Gluten-free diets have seen a huge surge in the last 15 years, partially because medical professionals have “rediscovered” gluten sensitivity. Diagnosis of celiac disease and non-celiac gluten intolerance has become more prevalent celiac disease, leading to the widespread maxim that gluten-free diets are healthier.
Gluten is a mixture of proteins called prolamins and glutelins that gives wheat, barley, rye and oat products a doughy texture: think bread and pasta. Thus, gluten-free versions of these beloved carbs lack their elasticity and tend to crumble apart. Many processed foods also contain gluten, either as a binder or as a component of a flavoring.
The effects of a gluten-free diet depend on a person’s relative sensitivity—people with celiac disease, for example, have to cut out gluten to reduce their chances of developing long-lasting or terminal complications. If you’re aiming to live healthier, removing gluten from a food item doesn’t necessarily make it better, just easier for those with a sensitivity to digest. Instead, you should aim to enrich your diet: the idea here is to consume more fresh food, which contains nutrients that alternative breads and waffles may lack. Trying to re-create your previous diet with gluten-free items will disappoint you as well as strain your budget.
Whether you’re going gluten-free for health, relief or survival, here are five things you should know.
1. Gluten sensitivity isn’t necessarily celiac disease
Non-celiac gluten sensitivity, the most common form of gluten intolerance, is characterized by gastrointestinal woes, headaches or fatigue. Around six to ten percent of the population suffers from NCGS. These symptoms clear up, well, when gluten-sensitive people eliminate it from their diet. An outright allergy to other proteins within wheat is rare. Meanwhile, celiac disease is an inherited autoimmune disorder that can affect multiple organs. Celiac disease can be identified by “classic symptoms,” namely malabsorption, impaired growth and chronic diarrhea or vomiting. However, “non-classic” or silent celiac, which can have milder symptoms and abnormalities in other organs, is more common. Untreated celiac disease can lead to heart failure, cancer, epilepsy, diabetes and thyroid disease—in short, if you have celiac disease, gluten can kill you.
2. Gluten isn’t only in grains
Although wheat and oats are most commonly associated with gluten, it hides in foods you wouldn’t suspect, particularly sauces and flavorings. Processed meats including meatballs, hot dogs and imitation crab meat get their spongy texture from gluten. Other items to watch out for include anything made with malt vinegar and powdered drinks such as instant coffee. Even medication can contain gluten.
3. Not all carbs are gluten
Going gluten-free doesn’t mean you have to completely give up on starchy foods. Corn, potatoes and unprocessed rice, for example, are all gluten-free. The danger in these starches instead lies in flavorings and cross-contamination from equipment that comes into contact with glutenous foods.
4. Gluten isn’t only linked to celiac disease
Unexplainable ailments in non-celiacs can often be solved by cutting out gluten. In addition to triggering migraines, gluten can exacerbate conditions like psoriasis and arthritis in people with non-celiac gluten sensitivity. Certain neurological disorders are linked to both celiac and non-celiac gluten intolerance.
5. Celiac disease is chronically undiagnosed
Only 17 percent of people who suffer from celiac disease are properly diagnosed. Undiagnosed celiac disease is fatal—especially when dietary adjustments aren’t implemented. Because most celiacs don’t experience gastrointestinal symptoms, the disease, or at least a screening, can be overlooked.
The process of diagnosing celiac disease starts with blood tests that screen for antibodies. The most common screening is the Tissue Transglutaminase Antibodies (tTG-IgA) test, which will only work in subjects who are ingesting gluten. The Anti-Gliadin Antibodies (AGA) test, on the other hand, searches for antibodies that do not indicate autoimmune reactions, meaning that it’s notoriously non-specific—a positive AGA result means you don’t have a gluten sensitivity. Positive tTG-IgA results are traditionally followed with an intestinal biopsy. If these results are positive, the next step is to eliminate gluten.
Photo by Yair Aronshtam, CC BY-SA 2.0
Sarra Sedghi is Paste Food’s and Paste Science’s assistant editor.