Elyse
Wasserstrom
Why
the Biggest Health Craze May Not Be So Healthy
A diet void of gluten means a diet
void of carbs, which results in weight loss, right? Isn’t that why one-third of
Americans have eliminated gluten from their diets? Surely, there must be a
sound reason behind passing up a cheesy slice of pizza on doughy crust, a
turkey sandwich on toasted sourdough bread, a hearty stack of fluffy pancakes
drizzled in warm maple syrup or a plate piled sky-high with spaghetti and
meatballs. What is this recent phobia of gluten that has emerged, and why are
Americans avoiding it like the plague?
Everyone loves trying out the
latest trendy fad diets, such as gluten-free, but it’s important to do the
research behind the diet to make sure that it is really going to benefit you
rather than be a crash diet that leaves you starving and crying in the kitchen
three days later because “you just can’t do it anymore”.
The gluten-free diet has become
increasingly popular as a fad diet as celiac awareness and prevalence has
increased. This increase in awareness did not begin until the 1990s because
“nobody really was ready to accept the one percent prevalence of celiac
disease,” founder and medical director of the University of Chicago Celiac
Disease Center Dr. Stefano Guandalini says. However, not only has awareness
increased but so has the prevalence of the disease itself. According to studies
conducted by the Mayo Clinic, celiac disease is four times more common now that
it was 60 years ago, and research shows that undiagnosed celiac disease can
quadruple the risk of death.
The gluten-free diet has become one
of the fastest growing nutritional movements in America. “It’s a fad right now
to eliminate gluten from your diet. There’s this assumption that it makes you
fat, sick or obese,” master’s student and dietetic intern Jennifer Fleming
says. Gluten-free sales reached more
than $2.6 billion by the end of 2010 and are now expected to exceed more than
$5 billion by 2015, according to Packaged Facts in 2011. In fact, leading
market research companies and industry authorities such as the National
Restaurant Association and the American Culinary Federation named “gluten-free”
as one of the top food trends in 2010.
‘What is celiac disease?’ you might
ask. Celiac disease is a genetic autoimmune digestive disease that damages the
villi of the small intestine and interferes with absorption of nutrients from
food. More simply put, it’s essentially the body attacking itself every time a
person with celiac disease consumes gluten, as told by the National Foundation
for Celiac Awareness. Testing for the disease is done with a blood test that
screens the blood for gluten antibodies.
‘What exactly is gluten?’ might be
your next question. You hear this word a lot, especially as of late, but do you
really know what it is? Gluten is a protein that is found in wheat, barley and
rye. Celiac disease is triggered by the consumption of this protein. When
people with celiac disease consume gluten, their immune systems responds by
damaging the villi of the small intestine which in turn results in the body
being unable to absorb nutrients into the bloodstream, which can lead to
malnourishment.
One in every 133 Americans has
celiac disease, and about 83 percent of Americans who have celiac disease are
undiagnosed or misdiagnosed with conditions such as chronic fatigue syndrome,
fibromyalgia, irritable bowel syndrome and other conditions. Celiac disease can
lead to a number of other disorders including infertility, reduced bone
density, neurological disorders, some cancers and other autoimmune diseases.
That’s why it’s important for those who do have this disease to stick to a strict
gluten-free dietary regime because, while there is no cure for the disease, a 100
percent gluten-free diet is the only existing way to manage it today.
Those that do follow a 100 percent
gluten-free diet realize just how restricting it is, and they have to pay close
attention to not only the food they are eating, but also the products they are
using. What many people fail to realize is that many common products contain
gluten. While these products may not be harmful to a person voluntarily
eliminating gluten from their diet for “fad-diet” reasons, these products are
harmful to those who have celiac disease. For example, some unexpected sources
of gluten to look out for in products include certain hand creams, sunscreens,
shampoos, conditioners, soaps, makeup, lotions and medicines. You probably
didn’t expect to hear a lot of those items had gluten in them, now did you?
