When I was a nutrition student the gluten free diet trend was just starting. To be honest, I had my hesitations. Many health professionals were poo-pooing it and calling it the latest fad. As with any fad the gluten free phase would soon fade away. In the meantime I would continue to promote whole wheat products. Well guess what? That was almost 10 years ago and gluten free is still here! In fact, the gluten free market is still growing.
Gluten free products have become a multi-billion dollar industry. Even mom & pop restaurants are offering gluten free options to their customers. Most surprisingly to me, almost every pizza place offers gluten free pizza crust! Pizza! My Italian grandmother must be rolling over in her grave. “That’s not real pizza,” I can hear her saying. I wonder what the New Yorkers and Chicagoans think of gluten free pizza?
So, what does all of this mean?
Is the food industry taking advantage of unsuspecting customers?
Or is gluten a true enemy that should be avoided?
Since graduating college I have discovered the answer lies somewhere in the middle. Yes, there are people who should ALWAYS avoid gluten. This group of people would include those diagnosed with celiac disease or a wheat allergy. Most reports estimate that 1% of the US population have celiac disease and about 2.5% have a wheat allergy. There is also a group diagnosed with non-celiac-gluten-sensitivity(NCGS) which accounts for about 6% of the population. These people have GI symptoms such as abdominal pain, diarrhea or constipation when wheat/gluten is ingested, but they lack biomarkers for celiac or wheat allergy NSGC is less understood but is being more accepted in the medical community. These people may be able to tolerate a small amount of gluten but larger amounts likely wreak havoc on their body. This group of people should mostly avoid gluten products.
There are a variety of other claims out there reporting that elimination of gluten may alleviate symptoms associated with ADHD, multiple sclerosis, rheumatoid arthritis, infertility, migraines, skin issues, joint pain, Alzheimer’s, autism or schizophrenia. But do they hold water? Some preliminary research is suggesting YES!
Now, does this mean going gluten free is the answer for everyone?
No, but it is worth looking into if you have ongoing health issues but no answer as to “why?” If you have ailments that are affected by gluten, you should begin to see improvements in your health within 2-4 weeks once gluten is eliminated from your diet. If no improvements are observed, then you likely do not need to continue to eliminate gluten (unless you have multiple food sensitivities with gluten being one of them). When starting any elimination diet I always recommend consulting your physician or dietitian first to make sure you are executing an elimination diet in a safe manner.
If you do choose to embark on the gluten-free journey please consider the following.
- Rule out other causes first- I can’t stress this enough! If you feel that something may be wrong with you then GO SEE A DOCTOR! I understand it may be more tempting and easier to consult Dr. Google, but you may be ignoring something that is more serious than a gluten intolerance. You might have a thyroid issue or inflammatory bowel disease or ??. If you are concerned you have a gluten intolerance make sure to get tested for celiac BEFORE you eliminate gluten. Once you eliminate gluten from your diet, the test for celiac will no longer be accurate. Your test will come back “negative” for celiac disease when indeed you have it. It is important for someone with celiac to avoid gluten forever, whereas someone with gluten intolerance may be able to tolerate gluten in small amounts. You and your doctor will want to know the difference. If you feel better removing gluten from your diet, would you really want to add it back in to test for celiac? Probably not.
- Intention- Why do you want to remove gluten from your diet? If you want to feel better, improve your energy level or lose weight then it may not be necessary to remove gluten from your diet as a first step toward improved health. I would recommend first to decrease the amount of processed food in your diet. Many people feel better and lose weight while eating a gluten free diet, because they are also eliminating processed food and refined sugar. If you are choosing whole foods and still feel lousy, then consider eliminating gluten.
- Meeting Nutritional Needs– Once you eliminate gluten from your diet you run the risk of nutritional deficiencies. In addition to the natural occurring nutrients in wheat products, many wheat products such as cereal and flours are fortified with additional vitamins and minerals to help the population meet their nutritional needs. If gluten is removed from the diet you may not be getting enough fiber, biotin, B-vitamins, iron, magnesium, selenium, and chromium. The good news is that you can still get these nutrients from other food products such as beans, dark leafy greens, nutritional yeast, prunes, oranges, strawberries, meat proteins, and non-gluten containing grains (i.e., quinoa, buckwheat, rice). The key message here is that you do not need wheat products in order to be healthy, but YOU DO NEED to get your nutrients from alternative sources
- Keep A Food Journal- A good tool to use while eliminating gluten is a food journal. This journal allows you to record the food you consume and your symptoms such as diarrhea, constipation, headaches, insomnia, indigestion, and etc. The purpose of the food journal is to help you identify a correlation between the food you are eating and negative symptoms that develop. If your symptoms resolve on a gluten-free diet then you may benefit from continuing gluten free. However, if your symptoms continue then you do not have a gluten sensitivity or there may be another food culprit. For instance, you may notice that every time you eat chocolate you develop a headache six hours later. If you believe you have multiple food sensitivities than I would recommend seeing a health professional.
- Keeping up with the Kardashians- Eliminating gluten from your diet can be socially isolating. Even though there are a lot more gluten free products out there, you may be limited on your food options when you go to parties or friend’s houses. Is this a good enough reason not to try gluten free if you feel it may help? No, of course not! Your overall health is more of a priority! However, I like to recommend to my clients to think ahead of time before embarking on the gluten free journey. You need to be prepared to bring your own food sometimes to social gatherings. It can be helpful to look at restaurant menus ahead of time or call ahead to a social gathering to see if there will be gluten free options.
Developing a healthy gluten free diet may take planning and dedication, but if you feel your health may improve on it then it is worth it!
Till next time,