Gluten is a family of storage proteins found in various grains such as barley, rye, and wheat. Gluten is responsible for the soft and chewy texture of pastries and baked items. It also retains the moisture in bread, pasta, and cereal.
Gluten intolerance and gluten sensitivity are two terms used interchangeably to describe a condition where the body recognizes gluten as an ‘enemy’ and initiates an immune response against it.
Table of Contents
- Knowing the difference between gluten intolerance and celiac disease.
- What are the symptoms of gluten sensitivity?
- Is avoiding carbs to avoid gluten the best idea?
- Evolutionary significance: How did our ancestors respond to gluten?
- Gluten sensitivity among different ethnic groups.
- The genetics behind gluten sensitivity
- Why get tested for gluten sensitivity?
- How to know if you are gluten-sensitive?
- Dietary recommendations to manage gluten sensitivity.
- Summary
- References
Knowing The Difference Between Gluten Intolerance And Celiac Disease
Gluten intolerance is also known as ‘non-celiac’ gluten sensitivity.
Celiac disease is an exaggerated form of gluten intolerance. Upon consuming gluten, the immune system attacks the lining of the intestines. When the symptoms are more severe, the recovery is a lot harder.
Here, the body’s immune system, which is meant to protect it, mistakenly acts against it. This is known as an auto-immune response, which can be due to genetic reasons.
Since intestines play a big role in the absorption of essential nutrients, attacks on them over time can result in poor absorption of nutrients, putting you at risk for various deficiencies. When the gluten intolerance is non-celiac, the immune responses triggered do not damage the intestines but instead contribute to milder symptoms.
Gluten sensitivity symptoms are not restricted to just the digestive system.
What are the symptoms of gluten sensitivity?
- Abdominal pain
- Diarrhea
- Bloating
- Constipation
- Nausea
- Headaches
- Fatigue
- Skin rashes
- Anxiety
- Depression
- Joint and muscle pain
- Numbness
Why Avoiding Carbs To Avoid Gluten May Not Be The Best Idea
All the fad about gluten-free diets has portrayed gluten-containing products, mainly wheat, in a bad light. While gluten is a big no-no for the gluten-sensitive, reduced consumption of whole grains may negatively impact your health.
Whole grains like wheat, bran, and rye are rich sources of fiber. They also contain carbohydrates, proteins, and small amounts of B vitamins and minerals.
- Fibers can slow down the absorption of sugar from food, and thereby lower and regulate the blood sugar levels
- In the process of waste removal, fiber also removes the excess cholesterol from the body
- The essential nutrients in whole grains may help protect against certain types of cancer
- Fiber also may prevent the formation of blood clots that can cause a stroke
Thus, avoiding gluten in the absence of an intolerance/sensitivity can end up being detrimental to your health.
Evolutionary Significance: How did our ancestors respond to gluten sensitivity?
Diana Gitig, a Ph. D. graduate from Cornell University, Massachusetts, mentions that celiac disease's first reported case dates back to 100 A.D. It was diagnosed by a Greek doctor, Aretaeus. Yet, the cause of the disease was never understood clearly.
During the Dutch famine in the 1940s, when celiac patients received very little flour (wheat) for consumption, their symptoms started improving.
When fresh supplies of bread were reintroduced, the symptoms started worsening again. This was when wheat was isolated as the cause of the intestinal symptoms.
Until the 1950s, only 1 out of 8000 were sensitive to gluten. Today, as high as 1 in every 100 individuals are gluten sensitive .
Prof. David Sanders from the University of Sheffield takes help from the concept of evolution to answer this huge rise in cases. He claims that humans started eating wheat only recently, about 10,000 years ago. This is a very brief period considering that humans have walked on the planet for more than 2 million years.
Humans initially consumed raw food, such as plants, fruits, and meat. Processed food (wheat, rye, and other grains), are relatively new in the evolutionary timeline. Prof. David acknowledges this fact and states that our body is still in the process of adapting, especially the food that contains gluten in it. With millions of years of having a gluten-free diet, it makes sense as to why gluten is considered a foreign body by our immune system.
