What’s All the Fuss about Gluten?
It has become quite fashionable these days for otherwise healthy individuals to go on a gluten-free diet. You may have even contemplated whether you should try eliminating gluten from your diet. There are many, however, who wonder if this is just another in the long list of fad diets that come in and out of vogue. Gluten is a protein found in wheat, rye and barley that can cause a serious condition called celiac sprue in a specific group of individuals and may lead to less severe symptoms in others who are thought to have gluten sensitivity. Most of us, on the other hand, have no problem when gluten is included in our diet. As we will see, following a gluten-free diet is difficult and can lead to certain dietary deficiencies. Once you are armed with the facts you should be able to make an informed decision about gluten in your diet.
Celiac Sprue
Celiac sprue or gluten-sensitive enteropathy affects 1 in every 150 to 250 individuals in the United States and Europe and the incidence seems to be increasing. It occurs when a genetically predisposed person ingests the protein gluten from wheat, rye or barley and an immune response directed against the gluten proteins causes inflammation in the mucosal lining of the small intestine. Signs and symptoms include diarrhea, bloating, flatulence, weight loss, fatigue, abdominal pain and skin problems. The resulting malabsorption can lead to malnutrition, iron deficiency anemia and vitamin D and vitamin K deficiency. Diagnosis can be made through biopsy of the small intestine and serologic testing. Approximately 20% of new diagnoses of celiac sprue are made in adults over the age of 60 years. Treatment consists of a lifetime adherence to a gluten-free diet and most patients experience an improvement within a few weeks of beginning the diet.
Gluten Sensitivity
Medical experts have begun to accept the idea that some individuals may have a reaction to gluten even though they test negative for celiac sprue. This condition is referred to as gluten sensitivity. These patients may experience some of the same signs and symptoms as those with celiac disease and they improve with a gluten-free diet. Patients who suspect that they may have a reaction to gluten should be evaluated by their physician and should be tested for celiac disease first before embarking on a gluten-free diet.
Are There Any Disadvantages to Following a Gluten-Free Diet?
Besides being difficult to follow, a gluten-free diet may cause a deficiency of minerals such as iron and calcium, as well as certain vitamins like B12 and Vitamin D. A gluten-free diet can also mean that you are getting less dietary fiber. While this restrictive diet has been touted for everything from migraines to autism, there is currently no evidence that a gluten-free diet helps these or other conditions such as Down Syndrome or ADHD. Following a gluten-free diet does not necessarily promote weight loss either. In fact, foods labeled as gluten-free in the grocery store may actually be higher in carbohydrates, fats and sodium.
The Bottom Line
Those who have undergone appropriate testing which confirms that they have celiac disease must adhere to a gluten-free diet for life and should experience an immediate improvement after beginning the diet. Others who have some of the symptoms of celiac disease but negative test results may have gluten sensitivity and may benefit from eliminating gluten from their diet. While the jury may still be out on whether a gluten- free diet is beneficial for otherwise healthy individuals, it is important to be aware that following this diet can lead to vitamin and mineral deficiencies. As always, it is important to consult your health care provider or a dietitian if you have questions about gluten and whether a gluten-free diet may benefit you.
Guidelines for Following a Gluten-Free Diet
Because many of us are gluttons for gluten, following a gluten-free diet can be difficult. This is because so many of the tasty things we enjoy eating contain gluten. Cross contamination and food additives also make it difficult to insure that you are not ingesting gluten. Grocery stores now have many items labeled ‘gluten-free’, which may mean that they contain a harmless level of gluten, but are not necessarily completely devoid of gluten. For all these reasons, it would be a good idea to consult a dietitian before embarking on a gluten-free diet.
Gluten-Free Diet Guidelines
Foods That Are Allowed
corn
flax
rice
soy
potato
beans, seeds, nuts
eggs
most dairy products
fruit and vegetables
meat, fish and poultry
Foods That Are Not Allowed
barley
rye
wheat
Foods to Avoid Unless Labeled Gluten-Free
pasta
gravy
French fries
croutons
cookies
crackers
cereal
candy
cakes and pies
bread
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