frequently, and can mount an immune response against them. Whether or not you have CD, eating a wide variety of foods daily is essential to good health.
Environmental - Changes to Gluten-containing Grains and Production Methods
The second issue with gluten is the changes to the actual wheat grain. During the last few decades, techniques such as hybridization, widespread use of pesticides, the injection of genes and using bacteria to transfer genetic information have been used to produce transgenic wheat. In this manner, the wheat has been genetically engineered to contain proteins from a variety of plant and animal sources including fish and mold. Bioengineering has changed grains in order to “improve” gluten and make it larger and more potent. Recent data revealed by USDA researcher, Donald Kasarda, suggests that there are no genetically engineered wheat being used commercially in the U.S. What has changed is the amount of “vital gluten”, a food additive from wheat flour that is added to a variety of food products. Vital gluten is added to bread flour and other food products to improve the product characteristics: loaf volume, texture, chewiness, etc. Vital gluten consumption has tripled since 1977. This time frame does fit with the predictions of an increase in celiac disease. Meanwhile, herbicides commonly used in large-scale production of wheat (including chlorophenoxy acids) have been found to be irritants to the gastrointestinal lining.
Immunological - Certain Stressors
The other potential contributing factor behind why the gluten protein is causing so many problems is exposure to certain stressors. According to the National Institute of Diabetes and Digestive and Kidney Diseases, sometimes CD is triggered “or becomes active for the first time—after surgery, pregnancy, childbirth, viral infection, or severe emotional stress.”
It is believed that when the lining of the intestine is disrupted by an infection or by the antibiotics used to treat it, large molecules like gluten can pass through the tight junctions between the epithelial cells and trigger the immune reaction. Increased symptoms or an activation of the disease later in life has been reported following a traumatic illness, accident or childbirth when the hormonal balance of the body can shift dramatically.
Celiac Disease: A Hidden Epidemic. By Peter H.R. Green, MD. (Director of the Celiac Disease Center at Columbia University) and Rory Jones. HarperCollins, 2006.
The Gluten Connection: How Gluten Sensitivity May Be Sabotaging Your Health. By Shari Lieberman, PhD, CNS, FACN. Rodale. 2007.