IS GOING GLUTEN-FREE RIGHT FORYOU?
These days it seems everyone is on a gluten-free diet. But is it really necessary? Is it healthy for everyone?
Shelley Case, registered dietician and author of Gluten Free: The Definitive Guide, wants to set the record straight.
“Everybody is hearing about the gluten-free diet,” she says, “from celebrities to athletes and so-called wellness experts – are promoting that a gluten-free diet will cure everything that ails you.”
And that may or may not be true. So who needs to be following a gluten-free diet?
According to Case it’s only two groups of people – those diagnosed with celiac disease and those with non-celiac gluten sensitivity.
Celiac disease is a hereditary autoimmune condition. When those with the condition consume foods with the gluten protein the body reacts by attacking the villi of the small intestine, which are responsible for absorbing nutrients from your food. Eventually the damage can cause serious problems such as anemia, osteoporosis and other nutrient deficits.
Case says she gets asked all the time if there’s any harm in going on a gluten-free diet if you don’t have those conditions. She says, “Technically no.” But it may not be the healthiest option either.
Going on a gluten-free diet without it being medically necessary may not be harmful, but it may not be the best thing. Gluten-free products – such as breads, pastas, and cereals – are not enriched with iron and B vitamins like those made with wheat. It can make getting enough of those nutrients a lot more challenging.
As well, some of those processed gluten-free products are not made with the most healthful ingredients.
“A lot of gluten-free products on the market use a base of rice flour and some type of starches such as tapioca starch or potato (starch),” explains Case, “and none of those are stellar for fibre or nutrients. So people think that they’re eating healthier by eating gluten-free products but that’s not necessarily so.”
Instead, Case recommends building a gluten-free diet around foods that are naturally gluten-free – such as vegetables, nuts, seeds, eggs, low-fat cheese and dairy products. For protein, Case suggests unprocessed meats like chicken, beef, fish – and pulses – such as lentils or beans.
“If you build your diet on those naturally gluten-free foods, your diet can be very healthy,” she says.
If you think you might have symptoms that suggest celiac disease or non-celiac gluten sensitivity, Case says you should not go on a glutenfree diet until you’ve seen your doctor for a diagnosis. That’s because the testing for celiac disease includes a blood test and a small intestinal biopsy. Those tests may come back falsely negative if gluten has already been removed from the diet.
“There has to be gluten in your system for an extended period of time for that blood test and that small intestinal biopsy to be accurate,” says Case.
A false negative on a celiac test can be a real problem. If left untreated celiac disease can cause nutrient deficiencies, neurological complications, infertility, and an increased risk of certain cancers. It’s thought celiac disease affects approximately one per cent of the population.
The treatment for celiac disease or non-celiac gluten sensitivity is pretty straight forward: a strict glutenfree diet for life. Even small amounts of gluten can continue the symptoms and ongoing damage to the body.
Celiac disease is tough to diagnose. In fact, according to Dr. Case, it can take up to 12 years after the onset of symptoms to get an official diagnosis. This is partly because the symptoms can mimic other illnesses or seem unconnected until resolved by a gluten-free diet.
In her book, Case has many gluten-free resources – including a list of over 3700 gluten-free products, tips for eating out, labeling laws, how to do substitutions, as well as recipes. Her suggestions have come in part from her own experience. She was diagnosed with celiac later in life.
“It can be challenging because gluten is in so many things,” says Case. “That’s why I wrote my book was to help people.”
Case’s book is available at most booksellers and on her website ShelleyCase.com.