Just about every restaurant you go to now has gluten-free menu options, and every supermarket has a designated gluten-free products section. With all the hype, it has people wondering, "Is gluten-free for me?" Pulse spoke with Oren Zaidel, MD, director of research at
South Bay Gastroenterology Medical Group to clear up the myths floating around and get the facts on gluten.
What exactly is gluten?
Gluten is a protein naturally occurring in wheat, rye and barley. It can be found in breads, pasta and other prepared foods such as beer and salad dressings.
Is gluten actually "bad" for your health?
Gluten is a naturally occurring protein, which can cause problems for people with a condition known as celiac disease. Because of a disorder in the immune system, people with celiac disease who eat gluten develop inflammation in the lining of their small intestine. This leads to problems absorbing nutrients and may lead to malnutrition, weight loss, diarrhea, abdominal pain and bloating.
Why does it appear that gluten intolerance is on the rise?
Rates of celiac have doubled in Western countries over the last 15 to 20 years. The reason may be our highly sanitized environments, which means children are exposed to fewer antigens while their immune systems are still developing. If their intestinal tract has not learned how to deal with these anti¬gens appropriately, the immune system may react to gluten with intolerance. We tend to see celiac disease much less frequently in developing countries.
I've heard the terms "gluten intolerance" and "gluten sensitivity." What is the difference?
Gluten intolerance is another term for celiac disease. Gluten sensitivity, on the other hand, is much harder to define but is an entity we have recognized much more commonly over the last few years. People with gluten sensitivity may test negative for celiac disease but still have gastrointestinal symptoms when they ingest gluten. In fact, their symptoms may be just as severe as those with celiac disease and can improve when gluten is eliminated from their diet. The difficulty is, unlike with gluten intolerance, there is no reliable test for gluten sensitivity.
Everyone I know is going gluten-free because they think it's healthier or because they want to lose weight. Is there any reason why I should not eat gluten?
Presently, there is no evidence that a gluten-free diet is healthier or that it will help you lose weight if you don't have gluten intolerance or gluten sensitivity. In fact, a gluten-free diet may lead to deficiencies in fiber, iron, vitamin B12, vitamin D and other nutrients, which are found in the fortified grains and cereals you may be avoiding.
How would I know if I had an intolerance to gluten? Are the symptoms purely digestive?
If you think you have a problem with gluten, definitely see your gastroenterologist for testing. While the common symptoms of gluten intolerance (celiac disease) are digestive, such as bloating, diarrhea and abdominal pain, there are many other associations as well. For example, osteoporosis, certain skin disorders, diabetes, thyroid problems, infertility, liver disease and even Down syndrome have been associated with gluten intolerance. At South Bay Gastroenterology, we have more than 35 years of experience helping people diagnose gluten intolerance through a combination of advanced blood testing and tissue sampling via endoscopy. We also help people understand and manage their symptoms of gluten sensitivity with dietary evaluation and modification.
Does gluten affect children differently than adults?
Although gluten affects children with gluten intolerance in the same way it does adults, the manifestations may be more severe, especially when growth and development are hampered.
What are some easy tips for avoiding gluten?
If it has wheat, rye, barley or malt-don't eat it! But check labels carefully because you may be surprised how many items contain these ingredients.