The prevalence of people who live a gluten-free life has skyrocketed in recent years. Many of us know friends who turn down a baked good with an apologetic “I can’t” due to their sensitivity. There’s a lot of confusion out there about what gluten is, where it comes from, and why some of people can’t consume it. So, let’s start at the beginning. Gluten is a protein that’s found in wheat, barley, and rye. For the Latin speakers among us, you may recognize that “gluten” is the Latin word for glue. Effectively, that’s the purpose it serves in food. It cross-links proteins together, which gives dough its elasticity and thickness, and helps dough rise while cooking. Gluten gives baked goods either a tender or chewy consistency, depending on the level of refinement. When you think of a chewy soft pretzel or a flaky croissant, it’s the gluten you have to thank for those delicious textures.
So if gluten is so wonderful, why are a rising number of individuals going gluten-free? For some, it’s not a choice. Approximately 1% of the population has a life-threatening condition known as celiac disease.1 Even a tiny trace of gluten causes severe damage to the lining of the small intestine in these individuals. In recent years, another condition called non-celiac gluten sensitivity has been diagnosed and recognized by the medical community. Those with this condition often experience stomach pain, headaches, rashes, insomnia, fatigue, and brain fog. Anywhere from 7-30% of the population is estimated to have gluten sensitivity which unlike celiac disease, is diagnosed on a spectrum.2 It’s still unknown what causes sensitivity, but a recent study found that approximately 50% of those diagnosed with gluten sensitivity possess IgG or IgA anti-gliadin antibodies. This means that their immune systems recognize gluten as a harmful substance. Generally, it’s recognized that gluten sensitivity involves the immune system, but is not an autoimmune disease.
On the other hand, some may simply “feel better” eating gluten-free foods even if they do not suffer from gluten sensitivity.There is indeed some precedence for this, as some evidence indicates that even healthy individuals never fully digest gluten.3 Gluten itself contains no nutritional value, and avoiding it also means avoiding the refined carbs and sugars found in many of the least nutritious foods on the market. However, many pre-packaged gluten-free substitute foods are high in saturated fats and sodium. Many whole grains can be healthy in moderation for the average consumer, and going gluten-free is often expensive and time-consuming. If your reasons for going gluten-free are non-medical, make sure to find substitutes for your diminished intake of iron, vitamin B, and fiber.
So how can you find out if gluten may be causing your symptoms? First, go to your doctor and discuss what symptoms you have, and let them know that you suspect gluten may be the problem. Your doctor can test you for celiac disease, and for the antibodies that sometimes signal gluten sensitivity. If either of these tests comes back positive, your doctor will probably recommend going completely gluten-free. This means that you should not consume any food with more then 20ppm (parts per million) of gluten. If these tests come back negative or inconclusive, you may still have gluten sensitivity. In this case, your doctor may recommend going completely gluten-free for three weeks. This will completely eliminate gluten from your system. Under your doctor’s guidance, try reintroducing gluten to your system. If you feel worse, then your doctor may recommend staying on a gluten-free diet.
If you do make an informed decision to go gluten-free, figuring out what you can and cannot eat is a challenging process. Anything made with wheat, barley, or rye is off the table. This eliminates baked goods such as bread, pizza, and cookies and drinks such as beer and whiskey. Because of its glue-like properties, gluten is often found where it doesn’t naturally belong. Notably, it shows up in soy sauce, caramel, and artificial flavorings. So what’s safe? As a general rule, the less processed the food is, the less likely it is to contain gluten. Fresh fruits, vegetables, meats, fish, rice, potatoes, beans, eggs, and most dairy products are all safe.4
Adjusting to a gluten-free lifestyle isn’t easy, and even the most dedicated individuals are bound to make mistakes. To avoid making these mistakes, make sure to check all the labels. If you’re uncertain about some of the more ambiguous ingredients (Maltodextrin anyone?), a quick Google check the manufacturer’s website will often provide you the information you need. Similarly, there are many websites dedicated to helping you live a gluten-free life. Also, grocery stores and restaurants often offer lists of gluten-free products and some may even have a gluten-free aisle. Reach out to others who are in the same proverbial boat, and find foods that are delicious and keep you healthy. Over time, eating gluten-free will feel less like a restriction, and more like an everyday part of life. And for the luck gluten-tolerant majority, make sure to offer your less fortunate friends a sympathetic smile and perhaps a piece of chocolate.
1.“Gluten intolerance rising in developed countries.” Journal Sentinel (Milwaukee). 27 June 2010
2. Chang, Kenneth. “Gluten-Free, Whether You Need It or Not.” New York Times. 4 Feb. 2013. Web. 16 Sept. 2013.
3. Agatston Arthur. “Gluten: 5 Things You Need to Know.” CNN. 01 Jan. 1970. Web. 16 Sept. 2013.
4. Green, Peter. Director, Celiac Disease Center, Columbia University