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Published on March 25, 2019

gluten free bread ingredients and utensils

Do You Need to be Gluten Free?

Gluten free. We’re seeing this label everywhere from cereal boxes, to restaurant menu selections to sections in the grocery store.

But what is gluten and who really benefits from not eating it?

Gluten is a general term for protein found in rye, barley, wheat and some oats. It creates the elastic texture of dough. There’s nothing bad or unhealthy about gluten, unless you have a condition known as celiac disease, or have gluten intolerance or sensitivity.

If you have this, eating gluten can cause symptoms such as abdominal pain, nausea, diarrhea, constipation, vomiting and unplanned weight loss.

However, only one-third of adults with celiac disease have digestive symptoms. Other common symptoms include unexplained anemia, fatigue, bone or joint pain, arthritis, depression or anxiety, seizures, migraines and more.

“It’s important that people don’t skip ahead to treating possible celiac disease or gluten sensitivity with a gluten-free diet without knowing for certain what’s causing their symptoms,” said Cristina Hill Jensen, MD, of Avera Medical Group Gastroenterology.

The Root of Many Issues, Some Serious

Left untreated, people with celiac disease can be at risk for serious conditions such as malnutrition and osteoporosis.

Celiac disease affects an estimated one in 100 people, and can strike both children and adults. The immune system forms antibodies to gluten, causing inflammation in the intestine.

Patients with celiac disease or gluten sensitivity often feel better soon after going gluten free. Yet it can take a year and a half to three years for the small intestine to return to normal.

While the gluten-free diet is gaining momentum for the entire population, there’s no health benefit to eating gluten free if you have not been diagnosed with either celiac disease or gluten intolerance, or if your doctor advises you to go gluten-free for other medical conditions. No harm is done if you go gluten free and don’t have this diagnosis. But the gluten-free diet an expensive and radical change in lifestyle that may not have any real impact.

“On the other hand, for people with celiac disease, the results of a gluten-free diet are fantastic; no medications are needed,” said Hill Jensen.

“When someone is diagnosed with celiac disease, a first reaction is to head to the grocery store to buy bags of expensive gluten-free products,” said Amanda Curley, MS, RD, LN, Registered Dietitian who specializes in GI care.

Making Adaptations

Yet once people understand the shopping lists and menu plans for gluten-free eating, it doesn’t take them long to adapt; in fact, sometimes entire families go gluten free when only one member has been diagnosed with celiac disease in order to prevent cross-contamination and make meal planning easier.

The current gluten-free fad is actually helpful for celiac disease patients, because more gluten free choices are on the market, and they are also clearly marked.

“Once patients are educated about gluten-free eating, they realize that there are a lot of foods that are naturally gluten free, and perhaps they’ve even unknowingly had gluten-free days in the past,” Curley said.

If patients “cheat” on the gluten-free diet, they either get sick, or they don’t get sick but continue damaging the intestinal tract by eating gluten, Curley said. “Patients often ask, ‘is it really going to hurt me,’ and my answer in a word is ‘yes.’”

Is it Gluten-Free?

YES: Fresh fruit, fresh or frozen vegetables, potatoes, fresh meats, eggs, most dairy products, potato chips, corn chips, popcorn, plain nuts and seeds, beans, rice, corn tortillas

NO: Barley, bran, durum, graham flower, rye, semolina and wheat. Gluten is also often found in beer, luncheon meats, pasta, soup base, supplements, lipstick and candy.

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