To Eat or Not to Eat … Gluten?

That is the question! But unless you have celiac disease, the answer is not so simple.

Celiac disease is an immune reaction caused by eating gluten, a protein found in wheat, barley and rye. If you have celiac disease, eating gluten may cause diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications. Over time, this immune response damages your small intestine’s lining and prevents absorption of some nutrients. In children, malabsorption can affect growth and development, in addition to the symptoms seen in adults.

There’s no cure for celiac disease, sometimes called sprue or coeliac, but for most people, following a strict gluten-free diet can help manage symptoms and help your intestine heal.

This increased awareness of celiac disease has led to earlier diagnosis, which has been of great benefit.  And the sooner a child is started on the gluten-restricted diet, the easier the adjustment.

Celiac disease accounts for a small portion of the gluten-free product market. A growing number of people report having gastrointestinal symptoms similar to those of celiac disease that disappear when gluten is removed from their diets. This condition, called non-celiac gluten sensitivity, does not damage the intestine and has no clear diagnostic test. For this reason, researchers from Italy and the United States have guessed that gluten-reactive patients may be up to 10 percent of the global population.

“Outside of this small percentage of the population, many people probably go on a gluten-free diet because of a misinformed belief that it is for some reason healthier,” explains Sheah Rarback, registered dietitian nutritionist at the University of Miami Health System.

Why all the gluten-free products?

Clearly, gluten is harmful to people with celiac disease and troublesome for people with non-celiac gluten sensitivity. But what about the rest of us?  Gluten-free diets are becoming more popular with the general population, even people who have never had any problem with the protein.

Most bread, pastas, flour mixes, cereals and other baked goods are high in gluten. While most dairy products are free of gluten, those with malt flavorings (like processed cheeses, chocolate milk and hot chocolate) contain a lot of gluten. It can also be found in many less obvious foods such as salad dressings and sauces, some soups, lunch meats, fruit jams with syrups, and potato chips, French fries, and many beers. Vegans and vegetarians who eat imitation meat might be surprised to find that gluten is often the basis for the products. It can also be found in some non-food items such as lip balms, medicines, and vitamins.

A decade ago, few Americans had heard of gluten. Today, one survey says, almost a third of us are trying to avoid it. In growing numbers, the world’s biggest food makers and restaurant chains are retooling recipes and labels to tap into the concern, creating a multibillion-dollar business out of gluten-free products.

Should you consider going gluten-free?

Here are some things to consider:

• Gluten helps dough to rise and gives many foods like pasta a chewy texture. Without it, some of those products more closely resemble cardboard to chew.
• There is some evidence that a gluten-free diet may improve symptoms of irritable bowel syndrome and other gastrointestinal problems.
• Gluten-free diets are difficult to follow, expensive, and can result in nutrient deficiencies, and the gluten-free processed foods might in some cases be less healthy than their gluten-containing counterparts.

Will eating gluten-free help me lose weight?

For those trying to lose weight, a gluten-free diet is not a good idea. There is NO evidence that a gluten-free diet is an effective weight loss tool.

Rarback says, “There are no nutritional advantages for a person not sensitive to gluten to be on a gluten-free diet. A gluten-free diet does NOT mean low sugar, low fat or low sodium. In fact, food manufacturers often add more fat and sugar to gluten-free versions of food that naturally contain gluten in order to mimic the taste and texture of these foods.”

A gluten-free diet limits the number of foods you eat, potentially causing deficiencies in many essential nutrients. According to a 2011 article published in the Journal of the American Dietetic Association, it may actually result in a diet that is low in carbohydrates, iron, folate, niacin, zinc, and fiber.

And it does nothing to address the fact that we still eat an average of 459 more calories a day than we did 40 years ago, more than a third of adults in the U.S. are obese, and 29 million of us aged 20 or older have diabetes.

For most of us, our best approach would be to stop focusing on not eating gluten and instead just focus on eating healthier.

Tags: celiac disease, gluten-free diets, healthy eating, irritable bowel syndrome, nutrition care in Miami