Gluten (from Latin gluten, "glue") is a composite of storage proteins termed

prolamins and glutelins[1] and stored together with starch in the endosperm (which
nourishes the embryonic plant during germination) of various grass-related grains.
It is found in wheat, barley, rye, oat, related species and hybrids (such as spelt,
khorasan, emmer, einkorn, triticale, kamut, etc.)[2] and products of these (such as
malt). Gluten is appreciated for its viscoelastic properties.[3][4] It gives
elasticity to dough, helping it rise and keep its shape and often gives the final
product a chewy texture.

Wheat prolamins are called gliadins, barley prolamins are hordeins, rye prolamins
are secalins and oats prolamins are avenins, which are collectively named gluten.
[2] Wheat glutelins are called glutenin.[5] In a small part of the general
population, gluten can trigger coeliac disease, non-coeliac gluten sensitivity,
gluten ataxia and dermatitis herpetiformis.[6] The occurrence of oat avenin
toxicity in people with gluten-related disorders depends on the oat cultivar
consumed, because the immunoreactivities of toxic prolamins are different among oat
varieties.[7][8][9] Also, many oat products are cross-contaminated with other
gluten-containing cereals.[8]

True gluten is limited to the grains listed above.[1] The stored proteins of
maiBread products[edit]
Gluten forms when glutenin molecules cross-link to form a submicroscopic network
attached to gliadin, which contributes viscosity (thickness) and extensibility to
the mix.[3][12] If this dough is leavened with yeast, fermentation produces carbon
dioxide bubbles, which, trapped by the gluten network, cause the dough to rise.
Baking coagulates the gluten, which, along with starch, stabilizes the shape of the
final product. Gluten content has been implicated as a factor in the staling of
bread, possibly because it binds water through hydration.[13]

The formation of gluten affects the texture of the baked goods.[3] Gluten's
attainable elasticity is proportional to its content of glutenins with low
molecular weights as this portion contains the preponderance of the sulfur atoms
responsible for the cross-linking in the network.[14][15] More refining (of the
gluten) leads to chewier products such as pizza and bagels, while less refining
yields tender baked goods such as pastry products.[16]

Generally, bread flours are high in gluten (hard wheat); pastry flours have a lower
gluten content. Kneading promotes the formation of gluten strands and cross-links,
creating baked products that are chewier (in contrast to crumbly). The "chewiness"
increases as the dough is kneaded for longer times. An increased moisture content
in the dough enhances gluten development,[16] and very wet doughs left to rise for
a long time require no kneading (see no-knead bread). Shortening inhibits formation
of cross-links and is used, along with diminished water and less kneading, when a
tender and flaky product, such as a pie crust, is desired.

The strength and elasticity of gluten in flour is measured in the baking industry
using a farinograph. This gives the baker a measurement of quality for different
varieties of flours in developing recipes for various baked goods.[3][17][18]

Added gluten[edit]
According to Understanding Baking, gluten, when dried, milled and added to ordinary
flouMain articles: Gluten-related disorders, Gluten-sensitive enteropathy-
associated conditions, and Gluten-sensitive idiopathic neuropathies
Gluten-related disorders is the umbrella term for all diseases triggered by gluten,
which include celiac disease (CD), non-celiac gluten sensitivity (NCGS), wheat
allergy, gluten ataxia, and dermatitis herpetiformis (DH).[6] Currently, their
incidence is increasing in most geographic areas of the world.[26][27][28] It can
be explained possibly by the growing westernization of diet,[26] increasing use of
wheat-based foods included in the Mediterranean diet,[29][30] the progressive
replacement of rice by wheat in many countries in Asia, the Middle East, and North
Africa,[26] the development in recent years of new types of wheat with a higher
amount of cytotoxic gluten peptides,[31][32] and the higher content of gluten in
bread and bakery products, due to the reduction of dough fermentation time.[31][33]

Celiac disease[edit]
Main article: Celiac disease
Celiac disease (CD) is a long term autoimmune disorder primarily affecting the
small intestine caused by the ingestion of wheat, barley, rye, and derivatives,
that appears in genetically predisposed people of all ages. CD is not only a
gastrointestinal disease, because it may involve several organs and cause an
extensive variety of non-gastrointestinal symptoms, and most importantly, it may
often be completely asymptomatic.[34] Added difficulties for diagnosis are the fact
that serological markers (anti-tissue transglutaminase [TG2]) are not always
present[35] and many people may have minor mucosal lesions, without atrophy of the
intestinal villi.[36]

CD affects approximately 1�2% of the general population,[37] but most cases remain
unrecognized, undiagnosed and untreated, and at risk for serious long-term health
complications.[27][37][38][39] People may suffer severe disease symptoms and be
subjected to extensive investigations for many years, before a proper diagnosis is
achieved.[40] Untreated CD may cause malabsorption, reduced quality of life, iron
deficiency, osteoporosis, an increased risk of intestinal lymphomas, and greater
mortality.[41] CD is associated with some other autoimmune diseases, such as
diabetes mellitus type 1, thyroiditis,[42] gluten ataxia, psoriasis, vitiligo,
autoimmune hepatitis, dermatitis herpetiformis, primary sclerosing cholangitis, and
more.[42]

CD with "classic symptoms", which include gastrointestinal manifestations such as

chronic diarrhea and abdominal distention, malabsorption, loss of appetite, and
impaired growth, is currently the least common presentation form of the disease and
affects predominantly small children generally younger than two years of age.[38]
[40]

