- Wide ranging debate over whether non-coeliac gluten sensitivity exists
- Coeliac disease is a serious digestive condition triggered by gluten
- New study examined 59 participants with suspected gluten intolerance
- Found those given low dose of gluten had worse symptoms than those given a placebo over the course of a two-week trial
Gluten intolerance is a legitimate health condition, a new study has concluded.
The subject has provoked long-raging debate among scientists, with experts divided over whether gluten sensitivity is a real health concern.
At one end of the spectrum there is coeliac disease, a serious but common illness, affecting one in every 100 people in both the US and UK.
But in their shadow are a group of people not thought to have the serious digestive condition, yet present similar albeit more mild symptoms.
For those diagnosed with coeliac disease, eating foods containing the protein triggers uncomfortable and painful symptoms.
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A new study has contributed to the debate over whether gluten sensitivity exists. Scientists examined two groups of participants with suspected non-coeliac gluten sensitivity – one group taking a low dose of gluten and the other on a placebo
They include diarrhoea, bloating, abdominal pain, weight loss, and feeling tired.
Despite many people complaining of an intolerance to gluten, studies have failed to prove a conclusive link.
In their new study, researchers from the National Institute for Health in the US performed a random, placebo-controlled trial involving patients thought to be suffering non-coeliac gluten sensitivity.
Those people chosen to take part did not have coeliac disease or a wheat allergy, but believed eating gluten was the cause of their intestinal symptoms.
They were randomly divided into two groups.
The first group was given a low dose of gluten each day, while the others were fed a rice starch placebo for one week.
After a week the participants switched groups.
The scientists noted their main finding was the change in overall symptoms between those who received gluten doses and those on the placebo.
The researchers note ‘the extra-intestinal symptoms were significantly more severe when subjects received gluten than placebo’.
And they found that when switching the groups around, participants’ suspected non-coeliac gluten sensitivity became worse with symptoms ‘increasing significantly’ during the one week of gluten intake, compared with their week on the placebo.
The results showed the participants’ symptoms worsened when they were given a low dose of gluten compared with a week on the placebo rice starch. Coeliac disease is an autoimmune condition, where the immune system – the body’s defence against infection – mistakenly attacks healthy tissue in the gut
However the small size of the study is unlikely to sway the consensus view.
In a recent article for the MailOnline, Dr Sally Norton warned those who are not coeliacs could be risking higher sugar and fat intake in their diets by switching to gluten-free foods.
She said: ‘While only a small proportion (around one in 100) of us actually have coeliac disease, many more are concerned that they have an intolerance to gluten which is a protein found in wheat, barley and rye.
‘These people may experience similar symptoms to coeliac disease – such as bloating, wind and diarrhoea – without actually having the intestinal damage found in coeliac disease.
‘Gluten intolerance, in people who do not have coeliac disease, is really a type of irritable bowel syndrome (IBS) that seems to improve if gluten-containing products are avoided.’
Dr Norton warned: ‘For those with coeliac disease, these products are indeed healthier, as they don’t cause the same damaging effects that ingesting gluten does.
‘However, many pre-packaged gluten-free products make up for their lack of gluten by including more sugar or fat to make the product more appetising, but may actually make the gluten-free products less healthy than the standard versions.
‘They may also contain a much lower level of fibre and minerals, which can be stripped during the production process.’
WHAT IS COELIAC DISEASE AND HOW CAN SUFFERERS AVOID GLUTEN?
With a rise in coeliac disease sufferers there has been an explosion in gluten-free foods in supermarkets and health food stores
Coeliac disease is a common digestive condition where a person has an adverse reaction to gluten.
Gluten is found primarily in wheat, but also in rye, barley, and to a lesser extent, oats.
It makes up the protein part of these grains, nourishing the plant embryos during germination.
It affects the elasticity of dough, so is used to make baked wheat products more or less chewy.
It is an autoimmune condition, where the immune system – the body’s defence against infection – mistakenly attacks healthy tissue.
For sufferers, eating food containing gluten can trigger a range of painful symptoms including:
- bloating and flatulence
- abdominal pain
- weight loss
- feeling tired all the time, resulting from malnutrition
- children not growing at expected rates
Coeliac disease is not an allergy, nor an intolerance.
The immune system mistakes substances found inside gluten as a threat to the body, and attacks them.
This damages the surface of the small bowel, disrupting the body’s ability to absorb nutrients in food.
Scientists still do not know exactly what it is that causes the body to act in this way, but a person’s genetic make up and the environment appear to play a part.
There is no cure for coeliac disease, but following a gluten-free diet can help control symptoms and prevent the long-term consequences of the disease.
Even for sufferers whose symptoms are mild, or non-existant, a gluten-free diet is advised, because continuing to eat gluten can cause serious long-term problems.
Complications include osteoporosis, and iron deficiency anaemia.
Less common and even more serious complications include some cancers, include bowel cancer.
Gluten is found in beer, breads, pasta, cakes and pies. It is also found in cereals, chips, croutons, cookies and processed meats. It can be found in salad dressings, sauces such as soy sauce and soup or soup bases.
Source: NHS Choices