Most of us know someone who is on a gluten-free diet or perhaps thinking about going gluten-free – but is it just a new health trend? Is it just for people with coeliac disease? Or should we eliminate all gluten from our diet to support a healthy gut?
Gluten is a protein found in wheat, barley and rye. It gives bread its stretchy texture. Gluten is present in many common foods like bread, pasta, cakes and cookies. Studies show that gluten can negatively affect gut health, not only for those with coeliac disease but for others as well. Likewise, non-celiac gluten sensitivity (NCGS) is a condition linked to gluten.
Coeliac disease, an autoimmune disorder, causes inflammation and damage to the small intestine upon gluten consumption, leading to impaired nutrient absorption. Strict gluten avoidance is essential for management. Symptoms of coeliac disease range from immediate reactions to delayed responses, including vomiting, intestinal pain, diarrhea and fatigue, highlighting the importance of avoiding gluten for those affected.
Cereals have been the staple food for humans and domestic animals for thousands of years. Einkorn, emmer and barley were the first cereals. Today, wheat, maize, rice and millet are the top choices in the world's diet.
The history of gluten intolerance dates back to the A.D. first century, when the Greek physician Aretäus from Cappadocia described the symptoms in a medical textbook, using the Greek word "koiliakos" to mean "suffering from indigestion."
In the 17th century, English pediatrician Dr. Samuel J. Gee was one of the first to recognize the importance of diet for patients with coeliac disease.
In 1908, American doctor Dr. Christian Herter published a book about children with coeliac disease and observed that his young patients tolerated fat better than carbohydrates.
It wasn't until World War II that Dutch pediatrician Dr. Willem Karel Dicke made the connection between coeliac disease and grains. When bread and flour were scarce during the war and the population was starving, the health of children with coeliac disease notably improved.
In 1952, Dr. Dicke, along with a medical team from Birmingham, proved that the gluten protein is responsible for coeliac disease.
Today, it is now understood that coeliac disease, which can be diagnosed by a small bowel biopsy, is just the beginning. Scientists worldwide are researching the range of gluten intolerance.
In addition to celiac disease, there is another form of gluten intolerance that is still not widely known today: gluten sensitivity. Gluten sensitivity is diagnosed when celiac disease and wheat allergy have been ruled out through blood tests and intestinal biopsy, and when symptoms improve after adopting a gluten-free diet. Because this diagnosis is based on the exclusion of other conditions, gluten sensitivity cannot be definitively proven.
Nevertheless, many people are sensitive to gluten even if they do not have celiac disease. They may experience symptoms like bloating, stomach pain and fatigue, as well as irritable bowel, insomnia, headaches and tiredness. The exact number of people with only one gluten sensitivity is difficult for experts to estimate.
Nutritionist Şükran Aydın explains that studies have shown that a small protein can make the intestines more permeable. This allows larger particles like toxins, undigested food and harmful organisms to pass through the intestinal barrier and enter the bloodstream. Gluten can increase the release of a substance called zonulin, which can loosen the "tight junctions" in the intestinal wall, leading to increased intestinal permeability.
This can cause a variety of symptoms and health issues, including food intolerances. It is believed that modern wheat with its higher gluten content may not be suitable for some people's digestion, leading to an increased prevalence of gluten intolerances such as coeliac disease or gluten sensitivity. Ongoing investigations into this issue are being conducted by various studies and experts.
When modern humans first arrived in Europe around 41,000 years ago, they primarily consumed a diet of wild herbs, fruits, roots, nuts, seeds, mushrooms and occasional meat from hunting, as they were nomadic. It wasn't until about 10,000 years ago that they transitioned to a settled agricultural lifestyle, cultivating early forms of grains such as spelt, amaranth and einkorn, as well as "ancient grains" like millet, emmer and kamut. It was only after this shift that grains became a regular part of their diet.
Between the fifth and the end of the 15th century, the eating culture changed considerably. One of the main reasons for this was global warming in the transition from the early to the high Middle Ages.
Additionally, mills improved technically, leading to the availability of a wider variety of foods in the country due to the crusades and the intensification of long-distance trade. Despite the increase in available foods, food shortages and severe famines were recurrent. The plague also had a significant impact on the eating habits of Europeans, as it spread epidemically and affected up to 30% of the population. As a result, the importance of grain diminished, and meat became the main source of calories.
Additionally, dried cod and salted herring were among the foods traded throughout Europe since the 10th century. However, cereal crops and groats remained staples throughout the Middle Ages, with wheat mainly reserved for the nobility. The early forms of wheat, oats and rye were not comparable to today's cereals, as the proportion of gluten was then negligible. Only through modern agrarian breeding did the grain change. The more gluten the cereal had, the better the baked bread and rolls.
As gluten is suspected of causing irritable bowel symptoms, there is a growing need for solutions and alternatives to conventional cereal products such as bread and pasta.
In the early 20th century, industrial bread, pastries and other foods could use alternative additives instead of gluten.
Manufacturers are continuously developing a wide variety of gluten-free foods that are delicious and diverse to ensure that enjoyment is not compromised. Idil Rodoplu, the marketing manager of Ulusoy Un & Söke Un, stated that while their main focus is producing gluten, they also consider it a part of their responsibility to provide consumers with a range of flavors that cater to their dietary and health requirements. They are aware of the new-age difficulties of nutrition and make efforts to be aligned with that vision.
