Gluten-free: Is it for Me?

 In Living Plate, Test Kitchen Tuesday

In the past several years, the gluten-free products section of the grocery store has grown from just a few selections to nearly an entire aisle, reflecting the growth of a 14+ billion dollar global industry.  With the continued popularity of following a gluten-free diet, the growth of this market segment shows no signs of slowing down.

With all the hype, you may be wondering if you should be following a gluten free-diet too. It can be confusing, but we’ll help simplify it. Let’s talk about what gluten is, some reasons why someone may need to go gluten-free, and some delicious ways to enjoy foods on a gluten-free diet.

Gluten is a protein found in the grains wheat, barley, and rye. Variations of these grains, such as bulgur, spelt, farro, kamut, durum, semolina, and triticale also contain gluten. These foods are found in likely places, such as breads, cereals, crackers, and pastas, but can also be found in unlikely places, such as gravies, vinegars, medications, broths, and pickles. Additionally, some non-gluten foods may be produced in facilities that also handle gluten-containing foods, exposing individuals to high enough levels to trigger symptoms. Reading labels of processed food products is key to complete avoidance.

Fortunately, there are many gluten-free alternatives and many whole foods such as fruits, vegetables, rice, potatoes, fish, and poultry that can be enjoyed on a gluten-free diet. Not everyone needs to go gluten-free, but here are several reasons why certain individuals may need to:

Celiac Disease

Celiac is an autoimmune disease. When a person with celiac disease eats gluten, the body attacks the villi on the surface of the small intestine. This damage to the villi interferes with the body’s ability to absorb nutrients from food. Gastrointestinal symptoms may include diarrhea, abdominal pain, and bloating. Malabsorption of nutrients symptoms may include anemia or tingling in the hands or feet. Individuals with celiac disease must completely avoid gluten.

Non-Celiac Gluten Sensitivity

Non-celiac gluten sensitivity is also triggered by gluten and symptoms resolve following a gluten-free diet. The symptoms may be similar to those of celiac disease, but unlike celiac disease, in those with non-celiac gluten sensitivity the body does not attack the intestine. Individuals who suspect this type of sensitivity should work with their healthcare provider to investigate an elimination diet to isolate gluten as a trigger.

Wheat Allergy

Wheat allergy occurs when the immune system overreacts to the collection of proteins within wheat. When these proteins are present, the immune system creates an antigen-specific antibody called immunoglobulin E and causes an allergic reaction. The signs and symptoms of an allergic reaction may include itching, swelling, rashes, vomiting, diarrhea, coughing, wheezing, and anaphylactic shock. People with wheat allergies may also be allergic to the similar proteins in barley and rye and thus may benefit from following a gluten-free diet.

Low-FODMAP

FODMAPs are poorly digested fermentable carbohydrates that cause gastric distress in some individuals. Those following a low-FODMAP diet may need to avoid wheat because it contains a FODMAP called fructan. However, there are gluten-containing foods that are low in FODMAPs (such as sourdough bread and conventional oats) as well as gluten-free foods that are high in FODMAPs (such as those made with bean flours and inulin). Individuals who need a low-FODMAP diet should focus on low-FODMAP foods rather than gluten-free foods.

Leaky Gut

In a healthy gut, the cells that line the intestinal wall use tight junctions to regulate intestinal permeability, allowing only certain things such as nutrients to pass into the body. Zonulin is a protein that can break apart the tight junctions, leading to a leaky gut and allowing unwanted things to be absorbed into the body. There is some evidence that in some people, gluten can cause the gut cells to release zonulin, leading to leaky gut. However, the current evidence is weak and further research is needed.

If you and your healthcare provider have decided that avoiding gluten long or short-term is in your best interest, focus on consuming a mostly whole food, gluten-free diet, limiting intake of processed foods.  When you have a craving for baked goods, try these recipes: Grain-free Pumpkin Scones and Chocolate Zucchini Muffins.

Written by: Lela Gentry, MS, RDN

Reviewed and edited by: Jeanne Petrucci, MS, RDN

Resources:

  • Celiac Disease Foundation. Celiac disease. Celiac.org website. http://celiac.org/celiac-disease/. Accessed April 2, 2018.
  • Fasano, A., Flaherty, S. (2014). Gluten Freedom. Nashville, TN: Wiley General Trade.
  • The Monash University Low FODMAP Diet. Department of Gastroenterology, Monash University. https://www.monash.edu/medicine/ccs/gastroenterology/fodmap.  Accessed April 2, 2018.
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