CD with "non-classic symptoms" is the most common clinical type[40] and occurs in
older children (over 2 years old),[40] adolescents, and adults.[40] It is
characterized by milder or even absent gastrointestinal symptoms and a wide
spectrum of non-intestinal manifestations that can involve any organ of the body,
and very frequently may be completely asymptomatic[38] both in children (at least
in 43% of the cases[43]) and adults.[38]

Non-celiac gluten sensitivity[edit]

Main article: Non-celiac gluten sensitivity
Non-celiac gluten sensitivity (NCGS) is described as a condition of multiple
symptoms that improves when switching to a gluten-free diet, after celiac disease
and wheat allergy are excluded.[44][45] Recognized since 2010,[46][47] it is
included among gluten-related disorders,[46] but its pathogenesis is not yet well
understood.[47] NCGS is the most common syndrome of gluten intolerance,[46][48]
with a prevalence estimated to be 6-10%.[49] People with NCGS remain habitually in
a "no man's land", without being recognized by the specialists and lacking the
adequate medical care and treatment.[50] Most of these people have a long history
of health complaints and unsuccessful consultations with numerous physicians, and
this is the reason why the majority of them end up resorting to a gluten-free diet
and a self-diagnosis of gluten sensitivity.[51]

People with NCGS may develop gastrointestinal symptoms, which resemble those of
irritable bowel syndrome or wheat allergy,[46][52] or a wide variety of non-
gastrointestinal symptoms, such as headache, chronic fatigue, fibromyalgia, atopic
diseases, allergies, neurological diseases, or psychiatric disorders, among others.
[41][47][53]

Besides gluten, additional components present in wheat, rye, barley, and their
derivatives, including other proteins and short-chain carbohydrates called FODMAPs,
may cause NCGS symptoms. The effects of FODMAPs are only limited to
gastrointestinal discomfort.[47]

Wheat allergy[edit]
Main article: Wheat allergy
People can also experience adverse effects of wheat as result of a wheat allergy.
[39] As with most allergies, a wheat allergy causes the immune system to abnormally
respond to a component of wheat that it treats as a threatening foreign body. This
immune response is often time-limited and does not cause lasting harm to body
tissues.[54] Wheat allergy and celiac disease are different disorders.[39][55]
Gastrointestinal symptoms of wheat allergy are similar to those of celiac disease
and non-celiac gluten sensitivity, but there is a different interval between
exposure to wheat and onset of symptoms. An allergic reaction to wheat has a fast
onset (from minutes to hours) after the consumption of food containing wheat and
could include anaphylaxis.[35]

Gluten ataxia[edit]
File:Gluten ataxia eng.ogv
A male with gluten ataxia: previous situation and evolution after 3 months of
gluten-free diet.
Gluten ataxia is an autoimmune disease triggered by the ingestion of gluten.[56]
With gluten ataxia, damage takes place in the cerebellum, the balance center of the
brain that controls coordination and complex movements like walking, speaking and
swallowing, with loss of Purkinje cells. People with gluten ataxia usually present
gait abnormality or incoordination and tremor of the upper limbs. Gaze-evoked
nystagmus and other ocular signs of cerebellar dysfunction are common. Myoclonus,
palatal tremor, and opsoclonus-myoclonus may also appear.[57]

Early diagnosis and treatment with a gluten-free diet can improve ataxia and
prevent its progression. The effectiveness of the treatment depends on the elapsed
time from the onset of the ataxia until diagnosis, because the death of neurons in
the cerebellum as a result of gluten exposure is irreversible.[57][58]

Gluten ataxia accounts for 40% of ataxias of unknown origin and 15% of all ataxias.
[57][59] Less than 10% of people with gluten ataxia present any gastrointestinal
symptom, yet about 40% have intestinal damage.[57]

Labelling[edit]
International standards[edit]
The Codex Alimentarius international standards for food labelling has a standard
relating to the labelling of products as "gluten-free". It only applies to foods
that would normally contain gluten.[60]

Brazil[edit]
By law in Brazil, all food products must display labels clearly indicating whether
or not they contain gluten.[61]

Canada[edit]
The Canadian Celiac Association estimates that one in 133 Canadians experiences
adverse symptoms from gluten in celiac disease.[62] Labels for all food products
sold in Canada must clearly identify the presence of gluten if it is present at a
level greater than 20 parts per million.[63]

United Kingdom[edit]
In the United Kingdom, all prepackaged foods and non-prepacked foods from a
restaurant, take-out food wrapped just before sale, or unpackaged food served in
institutions must be identified if gluten-free.[64] "Gluten-free" is defined as 20
parts per million of gluten or less and "very low gluten" is 100 parts per million
of gluten or less; only foods with cereal ingredients processed to remove gluten
can claim "very low gluten" on labels.[64]

United States[edit]
In the United States, gluten is not listed on labels unless added as a stand-alone
ingredient. Wheat or other allergens are listed after the ingredient line. The US
Food and Drug Administration (FDA) has historically classified gluten as "generally
recognized as safe" (GRAS). In August 2013, FDA issued a final rule, effective
August 2014, that defined the term "gluten-free" for voluntary use in the labeling
of foods as meaning that the amount of gluten contained in the food is below 20
parts per million.[65]

See also[edit]
Gluten-free diet
Gliadin
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