Ethnicity And Gluten Sensitivity
Although a global analysis of gluten intolerance is yet to be done, a nationwide study was conducted in the United States. Over 400,000 biopsy results were examined to understand if ethnicity played a role in gluten intolerance and celiac disease. The following results were concluded after the study :
- Most of the Americans who were from the Punjab region of India were gluten sensitive.
- Significantly lower numbers of gluten-sensitive cases were reported by Americans of South Indian, East Asian, and Hispanic descent.
- Jewish and Middle Eastern people had no notable differences and had similar chances of being gluten-sensitive than any average American.
It is also worth mentioning that gender studies showed that both men and women had equal chances of being gluten-sensitive. Hence it can be inferred that gender does not play a role in this intolerance.
Genetics And Gluten Sensitivity
The HLA gene
The Human Leukocyte Antigen (HLA) gene system plays a role in the production of the Major Histocompatibility Complex (MHC), which are proteins present on the cell surfaces. They play a role in regulating the immune system.
Two classes of the HLA gene known as HLA-DQ2 (HLA-DQ2.2 and HLA-DQ2.5) and HLA-DQ8 are linked with gluten intolerance risk.
Four types of the HLA gene, HLA DQ, HLA DQ 2.5, HLA DQ 2.2 (has three sub-types), and HLA DQ7, have been linked to gluten intolerance.
In a study conducted to assess the genetic influence on gluten intolerance, nearly all the patients with celiac disease had the risk allele in the HLA DQ2 and the HLA DQ8 genes. The absence of the same was found in 100% of people without celiac disease. In another study conducted to analyze the HLA gene types, people with the C allele in HLA DQ8, T allele in HLA DQ 2.5, the T, C and A alleles in different subtypes of HLA DQ 2.2 (M1, M2, and M3 respectively), and A allele in HLA DQ7 were shown to have an increased risk of reacting to gluten in their diets.
Non-Genetic Causes Of Gluten Sensitivity
Some of the non-genetic causes of gluten sensitivity are:
- Poor infant-feeding practices
- Gastrointestinal infections
- Abnormal gut bacteria
Not all people are born with gluten sensitivity. It is possible to acquire it during the course of life. This intolerance can be triggered after surgery, childbirth, or after a period of severe stress.
Commonly Associated Conditions With Gluten Sensitivity
Gluten Sensitivity Can Affect Hormone Levels
Gluten sensitivity increases the risk of an adrenal hormone imbalance.
The adrenal glands pick up on the stress levels.
Unstable sugar levels and inflammation of the digestive tract resulting from gluten intolerance cause the adrenal glands to secrete cortisol.
This leads to an increase in body fat, fatigue, and irritable mood.
Gluten Sensitivity Can Increase Fatigue
Fatigue is one of the most common symptoms of celiac disease and non-celiac gluten sensitivity.
In fact, fatigue and tiredness are the symptoms that last longest, even after the individual has shifted to a gluten-free diet.
Fatigue in gluten intolerant individuals occurs due to two main reasons:
- The inflammation in the digestive system results in improper absorption of nutrition, leaving the body deficient in certain nutrients.
- Gluten-allergy or sensitivity leads to diarrhea, characterized by loose, watery stools. This leads to lots of water and nutrients elimination from the body.
Dehydration is also a major cause of fatigue and tiredness in gluten intolerant people.
Gluten Sensitivity Can Cause Neurological Symptoms
Patients suffering from celiac and non-celiac forms of gluten intolerance have reported neurological symptoms such as headaches, brain fog, anxiety, depression, and peripheral neuropathy.
Gluten can also cause other disorders like insomnia, migraines, ADHD, epilepsy, schizophrenia, bipolar disorder, and in a minute number of cases, gluten ataxia (antibodies directed at gluten attacks the brain).
Gluten Sensitivity Can Cause Mood Disorders
Many studies have shown a correlation between gluten intolerance and depression, anxiety, and other neurological syndromes.
A study conducted by Christine Zioudrou and her colleagues at the National Institute of Mental Health in 1979 found that some gluten compounds can attach to the morphine receptors in the brain.
