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?
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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.
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