It seems like nearly everything
contains gluten, so how does a person with celiac disease survive on a
gluten-free diet? There are many alternatives that are safe for those with
celiac disease to consume that naturally do not contain gluten. Some of these
alternatives include almond meal flour, amaranth, buckwheat, coconut flour, corn,
cornstarch, guar gum, pea flour, potatoes, potato flour, quinoa, rice, sorghum
flour, soy flour and white rice flour.
Katie Norris, a dietetic intern at
the University of Georgia, uses her own experience with celiac disease to
educate and motivate others who also suffer from the disease. Katie was
diagnosed her senior year of high school with celiac disease. “I grew up with
symptoms, but as a kid I thought that they were normal because I had always had
them,” she says. It was not until her mom was diagnosed with rheumatoid
arthritis when she turned 50 and found out she had celiac disease a couple
years later that Katie was tested for the disease, too. “The risk for having
celiac disease goes up with the number of immediate relatives you have who are
afflicted with the disease, so it made sense to get tested at that point,”
Katie explains. Katie’s mom serves as her motivation to stick to her
gluten-free diet to avoid health problems and complications. Just because she
sticks to the gluten-free diet, doesn’t mean it’s easy for her, though. “The
thing about being gluten-free is that it can be incredibly inconvenient,” Katie
says, “It’s easier today, but it still requires planning every day to make sure
there’s going to be something you can eat wherever you’re going. It gets old
having to deal with that all the time, and there have been many occasions when
I had to skip a meal because there weren’t any options.”
Katie has not let the ‘inconvenience’
of celiac disease slow her down in the slightest bit, though. To help others
struggling with the frustrations of celiac disease, she helped start a
gluten-free awareness organization at the University of Georgia three years ago
called Dawgs for Gluten-Free Awareness. Dawgs for Gluten Free Awareness is an organization at the
university that seeks to provide support for those adhering to a gluten-free
diet, to promote awareness of gluten intolerance, allergy and sensitivity and
to encourage following a healthy diet and lifestyle. “As a support group for
students, we discuss safe places to eat in Athens, good gluten-free products
and recipes that we’ve discovered and the difficulties of being on the diet.
It’s especially helpful for the college student body because this is the first
time celiac individuals have had to deal with being on the gluten-free diet on
their own. It can be scary and extremely challenging sometimes. We wanted to
offer a resource for these students so they don’t feel alone,” Katie says. The
organization strives not to perpetuate the gluten-free trend but rather aims to
teach students about how you should only go gluten-free if you need to for
medical reasons, about the seriousness of celiac disease and about the
importance of sticking to the gluten-free diet if you do have celiac disease.
Does reading this have you convincing yourself you may
have celiac disease? Joseph Murry, M.D., a Mayo gastroenterologist urges people
who think they may have the disease to be tested before they self-diagnose and
eliminate gluten from their diet. Eliminating gluten prematurely can cause a
false-negative test result.
What if you don’t have celiac disease, though? Should
you be avoiding gluten, too? Some people that eliminate gluten from their diet hold
the belief that they will lose weight and that they will gain additional
energy. “The problem with this they may see those with celiac disease as
skinnier, and the reason is because they have trouble absorbing the nutrients
because their intestinal lining has been broken down by the gluten but as soon
as they are able to fix that damage by going gluten free they can start putting
on weight,” clinical dietician and hospital nutrition director Katherine
Huffman explains. After those with celiac disease eliminate gluten, their
bodies begin to repair themselves and they are able to keep on weight, but this
is the part of the process observes fail to take note of. This short-term view
of what a person with celiac disease goes through may give a healthy person the
wrong idea about gluten. People assume gluten-free will just be a weight loss
diet for them, but this does not necessary prove true.
