5.5: Celiac Disease and Gluten

1 out of every 133 people in the United States has celiac disease1. People with celiac disease cannot consume the protein gluten because it causes their body to generate an autoimmune response (immune cells attack the body's own cells) that causes damage to the villi in the intestine, as shown below.

Figure $\PageIndex{1}$: Different stages of celiac disease2

This damage to the villi impairs the absorption of macronutrients and micronutrients from food. There are a variety of symptoms for celiac disease that vary depending on age and from person to person.

Query $\PageIndex{1}$

What is gluten?

Gluten is a protein that is bound to starch in the endosperm of grains such as:

• Wheat
• Barley
• Rye
• Triticale

Figure $\PageIndex{2}$: Parts of a wheat granule3

Gluten-free diets have been increasing in popularity even for people who don’t have celiac disease. The thinking among those consuming these diets is that they might be non-celiac, gluten-sensitive, meaning that they experience adverse effects from consuming it. However, as the study describes, it seems more likely that it is fructan, a fructooligosaccharide, that causes these issues as found in the research described in the abstract below. These are apart of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs). Low FODMAP diets are increasing in use for similar reasons as gluten-free diets were used, but there is better evidence justification for their use.

Web Link

Fructan, Rather Than Gluten, Induces Symptoms in Patients With Self-Reported Non-Celiac Gluten Sensitivity

Query $\PageIndex{2}$

References

1. http://www.celiac.org/
2. en.Wikipedia.org/wiki/File:Coeliac_Disease.png
3. en.Wikipedia.org/wiki/File:Wheat_seed.jpg