Written by guest blogger, Mary Ellen Williams, RD from MaryEllenRD.com

The gluten debate.

It’s everywhere. The food industry has made a fortune from selling gluten-free products. To be exact, around 15.6 billion dollars last year. Now, it’s important to say that gluten ain’t the devil. If any food were the devil it would probably be licorice jelly beans. I mean, is there anyone who honestly likes those things?

Either way, there’s a lot of confusion around gluten. So, in this post, we will answer a few questions to try and clear it up for you.

• What exactly is gluten?
• Which foods contain gluten?
• Who needs to eat gluten-free?
• What are the negatives of eating gluten-free?
• Should I eat gluten-free?

#1 What is Gluten?

First of all, everyone is willing to jump on the gluten-is-the-devil train, but many people cannot explain what gluten even is! So, before you get all avada kedavra on me, please watch this Jimmy Kimmel video of some people eating a piece of humble-gluten-pie.

Alright, now down to business.

Gluten is one of the proteins found in wheat, rye, barley and triticale – a cross between wheat and rye.  Bakers love gluten. Why? Because gluten is what helps baked goods and other foods maintain their shape. Trying to bake without gluten is like building a house made from straw, or playing Jenga in a wind storm.  Gluten provides the infrastructure to many of the foods we enjoy.

Gluten consumption has drastically increased over the years. This is mostly because we eat bigger portions, and (as a country) buy more refined, processed carbohydrates. In fact, Americans are such gluten hounds that the U.S. Department of Agriculture estimates our global grain production to be 1.5 MILLION TONS higher than previous months in 2018. Holy gluten batman.

#2 Which foods contain gluten?

Any foods made with wheat, barley, and/or rye will contain gluten. This is generally foods like bread, and pasta.  But, it also means barley containing drinks like – yep you guessed it – beer! Of course, we wish it were that simple. However, gluten is also found in a random assortment of foods: deli meat, salad dressings, marinades, granola bars, candy, French fries, the works.

#3 Who may need to eat gluten-free?

There are some people who can benefit from removing gluten.

Celiac disease

This is an autoimmune disease that affects the lining of the small intestine. Autoimmunity means the person’s body basically goes rogue and “attacks itself”.  In Celiac disease, the body creates immune cells (antibodies) that attack and damage the intestinal lining whenever gluten containing foods are eaten.  Left untreated or undiagnosed, the damaged intestinal lining can cause serious vitamin and mineral deficiencies, constipation and/or diarrhea, and even gastrointestinal cancer. The symptoms of Celiac disease can span far beyond the GI tract, and can cause conditions such as epilepsy, migraines, and dermatitis.

People with Celiac disease require a gluten-free diet for life. Even the smallest amount of gluten may trigger a symptomatic response (like using an unwashed cutting board that was used to prepare gluten-containing foods).

We could expand this into a nice science anatomy lesson about how the pathophysiology works with Celiac disease. However, we figured we would spare you the details and emphasize that this is a serious condition. For individuals diagnosed with Celiac disease, this is a life-long diagnosis. This is not some fad diet that they decided on a whim to follow. If you meet someone that has Celiac disease, be supportive. Be sensitive to what they are going through. Hollywood and the food industry world have created a monster of misinformation surrounding gluten and diet.

Note: If you think you may have Celiac disease, please ask your doctor to test you for it (with a Celiac blood panel). It is important to get tested BEFORE removing gluten from your diet, otherwise you may have a false negative test result.

Other autoimmune diseases and conditions

Gluten-free diets for other autoimmune diseases like Multiple Sclerosis, Hashimotos, Systemic Lupus etc. is growing in popularity.  But, does it have any merit? Although the studies are limited at this time, some researchers have found evidence that gluten may increase intestinal permeability (also known to the public as “leaky gut”). A leaky gut may allow larger “macromolecules” to enter the body. In individuals with a genetic predisposition, this can cause an immune response, and may trigger or worsen the development of autoimmune disease. As research continues, we are discovering that gluten consumption and autoimmune diseases may be more related to one another than we once knew.

