Gluten-Free: Is It for Me?
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You may be one of the lucky few who have absolutely no reaction to gluten whatsoever. But for many, the presence of gluten in food has become a major disruption in daily life. According to the Center for Celiac Disease at the University of Maryland, one in every 132 people in America has celiac disease, and nearly 15 times that number—up to 15 percent of the world's population, or one in seven people—have a non-celiac gluten intolerance.
More likely, whatever your body's response, you chalk it up to how you "normally" feel. But if what you "normally" feel is bloated, gaseous or lethargic every time you eat gluten, your body may be trying to tell you something. If you also experience diarrhea, skin rash or irritability and depression, you better start listening.
What Is Gluten?
First things first: What is gluten, anyway? Gluten is a composite protein that results when the proteins gliadin and glutenin join together with starch in the seed of grass-related grains such as wheat, rye and barley. Gluten is an elastic protein, meaning it's sticky: You can think of it as the glue (glu-ten) that holds all your favorite bakery confections together—everything from baguettes to beignets get their flaky, doughy, fluffy, chewy texture from the little gluten particles binding their flour base to all the other ingredients.
While proteins in maize (corn) and rice are also sometimes called glutens, they differ from wheat gluten because they lack the gliadin component. Although subtle, this difference allows those with gluten sensitivity to enjoy corn and rice generally unscathed.
How does gluten affect you?
More likely, whatever your body's response, you chalk it up to how you "normally" feel. But if what you "normally" feel is bloated, gaseous or lethargic every time you eat gluten, your body may be trying to tell you something. If you also experience diarrhea, skin rash or irritability and depression, you better start listening.
What Is Gluten?
First things first: What is gluten, anyway? Gluten is a composite protein that results when the proteins gliadin and glutenin join together with starch in the seed of grass-related grains such as wheat, rye and barley. Gluten is an elastic protein, meaning it's sticky: You can think of it as the glue (glu-ten) that holds all your favorite bakery confections together—everything from baguettes to beignets get their flaky, doughy, fluffy, chewy texture from the little gluten particles binding their flour base to all the other ingredients.
While proteins in maize (corn) and rice are also sometimes called glutens, they differ from wheat gluten because they lack the gliadin component. Although subtle, this difference allows those with gluten sensitivity to enjoy corn and rice generally unscathed.
How does gluten affect you?
How Does Gluten Affect You?
Try this simple test: Eliminate wheat products from your diet for one week (this generally means all regular cereals, breads, pastas, bakery items, etc.) and observe your body's reaction. This is called an "elimination diet," whereby you single out one food group at a time to discover whether those items that have a noticeable impact on how you function, feel and look.
I decided to try this elimination technique to figure out whether gluten could have anything to do with my chronic stomachaches, weariness and post-nasal drip. Before I started, I tried writing down what I thought my symptoms were. After my first week of no wheat, my stomachaches were gone, my mucous cleared up, and I felt incredibly energetic. My headaches were also less frequent and less severe, and I had lost 3 pounds, most of it swelling and water weight my body had been holding onto as part of its response to the wheat products in my diet. I was also told I was less irritable. (Good to know.) These last few symptoms were things I hadn't even noticed were affecting me daily until they were gone! Even more compelling, within a day of reincorporating wheat into my diet, I was back to my achy, cranky, stuffy self. That's how quickly my body rejected the presence of gluten.
Just limiting your gluten intake (once a day, once a week) can have dramatic benefits for those of us who have mild reactions. My symptoms are noticeable, but not terribly severe, so I've tried to limit gluten to special occasions. You may find this to be your perfect solution too. However, for those with a real gluten allergy, complete eradication is the only answer.
Celiac disease vs. non-celiac gluten intolerance
Try this simple test: Eliminate wheat products from your diet for one week (this generally means all regular cereals, breads, pastas, bakery items, etc.) and observe your body's reaction. This is called an "elimination diet," whereby you single out one food group at a time to discover whether those items that have a noticeable impact on how you function, feel and look.
