I’ve been getting a lot of questions lately on wheat- and gluten- free diets. People often ask if they should be avoiding these in order to eat a healthy diet. I will address each of these separately to sort out the issues.
Part 1: Gluten-Free Diets
It’s surprising to me how many people say they follow a gluten-free diet, yet don’t know what gluten is or why they think it is important to exclude from the diet. A humorous clip from the Jimmy Fallon show was posted on YouTube recently on this very topic (“Jimmy Fallon, Pedestrian Question – What is gluten?”)
Gluten-free is not part of a healthy diet. You do not need to avoid gluten unless you are intolerant. In fact, it is difficult to find gluten-free baked products that contain whole grains; and the importance of including whole grains as part of a healthy diet are well documented.
There are two kinds of gluten intolerance: celiac disease and non-celiac gluten intolerance (NCGI). The much more serious of the two is celiac disease, a lifelong digestive disorder that causes intestinal damage. To make it even more confusing, not everyone with celiac disease has intestinal symptoms. It is one of the most common genetic conditions in the world. Approximately 1% of the American population has celiac disease and it’s estimated that 83% of those with celiac are misdiagnosed, or not diagnosed. Blood tests are available to help diagnose celiac disease with a subsequent blood test and small bowel biopsy to confirm diagnosis. It’s important to continue eating gluten-containing foods daily while being tested in order to get accurate results.
Non-celiac gluten intolerance (NCGI) causes similar symptoms as celiac disease, but does not result in the same type of intestinal damage and clears with a gluten-free diet. People who get a negative test for celiac may have NCGI.
|Symptoms of Celiac Disease||Symptoms of Non-Celiac Gluten Intolerance|
|Recurring bloating, gas or abdominal pain|
Chronic diarrhea or constipation or both
Unexplained significant weight loss
Bone or joint pain
Missed menstrual periods
Tooth discoloration or loss of enamel
Tingling or numbness in hand and feet
Itchy skin rash
|Includes many of the same symptoms as celiac disease, plus:|
Symptoms typically appear hours or days following gluten ingestion.
Illnesses/problems associated with celiac disease:
- Type 1 diabetes
- Sjogren’s disease
- Iron deficiency anemia
- Irritable bowel syndrome
- Peripheral neuropathy
- Juvenile idiopathic arthritis
- Turner syndrome
- Thyroid disease
- Intestinal cancer
- Down syndrome
- Williams syndrome
- Dermatitis herpetiformis
Treatment for both celiac disease and NCGI are the same: excluding gluten from the diet, though people with NCGI may tolerate small amounts of gluten, while those with celiac must avoid all traces.
Gluten is a protein found in wheat, rye, barley and their derivatives. Some non-gluten containing grains, such as oats may be contaminated during their processing, so some oats are labeled “gluten-free” to clarify that they are not cross-contaminated. Other names for wheat include einkorn, durum, faro, graham, kamut, semolina, spelt and triticale. It’s important to note that wheat free isn’t necessarily gluten free.
Other sources of gluten: malt, malt flavoring, malt vinegar, soy sauce, breading and coating mixes, panko, pastas, sauces, gravies, soup bases, thickeners, some herbal and vitamin supplements and medications. (For a more complete list visit www.CeliacCentral.org or www.Celiac.com.)
Allowed grains/flours are rice, corn, soy, potato, tapioca, beans, garfava, sorghum, quinoa, millet, buckwheat, arrowroot, amaranth, teff, flax and nut flours. Some good sources of gluten-free whole grains are: sorghum, millet, brown rice, quinoa and oats.
If you have symptoms of celiac disease, it is worth getting tested. The treatment is simple and your health will be much improved by adhering to a gluten-free diet. If you have symptoms and test negatively for celiac disease, it’s worth a trial of eating gluten free to rule out gluten as the culprit.
Part 2 – Wheat-Free Diets
What is a gluten-free diet? – WebMD