There are also a few studies about the benefit of gluten-free diets in other conditions like autism, fibromyalgia, and eczema. Because this is a newer area of research, the evidence is currently not strong enough to recommend avoidance of gluten for these conditions right off the bat. However, with the right guidance from a registered dietitian, a gluten-free trial or personalized elimination diet is safe, and may provide symptom improvement.

Gluten Intolerance

Non-celiac gluten sensitivity (NCGS) is a term used by the medical community to explain an array of symptoms: bloating, discomfort, diarrhea, stomach ulcers, depression, and foggy mind. These people find improvement in symptoms by removing gluten. Celiac disease and wheat allergies have been ruled out in these people.

There is a large cloud of skepticism surrounding NCGS, and much public debate exists over this topic. Is this a real condition? Or is this just a delusional state of mind for picky eaters and the overly health conscious?

The truth is, this condition does exist. Research estimates roughly 18 million Americans have adverse symptoms related to gluten consumption, yet have a negative celiac panel or wheat allergy.

The solution (after ruling out Celiac disease) is to trial a gluten-free diet. If symptoms resolve, there is a valid chance you are one of the 18 million. After eliminating gluten for about 2 weeks, trial a re-introduction of a gluten-containing food. If symptoms resurface, well, there’s your answer. It should only take a small amount to test this, perhaps 1 small muffin, or 1 slice of bread. It is important to include this re-trial, because some people feel better on a gluten-free diet, simply because they are eating less processed carbohydrates (not necessarily related to the gluten).

Related Post: Food Allergy vs. Food Sensitivity: What’s the Difference?

Irritable Bowel Syndrome

The terms “gluten” and “wheat” have become interchangeable in society today. However, they are actually quite different. It is important to distinguish between the two because wheat allergens/sensitivities are separate from gluten sensitivities. In simple terms:

Gluten is the protein in wheat.  Wheat is the actual grain portion of the food. A food item labeled as “wheat-free” may not be “gluten-free”. This is because gluten is also found in non-wheat foods (like barley and rye).

Those diagnosed with Irritable Bowel Syndrome (IBS) may have intolerance to wheat (not necessarily gluten). The FODMAP diet has been proven quite successful in management of IBS. This diet is an elimination diet that temporarily restricts certain types of carbohydrates (like wheat). People with IBS may not properly absorb/digest these types of carbohydrates.  To find out more about the low FODMAP diet, click here.

#4 What are the negatives of eating gluten-free?

Let’s talk about some of the pitfalls of eating gluten-free:

• Many gluten free products simply are not as good as their “gluten full” counterparts. Since gluten is the glue that holds foods together, leaving it out can result in crumbly brownies and crackers. Also, a cookie (even a gluten-free one) is still a cookie (and probably not any healthier than a regular one).
• You may eat less fiber and B-vitamin foods with a gluten free diet. Eating plenty of vegetables and other higher fiber gluten-free grains (like quinoa) will be important to keep in mind when eating gluten-free.
• Eating gluten-free may not be good for your gut bacteria. This is because wheat is the main source of a prebiotic called fructan. Prebiotics are basically the food that probiotics need to function (your good bacteria!). By eliminating wheat, people on a gluten-free diet may have less intake of prebiotics, which can negatively affect your gut bacteria. If you are trialing or need to follow a gluten-free diet, make sure to add other good sources of prebiotics like onions, asparagus, garlic, and artichokes (to name a few).
• Your friends may get annoyed. (If you truly have a symptomatic response to wheat/gluten, I give you permission to tell them to kiss your you know what.)

#5 Should I eat gluten-free?

Basically, gluten (and/or wheat) may negatively affect certain individuals, and for those individuals, the symptoms are quite uncomfortable and painful. It is important to be supportive rather than critical.  There is much research yet to be done on this topic, but there is no question that celiac disease and gluten sensitivity are real.

That being said, we feel there is not enough evidence right now to suggest we should all be avoiding gluten like the plague. Instead of focusing on gluten-free, focus on the wholesome foods that we know provide major benefits like non-starchy vegetables, fruits, and healthy fats. Everyone can benefit from eating more of these items!

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