I decided to try this elimination technique to figure out whether gluten could have anything to do with my chronic stomachaches, weariness and post-nasal drip. Before I started, I tried writing down what I thought my symptoms were. After my first week of no wheat, my stomachaches were gone, my mucous cleared up, and I felt incredibly energetic. My headaches were also less frequent and less severe, and I had lost 3 pounds, most of it swelling and water weight my body had been holding onto as part of its response to the wheat products in my diet. I was also told I was less irritable. (Good to know.) These last few symptoms were things I hadn't even noticed were affecting me daily until they were gone! Even more compelling, within a day of reincorporating wheat into my diet, I was back to my achy, cranky, stuffy self. That's how quickly my body rejected the presence of gluten.
Just limiting your gluten intake (once a day, once a week) can have dramatic benefits for those of us who have mild reactions. My symptoms are noticeable, but not terribly severe, so I've tried to limit gluten to special occasions. You may find this to be your perfect solution too. However, for those with a real gluten allergy, complete eradication is the only answer.
Celiac disease vs. non-celiac gluten intolerance
Celiac Disease vs. Non-Celiac Gluten Intolerance
With celiac disease, or gluten allergy, the body exhibits an immune response in the small intestine whenever gluten protein is present. Such a reaction aggravates the intestinal lining and damages the little "hairs" (villi) covering the wall of the digestive tract. In properly functioning organs, these villi will help push food along the intestinal tube while aiding in the absorption of nutrients into the bloodstream. In patients with celiac disease, this absorption process is impeded and can lead to cases of rapid weight loss and eventual malnutrition if left untreated.
A simple blood test can help reveal whether someone has celiac disease by measuring the antibody count in their bloodstream. People with non-celiac gluten intolerance may experience similar symptoms to those with celiac disease encounter, but for one reason or another, their blood work came back negative or inconclusive. In these cases, certain antibody counts were not high enough to signify celiac disease, although they did indicate a gluten sensitivity.
Common symptoms of both celiac disease and non-celiac gluten intolerance involve indigestion, bloating, diarrhea, fatigue, nausea, swelling, skin rash, nutrient deficiency, bone density loss, irritability, depression and sometimes no symptoms at all. The fact that expressions of gluten sensitivity can vary so greatly from person to person—or be completely invisible—makes diagnosing patients with this issue very difficult.
Oftentimes, those people who eventually end up being diagnosed with gluten intolerance or allergy, whether through antibody testing or elimination dieting, will first be diagnosed with Irritable Bowel Syndrome or Irritable Bowel Disease, delaying their recovery. These kinds of intestinal disorders, while similar in effect, stem from a very different cause and are treated with therapies that include medication and sometimes surgery. People with celiac disease rarely benefit from these treatments, as neither addresses the root irritant: gluten in the diet.
So what's the cure?
With celiac disease, or gluten allergy, the body exhibits an immune response in the small intestine whenever gluten protein is present. Such a reaction aggravates the intestinal lining and damages the little "hairs" (villi) covering the wall of the digestive tract. In properly functioning organs, these villi will help push food along the intestinal tube while aiding in the absorption of nutrients into the bloodstream. In patients with celiac disease, this absorption process is impeded and can lead to cases of rapid weight loss and eventual malnutrition if left untreated.
A simple blood test can help reveal whether someone has celiac disease by measuring the antibody count in their bloodstream. People with non-celiac gluten intolerance may experience similar symptoms to those with celiac disease encounter, but for one reason or another, their blood work came back negative or inconclusive. In these cases, certain antibody counts were not high enough to signify celiac disease, although they did indicate a gluten sensitivity.
Common symptoms of both celiac disease and non-celiac gluten intolerance involve indigestion, bloating, diarrhea, fatigue, nausea, swelling, skin rash, nutrient deficiency, bone density loss, irritability, depression and sometimes no symptoms at all. The fact that expressions of gluten sensitivity can vary so greatly from person to person—or be completely invisible—makes diagnosing patients with this issue very difficult.
Oftentimes, those people who eventually end up being diagnosed with gluten intolerance or allergy, whether through antibody testing or elimination dieting, will first be diagnosed with Irritable Bowel Syndrome or Irritable Bowel Disease, delaying their recovery. These kinds of intestinal disorders, while similar in effect, stem from a very different cause and are treated with therapies that include medication and sometimes surgery. People with celiac disease rarely benefit from these treatments, as neither addresses the root irritant: gluten in the diet.
