By John Hoeber, MS, RD, Owner of Body Kinetics
From celebrities who swear by it to the menu at the hot new restaurant in town, gluten-free is all the rage. Your grocery store may even have a whole aisle dedicated to gluten-free fare. But what exactly is gluten? Is it really that bad for your body? And who needs to worry about it?
Foods to eat — and avoid — on a gluten-free diet
Let’s start with the basics. Gluten is a protein found in certain grains, specifically in wheat, rye, barley, spelt and kamut. Going “g-free,” as some call it, means eliminating these grains and any foods made with them from your diet. Most types of bread, bagels, pasta, muffins, flour tortillas, pizza crust, hot dog and hamburger buns, couscous, tabbouleh, bulgar, cookies, brownies and cereals that contain wheat shreds or flakes are off-limits to those avoiding gluten.
But there are other, unexpected, gluten-containing foods that you need to avoid, too. These include: beer (it’s made with malt, which comes from barley), malt vinegar and other items made with malt or malt flavoring, soy sauce, teriyaki sauce, many gravies (gravy is typically thickened with flour), many fried foods (which are typically coated in flour before frying), brewer’s yeast and imitation crab meat, among others. It is also recommended to avoid oats that don’t specifically say “gluten-free,” as they are often contaminated with wheat during processing.
Gluten is also used in lipstick and some medications, according to the National Institute of Diabetes and Digestive and Kidney Diseases. If you are truly allergic to gluten or have been diagnosed with celiac disease, speak with your pharmacist to see if your prescription medications contain wheat and read all product labels carefully.
What is safe to eat on a gluten-free diet? Any product made with potato, rice, soy, amaranth, quinoa, buckwheat or bean flour (instead of wheat flour).
Gluten allergy, gluten intolerance or celiac disease?
Gluten sensitivity can range from simple gluten intolerance, which can cause mild but fleeting discomfort, to serious gluten intolerance, also known as celiac disease. These are both different than having a wheat or gluten food allergy.
Unlike celiac disease, where gluten is the source of symptoms, a wheat allergy can be caused by any number of proteins, including albumin, globulin, gliadin and gluten. Wheat allergies are commonly found in children and are typically outgrown before adulthood, whereas celiac disease can develop and be diagnosed at any age. While celiac disease can be successfully managed through dietary changes, it is a chronic condition that a person will have to deal with for the rest of his or her life (in other words, there is no cure yet for celiac disease).
Some have suggested that the increase in gluten intolerance in our society is a result of genetically-modified varieties of wheat and other grains being introduced in increasing quantities into our diet. But I suspect that the increase in gluten sensitivity is due to improved diagnosis and wider acceptance of this problem.
Symptoms associated with gluten intolerance
Gluten intolerance has been blamed for more than 250 symptoms. Most of those are digestive and includegas, bloating, nausea, abdominal pain, diarrhea, constipation and vomiting. Other common, non-digestive symptoms include weight gain, dermatitis (a broad term for several types of skin rashes), joint pain,tendonitis, headaches, migraines, depression, anxiety and irritability.
Celiac disease presents with different symptoms in children than in adults. In children, most symptoms are digestive, such as abdominal pain and bloating, chronic diarrhea, constipation, foul-smelling or fatty stool, or vomiting.
In adults, celiac disease symptoms vary widely and can include fatigue, bone or joint pain, bone loss, depression, anxiety, missed periods, canker sores or an itchy rash.
How to tell if you’re sensitive to gluten
Clinical diagnosis is often tricky, but checking to see if you’re sensitive to gluten is relatively easy by way of an elimination-challenge diet. As its name suggests, you start by completely eliminating gluten from your diet for at least three weeks. This means not eating one crumb of wheat bread or drinking one sip of beer.
First do a detailed symptom check by rating, on a scale of 1 to 10, any symptoms that are bothering you. Track these symptoms for at least a week before beginning the diet, and continue to track and note how you’re feeling every day for the three weeks you’re on the gluten-free diet.
At the end of the three weeks, introduce gluten products back into your diet. Have a moderate amount of gluten right away rather than add it gradually. Start with steel cut, whole wheat hot cereal for breakfast, Tabouli salad made with bulgar wheat (cracked wheat) for lunch and wheat berries (cooked like rice) for dinner. Try that for a week before adding in breads and pasta.
Continue to check your symptoms for one more week. If gluten is indeed the source of your symptoms, you will notice an easing or elimination of those symptoms during the three gluten-free weeks, and then a recurrence when you begin to eat gluten again. If you do notice a reaction to gluten, talk to your doctor and describe what you did and how you felt.
The paper mache paste diet
If you feel better without wheat and gluten, it still doesn’t necessarily mean you have gluten intolerance or celiac disease. Rather, you simply may have been eating way too much bread, bagels, pasta, cereal, muffins, tortillas, pizza crust, cookies and brownies. They are all made from flour. Despite forming the basis of most Western diets, flour, whether it’s white or whole grain, is still a processed food and is relatively devoid of nutrients.
When you think about it, the basic recipes for all of those foods are not that much different from making paste for your paper mache art projects: mix together flour and water (or some type of liquid). Put another way, we eat a lot of paste at each meal and then wonder why we have so many digestive complaints.
Going gluten-free for weight loss
Many people have jumped on the gluten-free bandwagon to lose weight — and have seen success from it. That’s expected when you eliminate bread, bagels, pasta, cereal, muffins, tortillas, pizza crust, cookies, brownies and beer from your diet. Especially if you replace them with good starchy veggies like squash, peas, carrots, beets, sweet potatoes, turnips, legumes and even potatoes.
Just don’t replace eating wheat-based pasta, bread and brownies with rice pasta, gluten-free bread, gluten-free cupcakes, gluten-free pancakes, and gluten-free brownies. If you do, well, you’re still eating paste.
The bottom line
If you’re trying to lose weight or just eat healthfully, it’s a good idea to reduce the amount of refined carbs and processed foods from your diet. You’ll probably notice you feel better and have more energy once you do.
However, if you think you might have a true wheat allergy or celiac disease, go see your doctor for a full evaluation.
John is a registered dietitian, certified specialist sports dietitian, wellness coach and personal fitness trainer. He is the owner of Body Kinetics Health Club and Spa in Mill Valley/Novato, CA.
