What is gluten and why are people eliminating it from their diets?
Gluten is a protein found in the endosperm of wheat. All grains are a relatively recent addition to the human diet, having become an integral part of our meals with the invention of agriculture. It is no surprise that this comparatively modern food may contribute to states of disease for some individuals. Some do not have the capacity to digest and metabolize this protein, due to their genetic disposition. For others, who are already in a diseased state, a compromised digestive function can impair their ability to break down gluten, triggering an immune reaction.
For many, adopting a gluten-free diet is a sacrifice for greater health and well-being. The standard American diet revolves around foods containing gluten such as bread, pasta, cereal, crackers, cookies and more. For many of us, these foods are familiar and comfortable, so it can be difficult to eliminate them from our diets. While the gluten-free diet may appear to be a fad to some, many people are eating this way because of the obvious beneficial effects this diet has on their health. There are many misconceptions regarding gluten-free diets, and it’s important to discern the gluten-free facts from myths to help decide whether this diet is the best choice for your body and overall health.
Let’s start with the facts.
It’s true: Eating a gluten-free diet can help modulate and even prevent some disease. A gluten-free diet has been shown to reduce the symptoms of irritable bowel syndrome (IBS), due to gluten’s role in altering bowl barrier functions. Evidence shows a relationship between gluten sensitivity or celiac disease and the development of autoimmune disease as well. While it is debated in the scientific community, some studies demonstrate that a gluten-free diet can even affect certain chronic behavioral conditions, such as autism, because of a suspected relationship between gastrointestinal symptoms, leaky gut and the prevalence of autism¹.
Today, gluten-related disorders are prevalent. Ten percent of our population is affected by gluten-related disorders³. These disorders vary in their degree of severity, but all impact health and wellness. Celiac disease is the gluten-related disorder that is most well-known. It can be identified through diagnostic testing, though due to the wide variety of symptoms in celiac patients, it can be difficult to recognize. Wheat allergy, an adverse immunological response to wheat, is the easiest gluten-related disorder to diagnose. The symptoms of wheat allergy are typically anaphylaxis, contact urticaria, baker’s asthma and rhinitis. The gluten-related disorder that was discovered nearly 30 years ago, but is just now garnering attention from the medical community, is non-celiac gluten sensitivity (NCGS). NCGS does not have confirmatory testing like celiac disease. The main indicators of NCGS are a variety of symptoms that appear after the ingestion of gluten and disappear when gluten is eliminated. Most of the cases of NCGS are not clinically diagnosed but rather self-diagnosed. The symptoms of NCGS range from abdominal pain, rash, “foggy mind,” diarrhea, depression, fatigue and joint pain³.
The gluten-free diet encompasses more than just excluding wheat from the diet. It also eliminates all grains that contain the gluten protein. Foods that contain gluten include barley and rye. While oats do not contain gluten, they are often contaminated with gluten, so buying gluten-free oats is necessary to avoid cross contamination. Many unsuspected foods also contain gluten, so it is important for a person embarking on a gluten-free diet to read labels, because wheat or gluten could be a hidden ingredient. Salad dressings, soy sauce, sauces and other processed foods may contain wheat or gluten. In cases of celiac disease or wheat allergy, where strict avoidance of gluten is necessary, it is also important to check labels of body care products, household cleaners and cosmetics. These products can also contain gluten, and skin exposure may cause further detriment.
The gluten-free diet isn’t always easy. It can be especially difficult when traveling or visiting friends or family. Being prepared and planning meals ahead of time can be some of the best tools in a gluten-free toolkit. Fortunately, if you do decide to go gluten-free, you are not alone. Because the gluten-free diet has become more popular over the past decade, there are usually gluten-free options on restaurant menus and often entire sections dedicated to gluten-free products in grocery stores. Whole foods such as meats, vegetables, fruits, nuts, seeds and gluten-free whole grains can be fun and easy to prepare. Bringing a gluten-free dish to a party or gathering helps to stick to the diet and may even encourage others to take a deeper look into their diet and health.
