What is Gluten?

In terms of the medical definition of Celiac Disease, or Gluten Intolerance, "gluten" is defined as the mixture of many protein fragments (called peptide chains or polypeptides) found in common cereal grains — wheat, rye, barley and sometimes oats (oats don’t naturally contain gluten, but are often subject to contamination with small amounts). Wheat is the only grain considered to contain true "gluten" and the peptides that predominate in wheat gluten are gliadin and glutenin. Gliadin is thought to be the peptide chain that instigates the toxic immune response and subsequent intestinal damage in celiacs. However, other protein fragments thought to be toxic to celiacs occur in rye, barley, and oats. They are secalins, hordeins, and avenins, respectively. Even though some research suggests that the avenins are not toxic, most celiacs still avoid oats just to be safe. Minute amounts of any of these protein fragments can cause intestinal damage in people with celiac disease. Because the disease is not fully understood, it is thought there may be other peptide chains including some derived from glutenin, that are also toxic. Because of the lack of definitive research on the disease, celiacs must often live by the saying, "when in doubt, leave it out."

Medical conditions associated with celiac disease

(Note: the nature of the association between these conditions and celiac disease is unknown. Celiac disease does not necessarily cause these disorders or vice versa. Factors that predispose a person to contracting celiac disease may also make them vulnerable to these other immunological disorders.)

• neurological complications
• kidney and liver disease
• insulin dependent diabetes mellitus
• systemic lupus erythematosus
• selective IgA deficiency
• thyroid disease
• lactose intolerance
• chronic active hepatitis
• scleroderma
• myasthenia gravis
• Addison's disease
• rheumatoid arthritis
• Sjogren's syndrome

Symptoms of celiac disease

The term "celiac" or coeliac is of Greek origin and means "of or in the cavity of the abdomen." The condition known as celiac disease was so named because many of the cardinal symptoms and effects of the disorder are related to the gastrointestinal tract. However, the full range of symptoms of celiac disease are varied and may occur at any time in the life of an individual who is genetically predisposed to the disorder. A significant number of people show no clinical symptoms, but are still incurring intestinal damage. Some symptoms include:

• diarrhea
• intestinal bloating or "pot belly"
• intestinal gas
• steatorrhea (fatty, floating and voluminous stools)
• fatigue
• weakness
• lack of energy
• bone or joint pain
• depression or irritability
• dental enamel defects
• anemia
• folate deficiency
• osteopenia and osteoporosis (bone mineral loss)
• infertility problems in women
• failure to thrive in children
• vomiting
• weight loss or wasting

Dermatitis Herpetiformis (DH) is a related skin condition characterized by blistering, itchy rashes on the back, legs, buttocks, and arms. Between 60 and 80 percent of those who suffer from DH also incur damage to the intestinal villi.

Safe grains for celiacs

Current scientific consensus is that rice and corn (maize) are considered safe for celiacs. In addition, millet, sorghum, Job's Tears, teff, and ragi are thought to be close enough to corn in their genetic make-up to be safe. More research is needed to substantiate this. Other grains suspected, but not proven, to be safe for celiacs include buckwheat, amaranth, quinoa and rape. Although their safety is debated, they are only very distantly related to wheat. Thus, it is unlikely their peptide chains are the same as the problematic chains found in wheat, rye and barley.

Courtesy References:

• Bernard, B., M.D., "Gluten Sensitive Disorders/celiac Disease and Dermatitis Herpetiformis," (1995). Department of Pediatrics, University of Southern California
• Celiac Disease Foundation Newsletter, (1997). Volume 7-3.
• Chartrand, L.J. & Seidman, E.G., "Celiac disease is a lifelong disorder," (1996). Clinical Investigation in Medicine, 19(5): 357-61.
• Chartrand et al., "Wheat starch intolerance in patients with celiac disease," (1997). Journal of the American Dietetic Association, 97(6): 612-618.
• Maki, M. & Collin , P., "Coeliac Disease," (1997). The Lancet, 349: 1755-1759.
• Malnick, S.D. et al., "Celiac disease: diagnostic clues to unmask an impostor," (1997). Postgraduate Medicine, 101(6): 239-244.
• Alford, Jeffrey & Duguid, Naomi, " Flatbreads and Flavors; A Baker's Atlas," 1995, William and Morrow and Company, Inc.
• Clayton, Bernard Jr.. "Bernard Clayton's New Complete Book of Breads," 1987, Simon & Schuster.
• Hagman, Bette, "The Gluten-Free Gourmet Cooks Fast and Healthy," 1996, Henry Holt & Company, NY.
• McGee, Harold, "On Food and Cooking: The Science and Lore of the Kitchen," 1984, MacMillen Publishing Company, NY.
• Wittenberg, Margaret M., "Good Food: The Comprehensive Food and Nutrition Resource," 1995, The Crossing Press, CA.