Do you need to be gluten-free?— published: 04-14-2014
Wheat products such as bread and pasta are mainstays of our diets. However, some people are sensitive to gluten, a blend of two proteins found in wheat and other grains such as rye and barley. Three distinct conditions caused by gluten sensitivities have been identified: wheat allergy, celiac disease, and non-celiac gluten sensitivity.
Wheat allergy is more common in children than adults, and many children outgrow the condition. Symptoms include hives, itchy throat or eyes, and difficulty breathing. Wheat allergy can be life threatening and requires immediate medical attention—an especially serious consideration for Warfighters in the field.
Celiac disease is an autoimmune disorder that affects the small intestine. When a person with celiac disease eats foods containing gluten, his/her immune system attacks the small intestine, impairing the way the body digests food. Symptoms include bloating, gas, diarrhea, abdominal pain, lactose intolerance, and anemia. If not treated, celiac disease can cause neurological disorders, osteoporosis, and other autoimmune disorders such as type 1 diabetes. About three million people in the U.S. have celiac disease.
In non-celiac gluten sensitivity, or NCGS, a person is sensitive to gluten but—as the name suggests—does not have celiac disease. Symptoms include diarrhea or abdominal pain and vague, non-intestinal symptoms such as bone or joint pain, leg numbness, or skin rashes, making diagnosis difficult. About 18 million people in the U.S. have NCGS.
The only way to treat gluten sensitivities is to adhere to a strict gluten-free diet. Things to avoid include:
- Wheat, rye, and barley
- Flours made from wheat: self-rising flour, graham flour, cake flour, pastry flour
- Oats, unless certified gluten-free
- Communion wafers and matzo
- Soy sauce
Even if a product label says it is “wheat free” it might contain rye or barley. FDA has established guidelines for labeling gluten-free foods.
Gluten-free foods can become “contaminated” with gluten in home kitchens, so be sure to use clean tools for preparing and serving gluten-free foods, and designate appliances, such as a toaster, for use with gluten-free products only.
Many people with gluten sensitivities are deficient in calcium, folate, iron, and certain B vitamins. They should have their vitamin and mineral status monitored by a doctor.
Although following a gluten-free diet can be challenging at first, with a little practice it can become second nature. There are many gluten-free products on the market and many bakeries now offer gluten free selections. People who follow the diet typically experience significant improvements in their health and quality of life that make the effort worth the challenges. You can learn more about celiac disease and gluten-free diets from the Academy of Nutrition and Dietetics.