A Gluten-Free Diet Reality Check

Even people without celiac disease have taken to eating only gluten-free foods, but the options are still limited, which means you might wind up in worse shape -- physically -- than ever before.

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Is gluten the latest dietary villain? It would seem so. Restaurant menus hype their gluten-free items. Food packages proclaim their gluten-free contents. Weight loss programs flaunt the purported benefits of avoiding gluten. And then there is the list of conditions apart from celiac disease that supposedly are helped by eliminating gluten from the diet. Such marketing tactics could lead a person to believe that the gluten-free diet is the greatest discovery since sliced bread.

So, let's examine the facts. Does going gluten-free help a person lose weight? Does it improve overall health? Is it the cure-all for what ails you? Is gluten the new nutritional enemy? The answer is ... well, it depends.

Gluten is a protein found in wheat, rye, and barley products. It gives an elastic consistency to flours made from these grains. Most breads, cereals, crackers, pasta, and baked goods contain gluten, and it is found in many processed and packaged foods disguised in ingredients like thickening agents and fillers made from these grains.

GLUTEN-FREE WEIGHT LOSS?

Many personal trainers, celebrities, and alternative health practitioners have joined the growing gluten-free trend and are recommending the diet for all sorts of inappropriate conditions. Weight loss is one example. There is no evidence that gluten-free foods promote weight loss, and no evidence that replacing a food that contains gluten with a gluten-free food can help a person lose weight. The gluten-free version has the same number of calories.

However, when a person avoids gluten, many foods must be avoided. Dee Sandquist, American Dietetic Association spokesperson and registered dietitian, says: " When people choose to follow a gluten-free diet for weight loss, most likely they have changed their eating habits to include fewer gluten-containing products overall such as cakes, cookies, rolls, etc." Cutting out those foods reduces calorie intake which will result in weight loss. Nothing magical there though. Reducing calories from any source results in weight loss.

The number of gluten-free products is limited, and trying to design a weight-loss plan around such few foods would be quite challenging to accomplish and difficult to stick to. In fact, a gluten-free diet may be high in calories and actually contribute to weight gain because food manufacturers often replace gluten with fat and sugar to impersonate the desirable qualities that gluten provides in baked goods.

Although a gluten-free diet may often be suggested for managing conditions like autism, irritable bowel syndrome, and attention deficit hyperactivity disorder, the research shows mixed results and further research is needed in these areas. There is also a lack of evidence that avoiding gluten boosts energy levels, improves digestion, or enhances attention span.

CELIAC DISEASE

The only condition that necessitates a gluten-free diet is celiac disease, an extreme manifestation of gluten intolerance or gluten sensitivity. Gluten really is the bad boy for people with this disease.

Celiac disease is a common genetic disorder affecting about 1 in 133 people in the United States. An autoimmune disorder characterized by an abnormal response to gluten, it causes severe damage to the mucosa that lines the small intestine. While the disease usually develops in early childhood, it is sometimes triggered by events such as surgery, pregnancy, childbirth, viral infection, or severe emotional stress.

When a person with celiac disease ingests gluten, the villi in the small intestine are damaged or destroyed. The result is a significant reduction in the surface area of the intestinal mucosa where the absorption of nutrients occurs. In addition, the secretion of intestinal enzymes that aid in digestion becomes impaired. Without healthy villi and adequate digestive enzymes, a person becomes malnourished regardless of how much they eat.

Symptoms of celiac disease vary between individuals. In childhood, celiac disease manifests itself primarily with digestive symptoms such as chronic diarrhea; vomiting; constipation; abdominal bloating and pain; pale, foul-smelling stools; and weight loss. Due to nutrient malabsorption, an infant or child may have other problems such as failure to thrive, delayed growth, short stature, delayed puberty, and defects in the enamel of the permanent teeth. Irritability is also a common symptom in children.

Celiac Symptoms

If celiac disease develops in adulthood, it is less likely to cause digestive symptoms. More commonly, adults will develop symptoms such as fatigue, unexplained iron-deficiency anemia, bone and joint problems, depression or anxiety, canker sores in the mouth, infertility, or a skin rash known as dermatitis herpetiformis. It is entirely possible for someone with celiac disease to have no symptoms at all, but still develop complications of the disease such as malnutrition, anemia, osteoporosis, liver disease, and intestinal cancer.

Presented by

Beth Fontenot is a registered dietitian and a licensed dietitian/nutritionist. She serves on the Louisiana Board of Examiners in Dietetics and Nutrition and writes for TheDoctorWillSeeYouNow.com.

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