Gluten-free diet can be helpful for some people
Q. I see many gluten-free products in my grocery shop? Are these healthier products? A. Gluten-free foods have become one of the fastest growing food segments in many parts of the world.
According to some reports, it has become an almost $20 billion industry and is growing rapidly.
Gluten-free foods were initially used for a condition called celiac disease.
Celiac disease, though known for over 50 years, has become more common in the last three decades and afflicts about 0.7% to 1.0% of the U.S. population. Celiac disease can present at any age.
The disease occurs in genetically predisposed individuals who are consuming gluten and then a trigger, a third required component initiates the illness in a minority of these individuals. This trigger is currently not known.
Celiac disease presents in a variety of ways involving the intestinal tract and outside the intestinal tract. There are accurate blood tests available for screening for the disease and endoscopy with biopsy is needed for diagnosis. Though a lot has changed in celiac disease, the treatment so far has not — the individual has to be on a strict gluten-free diet for life. So what is gluten? Gluten is a protein found in wheat, rye and barley, and a similar protein is found in oats. Hence, a gluten-free diet is devoid of any of these grains or anything made from them.
Gluten-free foods are labeled as such if they have less than 20 parts per million, i.e., less than 20 mg of gluten, in 1 kilogram of the product.
Just as an example, a slice of bread can have anywhere from 3 to 5 grams of gluten, equaling 3,000 to 5,000 mg of gluten, way too much for a celiac patient to be able to tolerate.
So the question really is: does it help to consume gluten-free foods even if you do not have celiac disease?
It may help some. It certainly helps if you have wheat or gluten allergy, meaning an individual that presents with an allergic reaction similar to a milk, egg, peanut or any other food allergy, and you need to avoid the allergen completely.
By comparison, celiac disease is an autoimmune disorder.
There are individuals who present with symptoms very similar to those who have celiac disease, but the blood tests are negative and the endoscopy and biopsy are normal even though they are consuming gluten at the time of the investigation. These individuals are referred to as having non-celiac gluten sensitivity. This diagnosis presently does not have a blood test or another confirmatory test.
According to some reports, there are many more individuals who suffer from non-celiac gluten sensitivity as compared to celiac disease. This population will also benefit from gluten-free foods.
Then there are individuals who do not fit into any of the above three categories, but feel well going off gluten. Many are also eating healthier as they pretty much go off junk food, are exercising more, maintain good sleep hygiene, and are drinking an adequate amount of water — all of which contribute to feeling better.
So is there a problem with gluten-free foods? Not if you are definitely benefitting from going on a gluten-free diet.
But keep in mind that they are more expensive. Moreover, processed gluten-free foods often have more fat and sugar, increasing caloric intake and contributing to obesity.
Even for patients with celiac disease, nonceliac gluten sensitivity and gluten allergy, we do recommend a fair portion of their meals be cooked at home using gluten-free grains and other naturally gluten-free products, so they get the benefit of healthier cooking along with their fiber and vitamins.
For those who don’t really need to be on a gluten-free diet, a balanced diet is the key.
One last thing before I go. If you feel unwell when consuming gluten, it could be due to several reasons. So it would be best to meet your health care provider to discuss investigations and diagnosis before going gluten-free, because once you go on a gluten-free diet, the accuracy of the tests to confirm a diagnosis of celiac disease — or rule it out — declines considerably.