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Gluten-free diets – 1

Watch dr. Krupa-Kozak begin our discussion of gluten-free diet by discussing the characteristics of gluten, a protein found in wheat and other cereals
-Hi, my name is Urszula Krupa-Kozak. Today, we’re going to talk about gluten. Certainly, you heard a lot about gluten and gluten-free diet some good things, some bad things. Some of this information are true whereas the other can be just myths. Why gluten protein became so popular today and shall we consider gluten-free diet as a super diet? This is the question. In general, gluten is a collective term used to define some storage proteins, prolamins that can be found in mature kernels of cereals from poaceae family like gliadins and glutenins of wheat secalin of rye and holin of barley. Gluten possess a unique viscoelastic properties. Hydrated gliadins are responsible for that elasticity and strength.
While gliadins are less elastic and less cohesive they contribute to the dough extensibility and viscosity but this is a theory. In practice glutenin is formed when wheat flour is simply mixed with the sufficient amount of water. In such conditions, the three-dimensional structure of glutenin is formed. Due to this unique properties gluten play important role in the majority of baked products. First of all, gluten contribute to the dough emulsification and viscoelasticity. Gluten network is necessary to hold gases mainly carbon dioxide produced during dough fermentation. Thus, gluten allow the dough to rise. Finally, during baking which is the last step of bread making gluten changes its characteristic from elastic into semi-rigid contributing to crumb formation and bread structure.
All these properties of gluten give the conventional bread its elastic structure and taste we like a lot. Till now, you may think that gluten is a super protein indeed. It has the unique technological properties that are essential in bread making. However, there is always a dark side of the moon because of the increasing prevalence of hypersensitivity to gluten Codex Alimentarius define gluten as a protein fraction of wheat, rye, barley, oats the hybrids and derivatives that cause intolerance in some predisposed individuals. You may see that gluten is also a trigger of a variety of gluten-related disorders. Gluten-related disorders include allergies like wheat allergy for example and autoimmune disorders like celiac disease.
In addition to allergy and autoimmune diseases recently a non-celiac gluten sensitivity was discovered. According to the latest guidelines of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition celiac disease is a systemic immune mandated disorder caused by gluten and related prolamines in genetically predisposed individuals. This definition modify the prior concept of celiac disease that was believed to be a RAR pediatric enteropathy. Today, we know that CD is a common pathology with multi-organ symptoms that can be diagnosed at any age. CD affects approximately 1% to 2% of the west world population.
There is a wide variety of CD symptoms from gastrointestinal symptoms typical for younger children like chronic diarrhea, lack of appetite and abdominal pain and distension to extraintestinal symptoms more often observed in older children and adults like headache, fog in mind, anemia osteoporosis and even neurological and psychological disorders. Wheat allergy, it is an adverse immunological reaction specific to wheat proteins. The prevalence of wheat allergy depends on age and varies from 0.4% up to 9%. Wheat allergy is the most frequently diagnosed in older children. Main sign of wheat allergy are skin lesion typical for food allergy but also gastrointestinal symptoms and gastrointestinal signs. Like diarrhea abdominal pain, and constipation. Recently, a non-celiac gluten sensitivity was discovered. It belongs to gluten-related disorders.
However, its characteristics and course does not feed to obtain your disorders nor allergies. It is suspected that the main trigger of non-celiac gluten sensitivity is imbalanced diet containing food of high gluten content. Non-celiac gluten sensitivity is mainly diagnosed in adults, particularly in females. Patients might suffer from symptoms similar to classic-celiac disease as well as extraintestinal symptoms like depression, fatigue and musculoskeletal pain. Okay, now you know the dual nature of gluten. The discovery of the link between gluten ingestion and development of gluten-related disorders required the obvious elimination of gluten from the diet of patients suffering from gluten-related disorders. This discovery contributed also to the development of gluten-free diet.
Following a gluten-free diet means a strict and lifelong elimination of all products containing gluten from the diet. It needs to be emphasized that gluten-free diet is not just a diet it is a critical medical therapy for CD patients and recommended dietotherapy for individuals suffering from gluten-related disorders. The adequate choice of gluten-free products is not as simple as it seems. Therefore it is essential to know which product contain gluten or might contain gluten and which do not. Food that contain gluten includes cereals with toxic prolamins and their derivatives. These proteins are harmful for celiac patients health.
Foods that do not contain gluten includes some cereals and grains naturally gluten-free like rice, maize, quinoa buckwheat and foods that are not cereals like meat fish, nut, all vegetables, and fruits.
Gluten-free products are common, but what is gluten?

In the first of a series of two videos, dr. Krupa-Kozak introduces gluten and its characteristics. Where is it found? What role does it have in bread and other products?

Gluten has a relevant role not only because of its importance in the Western diet, but also because of the different medical conditions linked to intolerance, allergy and sensitivity to it. Discussing them is the first step in analyzing gluten-free diets, and considering whether they can really be thought of as “super”.

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