Getting the facts about going gluten free
8/12/2019 by Rose Prissel, RDN, LD
If you're considering going gluten free, you will want to factor these facts into your decision.
Fact: Gluten is a protein found in wheat, barley, rye, triticale (a hybrid of wheat and rye), as well as wheat varieties like spelt, kamut, farro and durum, plus products like bulgur and semolina.
Fact: A gluten-free diet is essential for managing the symptoms of:
- Celiac disease, which damages the lining of the small intestine and prevents the normal absorption of nutrients.
- Dermatitis herpetiformis, a skin disease marked by rashes and blisters that also damages the intestine.
- People with non-celiac gluten sensitivity (NCGS) may suffer similar symptoms, but NCGS won't damage the intestine.
For people with these diseases, just 50 milligrams of gluten — the amount in one small crouton — is enough to cause trouble. This small quantity means gluten needs to be treated like other food allergies by avoiding cross-contamination throughout processing, at home and in restaurants. Those with NCGS may be affected by varying amounts of gluten. Symptoms include recurring abdominal pain, chronic diarrhea or constipation, joint pain, unexplained infertility and low bone density.
Fact: About one in 100 people in the U.S. have celiac disease. If you're concerned you might have a gluten intolerance, talk with your health care provider, who may refer you to a specialist. Celiac disease can be diagnosed with a blood test. However, starting a gluten-free diet on your own can complicate the diagnostic process. Currently, there are no recommended methods to test for NCGS. Some doctors offer saliva, blood or stool testing, but these tests haven't been validated.
Fact: There is no evidence that a gluten-free diet is healthier, that it will help you lose weight, give you more energy or treat autism.
Fact: Some foods are naturally gluten-free, such as plain meats, poultry, fish, eggs, unprocessed beans and nuts, fruits, vegetables, corn, rice, potatoes and most low-fat dairy products.
Fact: Since gluten is in countless products from traditional breads, cereals, pastas, pizza and beer to soy sauce, gravies, salad dressing, candy, corn chips and ice cream, going gluten free is a major challenge. You need to become a devoted reader of product labels, ingredient lists and menu information at restaurants.
Fact: Gluten-free diets aren't necessarily healthier, since they can lack needed vitamins, minerals and fiber. For example, many gluten-containing products, such as breads and cereals are fortified with essential B vitamins, and whole wheat is a major source of fiber. While the availability of gluten-free products has skyrocketed, many of these products tend to be lower in B vitamins, folate and iron because they're not fortified, studies have also shown they can be lower in protein and fiber.
Fact: Just because bakery goods and snacks are gluten-free doesn't give you permission to eat as much as you like. They can be high in refined carbs, fat, sugar, salt and calories — just like their gluten-containing counterparts.
Fact: For people with celiac disease, dermatitis herpetiformis or NCGS, avoiding gluten and eating a healthy-well balanced diet takes knowledge, awareness and persistence — every day. But eating gluten-free does get easier with time and for them, the rewards are worth it.
If you've been diagnosed with one of these conditions, your dietitian, support groups, reputable apps and websites, along with gluten-free cookbooks are excellent resources for creating a healthy and enjoyable gluten-free diet. If friends or family are on a gluten-free diet, be respectful and don't just assume they're hopping on the latest fad diet.
Rose Prissel is a dietitian at Mayo Clinic working in pediatric and adult nutrition, with a focus on preventive care, sports nutrition and weight management.