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News Stories in Perspective
Going Gluten-Free?
Sales of gluten-free foods are booming. A strict gluten-free diet is essential for people with celiac disease – a digestive disorder that results from intolerance to gluten, a protein found in wheat, rye and barley. Those with gluten sensitivity can also benefit from avoiding the major dietary sources of gluten. But what about shoppers who are buying gluten-free foods expecting better nutrition or weight loss? These people may be paying dramatically more without receiving any benefits.
Although sometimes mistakenly referred to as a “wheat allergy,” celiac disease is actually an autoimmune disorder in which immune cells, meant to protect the body, attack it instead. Triggered by the presence of gluten, a celiac patient’s immune cells damage the small intestine, resulting in malabsorption of nutrients and inflammation, which in turn lead to more health problems. Celiac disease cannot be cured, but it can be controlled through a strict avoidance of gluten.
Celiac disease is distinct from a gluten sensitivity, in which people may be able to tolerate trace amounts of gluten as long as they limit (or avoid) major gluten sources like bread, cereal and pasta made from wheat, rye or barley. This difference is important: Both groups may develop bloating, constipation, diarrhea or skin problems that disappear when major sources of gluten are avoided. But people with celiac disease exposed to even trace amounts of gluten (like wheat-containing seasonings in salad dressing or barley extract flavoring in a wheat-free cereal) will trigger an immune reaction that damages their intestinal tract. Symptoms may not always be apparent immediately, but that unnoticed cell damage can lead to other autoimmune disorders, infertility and cancer.
Studies suggest that the diagnosis of celiac disease in adults occurs an average of 11 to 12 years after symptoms begin. While that’s a long time to live with discomfort, more importantly, the extended timeline provides an opportunity for serious consequences like osteoporosis, nerve damage or cancer to develop.
Diagnosis of celiac disease requires blood tests and confirmation by a biopsy. But it’s a Catch-22 situation: Because celiac disease is diagnosed by the presence of antibodies to gluten, if you have been avoiding gluten, you won’t have elevated levels of these antibodies when tested and the tests will give a false negative. If you suspect you suffer from celiac disease, your physician may ask you to deliberately consume gluten just prior to your diagnostic tests.
Although those with celiac disease or gluten sensitivity benefit from avoiding gluten, people who pursue a gluten-free diet only because they believe it to be more nutritious have been misguided. There is nothing inherently unhealthy about gluten if you are not intolerant to it. Your health and weight may benefit if you give up less healthful gluten sources like cookies, fast food and food that is batter-coated and fried, but that’s no reason to avoid beneficial gluten-containing foods like nutrient-rich whole-wheat bread, veggie burgers and soups. In addition gluten-free specialty products are generally two to six times the cost of regular wheat-based counterparts.
Research shows that a gluten-free diet can be high fat, low-fiber and low in iron, folate, zinc and other nutrients. But a well-planned gluten-free diet can be nutritious. Simply build your meals around plenty of vegetables, fruit and beans; unprocessed poultry, seafood and lean meat; and gluten-free whole grains like brown rice, corn and quinoa. Do note that gluten-free grains are not necessarily fortified with the vitamins and iron we expect and often lack the fiber and phytochemicals of whole grains.
If you need to follow a gluten-free diet, experts strongly recommend working with a registered dietitian to make sure that you get the nutrients you need and avoid even the trace amounts of gluten that can do you harm.