I have been writing this column for a long time. On each trip I give to the supermarket I am amazed at the proliferation of products labeled "Gluten-Free" (gluten free). The skeptical side of my brain causes me two questions: why is this phenomenon? How many consumers really know what gluten is? This is nothing more than a set of proteins mostly from wheat flour, oats and barley. How harmful is it? To answer this, I first have to explain two medical conditions that have been associated with these proteins.

The condition known as "celiac disease" is the best studied. It is a condition in which the immune system, when exposed to gluten, confuses it with an aggressor and defends itself by counterattacking, but directs part of that attack towards its own intestine. It is another disease of what we call autoimmune. This attack causes a series of symptoms that include diarrhea, weight loss, flatulence, bloating, and feces with a very bad smell.. The reaction occurs mostly in the small intestine, including the duodenum, but it can also affect other organs, which diverts attention to other parts of the body. This can cause confusion to the doctor and often causes a diagnostic error. Because the clinical presentation can be very diverse, the vast majority of patients with celiac disease are not diagnosed correctly. More difficult to identify are those that first show symptoms not associated with the intestine. The so-called "herpetiform dermatitis" was the first extraintestinal symptom that was recognized. Later, others such as anemia, osteoporosis, arthritis and inflammation of the liver were discovered. In a study of thousands of stored blood samples, 35 cases of celiac disease were identified, and only six of these were correctly diagnosed. This suggests that it is one of the diseases that doctors have less success in diagnosing, which has serious implications, since the delay can result in complications that include lymphoma of the small intestine, if it is not managed early with a diet low in gluten .

The disease occurs more frequently in people of Celtic origin, such as the Irish and Scots, like many Asturians and Galicians, this due to a type of blood that is associated with the condition.

To diagnose celiac disease we have blood tests that measure specific antibodies. In a study conducted on blood samples preserved for years, the results indicated that 7 out of every thousand people (0.7%) in the United States suffer from it, while in Ireland the prevalence reaches 60 out of every thousand (6%). In Puerto Rico its frequency is not known with precision, but thanks to our Taíno and West African genes, it seems to be much lower in the United States and Ireland. We know that in the African American population it is extremely rare.

There are also some people who do not have the condition, but who when exposed to gluten develop identical symptoms. This condition has been called "gluten sensitivity not related to celiac disease." Despite its similarity to the disease, it differs from this because it is not an autoimmune condition and the intestine looks normal under the microscope. In contrast to celiac disease, there are no blood tests to diagnose this condition, which has caused some skepticism as to whether it is a real entity. However, there are studies, including one published by the Dr. María Vázquez Roque, expert on the subject and graduated from our School of Medicine of the University of Puerto Rico, now featured at the Mayo Clinic, which suggest that it could be a real condition. Vázquez Roque's study included 45 patients with irritable bowel and diarrhea. Half were randomly assigned a low gluten diet and the rest a gluten diet. The frequency and consistency of excreta improved in some assigned to the gluten-free diet. This study suggested that gluten could be the cause of diarrhea. However, it has been proposed that these patients may have an intolerance, not to gluten itself, but to certain fermentable carbohydrates. Our normal diet contains many of these carbohydrates, while low gluten has few, which would explain diarrhea when exposed to the gluten regimen.

In the 90s it was almost impossible to follow a low-gluten diet because there were few foods free of this substance in supermarkets. Now we have the opposite problem, we have gone from poor to extremely rich in a short time, all because manufacturers have exploited a rare disease for their benefit. They have made us think that we should all avoid gluten. Even many athletes are totally convinced that a low-gluten diet increases their energy level, although a rigorous study showed that it didn't help at all in athletic performance.

Less than 1% of people in the world suffer from celiac disease. The low-gluten diet is extremely important for those, but for the rest of us it is unnecessary to follow that regimen. But nevertheless, 30% of the population of the United States consume a diet low in gluten: an impressive triumph for the marketing of these companies, but a great defeat for the consumer's pocket and for common sense.

Apart from the symptoms caused by gluten, what other manifestations should lead us to suspect if we have the genetic predisposition to celiac disease that the Celts have? As we know that the Irish and the Celts, typically have certain physical features such as light skin, and are redheads with curly hair. It is no secret that their butts are quite small. If the color of your skin and your innkeepers are J Lo style, it is highly unlikely that you have this disease. Could you take this to the extreme of recommending: zero glutes zero gluten? No, because the reality is that 94% of Celts do not suffer from celiac disease and therefore it is not necessary for everyone to avoid gluten.


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. (tagsToTranslate) Gluten (t) Health


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