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HEALTH

Do you know your Gluten ID?

If not, here’s why you should

By Shelly Gunn, MD, PhD

Chances are you’ve noticed the growing number of gluten free commodity soon spreading via trade routes around the globe. How-
food choices when shopping at your local grocery store or dining ever, a small percentage of the human population was unable to
at a favorite restaurant. Clearly supply is increasing to meet a certain consume wheat without experiencing gastrointestinal (GI) symp-
demand, but what is motivating consumers to adopt a non-grain- toms. The earliest reports of diarrhea and malabsorption from
based diet? We know that approximately 1 percent of the world wheat consumption were reported by the celebrated Greek physi-
population is afflicted with pathology proven celiac disease, but the cian Aretaeus of Cappadocia 2,000 years ago. He described the mal-
ubiquity of gluten free options clearly appeals to a broader popula- ady as “koiliakos” meaning “abdominal” from which the term
tion. Many U.S. consumers, savvy about health and wellness, proac- “celiac” was later derived. In the late 19th century, celiac disease
tively reduce gluten consumption based on directives from the (CD) from wheat consumption was documented in the Northern
wellness ‘self-help’ literature, or as a reaction to peer and family European medical literature. By the 1990’s, CD had come to be rec-
pressure. However, a growing number of individuals, eager to learn ognized as a worldwide disease entity affecting approximately 1 per-
their genetic predisposition for developing gluten intolerance dis- cent of the population in gluten-consuming countries.
order, are opting for DNA-based Gluten ID testing. Who can ben- The Molecule: Comprised of long strands of protein chains,
efit from knowing their unique inherited susceptibility to gluten the gluten molecule cannot be completely broken down by human
intolerance? The answer is virtually everyone. In fact, universal digestive enzymes. Thus, the stable attributes of wheat that made it
screening for gluten sensitivity has been on the table for decades such a valuable exchange commodity in the ancient world are also
but in this new era of personalized medicine, we finally have the a major reason why wheat consumption can trigger symptoms of
laboratory tools to make it a reality. gluten intolerance. Once gluten enters the human gut it remains
The Backstory: Gluten, the major storage protein in wheat, was there for many hours, long enough for the immune system to mount
first introduced into the human diet around 10,000 years ago when a response against specific regions of the protein chains. However,
the Paleolithic period menu of hunted meats and gathered fruits this strong immune reaction occurs only in individuals who have
was replaced by farmed, grain-based nutrition. Due to the inherent inherited the gene’s coding for the specific immune cell receptors
stability of wheat, it became a valuable nonperishable exchange capable of recognizing gluten proteins. Gluten does not evoke the

34 San Antonio Medicine • February 2019