A current dietary restriction hitting the headlines, gourmet “foodie” magazines and grocery aisles is the gluten-free diet. While this diet is an absolute must for some people, it isn’t necessary or even healthy for others. Let’s dig in to the details to see if going gluten-free makes sense for you and your family.
What is a gluten-free diet?
There is a common misunderstanding that gluten is wheat. Gluten is a protein found in wheat but it is also found in other grains such as rye, barley and triticale. While this may not sound like that many ingredients to avoid, remnants from each of these grains tend to make their way into a large number of foods. Even oats, which do not contain gluten may be grown or processed along with wheat, contaminating them with gluten. Salad dressings, beer, soy sauce and even some vitamins contain gluten, which makes following a true gluten-free diet challenging. Thankfully, for those who do need strict gluten-free foods, more and more options are now available in health food stores and even mainline grocery stores; but, these items often come at a premium price.
Is a gluten-free diet healthy or necessary for everyone?
Many magazines and health resources have recently been pushing the gluten-free diet as a healthier alternative for everyone, but in reality this may not be the case. Many gluten free foods simply substitute wheat and other gluten containing grains with rice based products. While brown rice may be a healthy alternative, white rice breaks down into a simple carbohydrate (or sugar) and may not be ideal for metabolism regulation or weight loss. Some of these products may not include the vitamin fortification found in gluten-based breads and cereals. Thus, those following a gluten-free diet should be aware of the risk for inadequate amounts of iron, fiber, calcium, riboflavin, thiamine, niacin and folate, and make sure that they are supplementing appropriately. Additionally, if you suspect that you might have gluten sensitivity, you should be tested prior to fully cutting gluten out of your diet. Eliminating gluten prior to testing may result in false negative results and a missed diagnosis for Celiac disease. So, if the gluten-free diet isn’t necessary for the general public, then who should be following it?
Reasons to go gluten-free:
For some people a gluten-free diet is absolutely necessary. Let’s take a look at three groups of people who need this dietary restriction.
- True wheat allergy:
Some people have a true allergy to wheat. For these people following a wheat-free diet (not necessarily gluten-free) is absolutely necessary. Some signs and symptoms of a wheat allergy include rashes, swelling of the lips and tongue, headaches, nasal congestion, diarrhea, nausea and vomiting, and sometimes even a life threatening reaction called anaphylaxis.
- Celiac disease:
Celiac disease is an autoimmune disease that results in inflammation in the small intestine when gluten related products are consumed. This reaction results in bloating, abdominal discomfort, diarrhea and weight loss. Over time and with repeated exposure, gluten can damage the intestine permanently resulting in malabsorption of necessary nutrients. This can lead to malnutrition, vitamin and mineral deficiencies, and even poor growth and development in children. This inflammation can also result in some types of intestinal cancer. For those who suffer from celiac disease, a strict gluten-free diet is absolutely necessary.
- Non-celiac gluten sensitivity
The diagnosis of gluten sensitivity has been a controversial topic in the medical community, but according to Dr. Patterson, MD, local allergist in Hamilton County, gluten sensitivities and related disorders do exist. The problem is that the medical community doesn’t have a full understanding of this condition or a test to diagnose these issues. According to Patterson, patients who have a negative workup but yet insist that they feel better when avoiding foods such as gluten are not crazy. They may actually have an underlying medical condition called Irritable Bowel Syndrome. IBS is poorly understood, but patients often feel better when they avoid gluten, dairy and other products in their diet. Dr. Patterson says that physicians need to take the time to explain to patients that although a test doesn’t yet exist to diagnose their condition, they do have a true disease that warrants attention and treatment.
While switching to a gluten-free diet isn’t necessary for most people, for some a gluten-free diet is medically necessary. Talk with your doctor if you or someone you love suffers from any of the symptoms mentioned above, and check out the sources below for more on the topic of gluten related diseases.
Dr. Emma Hostetter is a Fishers family physician and public health specialist. Find her blog “The Mom in Me, MD” on the Hamilton County Family web site or visit her at www.themominmemd.com.
Dr. Patterson, MD-Local Allergist in Hamilton County, Indiana