Cereals & Grains Association
Log In

Chapter 13: Medical Applications of Gluten-Composition Knowledge


R.P. Anderson, Autoimmunity and Transplantation Division, Walter and Eliza Hall Institute, Parkville, Australia 3050; H. Wieser, Deutsche Forschungsanstalt für Lebensmittelchemie, Garching, Germany

Gliadin and Glutenin: The Unique Balance of Wheat Quality
Pages 387-409
DOI: https://doi.org/10.1094/9781891127519.017
ISBN: 978-1-891127-51-9






Abstract

Gluten causes disease for a significant minority of people who consume foods derived from wheat, rye, barley and oats. The general public in most Western countries is now aware of the potential adverse effects of gluten, with stories and books appearing in the lay press promoting gluten-free diets, many without drawing attention to the importance of appropriate diagnosis or defining what gluten “intolerance” an individual may have. Such adverse publicity poses a significant threat to the grain industry. Celiac disease affects 1% of Caucasians and South Asians (Maki et al 2003; Fasano et al 2003; Dube et al 2005), gluten allergy is well described (Rasanen et al 1994; Sicherer 2000) and fructose malabsorption causing symptoms associated with irritable bowel syndrome may affect 30% of Westerners (Skoog and Bharucha 2004).

Commercial activity related to “gluten toxicity” is largely centered upon “gluten-free” food. “Gluten-free” substitutes attract a premium over standard gluten-containing products, yet in only a few countries are patients with gluten-related disease assisted with the costs of following a gluten-free diet. In addition, standards for “gluten-free” labeling vary between countries, most gluten-free products are not labeled as such, and substitutes for gluten-containing foods (e.g., bread) are seldom as palatable or as versatile in cooking. Frequently, the gluten-free diet is further complicated by the need to treat co-existent diabetes, fructose or lactose intolerance, which may compromise the utility of many “gluten-free” substitutes.

In this chapter, gluten-related disease will be defined, the molecular basis for these conditions outlined, and approaches to improving the treatment of these diseases, in particular celiac disease, will be discussed.