Gluten-free alternatives are not
always a safe bet, either. You can’t assume that a label that reads
“gluten-free” automatically means that it’s healthier for you. “Some
[alternatives] are high in saturated fat and/or cholesterol, while others may
be high in calories and lack beneficial nutrients. Overall, people could be consuming too much
fat and not enough fiber and be lacking in certain vitamins and minerals,” University
of Georgia nutrition instructor Angie Garcia says. Make sure to read labels
carefully!
If you’re
not careful to take the proper precautions when eliminating gluten from your
diet, you risk many nutrient deficiencies. By removing gluten products from
your diet you’re also removing foods like bread that have been fortified with B
vitamins and that have additional iron and fiber in them. “The most important
of these B vitamins that are lacking in a gluten-free diet are thiamin,
riboflavin, niacin, foliate and fiber,” Huffman says. By removing these foods
from your diet you might have nutrient inadequacies. “Also, the fact that
people sometimes don’t realize, is that by removing gluten, in order to get the
same texture and mouth-feel, companies have to some times put in more fat and
sugar, so it’s not always as healthy as people think it is,” Huffman says. In
order to make sure you’re getting all the health and nutritional benefits you
need from a gluten-free diet, you should make sure you’re eating a variety of
naturally gluten-free foods like lean meats, fruits and vegetables. “People
with celiac do their research and know how to navigate that [possible
deficiency]. If you’re not educated it can be detrimental [to your health],” University
of Georgia master’s student Gisselle Rosa says.
Even more
common than celiac disease is another gluten-related illness that many people
are suffering from. Roughly 18 million Americans suffer from symptoms related
from gluten but test negative to celiac disease. There is the possibility that
these people suffer from non-celiac gluten sensitivity. Research is slowly but
surely developing in this area as the science on gluten sensitivity evolves.
According to the National Foundation for Celiac Awareness, new research done in
June 2014 shows that gluten alone may not be responsible for all of the
symptoms produced by gluten sensitivity. The research suggests that FODMAPS, an
acronym for a short chain of carbohydrates that are poorly absorbed by the
small intestine, may play a role in the disease, as well. Many grains
containing gluten, such as wheat, barley and rye, all contain high amounts of
FODMAPs.
Still considering a gluten-free
diet for yourself? If this is the case, it is so important to know and
understand all the factors before eliminating gluten—or anything else for that
matter—from your diet. It’s called a balanced diet for a reason. If you take
something out, you need to make sure other areas will cover and make up for
that loss. When asked what advice health experts have for a person considering
a gluten-free diet, the responses are all nearly identical. “I would recommend
that anyone experiencing symptoms of celiac disease have an intestinal biopsy
while they are still consuming gluten foods. This will let them know that a
100% gluten-free diet is imperative to intestinal healing and symptom
alleviation. Anyone considering a gluten-free diet in general would benefit
from a nutrition consultation with a registered dietitian to ensure proper
nutrient intake,” says Garcia. Most health experts are not recommending a
gluten-free diet to someone who does not have celiac disease or gluten
sensitivity. However, “If the person is really adamant, see a dietician so
dietician can make sure they’re getting all the nutrients that they are losing
from the grain source,” Huffman says. What advice does someone with celiac
disease give on the matter? “I would advise someone who was recently diagnosed
to talked to someone who has been on the diet for a while,” Katie says, “My
other piece of advice is to not “cheat” on the gluten-free diet if you
have celiac disease. I have met numerous people who think they can occasionally
have a “little bit of gluten,” as long as they are good most of the time. This
is absolutely not true. Every time gluten is consumed, your body has an
autoimmune response, and this damages the body. This is unhealthy and can lead
to other very serious health issues, so it’s incredibly important to adhere to
the gluten-free diet 100% of the time if you are celiac.”
Sources
Angela Garcia
(interview conducted via email)
Carter Barnett
(interview conducted in person)
Gisselle Rosa
(interview conducted in person)
Jennifer Fleming
(interview conducted in person)
Katherine Huffman
(interview conducted in person)
Katie Norris
(interview conducted via email)
