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Should you be eating a gluten-free diet?

Posted by Joan Salge Blake  August 7, 2012 01:04 PM

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Source: Academy of Nutrition and Dietetics
Elizabeth, a  married 35 year old, was continually feeling exhausted.  At first, she thought it was the typical fatigue that accompanies a busy schedule of raising three active adolescents and juggling her own life.  Her daily fatigue caused her to minimized the times that she climbed the stairs to the second floor of her home as she found that the mere 14 steps took her breathe away.  One afternoon, she dozed off at 4 pm while folding the wash only to be awakened by her son at 6 pm asking about dinner. 

At this point, she nervously knew something was very wrong.  Thinking the worse, she made an appointment with her physician.  After a number of tests, her doctor diagnosed her as having celiac disease, an autoimmune disorder. 

Elizabeth isn’t alone in her disorder.   According to the National Institutes of Health (NIH), more than 2 million people have the disease, which amounts to about 1 in 133 Americans.  In a recent study in the American Journal of Gastroenterology, researchers at the Mayo Clinic uncovered that the majority of Americans who have celiac disease, don’t know that they have it. 

Individuals with celiac disease can’t tolerate specific proteins, collectively called “gluten” that are found in the grains, wheat, barley, and rye.  When these individuals consume gluten, it triggers an inflammatory response in their bodies that damages the lining of the small intestine and interferes with the digestion and absorption of the nutrients in food.  This leads to numerous vitamin, minerals, and other nutrient deficiencies, as well as their corresponding short-term health problems, such as depression, anemia, abdominal pain, irritability, nausea, weight loss, diarrhea, and fatigue – to name a few.  Over the long-term, complications such as osteoporosis, infertility, liver diseases, and intestinal cancers can occur.

Since there isn’t any cure for celiac disease, the only treatment is a lifetime of adhering to a gluten-free diet. Unfortunately, even traces of gluten in the diet can cause problems.  Gluten can also be added to foods, such as soup, cold cuts, seasoned frozen vegetables, and even products such as vitamins and lipstick.  Consequently, reading ingredients labels when shopping is mandatory to avoid even a morsel of gluten. 

To make matters a tad more complicated, some individuals have gluten sensitivity, which means that while they don’t have the full-fledged, autoimmune response seen in celiac disease, they may still suffer from some of the gastrointestinal discomfort as well as other symptoms.  According registered dietitian and Academy of Nutrition and Dietetics spokesperson, Dee Sandquist, individuals with gluten sensitivity may be able to safely tolerate small amounts of gluten.  “However, it is extremely important that these individuals get tested by their physician to make sure that they don’t have celiac disease, which requires strict avoidance of gluten.  All individuals, whether with celiac disease or gluten sensitivity, should work with a registered dietitian to develop a healthy, well-balanced diet that meets their unique medical and nutritional needs” says Sandquist.  When a variety of grains are eliminated from the diet, an individual could fall short of their daily vitamin B and fiber needs. 
  
Interestingly, the Mayo Center researchers also uncovered that 1.6 million people are on a gluten-free diet even though they don’t have celiac disease.  The popularity for these foods hasn't gone unnoticed.  The food industry has been fueling the public’s appetite for gluten-free foods as the market for these products has ballooned to over $6 billion annually.  “For some folks, a gluten-free diet has become a fad diet for weight loss,” claims Sandquist. 

Keep in mind that it’s the calories, not the gluten, in the diet that counts when it comes to managing your weight.  Interestingly, gluten-free foods may actually have more calories than the traditionally baked products, as extra fat is often added to make the product palatable, according to Sandquist. 

Cost in another factor.  A NIH study uncovered that gluten-free products can cost over 240 percent more than regular products.  Ouch.


For those who must manage the gluten in their diet, here are some resources that may help:
  • Easy Gluten-Free Expert Nutrition Advice with More than 100 Recipes.
  • The Gluten Dietetic App, which helps you safely choose the foods to buy in the supermarket.
  • To find a local registered dietitian for personalized guidance, click here.  (Note: A consultation with a dietitian could be covered by your health insurance.  Check with your policy.)
Follow Joan on Twitter at: joansalgeblake
Originally published on the blog Nutrition and You!.
This blog is not written or edited by Boston.com or the Boston Globe.
The author is solely responsible for the content.

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About the author

Joan Salge Blake, MS, RD, LDN, is a clinical associate professor and registered dietitian at Boston University in the Nutrition Program. Joan is the author of Nutrition &You, 2nd Edition, More »

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