Gluten-free diet has become a nutritional trend as the number of people who decide to take gluten out of their diet is on a significant rise. A numerous amount of publications, online and printed, which incriminate gluten for various health issues and negative symptoms, have led many people to seek the remedy for their problems in a gluten-free lifestyle.
But is a gluten-free diet beneficial for everyone? And are all those people really negatively affected by the consumption of a protein that has been an essential constituent of the human diet since the ancient years?
What is gluten?
Gluten is the common name of a family of proteins found in some grains and specifically in all kinds of wheat, in rye, in barley and in triticale – a hybrid grain which is a cross between wheat and rye. Gluten is responsible for the creation of bread as its presence in flour is what gives it the ability to rise. Apart from grain and flour products like bread, cereal, pasta and many more, gluten can also be found in many processed and packaged foods as it is a component of a lot of food additives. It is also used as a drug excipient, as an ingredient of nutritional supplements, and it has also been found in cosmetics and skin products. Therefore, it is easily understandable that leading a gluten-free lifestyle is not as simple as quitting on bread and cereals.
Is gluten bad?
Gluten is a protein. Proteins are nutrients. All nutrients’ job is to nourish. And nourishment is definitely not a bad thing for our bodies. But gluten can actually be harmful for one group of people and potentially harmful for some others.
Coeliac disease
Coeliac disease is an autoimmune disorder that generally occurs in people with a genetic predisposition. When someone with coeliac disease eats gluten, their immune system responds by attacking their small intestine. These attacks cause damages to the intestine lining whose main role is nutrient absorption. If the gluten consumption continues and the disease is left untreated, the patient could suffer serious nutrient deficiencies and be at risk for more serious health problems.
The symptoms of the disease could be different in each individual and at different ages. Common symptoms include chronic diarrhea, abdominal bloating and pain, fatigue, weight loss, anemia and irritability. The disease is diagnosed with antibody blood tests and/or endoscopic biopsy.
Coeliac disease is also spelled as Celiac disease and is also called Gluten-sensitive enteropathy, Celiac sprue and Non-tropical sprue.
The only possible treatment for coeliac disease is a lifelong adherence to a gluten-free diet and lifestyle and coeliac disease patients are the only people who are evidentially harmed by the consumption of gluten.
Wheat allergy
An allergic response to wheat is among the most common allergies that appear during childhood but it can also affect adults. People who are allergic to wheat can have abnormal immune system responses that range from a simple rash to a life-threatening anaphylactic shock. The allergic reaction can occur not only after consumption of wheat but also after inhalation of wheat products such as flour.
A person with a wheat allergy does not necessarily need to eliminate gluten from their diet. And even if they do need to avoid wheat, they probably don’t need to do the same with other gluten-containing grains like barley and rye. They could be allergic to any one of the proteins found in wheat or even to some of its phytochemicals. Several tests need to be done that will pinpoint the source of the allergic reaction and will aid their health care professional in providing the right course of action for their case. So, all things considered, gluten could be potentially harmful for people with a wheat allergy but that is not always the case.
Nonceliac Gluten Sensitivity (NCGS)
This is a clinical term used by health professionals to describe gastrointestinal and other symptoms associated with gluten ingestion in patients who have been tested negative for coeliac disease and do not suffer from any kind of wheat allergy. Healthcare providers were and still remain skeptical of this gluten-related disorder. However, there has recently been a significant rise in cases of patients with symptoms similar to celiac disease and/or wheat allergy, who are tested negative for the diseases but claim that their symptoms receded after gluten elimination. The diagnosis of Nonceliac Gluten Sensitivity is still based on exclusion and absence of other diagnostic criteria. A gluten-free diet is advised only when NCGS is strongly suggested by the combining findings from the clinical history, symptoms, and medical tests.
How do I know if gluten is bad for me?
Any symptoms seemingly related with gluten consumption should be reported to physicians and health care providers who will order blood tests and possibly an endoscopic biopsy of the intestine. It is really important that screening is performed before a gluten-free diet is implemented, because once a patient eliminates gluten from their diet, testing for celiac disease will no longer be accurate.
Will a gluten-free diet help me lose weight?