What about the myths?
A gluten-free diet is often touted as healthier than one containing gluten, but this is simply not true. For a person who has celiac disease, wheat allergy or NCGS, a gluten-free diet is certainly healthier. When these individuals eliminate gluten from their diets, they experience reduced inflammation. A healthy diet contains a variety foods, plenty of fruits and vegetables, whole grains, limited refined sugar and little-processed food. A diet which relies heavily on processed wheat products, such as pasta, bread, and packaged cereals, can be problematic for anyone, gluten-free or not, due to the lack of variety in the diet and the excess of processed grain as opposed to whole grains, such as brown rice, quinoa, oats or millet. This is important even for a person on a gluten-free diet to remember, because substituting processed gluten products with processed gluten-free products is still not optimal. Processed gluten-free products are lacking in fiber, vitamins and minerals, and they often have a high content of refined sugar.
Another myth surrounding the gluten-free diet is that it is limiting, restrictive or extreme. Eating a gluten-free diet does mean that numerous foods are eliminated, but it can also be eye-opening in terms of what other foods are out there waiting to be explored! The gluten-free diet can often be a gateway into experimenting with new foods. Grains like millet, buckwheat, quinoa, teff, amaranth and sorghum are all different in their flavor, texture and nutrient content. A well-rounded gluten-free diet does not just eliminate, it substitutes and encourages us to become more adventurous in our food choices, to think outside the box (literally!). A gluten-free diet also doesn’t mean that all baked goods must be eliminated. There are many resources for gluten-free recipes for breads, crackers, cookies and cakes.
Many people believe that the gluten-free diet is just a health trend that will fade out in time. While the gluten-free diet has become somewhat trendy, it is not likely that this trend will fade away. If anything, more people may start adopting this diet due to the rising prevalence of gluten-related disorders, including celiac disease³ and digestive disorders such as IBS, which causes additional issues with the digestion of gluten³. People who are eliminating gluten from their diets and noticing positive changes in their health are spreading the word.
How do I know if the gluten-free diet is for me?
Gaining a broader understanding of the facts and myths surrounding the gluten-free phenomenon may help in deciding whether the gluten-free diet is for you. A good indicator of whether this diet may be beneficial for you, personally, is to consider symptoms that you may or may not have on a regular basis. Even small symptoms signal that there may be something deeper that needs to be addressed, modified or changed to obtain optimal health. Listening to our bodies and exploring the foods that make us feel good and those that may not serve us can help us achieve greater wellness.
Due to our biochemical individuality, a gluten-related digestive disorder does not present itself in the same way for each person. Symptoms such as fatigue, weight loss or gain, headaches, diarrhea, constipation, joint pain and acid reflux can all be indicators that one is not properly digesting gluten. If you suspect a gluten-related digestive disorder, ask your doctor to test for celiac disease. If celiac disease is not present in your case, the best way to know whether you have NCGS is an elimination diet. Try eliminating gluten from your diet for 3-4 weeks and notice whether your symptoms change. How do you feel adding gluten back into your diet? Note the changes that took place when you subtracted gluten from your diet as well as what happened when you added it back in.
A gluten-free diet is not for everyone, but it may just be the next step on your path to wellness. Be your best advocate and take charge of your health!
1 Catassi, C., Bai, J., Bonaz, B., et al. (2013, Sept). Non-Celiac Gluten Sensitivity: The New Frontier of Gluten-related Disorders. Nutrients; 5(10): 3839–3853. doi: 10.3390/nu5103839
2 Nelsen, D. (2002, Dec). Gluten-sensitive enteropathy (celiac disease): more common than you think. American Family Physician; 66(12):2259-66. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12507163
3 Leonard, M. and Vasagar, B. (2014). US Perspective on Gluten-related Diseases. Clinical and experimental gastroenterology; 7:25-37. doi: 10.2147/CEG.S54567