The morphine that is produced in the body is known as endorphins. These are released in our body for various reasons, for instance, to reduce/manage pain.
Certain compounds of gluten (exorphins) mimic the structure of endorphins and attach to the receptors.
Thus, the endorphins have no place to attach to and are not activated. This can lead to mood-related disorders like depression and anxiety.
Gluten Sensitivity Can Cause Insomnia
A large majority of the people who suffer from gluten-intolerance report lack of sleep and poor sleep quality.
Due to digestive symptoms, neurological symptoms, and generalized fatigue and tiredness, most people suffer from a lack of sleep or other related conditions.
How To Know If You Are Gluten Sensitive
If you think you have some of the symptoms of gluten sensitivity, talk to your doctor before jumping to any conclusions. The doctor can run tests and review your history to help reach a diagnosis.
Another way to find out if you have a risk for gluten allergy is to do a genetic test. If you already have your DNA raw data from any ancestry company like 23andMe, Ancestry DNA, Family Tree DNA or whole genome data, you can upload it to Xcode Life for a Gene Nutrition report.
In the Gene Nutrition report you can find an in-depth analysis of your genetic variants for gluten sensitivity and ways to manage or prevent it.
Dietary Recommendations For Gluten-Sensitive Individuals
A gluten-free diet seems pretty straightforward - just removing gluten from your diet. But completely avoiding gluten can be challenging as many ingredients added to food like soy sauce, mayonnaise, and roasted nuts also contain gluten.
Whole grains like wheat and barley are well-known harbourers of gluten. So wheat-based bread, pasta, or baked goods should be avoided.
What are the naturally gluten-free foods?
- Fish and seafood
- Eggs
- Meat and poultry
- Beans and legumes
- Fruits and vegetables
- Oats and oatmeals
- Coconuts
- Nuts and seeds
- Rice
- Starches and flours
Summary
- Gluten gluten sensitivity is a condition where the body recognizes gluten as an ‘enemy’ and initiates an immune response against it.
- Celiac disease is an exaggerated form of gluten sensitivity.
- Evolutionarily, gluten could be considered foreign by the immune system since humans have gone millions of on a gluten-free diet.
- Studies have shown that individuals with with celiac disease had risk variants in the HLA DQ2 and the HLA DQ8 genes. Check you DNA raw data to know whether you have the risk variants.
- The absence of the same was found in 100% of people without celiac disease.
- Non-genetic causes of gluten sensitivity: gastrointestinal infections and abnormal gut bacteria.
- Conditions associated with gluten sensitivity: hormonal imbalance, depression, fatigue and insomnia.
- Genetic analysis is good way to prevent and manage gluten sensitivity effectively.
- You can use your 23andMe, AncestryDNA, Family Tree DNA, or whole genome data to check if you have the risk variants for gluten sensitivity.
Reference
- https://www.sciencedaily.com/releases/2016/05/160509101719.htm
- https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0002270
- https://www.ncbi.nlm.nih.gov/pubmed/18184122
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2386975/
- https://www.celiac.com/articles.html/gluten-intolerance-affects-hormonal-balance-r4395/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3641836/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266949/
What Is Food Intolerance?
Food intolerance or food sensitivity describes the difficulty in digesting certain foods and can lead to unpleasant reactions like intestinal gas, abdominal pain, or diarrhea.
The symptoms of food intolerance appear only after a few hours of consuming the food.
It can be difficult to identify food intolerance as the symptoms are often mistaken for other conditions.
Some common symptoms of food intolerance include:
- Bloating
- Headaches/Migraines
- Runny nose
- Stomach ache
- Hives
Food intolerances aren’t life-threatening. However, they can be very problematic for those affected.
Some causes of food intolerance are the absence of certain digestive enzymes (proteins that help with the digestion of food), some chemicals/additives in the food, and toxins.
Common food intolerances seen in people are:
- Lactose intolerance: Inability to digest a protein, lactose, found in dairy products
- Gluten intolerance: Inability to digest a protein, gluten, found in barley, wheat, and rye
- Caffeine intolerance: Inability to digest a chemical, caffeine, found in beverages like coffee and tea
What Is The Difference Between A Food Allergy And Food Intolerance?
