Eli5: what is so bad about gluten and why is everyone gluten intolerant nowadays?


Gluten has always been a huge part of diet so how come people are now intolerant? Is it just a trend? Were people always intolerant but there was no other option? Or has gluten changed though breeding?

Is it possible that people have made themselves more intolerant by excluding gluten from their diet thus losing the ability to digest it?

In: 1

Spent most of my life never hearing about gluten and suddenly like 20 percent of the population is allergic to it. Sorry, have to be skeptical that it is a real thing in the vast majority of cases.

I believe most people simply eat too much food, and don’t get nearly enough exercise, and are looking for something else to blame the results on. Gluten is convenient.

Source: am a baker.

I don’t believe that *all* the gluten free hype is legit, but I do know that some things have actually changed.

Wheat genetics have changed drastically. Wheat has been bred for a lot of things, including a shorter stalk, higher protein (gluten is a protein), and higher yield.

Milling has changed drastically. Stone ground wheat is ground with the bran and germ, and while some of that may be sifted out afterwards, it is more nutritious than wheat milled on steel rollers.

Baking has also changed. Fermentation has been pushed faster and faster by ever increasing amounts of added yeast, giving the dough less time to develop. Some baking processes don’t use yeast at all, relying on chemical leveners that raise the bread but do nothing to make it more digestible.

I personally know people who can digest sourdough bread made with stone ground flour, but have a hard time with factory-made American sandwich bread. These people wouldn’t call themselves ‘gluten intolerant’ since they can clearly digest gluten in some forms, but *something* is going on for real.

First, “everyone” is not gluten intolerant.

One theory as to why there seems to be more gluten intolerant people now is due to genetically modified wheat. Basically, the idea is that the higher yield, drought tolerant, etc. wheat is what causes gluten sensitivity.

Gluten intolerance in general is a fairly contentious subject, but there is one form of gluten intolerance that isn’t: celiac disease.

Celiac disease is an autoimmune disorder where the body attacks the lining of the intestines when a person with the disease eats gluten-containing food. As it is an autoimmune disorder (and kind of like an allergy, though it is a somewhat different immune response), very small amounts of gluten can trigger the reaction. People who have celiac disease therefore have to take great care not to ingest any gluten, so even shared utensils cannot be used. If someone tells you they can eat “a little gluten” or they’re “kinda gluten intolerant”, they almost certainly do not have (diagnosed) celiac disease, as people with celiac disease have to go to great lengths to avoid contamination in their food.

If someone with celiac disease eats gluten, the response can be somewhat variable, from very little response from a single exposure to days of cramps, diarrhea, bloating, and vomiting. Chronic exposure causes the villi, the little carpet-pile like things lining the small intestines that increases their surface area, to be effectively mowed off. The reduced surface area of the small intestines leads to all sorts of malabsorption issues, like anemia and bone density loss. People with celiac disease are also at risk of a lot of other related or downstream diseases, like certain cancers, other autoimmune issues, and infertility. Eating an extremely strict gluten-free diet for life allows the intestines to heal and non-permanent damage elsewhere can then be reversed.

Celiac disease is usually diagnosed by an anti-gliadin antibody test, followed by a week or so of eating a lot of gluten, followed by a second antibody test. If those both come back above the lower threshold for celiac disease, the final diagnosis is usually done after that by an endoscopy where the state of the small intestines is directly observed, followed by a biopsy where the microscopic structure and biochemistry of the intestinal lining can be evaluated in a lab. It’s not diagnosed with an elimination diet or without the use of an actual GI doctor and a lab, though sometimes just the antibody tests are considered enough for a formal diagnosis.

The percentage of the population diagnosed with celiac disease has gone up a fair bit recently, though this is generally not thought to be because more people have it, but because a larger percentage of people with the disease are having it properly detected. Recent broad-scale research screening has also indicated that a decent proportion of people with celiac disease do not experience significant (or, in some cases, any) outward symptoms, though they may still have other medical issues as a result. So some of the increase in the number of people with celiac disease we see around these days is just due to better testing and detection. There are also definitely self-diagnosed people who may or may not actually have celiac disease as well.

The underlying cause of celiac disease remains somewhat of a mystery, though it is known there is a strong genetic component to it, and a pair of genes have been identified as being very strongly associated with celiac disease (though not everyone who carries those genes gets the disease, the picture is incomplete).

As for wheat (and other gluten-containing grains), these have always had gluten in them. We have bred some strains to have more (as gluten has some great properties for baking), but there’s nothing special in and of itself about modern strains of wheat when it comes to celiac disease as far as we can tell.

Source: wife has celiac disease. It sucks.

I’d bet over 90% of the people going gluten-free don’t actually have a medical issue with gluten. It’s just become a popular thing. However, I find that cool since it means the stores are now full of gluten-free products, which really benefits those who do have medical issues with gluten. Twenty years ago there was nothing for them except to just avoid anything with gluten in it, which severely restricted their choices.