The truth about gluten

Gluten.Lately, there’s been a lot of talk in both the health and culinary communities about gluten.  Though only 1 percent of the population suffers from celiac disease going gluten-free has become a new dietary craze, causing many people to give up bread, pasta, beer and mistakenly any other food with gluten in it.1 As a result, health care professionals will likely see an increasing amount of patients inquiring about the benefits of eliminating gluten from their diets. But what is gluten? And what exactly are its effects on human health?

Gluten is a protein

Though many consumers mistake gluten for a carbohydrate, in reality gluten is a protein found in barley, wheat and rye.This is why gluten is often found in food loaded with carbohydrates, such as bread, because those foods tend to contain barley, wheat or rye. Gluten works as an adhesive in these products to give them shape and texture. Until recently, this meant that many foods made without gluten or a gluten substitute had a dense, chewy texture. But like most dietary crazes, the gluten-free trend has encouraged food companies to create varieties of their products that are not only free of the protein, but also appealing to a wide range of consumer tastes.3 Odds are your local grocery store now has a gluten-free section, or at the very least, a few shelves dedicated to products without gluten.

In addition, the increased production of naturally gluten-free hard ciders, and the development of beers without the protein, are on the rise as a result of this movement.

What is Celiac Disease?

Around two million people in the United States are thought to have celiac disease, though only around 300,000 have been diagnosed.4 The disease causes the body to trigger the immune system to attack villi lining the small intestine when gluten is ingested. This can cause uncomfortable symptoms including gas, bloating, diarrhea, constipation, headache and fatigue, while also preventing the body’s absorption of vitamins and minerals, causing long-term malnutrition.5 If celiac disease goes undiagnosed, it can eventually be fatal.

The disease is diagnosed by a blood test or intestinal biopsy. If the test comes back negative but a patient is still experiencing symptoms,  they are sometimes diagnosed with gluten intolerance.However, as of now there is no proven test to determine if a person has a nonceliac intolerance to gluten – this makes it challenging to assess if gluten is doing any actual harm.8

Guidance for people considering a gluten-free diet

Those who are concerned they have celiac disease should not begin a gluten-free diet before receiving a diagnosis. The disease can be misdiagnosed if there are no antibodies present in the small intestine as evidence of the disease. See a specialist as soon as possible and once diagnosed maintain a proper diet. Spending a lifetime avoiding gluten is a continuous challenge for those with celiac disease and requires diligence. Those who suffer from celiac disease will need to find other foods to provide necessary nutrients to their diet.

When guiding patients who believe they are experiencing gluten sensitivity but have already tested negative for celiac disease, try a trial gluten-free period to see if the symptoms are eliminated. However, this should only be done after you have received a diagnosis and spoken with a physician. If removing gluten from your diet proves ineffective, make sure to either return to eating gluten in moderation or find other foods to fill in the gaps in your nutrition.

If you are merely considering going gluten-free for health purposes, think twice before committing to eliminating the protein from your diet. Foods that contain gluten hold important vitamins and minerals that gluten-free foods often do not, and sometimes gluten-free foods have extra sugar or additives to make up for their chewy texture.

1“Going gluten-free for weight loss? Think again” by Melissa Waara. A Healthier Michigan. June 13, 2014. http://www.ahealthiermichigan.org/2014/06/13/going-gluten-free-for-weight-loss-think-again/

2“Considering a gluten-free diet” Harvard Medical School. April 2013 http://www.health.harvard.edu/newsletters/Harvard_Health_Letter/2013/April/considering-a-gluten-free-diet

3“Should We All Go Gluten-Free?” by Keith O’Brien. New York Times. November 25, 2011. http://www.nytimes.com/2011/11/27/magazine/Should-We-All-Go-Gluten-Free.html?pagewanted=all&_r=0

4“Considering a gluten-free diet” Harvard Medical School. April 2013 http://www.health.harvard.edu/newsletters/Harvard_Health_Letter/2013/April/considering-a-gluten-free-diet

5“Considering a gluten-free diet” Harvard Medical School. April 2013 http://www.health.harvard.edu/newsletters/Harvard_Health_Letter/2013/April/considering-a-gluten-free-diet

6“Should We All Go Gluten-Free?” by Keith O’Brien. New York Times. November 25, 2011. http://www.nytimes.com/2011/11/27/magazine/Should-We-All-Go-Gluten-Free.html?pagewanted=all&_r=0

7“GLUTEN SENSITIVITY” Celiac Disease Foundation. http://celiac.org/celiac-disease/non-celiac-gluten-sensitivity/

8“GLUTEN SENSITIVITY” Celiac Disease Foundation. http://celiac.org/celiac-disease/non-celiac-gluten-sensitivity/

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