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Natural Support for Gluten & Casein Sensitivity
by Carrie Louise Daenell, ND
Gluten is the ingredient that makes bagels chewy and cakes light and airy. It is the glue that holds pasta together (in Latin, glutin means glue). Gluten helps bread rise by trapping the gases during yeast fermentation. Casein is the main protein of dairy products. It's what makes cheese firm. Despite all this goodness, gluten and casein have their downsides. Some people have trouble digesting gluten and casein, which can lead to troublesome problems.
In this issue of Integrative Interventions, we are going to look at gluten intolerance and casein intolerance, current treatment recommendations, why gluten and casein can be hard to avoid, and what we can do to protect ourselves from hidden gluten and casein in foods and other products.
Q. What is gluten intolerance?
A. Gluten is a protein found in grass-related grains, such as wheat, barley, and rye. Gluten is found in most grain-based products we eat, such as bread, pasta, and cereal. Gluten intolerance is defined as difficulty digesting gluten. Many people have a simple form of gluten intolerance or sensitivity, with mild, but distressing, symptoms such as gas and occasional diarrhea. Other people have a serious form of gluten intolerance, known as Celiac disease.
Some researchers speculate that gluten intolerance stems from our evolutionary development. Using grain as a food source only became common about 10,000 years ago -- a very short time by evolutionary standards. Their theory is that some of us have not yet fully developed the ability to digest gluten. In fact, in countries where grains have been consumed for a longer period, gluten sensitivities are less common.
The culprits in gluten intolerance are gliadin and glutenin -- the proteins that make up gluten. These proteins are very complex, with long polypeptide chains. These chains can be difficult to break into smaller pieces during digestion (3).
Celiac Disease
It is important to note that a simple sensitivity to gluten is not the same as Celiac disease. Celiac disease is an autoimmune disease that requires a lifetime elimination of gluten from the diet in order to heal damage done to the small intestine. Some researchers suspect a genetic predisposition to the disease. When a person with Celiac disease consumes gluten, it sets off an immune system reaction that damages the villi that line the small intestine; the lining then becomes swollen and inflamed. Because the villi are primarily responsible for nutrient absorption, malnutrition is common in celiac sufferers, which makes the body susceptible to disease (1,4).
Q. What is casein intolerance?
A. Casein is the primary protein in animal milk. Casein intolerance is difficulty digesting casein. Casein intolerance is different from lactose intolerance. Lactose is a type of sugar found in milk. One of the peptides of casein, casomorphin, is similar to gliadin in chemical structure, making it tough to digest.
Q. How is gluten and casein intolerance treated?
A. Gluten and casein intolerance is typically treated by maintaining a gluten-free or casein-free diet. A gluten-free diet can be difficult to follow because so much of a mainstream American diet is eliminated, including most breads, cereals, and pastas. Finding suitable replacements can be difficult, even with increased options on the Internet. In addiiton, a lot of processed food contains gluten, often used as a thickener or binder. Anyone who strives to eat a healthy diet should limit processed foods, regardless of gluten content. Casein-free diets can also be challenging for similar reasons. Although many foods are labeled as lactose-free, consumers cannot assume that means casein-free as well.
Gluten-Free/Casein Free (GFCF) Diets in Autism Spectrum Disorder
Many parents of children with an Autism Spectrum Disorder (ASD) are turning to gluten-free/casein-free diets as a way to improve behavior and decrease digestive issues that are common with autism and similar disorders. The theory is that gluten and casein produce natural opiates that can cause excitability and aggressiveness (5). Studies have shown that GFCF diets can improve development in autistic children (5,6).
Q. What are hidden sources of gluten?
A. Gluten is hidden in many foods, including salad dressing, cold cuts, frozen yogurt, ketchup, and spices (which may include flour to improve flow). Candy is often dusted with flour to prevent sticking. Gluten is also found in prepackaged gravy and gravy mixes, hot dogs and lunch meat (fillers); toothpaste, canned soup, and potato chips. Even the glue on envelopes can contain gluten.
Q. What are hidden sources of casein?
A. Chocolate, margarine, butter or caramel flavoring, deli meats cut with same slicer used for cheese, some brands of tuna, jelly beans, and fast food French fries.
Q. What can I do about hidden gluten or casein?
A. The first thing you need to do to combat hidden gluten and casein is to become an avid label reader and learn where gluten or casein can be commonly found. Next, taking an enzyme product formulated to aid in the digestion of gluten and casein can help. Dipeptidyl Peptidase IV (DPP IV), a type of protease, has been shown to break down the proteins in gluten and casein in laboratory tests (7).
Q. What should I look for in a quality product?
A. A quality enzyme product should contain a variety of enzymes formulated to be effective across the range of pH levels present in the digestive tract. While digesting proteins is most important to those suffering with gluten or casein intolerance, digesting fats, sugars, fiber and carbohydrates is also needed. An enzyme product that contains a variety of proteases (for digesting proteins), amylase, cellulase, phytase, lactase, sucrase, (carbohydrates) and lipase (fats) is most beneficial. The other important point to consider when choosing an enzyme product is that you choose a quality manufacturer. Some companies tout their refusal to use excipients. But many excipients can serve a useful function. They help ensure consistent dosing and assist in disintegration and absorption. The most healthful enzyme in the world won't be effective if it stays in a clump in the stomach instead of breaking up. The company should also have quality manufacturing practices. The highest level of quality is attained in FDA-registered drug manufacturing establishments. These companies follow guidelines used for manufacturing pharmaceuticals -- the strictest standards in the industry.
Q. Could enzymes benefit Celiac Disease?
A. Celiac Disease is a serious disorder that requires a strict gluten-free diet in order to prevent further damage to the intestines. While enzymes may assist in digesting hidden gluten in foods, a person with Celiac's Disease should remain vigilant in maintaining a gluten-free diet and under no circumstances should the diet by discontinued. Enzyme products cannot replace the diet.
Conclusion
While we would all like to be able to eat anything we desire, unfortunately for some of us, our bodies just won't have it. Although following a GFCF diet can be difficult, it can be essential to health for those who can't digest gluten and casein. Using an enzyme product specifically formulated to digest those troublesome proteins hiding in unexpected places provides extra support for the success of the diet and gives peace of mind.
References:
1. Mayo Clinic. Celiac Disease. Available at www.mayoclinic.com Accessed on January 7, 2008.
2. Czapp K. Against the grain: the case for rejecting or respecting the staff of life. The Weston A. Price Foundation. Available at: www.westonaprice.org. Accessed on October 18, 2007.
3. Piper JL, Gray GM, Khosla C. Effect of prolyl endopeptidase on digestive-resistant gliadin peptides in vivo. Pharmacol Exp Ther. 2004 Oct;311(1):213-9.
4. Celiac Disease. Celiac Disease Foundation. Available at www.celiac.org. Accessed January 11, 2008.
5. KiddPM. Autism an extreme challenge to integrative medicine. Part 2: medical management. Altern Med Rev. 2002 Dec;7(6):472-99.
6. Knivsberg AM, Reichelt KL, Hoien T, Nodland M. A randomised, controlled study of dietary intervention in autistic syndromes. Nutr Neurosci. 2002 Sep;5(4):251-61.
7. Hausch F, Shan L, Santiago NA, Gray GM, Khosla C. Intestinal digestive resistance of immunodominant gliadin peptides. Am J Physiol Gastrointest Liver Physiol. 2002 Oct;283(4):G996-G1003.
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