Gluten is found in the protein component of some grains.

Gluten-free – The Inside Story

Dr. Andrea Purcell, NMD

The latest conversation among patients, consumers, doctors, & nutritionists is whether or not to be gluten-free. Does it have any health benefits? Is it better for you and your family? Can it help with digestive symptoms? Is it a good idea in general? The information about gluten and the awareness around Celiac disease seems to have thrown the nation into a gluten-free frenzy. Many people are eating gluten-free as a type of fad diet. They have heard that gluten is bad and have chosen to avoid it as a way to be healthy. As the awareness builds so does the availability of gluten-free products. It is easier than ever to find gluten-free breads, cakes, cookies, and brownie mixes. Buyer beware, gluten-free eating is not necessarily synonymous with healthy eating. 

 This article will cover the who, what, where, when, and why to going gluten-free and what exactly is gluten and where is it found?

Gluten is found in the protein component of some grains. Not all grains contain gluten. Examples of foods that include grains are: bread, pasta, tortillas, cereal, baked goods and cookies. Gluten is what makes bread moist and stick together.

The grains to avoid when you are avoiding gluten are wheat, rye, barley, spelt, and possibly oats. Oats can be grown in fields close to wheat and other grains that contain gluten and may become cross contaminated with them. Oats have a protein that looks similar to gluten. It is not gluten, but in a person with a weakened digestive system the body may react to oats as well. Due to these two factors, oats may or may not cause a reaction and a sensitive patient is best to use gluten-free oats or avoid them all together. 

There are two main proteins in gluten; gliadins and glutenins.  Gliadin, found in wheat, is what leads to Celiac disease and gluten sensitivity. Barley and rye contain a gliadin that looks very similar to the one in wheat, and therefore, when the body reacts to wheat gluten, it usually reacts to barley and rye gluten too.

CELIAC DISEASE

The shocking news in 2003 was that 1 in 133 people had Celiac disease. The statistics show that Celiac disease is much more prevalent than the conventional medical community acknowledged it to be.

 What is Celiac disease? 

Celiac disease is a genetic intolerance to gluten contained in wheat, rye, spelt, and barley. The allergy to gluten damages the absorptive capability of the small intestine leading to mal-absorption.  When a person has Celiac disease they are unable to absorb vitamins, minerals, and nutrients properly leading to severe depletion.  Depending on the degree of mal-absorption, the signs and symptoms of Celiac disease vary among individuals, ranging from no symptoms to many. All body functions and organs rely on nutrients absorbed through the digestive tract for proper function. Severe depletion over time can lead to total body breakdown and will literally affect every organ system.  There are no drugs available to treat Celiac disease and the current recommendation is the avoidance of any and all gluten.

Once considered rare, Celiac disease, is now a common autoimmune disease afflicting one in 133 people according to the National Institutes of Health.  Since Celiac disease is genetic, if you or a loved one has Celiac disease there is a good chance that first and second-degree relatives will have the diagnosis as well.  Currently 97% of Americans with Celiac disease are not diagnosed, and 500,000 new cases are expected to be diagnosed in 2012, due to increased public awareness.

Celiac disease is diagnosed via a blood test called Tissue Trans Glutaminase (TTG) IgM & IgA,  as well as through a biopsy of the gastrointestinal tract. In order to be properly diagnosed, gluten must be consumed in the diet for 4-6 weeks before and during testing.

Who should avoid gluten?

 As a medical necessity, there are three groups of people who should avoid gluten:

Any person with a diagnosis of Celiac disease

Any person with an allergic reaction to wheat as determined either by an IgG blood or an IgE blood or skin scratch test test

Any person with gluten sensitivity- People can be sensitive to gluten without having Celiac disease 

Gluten Sensitivity vs Allergy

Many people are sensitive to wheat and/or gluten but do not have the diagnosis of Celiac disease. Sensitivities can cause symptoms such as skin reactions, congestion in the throat, ears, or sinuses, digestive upset, or other body inflammation such as fatigue and aching joints. 

If someone is sensitive, the test results will be negative but the patient generally feels better when they avoid gluten. People can become sensitive to foods after repeatedly eating them over a long time, or from a slow breakdown of the digestive lining due to environmental exposures to toxins, medications, and vaccinations. 