Doing away with gluten could also help with weight loss according to some claims. However…
According to a systematic review published in the Journal of the American Academy of Physician Assistants, “despite the health claims for gluten-free eating, no published experimental evidence supports weight-loss with a gluten-free diet or suggests that the general population would benefit from avoiding gluten.” (Reference: https://www.ncbi.nlm.nih.gov/pubmed/26208009)
A few things we need to remember about the gluten-free diet:
- A gluten-free diet is a restrictive diet that could lead to nutrient deficiencies and should only be followed in certain cases and under supervision from a clinical dietitian and a physician.
- A gluten-free diet is not necessarily healthy. Gluten-free junk food exists and it’s still junk food.
- A gluten-free diet cannot lead to weight loss unless there is a negative energy balance, in which case weight loss can in no way be attributed to the lack of gluten in the diet.
With that said, only people who have been properly screened for celiac disease and have been advised by their physician to follow a gluten-free diet should eliminate all sources of gluten from their diet.
What do I eat on a gluten-free diet?
The best way for someone to follow a completely gluten-free diet is by educating themselves on the content of gluten in the foods that end up on their plates. And the easiest way to start is by dividing food into two categories: whole, natural foods and processed / packaged ones.
Natural foods containing gluten
- Wheat (including emmer wheat, faro and other varieties)
- Rye
- Barley
- Triticale, and other grain hybrids
- All products of the above
- Oats (due to cross-contamination)
Even though oats is a naturally gluten-free product, it is often harvested and processed together with gluten-containing grains and it is, therefore, not safe to eat. Only packaged oats with the gluten-free label should be considered safe and consumed (see packaged food information below).
Natural gluten-free foods
- Fruits
- Vegetables (including potatoes)
- Legumes (including beans)
- Nuts and nut flours
- Meat and poultry
- Fish and seafood
- Milk and plain yogurt
- Naturally gluten-free grains (Rice, Corn, Soy, Quinoa, Flaxseed, Chia seeds, Millet, Amaranth, Cassava, Tapioca)
Processed / Packaged Foods
When a celiac disease patient shops for processed/packaged foods, they should ALWAYS check the food labeling. Make sure you learn the laws and regulations of the country you reside about gluten-free labeling. Usually, the products that are safe to be consumed by people with celiac disease are labeled “gluten-free” and/or carry the Crossed Grain symbol gluten-free product certification which is an internationally registered trademark.
The term gluten-free can only be used on foods which contain 20 parts of million (ppm) or less of gluten. Gluten and gluten-containing ingredients should be listed in the ingredients list of all packaged foods and be specifically emphasized as potential allergens. Gluten-containing additives could also be present in medication (prescription and over-the-counter), supplements and beverages, so their ingredients list should also be checked.
Gluten could also be present in cosmetics and skin products and although it is unlikely that this gluten will be ingested and end up in your gut, it is still a possibility, so you’d better avoid these products.
Cross-contamination
People with celiac disease should be very careful when cooking and preparing meals, especially if they live with family members who eat gluten. When gluten-free meals are prepared in the same kitchen with gluten-containing ones, there is a high risk of cross-contamination. In order to avoid this, it is best to use different kitchenware, plates, tools, and utensils for gluten-free and gluten-containing meals. All kitchen counters, appliances, ovens and any surface that could have gluten residues should be thoroughly washed after every use of gluten-containing products.
I think I have celiac disease! What do I do?
If you suspect that you may have celiac disease, the first thing you should do is talk to your doctor so that you can get properly screened. It is really important that you DO NOT start a gluten-free diet before getting screened because then the test results will not be accurate.
If you have been diagnosed with celiac disease, there are many websites and online communities where you can find information and support. Some of them are listed below.
https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease
https://medlineplus.gov/celiacdisease.html
Gluten-free recipes
There are many recipes on Off a diet that are labeled gluten-free. Even though most of the times, the ingredients that are used for these recipes are naturally gluten-free, there are times that certain products are unavoidably packaged (like cheese, for example). In that case, always check the labeling and the ingredients to ensure that you buy gluten-free products which are safe for you to consume.