So what's the cure?
So What's the Cure?
There's no magic pill. A gluten-free diet is not only the medicine, it is the cure.
It's probably a smart decision to get tested for gluten response before going on a gluten-free diet, as it may be more difficult for your doctor to diagnose once your body has begun adjusting to the absence of gluten.
What Is a Gluten-Free Diet Like?
I think most of us would be surprised to find that the kitchen a person with celiac disease looks a lot like everybody else's. There might be a couple of refined, processed, packaged foods missing—and these probably shouldn't be there anyway (don't worry, I won't tell)!
A gluten-free diet still allows you access to almost every fruit and vegetable, a variety of grains and legumes, your pick of dairy products, fresh meats and fish and a whole slew of special gluten-free delights to satisfy your pretzel-bagel-muffin-doughnut craving. In fact, now might be the best time, if there is such a thing, to eliminate gluten from your diet. A rise in public awareness and demand have brought about a plethora of companies wholly dedicated to making your gluten-free life delicious (Arrowhead, Glutino and Mary's Gone Crackers are some of my favorites). Whether in your local grocery store or at your favorite online purveyor, there is now a substitute for almost every gluten-laden delicacy.
The newly diagnosed patient
There's no magic pill. A gluten-free diet is not only the medicine, it is the cure.
It's probably a smart decision to get tested for gluten response before going on a gluten-free diet, as it may be more difficult for your doctor to diagnose once your body has begun adjusting to the absence of gluten.
What Is a Gluten-Free Diet Like?
I think most of us would be surprised to find that the kitchen a person with celiac disease looks a lot like everybody else's. There might be a couple of refined, processed, packaged foods missing—and these probably shouldn't be there anyway (don't worry, I won't tell)!
A gluten-free diet still allows you access to almost every fruit and vegetable, a variety of grains and legumes, your pick of dairy products, fresh meats and fish and a whole slew of special gluten-free delights to satisfy your pretzel-bagel-muffin-doughnut craving. In fact, now might be the best time, if there is such a thing, to eliminate gluten from your diet. A rise in public awareness and demand have brought about a plethora of companies wholly dedicated to making your gluten-free life delicious (Arrowhead, Glutino and Mary's Gone Crackers are some of my favorites). Whether in your local grocery store or at your favorite online purveyor, there is now a substitute for almost every gluten-laden delicacy.
The newly diagnosed patient
For Those Newly Diagnosed with Celiac Disease
The first thing to do when you get home after your diagnosis is to clear your house of anything with gluten. Some might say to indulge in all your favorite gluten things one last time before the big farewell. If you think this would work for you, go for it. It will probably leave you feeling dreadful, and most likely gorging today won't take the edge off missing these items tomorrow.
Getting gluten out of sight and out of mind is your best bet if you want to make your home a safe, gluten-free environment. You may come up against resistance, especially if you have a spouse and kids who don't want to give up all their favorite things along with you (although, chances are some of them suffer from gluten intolerance themselves, given the hereditary linkages prevalent with this disease). To coax everyone on board, assure them it will only be while you get your bearings. You can tell them that once you understand how to eat gluten-free, it won't have to be such a strict environment. You will, however, have to try to avoid cross-contamination as best you can by using different utensils, cutting boards, etc.
How to eat gluten-free
The first thing to do when you get home after your diagnosis is to clear your house of anything with gluten. Some might say to indulge in all your favorite gluten things one last time before the big farewell. If you think this would work for you, go for it. It will probably leave you feeling dreadful, and most likely gorging today won't take the edge off missing these items tomorrow.
Getting gluten out of sight and out of mind is your best bet if you want to make your home a safe, gluten-free environment. You may come up against resistance, especially if you have a spouse and kids who don't want to give up all their favorite things along with you (although, chances are some of them suffer from gluten intolerance themselves, given the hereditary linkages prevalent with this disease). To coax everyone on board, assure them it will only be while you get your bearings. You can tell them that once you understand how to eat gluten-free, it won't have to be such a strict environment. You will, however, have to try to avoid cross-contamination as best you can by using different utensils, cutting boards, etc.
