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29
MAY
2014

What Is Gluten and Gluten Intolerance?

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You may be one of those people who has no problem with eating whole grains, especially wheat.  But for many people, the presence of a protein found in wheat (gluten) is often an unknown cause for severe gastric distress including gas and bloating.

What is gluten? The gluten that I’m referring to is a type of protein found only in wheat, rye, and barley.  These gluten proteins are the elastic-type substance that gives a flaky, fluffy, chewy texture to foods such as whole wheat bread and other baked goods.  For certain people, consuming wheat, rye and barley can cause one of three conditions: a wheat allergy, gluten sensitivity (non-celiac) or celiac disease.  Here is the difference between the three conditions:

Wheat allergy is an inflammatory response to wheat.  Simply avoiding wheat products may be enough to eliminate the symptoms. It may be fine to continue eating barley and  rye.

Gluten sensitivity (non-celiac) to gluten is what happens when someone experiences unpleasant digestive distress, fatigue and malabsorbtion when they eat a certain food.  If you are gluten sensitive, simply eliminating gluten-containing foods (wheat, rye and barley) from your diet will improve your health.

Celiac is a genetic intolerance to gluten.  This is an autoimmune disease that causes the body to attack itself when gluten is eaten, resulting in damage to the small intestine. When someone with celiac disease eats wheat, barley or rye, it damages the villi, the hair-like projections that absorb nutrients in the small intestine. This makes digestion difficult and painful. When the villi are damaged, then it’s possible to develop an intolerance to milk products as well.

Until fairly recently, celiac disease was considered rare among Americans. In 2003, the results of a large study published in the Archives of Internal Medicine found celiac disease in one in 133 Americans.  Another study by the University of Maryland showed that 15 percent of the world’s population have non-celiac gluten intolerance.  Celiac disease is linked to malnutrition that can lead to anemia, depression, behavioral problems, and stunted growth in children, among other problems. People who have celiac disease may also have other autoimmune conditions, such as Type 1 Diabetes and Rheumatoid Arthritis.

What are the symptoms?  Common symptoms of both gluten sensitivity and celiac disease are gas, stomach pain, weight loss, bloating, diarrhea or constipation, fatigue, nausea, depression, lactose intolerance and skin rashes.  Symptoms can vary greatly from person to person and everyone who has Celiac is gluten sensitive, but not everyone who is gluten sensitive will develop celiac.

How Do You Know For Sure if You Are Gluten Intolerant?

To diagnose celiac disease, you should get a blood test from your doctor with a complete celiac panel.  Blood tests are only conclusive for full-blown celiac disease.   It’s a good idea to get tested for gluten response before going on a gluten-free diet, since it may be harder for your doctor to diagnose once your body adjusts to the absence of gluten.

What Can You Do About It?

Adherence to a gluten-free diet is the only medical treatment for celiac disease. This is the only way to stop the disease’s symptoms, heal existing villi damage, and prevent destruction of the small intestine. Even if you have only a mild reaction to gluten, you may decide to keep this protein out of your diet. Proteins in corn and rice, however, lack this gluten protein so people with gluten sensitivity can eat corn and rice.

It may seem overwhelming at first to change your diet because wheat and gluten show up everywhere.  However, a gluten-free diet allows nearly every fruit and vegetable, a variety of legumes, dairy products, fresh meats and fish and any products labeled as “gluten-free.”  Additionally, most health food stores and some local grocers carry special gluten-free versions of foods such as pretzels, muffins, bagels, and so on.

Foods With Hidden Sources of Gluten

Since the term gluten is rarely used on a product label, it’s vital that you learn to read labels carefully.  Recognize the common names for gluten such as wheat starch, modified food starch, maltodextrin, hydrolyzed wheat or vegetable protein, or malt flavoring. Beers, ales and lagers are not gluten free. Gluten can be hidden in many unsuspecting food items, such as your favorite salad dressing or soy sauce, cold cuts and flavored chips and rice mixes.  Additionally, many veggie burgers, soy burgers, imitation seafood and textured vegetable protein contain gluten. Finally, wheat-free does not mean it’s gluten-free; check for hidden rye or barley. For an extended list of names of gluten, go t www.celiac.com and click on the “Unsafe Foods and Ingredients” tab.

When you eat out, ask questions about how your food is prepared.  If you have any children who are gluten intolerant, stock your kitchen with gluten-free foods.  Gluten-free eating may seem restrictive because it eliminates many products such as breakfast cereals, breads, and pasta, but  it’s not as bad as it sounds.  The foods you should be eating a lot of anyway, such as fresh meats, fruits, vegetables, milk, and legumes are naturally gluten-free. Know which grains to eat and which to avoid.  Avoid wheat and all its forms, including wheat germ, semolina, spelt, kamut, and triticale.  Additionally, avoid rye, barley, barley grass, graham, bran and farina.

It’s okay to eat amaranth, quinoa, buckwheat, millet, popcorn, cornmeal (polenta and tortillas), and breads, cereals and pasta made from corn, brown rice or potato.

 What About Oats?

Oats for celiac disease has been controversial, but recent research has given oats the thumbs up. The main problem with oats is cross contamination of oats with other gluten-containing grains. Pure oats that are not contaminated by other grains are recommended by a majority of celiac organizations in the U.S.

Finally, in addition to working on the gluten-free diet, I recommend taking digestive enzymes and addressing nutrient and vitamin deficiencies with gluten-free supplements.

Join me back in June where I will be writing a series about grains asking questions such as should we eat them or not, if so, what kind and how much?

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