While food intolerance is a problem with digesting food, food allergies are due to our immune system reacting to the food item itself.
Food allergy occurs when the immune system sees a specific component in the consumed food as an “enemy” to the body and sends out a response that results in allergic reactions.
The symptoms of food allergy occur soon after eating the food and are much more severe than those seen in the case of food intolerances.
In rare cases, food allergies can result in a reaction called ‘anaphylaxis’ where your blood pressure drops and your airway narrows down - this can potentially be life-threatening.
Introduction to Mushroom Intolerance
Mushrooms are loved worldwide as they contain flavor enhancers and are a gourmet’s delight. This makes them the most popular choice for pizza topping, after pepperoni!
Some nutritional facts about mushrooms
Mushrooms are a “powerhouse of nutrition” and not a white food to be avoided.
- Not only are they cholesterol-free, but they are also low in calories, fats, and sugars.
- They also contain modest amounts of minerals and vitamins.
- In fact, they are also claimed to be one of the richest sources of an antioxidant, ergothioneine.
Some research studies show that they can be used to lower the risk of diseases such as cancer, Alzheimer’s, and Parkinson’s.
The Genetic Basis of Mushroom Intolerance
OCTN1 Gene
Also known as SLC22A4, this gene is located on the long arm or the q arm of chromosome 5.
OCTN1 produces a protein that is responsible for the transport of positively charged compounds - in this case, ergothioneine - a substance present at high levels in mushrooms.
A study established an association between the OCTN1 gene and mushroom intolerance risk.
This interaction was observed among patients with Crohn’s disease.
Crohn’s falls under a group of diseases (called the inflammatory bowel diseases) that affect the digestive tract - the mouth, esophagus, stomach, small intestine, and large intestine. Crohn’s results in the inflammation or swelling of the digestive tract, which can lead to side effects like stomach pain, diarrhea, and weight loss.
rs1050152
rs1050152 of the OCTN1 gene has an association with mushroom intolerance. In a study conducted in the New Zealand population, among the people who were mushroom intolerant, it was found that the T allele of rs1050152 was present in a higher number (in people with and without Crohn’s disease). This suggests that having a T allele in rs1050152 can increase your risk for mushroom intolerance.
rs1050152 was previously found to be associated with a risk for Crohn’s disease.
Shiitake Mushroom Intolerance
The shiitake is an edible mushroom native to East Asia. Shiitake mushroom intolerance is one of the most common forms of mushroom intolerance.
The American chemical society in 2005 stated that mushroom contained the highest concentrations of ergothioneine, higher than either of the two dietary sources, wheat germ and chicken liver - which were previously believed to contain the most.
When compared with the other types of mushrooms cultivated in the US, the shiitake variety contained the highest amount of L-ergothioneine, which explains why shiitake mushroom intolerance is more common.
Sudden Mushroom intolerance
There have been reported instances of people developing sudden mushroom intolerance, without any prior incidents.
This could either be due to the type of mushroom consumed or a mushroom allergy.
The best way to find out is to take up a food intolerance test.
Risk Factors For Mushroom Intolerance
People at high risk for mushroom allergy include:
- Individuals handling mushrooms in packaging industries
- Those who consume mushrooms without sufficient cleaning
- Those who inhale the fungal spores
Remedies For Mushroom Intolerance
The best and the only way to avoid mushroom intolerance is to remove mushrooms from the diet completely.
The available study on the reason behind mushroom intolerance identified ergothioneine as the ‘component’ that leads to intolerance. So, it is also important to be wary of foods containing ergothioneine. Foods high in ergothioneine include:
- Mushrooms
- Asparagus
- Black beans
- Oat bran
- Kidney beans
- Garlic
- Soy products
- Brazil nuts
References:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4320875/
- https://www.ncbi.nlm.nih.gov/pubmed/19660151
- https://pubmed.ncbi.nlm.nih.gov/15107849/?dopt=Abstract
Updated 13th March, 2021
