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Should You Go Gluten-Free?

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 Bloating, abdominal discomfort, and diarrhea are signals that something is amiss in the digestive system. Two common causes for the symptoms are: celiac disease and food sensitivities.

Celiac disease is an autoimmune condition in which antibodies are formed to gluten, a protein found in grains of wheat, barley, and rye. It has increased dramatically in the U.S. and now affects 1 percent of the population. It doesn’t appear that the increase is simply due to better diagnosis: because the prevalence is increasing in other countries as well. And celiac disease occurs across all age groups – small children to the elderly.

What happened?

While grains have entered our diets only 10,000 years ago, humans have eaten wheat and the handful of grains that contain gluten with relative ease. But within the last 50 years two big changes have occurred: 1.) how we grow and process wheat and 2.) how we turn flour into dough. As farming has grown, high-yield wheat strains that are resistant to drought and disease have become the norm. Previously, our wheat could have come from many strains but now there are just a few. And only high-gluten wheat dough is able survive the high speed rollers and industrial mixers required for mass production of bread. The result is we consume the same strains of high-gluten wheat over and over again.

When an immune response to gluten develops an inflammatory reaction occurs within the small intestine, causing injury to the intestinal cells. This accounts for the abdominal pain. The bloating and diarrhea are the result of damaged intestine’s inability to absorb ingested food. These symptoms can progress to anemia, vitamin deficiencies, osteoporosis, and malnutrition.

Who is at risk?

Celiac disease does not develop unless a person carries certain genes – the HLA DQ2 or DQ8 genes. However, many people, most of whom do not have celiac disease, carry the genes; thus, their presence is necessary but not sufficient for the development of the disease. Environment plays a role: for the infant, breast-feeding is protective and introduction of gluten to the infant before 4 months is a risk.

Blood tests

We now have blood tests that can accurately identify your risk for celiac disease. Anyone who has a family member with celiac disease or symptoms that are suggestive of celiac disease – bloating, abdominal discomfort, gas or diarrhea – should have a blood test. If a person has been given the diagnosis of irritable bowel syndrome, I suggest that they have the tests because the two conditions are frequently confused.

After the diagnosis has been established, one needs to follow a gluten-free diet for life. Although this may sound daunting, the gluten free diet is an easy plan to live with. Food companies now sell a growing variety of healthy gluten-free foods like whole-grain pasta, crackers, and cereals.

Fundamentals of the Gluten-free Diet

Grains that should be avoided
Wheat (includes spelt, kamut, semolina, triticale, graham), rye, barley (including malt)

Safe grains (gluten –free)
Rice, amaranth, buckwheat, corn, millet, quinoa, sorghum, teff, (an Ethiopian cereal grain), oats

Sources of gluten free starches that can be used as flour alternatives
Cereal grains, amaranth, buckwheat, corn (polenta), millet, quinoa, sorghum, teff, rice (white, brown, wild, basmati, jasmine), montina (Indian rice grass)

Tubers: arrowroot, jicama, taro, potato, tapioca (cassava, manioc, yucca)

Legumes: chickpeas, lentils, kidney beans, navy beans, pea beans, peanuts, soybeans

Nuts: almonds, walnuts, chestnuts, hazelnuts, cashews

Seeds: sunflower, flax, pumpkin

Become a Label-reader!

It is important to learn the other names for wheat, like semolina, bulgar, farina, durum, graham, and enriched flour. The malt in beer is made from barley, so it, too, contains gluten and should be avoided. Foods like bouillon cubes, cold cuts, hot dogs, sausage, gravy, rice mixes, soups, and soy sauce may have gluten hidden in ingredients like “vegetable protein” or “wheat starch”. By the way, it may surprise you to learn the International House of Pancakes puts pancake mix into its omelets –  these should be avoided.

Non-celiac gluten sensitivity

There is a spectrum of how one reacts to gluten, with some individuals reacting strongly and others less so. There are individuals who experience distress when eating gluten-containing foods but their blood tests do not meet the criteria for celiac disease. These individuals are said to have gluten sensitivity. If they eliminate gluten from their diets, they feel significantly better.

Gluten in grains can give rise to a range of problems in sensitive individuals. In addition to the gastrointestinal symptoms, there can be bone or joint pain, muscle cramps, leg numbness and chronic fatigue. Does this sound familiar? If so, you are wise to go on a gluten free diet.

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