Is Gluten Free For Me?
Unless you have been hiding under a rock the past few years, you have seen the phrase ‘gluten free (GF)’ appear on various food products and menus and heard your friends or co-workers boast about ‘going GF.’ However, a recent survey from the certification organization ‘NSF International,’ revealed that 90 percent of Americans have heard of gluten, but more than half (54%) are unable to correctly define it (1). So what is gluten? Gluten is composed of the gliadin and glutenin proteins found in wheat, barley and rye, and is responsible for the elasticity of dough. Contrary to popular belief, the GF diet is not beneficial for everyone. Unless you are diagnosed with one of the three disorders listed below, there is no reason to avoid gluten.
For those suffering from celiac disease (CD), an autoimmune disorder, the ingestion of gluten causes to damage to the small intestine, leading to serious long-term health consequences. It is estimated that 1 in 100 people worldwide are afflicted with celiac disease and 2.5 million Americans remain undiagnosed (2). If you suspect you have a problem digesting foods containing gluten, speak with your doctor about a blood test screening. Testing must be done while you are still consuming gluten-containing foods. If you test positive, an endoscopic biopsy of the small intestine should be done to confirm the diagnosis.
Once diagnosed, it is necessary to follow up with your physician and a Registered Dietitian to monitor nutritional deficiencies and learn how to follow a GF diet. ‘Going GF’ does not just mean cutting breads, cereals, pasta and baked goods out of the diet. Gluten is found in various soups, condiments, sauces, fried foods, beer, toothpaste and even certain medications. For more information on the topic and to learn about the symptoms associated with CD, please visit: www.celiac.org
Many individuals test negative for CD but still experience adverse symptoms after ingesting gluten-containing foods. A related condition called ‘gluten sensitivity’ or ‘non-celiac gluten sensitivity’ (NCGS) can cause symptoms similar to those seen with CD. The only current way to test for NCGS is through an elimination diet. The individual must eliminate gluten from the diet for at least 7-10 days and then reintroduce gluten back into the diet. If there is a noticeable disappearance of symptoms while following a GF diet and a noticeable reoccurrence of symptoms after a reintroduction of gluten, than NCGS may be diagnosed.
A small percentage of Americans suffer from wheat allergy. Wheat allergy is an overreaction of the immune system to wheat protein. A skin test and/or blood test can easily confirm a wheat allergy. Symptoms can be avoided through a wheat-free diet, which is less restrictive than a GF diet. On a GF diet, the individual must exclude all foods containing wheat, barley and rye. On a wheat-free diet, individuals must exclude wheat-containing products only.
If you test negative for CD and wheat allergy and do not experience any symptoms after ingesting gluten-containing foods, you can leave the GF food products on the shelf at the store. These products tend to be more expensive than their counterparts and are lacking in certain nutrients found in whole grain (gluten-containing) products.
Andrea Gamber, RDN, LDN, Clinical Dietitian. Have questions concerning gluten? Interested in individual outpatient nutrition counseling? Contact Andrea Gamber, Clinical Dietitian, and she will share some food for thought!
610-208-4735 | AGamber1@pennstatehealth.psu.edu | Schedule an appointment at 610-378-2100.