Gluten-free food is now everywhere. Grocery stores are full of items proudly labeled "gluten-free," and many restaurants now offer gluten-free options. For people who cannot tolerate gluten, a protein found in wheat, rye and barley, this abundance is a blessing. But lately, it's become hip to go gluten-free. Based on little or no evidence, other than media testimony, people have turned to gluten-free diets to lose weight, increase energy, treat autism, or feel healthier overall.
This is not so logical. People who are sensitive to gluten may feel better, but a larger proportion will not have a significant benefit. They will just waste their money because these products are expensive.
How gluten causes problems
People with celiac disease do not tolerate gluten, even small amounts. Just 50 milligrams of the protein — about the amount in a small crouton — is enough to cause problems. In people with celiac disease, gluten triggers an immune response that damages the lining of the small intestine. This can interfere with the absorption of nutrients from food, cause a host of symptoms and lead to other problems such as osteoporosis, infertility, nerve damage and seizures.
A related condition called gluten sensitivity or non-celiac gluten sensitivity can generate symptoms similar to celiac disease, but without the gut damage.
Not long ago, celiac disease was diagnosed through a process of elimination. Today, it can be identified with a blood test for the presence of antibodies to a protein called tissue transglutaminase. A biopsy of the gut confirms the diagnosis.
Go gluten-free Avoiding gluten means more than giving up traditional breads, cereals, pasta, pizza and beer. Gluten is also in many other products, including frozen vegetables in sauces, soy sauce, some foods made with "natural flavors", vitamins and mineral supplements, some medications and even toothpaste. This makes following a gluten-free diet extremely challenging.
If you're determined to go gluten-free, it's important to know that it will enable you to overcome some nutritional deficiencies. Fortified breads and grains are an important source of B vitamins. Although breads made with gluten-free flours are becoming more common, they are generally not fortified with vitamins. This can be a problem for anyone, but it is especially worrisome for women who are pregnant or planning to become pregnant. They need vitamin B9, more commonly known as folate or folic acid, to prevent birth defects. Taking a gluten-free multivitamin-multimineral supplement is a good idea for anyone trying to avoid gluten.
Whole wheat is also an important source of dietary fiber, which the gut needs to work properly. It is possible to get the fiber you need from other grains, such as brown rice or quinoa, or from fruits, vegetables, and beans, but you have to put in the effort.
If you think you may have celiac disease or gluten sensitivity, it's best to see a doctor before going gluten-free. Once a person has avoided gluten for a while, it becomes difficult to determine whether he or she has celiac disease, gluten sensitivity, or neither.
