Decades ago, American doctors believed they would never see a case of celiac disease because it was considered too rare. Over the years, though, research showed that celiac disease is not rare. Now, there are many Americans following a gluten-free diet even though they do not have celiac disease. They say they simply feel better when they avoid gluten. Many physicians are skeptical about this condition, termed non-celiac gluten sensitivity (NCGS). We have heard them describe these patients as nut jobs. They consider this a fad that will fade with time.
Is non-celiac gluten sensitivity all in people’s heads? We don’t think so! Italian researchers agree and suggest that polyphenols in foods could provide protection against NCGS (Nutrients, June 28, 2022).
What Is Gluten and When Is It a Problem?
About 1 person in 100 with European ancestry has celiac disease and cannot tolerate gluten. This protein is found in wheat, barley and rye. When a person with celiac disease consumes food containing gluten, the immune system goes a bit haywire and attacks the lining of the small intestine. The tiny cellular “bumps” that are part of the lining called villi are destroyed, and the ability of the intestine to absorb nutrients becomes seriously impaired.
The consequences of celiac disease can be severe: osteoporosis, anemia, joint pain, headache, fatigue and itchy dermatitis in addition to digestive distress including diarrhea or constipation, nausea and vomiting, flatulence or heartburn. People with celiac disease are also more susceptible to cancers such as lymphomas.
Following a strict gluten-free diet can make a huge difference for such people. Doctors no longer think this is a rare condition. Learn more about the complications of celiac disease and find out: “Are You Suffering from Celiac Disease?” at this link.
Should People Without Celiac Disease Also Avoid Gluten?
Over the last few decades, as word has gotten out about celiac disease and gluten-free foods have become more readily available, many people have decided to avoid gluten themselves even though they do not have a diagnosis of celiac disease. For some of these individuals, it just seems like a good idea. Others, however, report that they have definite symptoms that disappear if they don’t eat foods containing gluten.
Gastroenterologists worry that people self-selecting a gluten-free diet that is unnecessary may be compromising their nutrition by limiting their fiber intake. Some doctors think this is the “disease du jour” and should be dismissed as nothing but a fad.
Non-Celiac Gluten Sensitivity Gets Attention:
A study from Columbia University Medical Center (New York City) and the University of Bologna (Bologna, Italy) shows that some of these individuals are objectively reacting to gluten even though they really don’t have celiac disease Gut, online July 25, 2016 . The researchers recruited 80 people with non-celiac gluten sensitivity, 40 people with celiac disease and 40 healthy individuals.
Those with celiac disease had intestinal damage, but markers of immune system activity were not elevated in their blood. The people with non-celiac gluten sensitivity, on the other hand, had high levels of CD14, a compound signaling systemic immune system activation. They also had higher levels of lipopolysaccharide-binding protein and antibody reactivity to microbe antigens. The researchers believe that this is due to microbes or bacterial toxins slipping through the intestinal wall into the circulation.
Italian Researchers Confirm Non-Celiac Gluten Sensitivity (NCGS)!
Italians lover their pasta! Yet traditional pasta made from wheat is loaded with gluten. Here is what Italian researchers have to say about NCGS (Nutrients, June 28, 2022):
“NCGS is a condition characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing foods, and it is relieved by a gluten-free diet (GFD) in patients in whom celiac disease and wheat allergy have been excluded. Gluten-related diseases are now a serious public health problem that can be overcome by adherence to a GFD. Because it is very difficult to maintain a complete GFD for extended periods, there is great interest in exploring alternative strategies aimed at reducing gluten concentrations in foods or mitigating the toxic effects of gluten on humans.”
Dietary Polyphenols vs. Gluten Sensitivity?
The Italian experts note that polyphenols are powerful bioactive compounds found in plants. Foods rich in polyphenols include fruits, vegetables, legumes, olive oil, red grapes, wine, cocoa, coffee, and tea.
In their brilliant article these scientists offer this overview:
“We here provide an up-to-date revision of the effects of polyphenols as possible dietary strategies to counteract the toxic effects of gluten, resulting in improved quality of life of patients with gluten-related intestinal diseases. In the attempt to explore the molecular and cellular mechanisms underlying the therapeutic and preventive properties of polyphenols in gluten-related disorders, we address different aspects including the metabolic fate of polyphenols as well as the potential polyphenol targets such as gluten seizure, intestinal epithelial barrier disruption, immune response, oxidative stress, inflammation, and dysbiosis.”
The role of polyphenols is complex. There are over 8,000 different polyphenolic compounds in nature. The authors point out that:
“These compounds have been demonstrated to exert health benefits thanks to their antioxidant activity and also antibacterial, iron-chelating, anti-inflammatory, and immunomodulatory properties.”
Their bottom line for people with non-celiac gluten sensitivity:
“These results demonstrated that polyphenols can improve gut health, even in the framework of gluten-related diseases, by preserving intestinal cells against oxidative aggression and inflammation triggered by gluten proteins.”
Leaky Gut?
It is hypothesized that NCGS occurs in part because of damage to the intestinal lining caused by gluten. It weakens the intestinal barrier and leads to intestinal permeability. A simple (and less elegant) way of describing this is to say “leaky gut.” Elevated levels of fatty acid-binding protein 2 found in some of these non-celiac disease patients also indicate increased intestinal wall permeability.
What Should People Do?
This research demonstrates that doctors should not automatically dismiss people who report problems with gluten even though they do not have celiac disease. If the physicians are truly skeptical of their patients, there are now objective markers that can be measured. The researchers who discovered this inflammatory immune response are among the best celiac scientists in the world.
There is also a straightforward treatment: people with non-celiac gluten sensitivity can greatly improve their symptoms and reduce their markers of inflammation and intestinal damage by following a gluten-free diet. But as the Italian researchers note, such a diet is challenging. That’s why the more polyphenols we consume, the better!
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