This is a follow up of sorts to an earlier post, Dec 19, 2016, on the Gluten-Free Dilemma and how we manage gluten-free diets in our nursing homes. Today, an interesting article crossed my desk about a new study determining a link between a protein in wheat that may cause inflammation of chronic diseases.  In determining the credibility of the article, I discovered an organization called United European Gastroenterology, UEG for short. According to their website

“UEG is a professional non-profit organization combining all the leading European societies concerned with digestive health. Together, the member societies represent over 22,000 specialists, working across medicine, surgery, paediatrics, GI oncology and endoscopy. This makes UEG the most comprehensive organisation of its kind in the world, and a unique platform for collaboration and the exchange of knowledge.”

Having determined the article to be credible, it appears scientists have found something other than gluten that may contribute towards non-celiac gluten sensitivity and which also triggers inflammation of a number of other chronic health conditions. There is a different family of proteins found in wheat called amylase-trypsin inhibitors (ATIs). Further to aggravating chronic health conditions outside of the bowel, ATIs may contribute to the development of non-celiac gluten sensitivity. This condition is now an accepted medical diagnosis for people who do not have celiac disease but benefit from a gluten free diet. Intestinal symptoms, such as abdominal pain and irregular bowel movements, are frequently reported, which can make it difficult to distinguish from IBS. However, extraintestinal symptoms can assist with diagnosis, which include headaches, joint pain and eczema. These symptoms typically appear after the consumption of gluten-containing food and improve rapidly on a gluten-free diet. Yet, gluten does not appear to cause the condition.

This is interesting because many people I know tell me they feel better when they stay away from wheat. And, to be honest, I do too. I tend to avoid eating (wheat) breads because I often feel gassy and bloated afterwards. The worst offenders are the wonderful crusty artisan types of rolls and baguettes. I just love them. Considering myself to be somewhat gluten sensitive for several years now, I still eat those wonderful breads from time to time but live with the consequences. Who knows, maybe for some of us, it’s not gluten that is the problem after all. Perhaps, as a result of this study and our experiences as Dietitians working in LTC, we may need to consider recommending “ATI-free diets” in the near future as part of our plan of care. Of course, our challenge continues with menu planning and ensuring we answer the call to meet the evolving needs of our residents.