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Is Gluten-Free for Everyone?

During a quick stroll down the grocery aisles, you are more than likely to find a plethora of products, from flour and bread to pasta, pizza crust, and crackers, all boasting gluten-free labels on the front of their packaging. The surge in popularity of gluten-free diets in recent decades has fueled consumer demand and significantly heightened interest in gluten-free foods.

Nearly one-third of adults in America have reported that they prefer to reduce or completely avoid gluten consumption altogether. For some of these individuals, restricting gluten intake comes from the belief that gluten is inherently harmful and that by removing it from their diet, their health will drastically improve. For others (like myself), a gluten-free diet provides relief from debilitating symptoms that accompany gluten consumption. If you are wondering if a gluten-free diet is right for you, below you will learn what gluten is and what conditions benefit from gluten avoidance. 

What is Gluten? 

Although gluten is often thought of as a single substance, it’s actually a complex mixture of proteins known as prolamins. Prolamins are plant storage proteins found in the seeds of certain cereal grains such as wheat, barley, and rye. The two main prolamins in gluten are glutenin and gliadin. These proteins contribute to the unique properties of gluten, providing elasticity, strength, and structure to various dough-based products.

Due to their desirable and palatable culinary characteristics, gluten-containing grains are widely used in breads, pastas, and pastries. You can even find gluten hidden in sauces, soups, salad dressings, beer, processed meats, and meat substitutes. In some cases, gluten is also found in oats due to cross-contamination during the growing or processing phases. Therefore, gluten is truly pervasive in our food supply.

Not only is gluten present in many foods, but gluten-containing grains vary from country to country. For example, a significant portion of the wheat produced in the United States is hard red wheat, which has a higher gluten content. Meanwhile, the wheat grown in regions of Europe is predominantly soft wheat, a variety that has a lower amount of gluten. As such, some individuals experience less digestive distress when they eat wheat-based foods abroad – something I have noticed personally when traveling throughout the years. 

Who Would Benefit From Going Gluten-Free?

A gluten-free diet can help prevent complications and manage the signs and symptoms of the following conditions.

Celiac Disease 

Celiac disease is a genetic, autoimmune condition in which the body’s immune system mistakenly labels gluten as a harmful substance. When individuals with celiac disease eat gluten-containing foods, the body’s immune system mounts an attack against gluten proteins in the small intestines. This overreactive immune response results in inflammation and damage to the finger-like projections called villi in the small intestines, which are important for nutrient absorption. 

As a result, those with celiac disease often experience abdominal pain, poor nutrient absorption, bloating, anemia, diarrhea, constipation, headaches, and chronic fatigue. If the condition progresses, some people may encounter joint pain, skin rashes, bone loss, nerve dysfunction, delayed menstruation, and even infertility. Therefore, I always advise my clients with celiac disease to refrain from eating gluten. As someone who struggled with celiac for years, I know firsthand how it can take a toll on the body. Fortunately, I have put my celiac in remission and no longer have massive reactions to gluten. However, I avoid gluten as much as possible to prevent potential complications.

Non-Celiac Gluten Sensitivity 

Similar to celiac disease, people with non-celiac gluten sensitivity (NCGS) experience adverse reactions to gluten, leading to symptoms such as abdominal discomfort, bloating, diarrhea, bone pain, achy joints, headaches and fatigue. However, they do not test positive for celiac disease (more on testing below). It was once believed that NCGS did not cause intestinal damage. But, research has since revealed that when a person with NCGS consumes wheat, the immune system initiates a reaction, and intestinal damage can occur. Therefore, it is best for those with NCGS to steer clear of gluten. However, because this condition is relatively new, researchers are still trying to determine if gluten is the only trigger. Some experts believe amylase-trypsin inhibitors (ATIs) and FODMAPS (fermentable oligo-, di-, mono-saccharides, and polyols) may also play a role.

Gluten-Sensitive Irritable Bowel Syndrome 

A gluten-free diet may also significantly improve the symptoms and quality of life of those with irritable bowel syndrome (IBS). IBS is characterized by abdominal pain, bloating, and bowel habit disturbances that can result in either constipation or diarrhea. The majority of people seeking care to alleviate these symptoms link their digestive disturbances to their diet. More specifically, some individuals find that their symptoms worsen following the consumption of gluten-rich grains. Therefore, I recommend switching over to a gluten-free diet and monitoring IBS symptoms to see if there is any improvement. However, like non-celiac gluten sensitivity, IBS symptoms can also be triggered by the ingestion of FODMAPS and ATIs. As a result, both low FODMAP and gluten-free diets may benefit those with IBS.

Who Can Safely Eat Gluten? 

While many individuals turn to a gluten-free diet in hopes of improving their health and preventing disease, avoiding gluten is only medically necessary for those with one of the above gluten-related conditions. In fact, less than 1% of the population has celiac disease, and roughly 0.6 to 13% of the population has NCGS. Therefore, most people can tolerate gluten without any issues. 

Furthermore, whole, unrefined grains that contain gluten can play a crucial role in a well-balanced diet, serving as valuable sources of fiber, iron, magnesium and b-vitamins. When gluten-containing grains are replaced with processed gluten-free foods, studies have shown that both men and women consume significantly lower amounts of fiber and b-vitamins, and higher amounts of fat and sodium. Therefore, if you do find gluten-elimination beneficial, it’s important to stock your pantry with unprocessed gluten-free grains like amaranth, quinoa, buckwheat, teff, and gluten-free oats to ensure you’re getting the nutrients you need.

What Tests Are Available For Gluten-Related Conditions? 

Before you consider going gluten-free, it’s important to test—not guess. This is because adopting a gluten-free diet prior to testing for celiac disease can result in a false negative test. In other words, your test may come back normal when you could, in fact, have celiac disease. Therefore, it’s important to refrain from self-diagnosis and seek the help of a physician for accurate testing.

Properly diagnosing celiac disease requires blood tests and a biopsy. First, your doctor will look for two antibodies in your blood known as anti-tissue transglutaminase antibodies and anti-endomysial antibodies. They may also decide to do genetic testing for human leukocyte antigens (HLA-DQ2 and HLA-DQ8) that can help identify if you have a genetic predisposition to celiac disease. If these tests come back positive, then an endoscopy and biopsy will be performed to check for intestinal damage.

Diagnosing NCGS and gluten-sensitive IBS can be a bit trickier because there are currently no specific tests or biomarkers for these conditions. Instead, the diagnosis usually involves a process of exclusion, meaning celiac disease and wheat allergy have to be ruled out first. Then, your doctor may recommend an elimination diet and gluten challenge, where you remove gluten-containing foods for a specific amount of time and then reintroduce them to assess your body’s response. If you find that gluten exacerbates your symptoms, you will be advised to adhere to a gluten-free diet.  

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For those who benefit, navigating a gluten-free diet may feel overwhelming and restrictive at first. But take it from someone who has dealt with the ins and outs of celiac disease: with a little extra planning and creativity, this dietary approach can be one of abundance—not deprivation. If you need inspiration for gluten-free recipes, check out my recipe blogs, which contain a delicious array of gluten-free breakfast, lunch, and dinner ideas. And if you need help navigating your gluten-related condition, feel free to book a one-on-one session with me here.

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