How to eat gluten-free
For Those Newly Diagnosed with Celiac Disease
The first thing to do when you get home after your diagnosis is to clear your house of anything with gluten. Some might say to indulge in all your favorite gluten things one last time before the big farewell. If you think this would work for you, go for it. It will probably leave you feeling dreadful, and most likely gorging today won't take the edge off missing these items tomorrow.
Getting gluten out of sight and out of mind is your best bet if you want to make your home a safe, gluten-free environment. You may come up against resistance, especially if you have a spouse and kids who don't want to give up all their favorite things along with you (although, chances are some of them suffer from gluten intolerance themselves, given the hereditary linkages prevalent with this disease). To coax everyone on board, assure them it will only be while you get your bearings. You can tell them that once you understand how to eat gluten-free, it won't have to be such a strict environment. You will, however, have to try to avoid cross-contamination as best you can by using different utensils, cutting boards, etc.
How to eat gluten-free
The first thing to do when you get home after your diagnosis is to clear your house of anything with gluten. Some might say to indulge in all your favorite gluten things one last time before the big farewell. If you think this would work for you, go for it. It will probably leave you feeling dreadful, and most likely gorging today won't take the edge off missing these items tomorrow.
Getting gluten out of sight and out of mind is your best bet if you want to make your home a safe, gluten-free environment. You may come up against resistance, especially if you have a spouse and kids who don't want to give up all their favorite things along with you (although, chances are some of them suffer from gluten intolerance themselves, given the hereditary linkages prevalent with this disease). To coax everyone on board, assure them it will only be while you get your bearings. You can tell them that once you understand how to eat gluten-free, it won't have to be such a strict environment. You will, however, have to try to avoid cross-contamination as best you can by using different utensils, cutting boards, etc.
How to eat gluten-free
A Quick Crash Course in Gluten-Free Foods:
Grains High in Gluten
From our friends at the Mayo Clinic:
Wheat
Barley
Rye
Farina
Graham flour
Semolina
Durham
Bulgur
Kamut
Kasha
Matzo meal
Couscous
Spelt (form of wheat)
Triticale
There is some controversy over whether oats are safe for those with gluten sensitivity, stemming from medical debate over what specific chemical compounds in grains cause immune responses in humans. In general, oats and oat products are a safe bet, as long as they are not contaminated with wheat. To be extra sure, buy those oats that say "gluten-free" on the package.
Gluten-Free Grains
Amaranth
Buckwheat
Quinoa
As always, even those grains that are gluten-free when they come out of the ground may get contaminated through contact with gluten during harvesting or processing. Especially for those with severe allergies, be sure the label reads "gluten-free" before ingesting.
Foods to enjoy and avoid
Grains High in Gluten
From our friends at the Mayo Clinic:
Wheat
Barley
Rye
Farina
Graham flour
Semolina
Durham
Bulgur
Kamut
Kasha
Matzo meal
Couscous
Spelt (form of wheat)
Triticale
There is some controversy over whether oats are safe for those with gluten sensitivity, stemming from medical debate over what specific chemical compounds in grains cause immune responses in humans. In general, oats and oat products are a safe bet, as long as they are not contaminated with wheat. To be extra sure, buy those oats that say "gluten-free" on the package.
Gluten-Free Grains
Amaranth
Buckwheat
Quinoa
As always, even those grains that are gluten-free when they come out of the ground may get contaminated through contact with gluten during harvesting or processing. Especially for those with severe allergies, be sure the label reads "gluten-free" before ingesting.
Foods to enjoy and avoid
Foods to Enjoy: Gluten-Free Foods
Fresh meats, fish, poultry (make sure any marinade you use is wheat-free)
Most dairy (no blue cheese, Gorgonzola)
Fruits
Vegetables
Rice
Potatoes
Gluten-free flours (rice, soy, corn, potato)
Wine
Any products labeled "gluten-free"
Foods to Avoid: Beware of Sneaky Gluten
Gluten hides in all sorts of unsuspecting food items, like the salad dressing at your work cafeteria or the candy at the movie theater (a common method of getting individual pieces to avoid clumping is to dust them with flour and/or dextrin). Soy sauce, imitation seafood, textured vegetable protein (veggie burgers, soy dogs) and beer are all laced with enough gluten to cause severe reactions in some.
