Are Small Amounts of Gluten Harmful?
Many people ask if perhaps it is ok to just cut way back on gluten. They wonder if they only have a very little bit of gluten, if that poses any risks to them. For people who have no obvious symptoms or only very mild symptoms, this possibility is especially tempting.
I did locate a study that compared two groups of celiacs -- one eating a completely gluten free diet, and the other eating a low-gluten diet:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1433820
Here is an excerpt from the abstract from this study:
"Treatment of patients with coeliac disease with a low gluten containing diet (LGD) remains controversial. We have studied jejunal morphology and antigluten (AG) antibody titres by ELISA in patients on a LGD of 2.5-5 g/day for three to 14 months (median six months) and compared results with patients on a strict gluten free diet (GFD) for six to 27 months (median 13 months). We found no significant difference in villous height or crypt depth (eight LGD v 10 GFD patients) or serum AG-IgA, -IgG, and IgM titres (13 LGD v 12 GFD patients). there was however, a significant increase (p less than 0.05) in intra-epithelial lymphocytes in those patients on a LGD. We conclude that adult coeliac patients can tolerate a LGD without gross morphological change and without initiating significant AG antibody responses."
Although the authors of this study appear to condone a low-gluten diet, notice that this study did indicate a significant increase in intraepithelial lymphocytes (IELs) in those eating a low gluten diet.
Now look at what Wikipedia has to say about IELs:
"Intraepithelial lymphocytes (IEL) are lymphocytes found in the epithelial layer of mammalian mucosal linings, such as the gastrointestinal (GI) tract and reproductive tract. In the GI tract, they are components of gut-associated lymphoid tissue (GALT).
An elevated IEL population, as determined by biopsy, typically indicates ongoing inflammation within the mucosa. In diseases such as coeliac sprue, IEL elevation throughout the small intestine is one of many specific markers.[1]
Alternatively, elevated IEL populations can be a marker for developing neoplasia in the tissue (such as found in cervical and prostate cancers). IELs themselves can of course, undergo mutation to become lymphoma."
Since some of the known long term health complications for celiacs and gluten sensitive people include being at increased risk of developing a variety of cancers, and since chronic inflammation is in itself a predisposing factor for some cancers, the wisest path is probably to be as close to 100% gluten-free as possible.
I did locate a study that compared two groups of celiacs -- one eating a completely gluten free diet, and the other eating a low-gluten diet:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1433820
Here is an excerpt from the abstract from this study:
"Treatment of patients with coeliac disease with a low gluten containing diet (LGD) remains controversial. We have studied jejunal morphology and antigluten (AG) antibody titres by ELISA in patients on a LGD of 2.5-5 g/day for three to 14 months (median six months) and compared results with patients on a strict gluten free diet (GFD) for six to 27 months (median 13 months). We found no significant difference in villous height or crypt depth (eight LGD v 10 GFD patients) or serum AG-IgA, -IgG, and IgM titres (13 LGD v 12 GFD patients). there was however, a significant increase (p less than 0.05) in intra-epithelial lymphocytes in those patients on a LGD. We conclude that adult coeliac patients can tolerate a LGD without gross morphological change and without initiating significant AG antibody responses."
Although the authors of this study appear to condone a low-gluten diet, notice that this study did indicate a significant increase in intraepithelial lymphocytes (IELs) in those eating a low gluten diet.
Now look at what Wikipedia has to say about IELs:
"Intraepithelial lymphocytes (IEL) are lymphocytes found in the epithelial layer of mammalian mucosal linings, such as the gastrointestinal (GI) tract and reproductive tract. In the GI tract, they are components of gut-associated lymphoid tissue (GALT).
An elevated IEL population, as determined by biopsy, typically indicates ongoing inflammation within the mucosa. In diseases such as coeliac sprue, IEL elevation throughout the small intestine is one of many specific markers.[1]
Alternatively, elevated IEL populations can be a marker for developing neoplasia in the tissue (such as found in cervical and prostate cancers). IELs themselves can of course, undergo mutation to become lymphoma."
Since some of the known long term health complications for celiacs and gluten sensitive people include being at increased risk of developing a variety of cancers, and since chronic inflammation is in itself a predisposing factor for some cancers, the wisest path is probably to be as close to 100% gluten-free as possible.
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