Gluten is a protein found in certain foods and beverages. Many people are fearful of this little protein and try their best to avoid it at all costs. If gluten can be so threatening, should everyone follow a gluten-free diet?

Where is gluten found?

Gluten containing products include wheat, barley, rye, and triticale (crossbreed between wheat and rye). Lesser known gluten products include beer, malt vinegars, and certain stabilizers or emulsifiers, which are often made from gluten-containing grains.

Celiac Disease

Celiac Disease (CeD) is an immune response in people who cannot eat gluten. Often, people are genetically predisposed to the disease. When people with CeD consume gluten, antibodies are triggered in the body that attack the lining of the small intestine of the GI tract. What does all of this mean? Well, for people with CeD, eating gluten can lead to many health problems including nutritional deficiencies, osteoporosis, slow wound healing, infertility, and intestinal cancers. Currently, the only treatment for CeD is the lifelong adherence to a strict Gluten-Free (GF) diet.

Although the FDA validates products as “gluten free” with a label, it is important to be on the look out for nutrition facts labels to help ensure it’s safety. Scanner apps may not have the most up-to-date information and also may give unclear answers. Instead it is ideal to be your own label scanner in terms of learning gluten-containing product names on nutrition facts labels to look out for; because this takes time to learn, apps can be helpful to assist in the process.

Diagnosing CeD

Most people with CeD show symptoms such as vomiting, floating and oily bowel movements, and unintentional weight loss; however, silent or “latent” CeD shows no symptoms. It is beyond the scope of this blog post to provide all detailed information involved in celiac disease diagnosis and care, and should be explored with your provider. Whether you are someone with or without common celiac disease symptoms, it is always helpful to ask your health care professional if they recommend testing for this common and destructive disease.

Wheat allergy vs Non-Celiac Gluten Sensitivity (NCGS)
A wheat allergy involves a different branch of the immune system than CeD. A wheat allergy can cause varying symptoms including a skin rash and should be diagnosed by an allergist. Because there is no single lab test to diagnose a wheat allergy, your provider may offer other lines of testing, including an elimination diet or a skin prick test. Treatment for a wheat allergy is a wheat-free diet and may include medications to manage symptoms.

Non-Celiac Gluten Sensitivity (NCGS) symptoms are similar to those with CeD. However, unlike CeD, NCGS shows minimal to no damage to the GI tract and often is limited to digestive symptoms when gluten is introduced to the diet. A diagnosis of NCGS can be made after CeD and wheat allergy have been ruled out. Currently, there is no test to diagnose NCGS. Eliminating gluten from the diet is the only treatment for NCGS.

Who should be “gluten-free”?
There is a chance that reducing intake of gluten-products can improve your digestion and help to reduce processed foods in your diet. However, keep in mind that a “gluten-free” label doesn’t necessarily make a food healthy. Some packaged/ processed GF foods contain high amounts of sodium, sugar and fat. Consuming these foods in excess can lead to weight gain, blood sugar swings, and high blood pressure. Unless your provider has diagnosed you with celiac disease, a wheat allergy, or gluten sensitivity, it is unnecessary to avoid gluten. If you are curious if you might benefit from a GF or wheat-free diet, you may try eliminating gluten or wheat temporarily with your provider’s guidance. They may also suggest certain supplements to take in order to reduce the risk of certain nutrient deficiencies when eliminating certain food groups.

An acronym that may help us remember steps to take when diagnosed with celiac disease:

Consultation with a skilled Registered Dietitian (RD)

Education about the disease

Lifelong adherence to a gluten-free diet

Identification and treatment of nutritional deficiencies

Access to an advocacy group

Continuous long-term follow-up by a multidisciplinary team

Living gluten free:

Thankfully, as gluten free diets have become more main stream, there are now many resources available to help stay on track with avoiding gluten. Some of these resources include a variety of apps to find safe restaurants to eat, recipe ideas, support groups, and more (found below).

Resources:

For more in depth information about gluten-free recipes, celiac disease treatment, and more, turn to these resources:

https://celiac.org/gluten-free-living/what-is-gluten/.

https://nationalceliac.org/resources/celiac-disease-the-facts-english/

https://nationalceliac.org/restaurants-dining-out/

https://celiac.org/gluten-free-living/gluten-free-foods/label-reading-the-fda/

Having a “Dining-Out-Card” for any allergies, including celiac disease can be helpful for service workers to improve the safety of your food: