The Truth About Gluten
Going gluten-free has become a trendy way to eat, and marketers are cashing in, selling specialty products for a premium. Avoiding gluten, a protein found in wheat, barley, and rye, is essential for people with a condition called celiac disease. For the rest of us, here are some need-to-know facts about the gluten-free craze:
Don’t confuse celiac disease with a food allergy. The two conditions are believed to involve different parts of the immune system. A wheat allergy causes symptoms similar to other allergies, and it’s often outgrown by adulthood. In celiac disease, on the other hand, gluten triggers an autoimmune condition in which the body starts attacking normal tissue in the small intestine. The condition can be inherited, and it persists through life. The only treatment is to avoid gluten completely.
Gluten intolerance is probably part fact, part fad. Of late, gluten has become the fall guy for every possible ill – “I recommend that everyone with any health problems go on a 60-day gluten-free eating trial”, one website gushes. Experts think those kinds of claims are way overblown. Gluten intolerance is real, but it probably affects only a small subset of of people. More research is needed before we know more for sure.
But some people with irritable bowel syndrome say that their symptoms improve on a gluten-free diet- and assertion supported by a small (34 participants) but well-done randomized controlled trial published recently in the American Journal of Gastroenterology.
Most people with celiac don’t know it. Even in the midst of the gluten-free fad, celiac disease, which affects about 1 in 100 people, remains woefully under-diagnosed. Only about half of celiac sufferers have the classic gastrointestinal symptoms such as bloating gas, and diarrhea, which patients and doctors alike might chalk up to something else. The other half might not have obvious symptoms at all.
Experts recommend that you get tested for celiac if you have a family history of the disease or a condition that is more prevalent in celiac patients. Those conditions include other autoimmune disorders, cancers of the intestines, and liver diseases. In addition, consider testing if you chronically experience symptoms like diarrhea, gas, hair loss, fertility issues, or extreme fatigue.
You should get tested before going gluten free. The blood test for celiac detects certain antibodies, which disappear when you stop eating gluten. If the test is positive, your physician might confirm the results with a biopsy of the small intestine.
If you don’t have celiac but feel better when you follow a gluten-free diet, it’s worth working with your physician or a nutritionist to determine whether gluten is truly the source of our symptoms.
Gluten-free products can be more expensive and less healthful. Specialty products cost up to three times more and in some cases have nutritional deficiencies. The starches substituted for wheat may lack B vitamins, iron, and fiber, and the end result can be higher in calories, fat, and carbs. If you must avoid gluten, be a careful label reader and opt for nutritious gluten-free grains such as amaranth, buckwheat, quinoa, sorghum, and teff. To save money, eat naturally gluten-free foods such as produce, nuts, corn tortillas, rice cereals, and popcorn.