ALLERGY/SENSTITIVITY SYMPTOMS INCLUDE:

Fatigue or low energy

Organ pain (Kidney/Liver)

Irritability, mood swings and/or anxiety

Eczema, dry skin or other dermatitis (rash)

Inability to lose or gain weight

Chronic Anemia

Diarrhea and/or constipation 

Reflux (GERD)

Insomnia or restless sleep

Recurrent infections (sinus, respiratory, vaginal, urinary)

 Gluten – Hidden foods:

Dijon mustard

Dextrin

Combination spices

Soups & Broths

Sliced deli meats

Cheese spread

Rice milk

Soy sauce

Licking envelopes

Shampoo and conditioner

Skin cream/moisturizers

Compounded (hormone) creams

 AT HOME TEST

A simple test can be done at home to determine if a person is sensitive to gluten. Avoid all gluten for 14 days. This means all gluten. Read labels carefully because many items contain hidden gluten such as cereals, sliced deli meats, and canned soups. After 14 days reintroduce foods containing gluten 1-2x daily for three days in a row. Observe the body for any signs of gluten sensitivity that are listed above.

Why is Gluten allergy/sensitivity is so prevalent today?

 A recent study posted in the Annals of Medicine in 2010 found that people could lose their tolerance to gluten as they age. These people are not born with the genetic intolerance commonly seen with Celiac disease but are developing the intolerance later on in life. This suggests a weakening of digestive function due to repeated exposure to gluten and other food allergens, which can cause a slow breakdown of the digestive lining known as “leaky gut”; toxin exposure; antibiotics; medications; and even vaccines.

 It is well known that certain medications can weaken and even damage digestive function. Just released in February 2011 in the Journal of Nature, a study, linked Accutane,  a drug used to treat acne, to an increase in Celiac disease and inflammatory bowel disorders.  Scientists state that the active component in the drug can exacerbate the presentation of Celiac disease in patients who were mild enough cases to be asymptomatic prior to taking the drug.  Plaintiffs have won more than $45 million in compensation for Accutane side effects, such as ulcerative colitis and Crohn’s disease.

What does it mean to be gluten-free?

 Eating and cooking gluten-free means consuming a whole food diet devoid of grains containing gluten. 

Don’t be fooled by gluten-free marketing; not everything gluten-free is in your best interest.

 Often, eating processed and refined grains that do not contain gluten, such as rice,  potato, and tapioca flours can still be high in simple carbohydrates,  low in fiber,  and are often combined with unhealthy sugars and oils.  Eating gluten-free, this way,  is not healthy at all, and weight gain can result due to excess intake of carbohydrates.  Gluten-free pizza crust, cookies, crackers, muffins, breads, cake mixes, pastas and cereals are all refined, and although they don’t contain gluten, they are not healthy when consumed in moderate to large amounts. These can cause blood sugar irregularities that result in feeling emotionally unstable and anxious. The key to a healthy diet is eating a well-balanced whole food or plant based diet that is gluten-free. 

 How to Cook Gluten-free…

For those first diagnosed with Celiac disease, the act of cooking and eating initially becomes very stressful. Learning a few  tried and true simple recipes that  can be whipped up in a flash will be extremely helpful.  Cooking gluten-free is much easier than baking gluten-free. My initial recommendation is that a person start with cooking. 

 The first thing to do is to focus on a plant based diet. This includes all vegetables, fruits, nuts, seeds, lean proteins, protein powders from whey, rice, soy, or pea, and dairy products in moderation. These foods will become the foundation of a daily food plan.

 Remember that gluten is only found in grains so you will need to know your list of safe grains. Experiment with non-gluten grains and find some easy recipes that include acceptable items such as brown rice, wild rice, quinoa, amaranth, buckwheat, sorghum, and teff.

 There are many benefits to home cooking. You have complete control over what you eat and the quality of ingredients, plus there will always be leftovers for lunch the next day; ” hooray”!

 Where to begin…

Now that you know the basics, you are armed with information to successfully eat gluten-free. Here are five health tips to follow if you decide to eliminate gluten:

 Keep it simple. 

Eat foods in their most natural state such as: fruits, vegetables, beans, hormone free organic meats, nuts and eggs. 

 Buy 1-2 healthy gluten-free cookbooks. 

These will help you prepare meals and baked goods that everyone can enjoy.

 Just because it is gluten-free doesn’t mean that it’s healthy. 

Many processed gluten-free foods contain refined grains, sugars, and unhealthy oils. These can cause blood sugars to rise and are lacking in vitamins and minerals.

 Know your safe grains. 

Safe grains include: rice, corn, and quinoa. Quinoa is actually a seed.

 Be a super label reader. 

Wheat and gluten are hidden in many items as filler. Check your tomato sauces, soups, seasonings, chicken broth, soy sauce, and most baked goods.

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