December 3, 2013
The Pros and Cons of Going Gluten-Free
Featuring: Marlo Mittler, RD, Cohen Children’s Medical Center
Anyone who spends time perusing supermarket shelves might be forgiven for thinking gluten has been dubbed a nutrition villain like trans fats, Big Macs and fettuccine "heart attack on a plate" Alfredo.
The reality, according to area nutritionists, is that gluten, a protein that's found in wheat, barley and rye, is perfectly OK for most people.
"A few years ago, it became the newest fashion to ditch gluten, and that trend is still lingering," said Marina Stauffer Bedrossian, a registered dietitian with St. Catherine of Siena Hospital in Smithtown. "But as of now, there is no research to show that people without celiac disease or non-celiac gluten sensitivity should eliminate gluten from their diets."
However, for people with celiac disease, which is a genetic disorder, gluten damages the small intestine, making the body unable to absorb and use the nutrients in food they've eaten. People with celiac disease often lose weight and develop diarrhea and stomach pain. The American Academy of Family Physicians labels gluten as poison to people with celiac disease. It's also possible to not have celiac disease but still be sensitive to gluten.
Celiac disease is rare
The fuss about gluten has developed as awareness of celiac disease has grown in recent years. Both celiac disease and gluten sensitivity are fairly rare, however.
"Studies report that one in 133 people has a gluten intolerance or allergy," said Marlo Mittler, a registered dietitian with the North Shore-LIJ Cohen Children's Medical Center of New York in New Hyde Park.
And though there are indications that reducing gluten may help conditions such as autism and asthma, "by taking out the gluten, you may be at risk for nutritional deficiencies," she said. "Essential nutrients such as calcium, thiamin, riboflavin, folate, iron and fiber may be lacking, and you will not meet the recommended daily allowances when on a gluten-free diet."
Mittler said that "there are no evident benefits to a gluten-free diet unless medically indicated."
People who think they might have celiac disease can ask their doctors to be tested for it, which can be done with blood tests and an intestinal biopsy. But even people who don't have celiac disease might be gluten-sensitive. "If you test negative and still believe gluten might be causing issues with your health, try eliminating all gluten from your diet for about three weeks," Stauffer Bedrossian said. "It is likely that a gluten sensitivity would be alleviated in this time frame." But even people who don't have celiac disease might be gluten-sensitive.
Don't expect going gluten-free to be simple, though, because it's not just a matter of giving up bread, though that's certainly part of it. "Gluten is found in wheat, rye, barley and other hybridized grains such as semolina, triticale, bulgur and farro," she said. "It gives bread that chewy texture we all love, which is brought upon by kneading."
Gluten is also found in other foods because it's often used as a stabilizer and a filler. "For example, it can be in salad dressings, gravies, soy sauces, beer, couscous, soups and stews, broth, lunch meats -- the possibilities are nearly endless," Stauffer Bedrossian said.
Going on a completely gluten-free diet requires avoiding exposure to foods with gluten in them and looking out for "cross-contamination" in home kitchens and in restaurants from foods with gluten in them, she said. Even a toaster or blender can be contaminated with gluten, she said, if it's used to cook or blend foods that contain gluten.
And though it might seem as though cutting out gluten would be a quick way to lose weight, that's not necessarily the case. "People who cut out all gluten-containing products like pasta, cookies and bagels will likely lose weight," Stauffer Bedrossian said. "However, if you substitute those foods for gluten-free foods that are equal in calories, you will not lose weight. It comes down to total calories consumed."
But for those who do want to go gluten-free, that's becoming easier to accomplish. For starters, the U.S. Food and Drug Administration expects to have new labeling laws in place by next summer that set more specific requirements for calling a product "gluten-free."
"There are clearer labeling laws in effect to help depict which products are safe," Mittler said. "Along with that, many product lines are making gluten-free alternatives, like gluten-free pasta, gluten-free pretzels, gluten-free soy sauce, etcetera. And more restaurants than ever are also adding gluten-free menus to their traditional menus," she added.
"It is amazing how the world is becoming much more gluten-free friendly," Mittler said.