The diseases clearly associated with Cereal grains or Gluten
intolerance are the bowel disorders bearing the names, "Celiac
Disease", "Non-Tropical- Sprue", or "Gluten-Enteropathy", and the skin
disorder, Dermatitis Herpetiformis.
Celiac disease is a genetic disorder that affects about 1 in every
150 Americans. The disease mostly affects people of European descent,
and occurs more rarely in black and Asian populations. Those affected
suffer damage to the villi (shortening and villous flattening) in the
lamina propria and crypt regions of their intestines when they eat
specific food-grain antigens (toxic amino acid sequences) that are
found in wheat, rye, and barley.
Oats have
traditionally been considered to be toxic to celiacs, but recent
scientific studies have shown otherwise. This research is ongoing,
however, and it may be too early to draw solid conclusions.
A study by Finnish researchers, published in 1995, remains the most
persuasive in suggesting that most adult Celiacs can tolerate moderate
amounts of oats in their diets, certainly in the short- term, This was
endorsed by the results of a 5-year follow-up study also in Finland.
However, reservations include the fact that the amount of toxic
protein the prolamin called avenin - in oats is relatively small
compared with the amounts of relevant toxic prolamins present in wheat,
barley and rye - hence the quantity of oats consumed may be critical.
Gluten is a mixture of individual proteins, classified in two
groups, the prolamines and the glutelins. The most troublesome
component of Gluten is the Prolamine, Gliadin. It is Gliadin in wheat
that causes the major problem in celiac disease, and Gliadin antibodies
are most commonly found in the immune complexes, associated with major
systemic disease.
We eat the seeds of the grain plants. The seed has a bran casing, a
starchy endosperm which contains 90 % of the protein, and a small germ
nucleus which is the plant embryo, waiting to grow. Any flour made from
the starchy endosperm contains prolamines and is potentially toxic to
the grain intolerant person.
If we look at the different grains we find that each has its own
prolamine. The following list gives the type of prolamine each grain
contains, and the percentage of protein the prolamine has in
relationship to the entire grain:
- Wheat - Gliadin - 69%
- Rye - Secalinin - 30-50%
- Oats - Avenin - 16%
- Barley - Hordein - 46-52%
- Millet - Panicin - 40%
- Corn - Zien - 55%
- Rice - Orzenin - 5%
- Sorghum - Kafirin - 52%
Celiac patients may be acutely and severely ill with weight loss,
vomiting and diarrhea or they may have chronic almost trivial symptoms
such as tiredness, lethargy and breathlessness. Usual symptoms would be
somewhere between these extremes. Adults may have a history of
abdominal or intestinal upsets, or they may suddenly develop the
condition at any time. Anemia, abdominal discomfort, mouth ulcers and
weight loss are common features.
To avoid serious complications of the condition, a strict
gluten-free diet is necessary for life. An adherence to a gluten-free
diet can prevent almost all complications caused by the disease. A
gluten-free diet means avoiding all products that contain wheat, rye
and barley, or any of their derivatives. This is a difficult task as
there are many hidden sources of gluten found in the ingredients of
many processed foods. Sometimes vitamin or mineral supplements may be
required to start with. The hospital consultant will know from tests
what the patient needs, and supplements should NOT be taken without
medical supervision.
There are at least four mechanisms involved at the bowel level for gluten intolerance:
A nutritional anemia may be a problem. The anemia results from malabsorption of iron, folic acid and/or vitamin B12.
Many foods are naturally gluten-free as they do not contain any
wheat, rye, barley and oats. For example, all fresh meat, fish, cheese,
eggs, milk, fruit and vegetables are gluten-free.
However, once such foods are processed or used as ingredients in
other foods, great care must be taken to ensure that wheat or other
gluten-containing cereals have not been added in the manufacture.
