Cigna health tips: Gluten-Free Eating

Gluten-Free Eating: Real Food Intolerance or Fad?
By: Roberta Anding

If you read the popular press, everyone should follow a gluten-free diet.

What is gluten, and should you avoid it? Gluten is a grain protein found in wheat, barley and rye. There is a segment of the population that has an immune-mediated reaction to this protein known as celiac disease. According to the National Health and Nutrition Examination Survey 2009-2010, the prevalence of celiac disease is one out of 140 Americans. This is approximately one percent of Americans. A series of blood tests is needed to make the diagnosis. Medical authorities recommend being tested before starting a gluten-free diet. If the diet precedes the testing, the test may result in a false negative and the disease could go undiagnosed. The body recognizes gluten as a foreign invader and produces antibodies against gluten. These antibodies attack the intestinal villi, the small fingerlike projections in the small intestine that absorb food. The result is weight loss, abdominal pain, constipation and diarrhea. The intestinal villi become damaged, and lactose intolerance often becomes part of the problem. Not all symptoms of celiac disease are intestinal in nature. According to the Gluten Intolerance Group, "Children may exhibit behavioral, learning or concentration problems, irritability, diarrhea, bloated abdomen, growth failure, dental enamel defects, or projectile vomiting."

More insidious, however, is gluten sensitivity. In this case, there is discomfort associated with eating gluten, but the blood test is negative. Estimates suggest that six percent of Americans have some degree of gluten sensitivity. Despite testing negative for celiac disease, these individuals have fatigue, bloating and migraines as just a few of the symptoms. Some experts believe that removal of gluten from the diet provides quick relief. In both celiac disease and gluten sensitivity, the intolerance is real, and removal of gluten eliminates most of the symptoms.

As awareness of the celiac disease and gluten sensitivity has increased, gluten-free eating has been used as a weight-loss strategy. There is no scientific evidence that supports removing gluten from the diet. Athletes will often try gluten-free eating to improve athletic performance. In the absence of any gluten intolerance, there is no data suggesting that this eating style increases performance on the field. Gluten-free eating is not always the healthiest choice, either. Gluten-free foods include unprocessed meats, fruits, vegetables, rice and potatoes. These foods are good choices and better than highly processed foods. However, gluten-free cookies, cakes and candies are still processed foods and just because they are gluten-free, it doesn't make them nutritious. Gluten-free foods are often not fortified and may actually reduce the vitamin and mineral content of the diet.

Foods that contain gluten include those made from wheat, barley and rye. Breads, cereals and baked goods are common offenders. Gluten, however, is found as an ingredient or byproduct of manufacturing and is found in beer, syrups, soups, spice blends, some beef jerky and many vegetarian foods. Consider consulting with a registered dietitian if you are considering going gluten-free, because it is much more than "wheat-free." Additionally, the Gluten Intolerance Group (GIG) is a great place to get started if you need additional resources. The website is www.gluten.net.

Eat well, Texans fans!

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