What do all of these products have in common? Wheat. Understandable, you might say. What if I told you the same was true of food additives (malt flavoring, modified food starch, etc.), medications, postage stamps, toothpaste and even your lipstick? The world starts to look like a veritable minefield of gluten, lurking in the most innocuous of places to bite you back when you bite it.
Questions to ask yourself
Fresh meats, fish, poultry (make sure any marinade you use is wheat-free)
Most dairy (no blue cheese, Gorgonzola)
Fruits
Vegetables
Rice
Potatoes
Gluten-free flours (rice, soy, corn, potato)
Wine
Any products labeled "gluten-free"
Foods to Avoid: Beware of Sneaky Gluten
Gluten hides in all sorts of unsuspecting food items, like the salad dressing at your work cafeteria or the candy at the movie theater (a common method of getting individual pieces to avoid clumping is to dust them with flour and/or dextrin). Soy sauce, imitation seafood, textured vegetable protein (veggie burgers, soy dogs) and beer are all laced with enough gluten to cause severe reactions in some.
What do all of these products have in common? Wheat. Understandable, you might say. What if I told you the same was true of food additives (malt flavoring, modified food starch, etc.), medications, postage stamps, toothpaste and even your lipstick? The world starts to look like a veritable minefield of gluten, lurking in the most innocuous of places to bite you back when you bite it.
Questions to ask yourself
The first question you might ask yourself is: Why is there wheat in everything? You might find the answer by spending a little time looking into U.S. Agricultural policy as it pertains to row crops over the past century.
Your next question, as someone looking to go without gluten, is: How do I avoid falling prey to this ubiquitous hazard?
1. Food label 411. First and foremost, you have to start reading food labels. Anything emblazoned with the words "gluten-free" is your friend ("wheat-free" is not the same thing). We are fortunate to live in an era where ingredient lists are almost always available: Get used to recognizing common villainous names (dextrin, malt flavoring or extract, wheat starch, etc.). The Gluten Free Diet by Shelley Case is a great resource when it comes to learning your labels.
2. Call for Help. When in doubt, contacting companies directly on their 1-800 numbers is a good way to discover all the contents of a food item, while also drawing the companies' attention to the prevalence of gluten intolerance.
3. Make friends! It's also a great idea to join a celiac support group in your area, since word-of-mouth is an incredibly efficient and reliable way to get your gluten-free life on track. The Internet is also rife with educational websites to teach you how to live healthily and happily without gluten.
The moral of the gluten-free story is that, for once, there is no gain in pain. So put your upset stomach days behind you and embrace the adventure!
Daphne Oz is the author of the national best-seller The Dorm Room Diet. She is the daughter of Dr. Mehmet Oz.
Dr. Oz on celiac disease
Your next question, as someone looking to go without gluten, is: How do I avoid falling prey to this ubiquitous hazard?
1. Food label 411. First and foremost, you have to start reading food labels. Anything emblazoned with the words "gluten-free" is your friend ("wheat-free" is not the same thing). We are fortunate to live in an era where ingredient lists are almost always available: Get used to recognizing common villainous names (dextrin, malt flavoring or extract, wheat starch, etc.). The Gluten Free Diet by Shelley Case is a great resource when it comes to learning your labels.
2. Call for Help. When in doubt, contacting companies directly on their 1-800 numbers is a good way to discover all the contents of a food item, while also drawing the companies' attention to the prevalence of gluten intolerance.
3. Make friends! It's also a great idea to join a celiac support group in your area, since word-of-mouth is an incredibly efficient and reliable way to get your gluten-free life on track. The Internet is also rife with educational websites to teach you how to live healthily and happily without gluten.
The moral of the gluten-free story is that, for once, there is no gain in pain. So put your upset stomach days behind you and embrace the adventure!
Daphne Oz is the author of the national best-seller The Dorm Room Diet. She is the daughter of Dr. Mehmet Oz.
Dr. Oz on celiac disease
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