Ah, 'gluten' – the word that gets casually thrown around nowadays thanks to its infamous personality. But what is it anyway, and why are so many people quick to cut it out of their lives, confused and afraid by it? Should we all be? Let's break things down.
What is gluten?
Gluten is a protein found in wheat, barley and rye, so foods with rice such as sushi are perfectly fine. Initially, gluten was eliminated from diet only by people with celiac disease (which is directly linked to gluten sensitivity), but as a result of new research published a few years ago, eliminating gluten from the diet has become super trendy among all people who consider themselves 'wellbeing warriors'.
According to a famous study conducted by Australian gastroenterologist Peter Gibson (1), gluten could have negative effects not only on people with celiac disease, but also on those who have not been diagnosed with it. The study spread across the globe like wildfire resulting in a great craze over the gluten-free diet to help ease digestive issues like bloating. The lack of gluten itself does not lead to weight loss, but weight loss can occur when someone changes to a gluten-free diet because people often end up cutting down on calories through this process.
Difference between celiac disease, gluten sensitivity or wheat allergy signs
It is important to note the different types of gluten intolerance, as the sensitivities, signs and symptoms may be similar, although they may impose different impacts on the body. Celiac disease is an autoimmune condition that triggers a response when gluten is consumed, leading to damage of the intestines. This is the most severe form of gluten intolerance requiring a strict gluten-free diet. Celiac disease affects people differently, leading some to experience no noticeable symptoms, while others may experience a checklist of abdominal pain, diarrhea, constipation, weight loss, fatigue, delayed growth, vomiting, or a variety of other symptoms.
Non-celiac gluten sensitivity may cause similar symptoms, such as abdominal pain, diarrhea, constipation, bloating, fatigue, headaches, and more, but there may be less permanent intestinal damage than in someone who has celiac disease.
Wheat allergy is an immune reaction to any of the hundreds of proteins in wheat. When a person has a wheat allergy, one type of white blood cells, called B-cells, send out immunoglobulin E (IgE) antibodies to 'attack' the wheat and can involve a range of symptoms from nausea, abdominal pain, itching, swelling of the lips and tongue, to trouble breathing. A person with a wheat allergy must avoid eating any form of wheat, but does not have trouble tolerating gluten from non-wheat sources.
How to test for celiac disease, gluten sensitivity or wheat allergy
At this moment in time, testing for non-celiac gluten sensitivity is really a matter of trial and error at home through, first, ruling out celiac disease, followed by removal of gluten from the diet to determine if symptoms resolve. The guidance of a Registered Dietitian is vital during this step of the process to prevent any type of malnutrition and ensure that gluten has been strictly removed from the diet – as it can be hidden in a lot of unexpected foods.
Testing for celiac disease, however, is a more involved process of testing that analyzes antibodies in the bloodstream to determine if there has been an autoimmune response to gluten, followed by
examinations of the damage done to the intestinal tract to make a firm diagnosis.
Diagnosis of a wheat allergy is generally done through RAST, or skin prick testing, and a double-blind placebo test using the allergen. This is usually completed by an allergist.
If you believe you may be intolerant to gluten in any way, it is important to note that you must be
consuming a gluten-containing diet during the time you are tested in order for the tests to provide
accurate results. Always make sure to talk with your physician before removing any major food or food group from your diet to ensure it will not interfere with any future testing needs or lead to any other health complications.
Can you become gluten intolerant later in life?
While autoimmune predispositions occur someone may test negative as a child and then test positive as an adult, but the onset of symptoms may start at various ages depending on the person. With non-celiac gluten sensitivity, symptoms may also arise at any point in life. Whether or not someone has always been able to eat gluten-containing foods without issue, if symptoms are now taking a toll on the body they should seek help from a medical professional to rule out any other causes or determine if gluten is in fact the culprit.
Side effects of reintroducing gluten
With celiac disease, a gluten-free diet needs to be strictly adhered to for life in order to avoid an autoimmune response and further intestinal damage. With gluten-sensitivity, symptoms not only vary from person to person, but the severity may also vary from person to person. Some people may find that having small amounts of gluten-containing foods occasionally may not induce much discomfort, however, consistently checking in with a doctor will ensure there is no damage being done to the digestive tract through doing so.
If you have tried cutting out gluten and are ready to slowly reintroduce certain foods and wheat into your diet, you may come face to face with familiar side effects to actually being intolerant, like bloating, digestive issues and fatigue. Working closely with a Registered Dietitian can be extremely helpful in staying on track with a gluten-free diet in a sustainable, enjoyable way to ensure long-term health and happiness.
List of gluten intolerance foods to avoid
There are many food items that may contain gluten, often hidden in food labels in unexpected ways. Some common foods to avoid if you have a gluten intolerance include:
• Pastas and noodles
• Bread, baked goods and pastries
• Granola and cereals
• Sauces and gravy
• Beer and malt
• Processed meats
• Refined sugar products
• Crisps, chips and bars
Note: Many food companies have developed gluten-free products that fall into these categories. Talk to a dietitian who can help you find gluten-free alternatives that work for you.
List of naturally gluten-free foods
The list of foods to avoid when you have a gluten intolerance can seem daunting, however there are plenty of delicious and healthy replacement foods that are naturally gluten-free, including:
• Fruits, vegetables and legumes
• Fish and other seafood
• Lean beef
• Nuts and seeds
• Oils and vinegar
Should I try a gluten-free diet?
Every body is different and the best indicator is to listen to your own and communicate what you notice with your doctor. If you want to start an elimination diet, do so under the guidance of an experienced Registered Dietitian. Remember, drastic and sudden exclusion of each group of products (of course, except unhealthy ones – junk food, alcohol, sweets, sugar) is not advised and carried out inconsistently can lead to lack of adequate nutrients in your diet, so be safe!
How do I know if my child is suffering from a gluten allergy or sensitivity?
If your child is experiencing any symptoms, including digestive distress, delayed growth, stomach pain, rashes, etc, it is extremely important to talk with their doctor to determine the root cause of these symptoms. While gluten may be the culprit, it is vital that gluten is not removed from their diet until their doctor has completed all necessary testing to rule out other causes and ensure gluten is in fact the cause.
What do I do if my child is diagnosed with Celiac disease, a gluten allergy, or a gluten sensitivity?
Meeting with a Registered Dietitian to discuss your child's current diet can be very helpful in learning how to transition into a gluten-free lifestyle that will still allow your child to enjoy their food. Birthday parties, school lunches, and eating in public spaces may become more challenging, but there are ways to ensure your child's safety in these settings with some extra planning and preparation. Keeping open communication with your child's teachers or school lunch staff, as well as your child's babysitter or friends' parents, is important to ensure that anyone who may be involved in food preparation for your child is aware of any cross-contamination risks to keep your child safe. Helping your child to learn about their "safe foods," and foods that may cause them unpleasant symptoms can also be extremely helpful in educating him/her on how to manage their diet on their own and protect themselves in public settings when you are not with them to assist in food safety practices.
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