Is going gluten-free a path to better health, or just another example of a fad diet? The answer depends on if you need to avoid gluten. Ironically, most people who avoid gluten don’t need to, while most people who need to avoid gluten don’t know they do.
Gluten is a type of protein found in wheat, rye and barley. Most of us can eat these grains without ill effects. However, a few of us can’t, because we have a wheat allergy, celiac disease or non-celiac gluten sensitivity.
If you don’t fall into one of these groups, there’s no evidence that you should avoid gluten. The words “gluten free” on a food package don’t translate to “healthy.” They usually just mean “more expensive.” Packaged gluten-free foods can be highly processed and full of sugar, fat and other less-healthful ingredients. Most are not enriched with vitamins and minerals.
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It’s estimated that fewer than one in 100 children have a wheat allergy, and about half will outgrow it before adulthood. If you have a wheat allergy, your body reacts badly to one (or more) of the many proteins found in wheat. This might include gluten. Symptoms appear within minutes or hours and can include skin rashes, intestinal discomfort, wheezing and anaphylaxis.
About one in 100 people have celiac disease and about six in 100 have gluten sensitivity. Celiac disease, an autoimmune disorder, is the more serious of the two, because eating gluten prompts the immune system to attack the lining of the small intestine. This causes damage that makes it harder for the body to absorb certain nutrients, including iron, calcium, vitamin D and folate. Down the road, this can lead to health problems such as anemia and osteoporosis.
Celiac disease can only develop in genetically predisposed people, but carrying the genes isn’t a guarantee you’ll develop the disease. Potential symptoms include the classic intestinal problems, as well as weight changes, chronic fatigue and neurological problems. The only known treatment for celiac disease is total, lifelong avoidance of gluten. Even tiny amounts can cause intestinal damage and long-term problems.
Gluten sensitivity has similar symptoms, but without the intestinal damage, so sufferers can usually be less strict.
Why is it that many people who need to avoid gluten don’t know they need to? Often it’s because their symptoms are mild or sort of vague. Even when symptoms are obvious, many other health conditions have similar symptoms, which can make diagnosis difficult. If you suspect you have celiac disease, get tested for the anti-gluten antibodies before you eliminate gluten. This increases the odds of an accurate test result. There is no test for gluten sensitivity, so diagnosis is based on ruling out other problems.
If you do need to avoid gluten, be sure to consider what you are eating as well as what you aren’t eating. There are many healthful, naturally gluten-free foods, such as fruits and vegetables, beans, fish, nuts, eggs, yogurt, poultry, lean meat and gluten-free grains like quinoa and brown rice.
Next time: Much ado about organics
Carrie Dennett: firstname.lastname@example.org. Dennett is a graduate student in the Nutritional Sciences Program at the University of Washington; her blog is nutritionbycarrie.com.