Perhaps no dietary ingredient has been more vilified in recent years than gluten, a group of indigestible proteins found in wheat, rye, barley, and triticale, a hybrid of wheat and rye.
Gluten is commonly blamed for a host of ailments, from bloating and gassiness to fatigue and headaches. But is it truly the culprit? Dr. Sophie Balzora, a gastroenterologist at NYU Langone, addresses a few common misconceptions.
Gluten is inherently unhealthy.
FALSE. About one-third of Americans say that due to health concerns, they want to reduce the amount of gluten they consume, or eliminate it altogether. But Dr. Balzora believes that many people may be needlessly restricting their diet. “People are more health conscious today,” she notes, “and somehow that health consciousness has translated into the idea that gluten is unhealthy, which is something we’re trying to debunk.” In fact, gluten-containing whole grains provide a valuable source of fiber, B-vitamins, and minerals, while many gluten-free products lack such nutrients.
People who suspect they may have a gluten-related disorder should eliminate gluten from their diet before seeing their doctor.
FALSE. Eliminating gluten may not only strip your diet of valuable nutrients, but also hinder the accuracy of tests for celiac disease, a serious autoimmune condition in which gluten signals the body to attack the lining of the small intestine. Celiac disease affects about 1 in 141 people in the US. If left untreated, it can lead to serious health problems like nutritional and vitamin deficiencies, osteoporosis, infertility, and even lymphoma of the small intestine in severe cases. “If someone suspects he or she has a gluten-related condition, the first thing we must do is rule out celiac disease with a blood test for certain antibodies,” explains Dr. Balzora. Unfortunately, adhering to a gluten-free diet prior to testing can render these tests unreliable, which is why it’s best to see a doctor before eliminating gluten from your diet. A confirmed diagnosis is important, because people with celiac disease need to know definitively that they will need to avoid all gluten in their diet for the rest of their lives. These individuals should also be assessed for vitamin deficiencies and other celiac-related health issues. Depending on your symptoms, a doctor may also want to test for a wheat allergy, a condition in which exposure to wheat causes allergic symptoms like hives, wheezing, and even anaphylaxis.
Gluten sensitivity is synonymous with celiac disease.
FALSE. Not everyone with gluten sensitivity has celiac disease. Recent studies suggest that some people may suffer from a condition called nonceliac gluten sensitivity (NCGS). Unlike those with celiac disease, however, people who have NCGS do not necessarily need to stick to a strict 100 percent gluten-free diet. “Tolerance varies,” explains Dr. Balzora. “Conversely, in celiac disease, even the smallest amount of gluten will cause damage over the long run.”
Celiac disease is overdiagnosed.
FALSE. In the US, an estimated 83 percent of people who suffer from celiac disease are undiagnosed or misdiagnosed. While celiac disease is four times more prevalent today than in the 1950s, the increase is simply too large to attribute to diagnostic trends alone, says Dr. Balzora. “It’s something we’re looking out for more today.” There are many theories about why celiac disease is on the rise. It could stem from changes in the way grains are grown or the ubiquity of gluten in today’s foods. The only thing that’s known for certain is the serious toll gluten takes on the lining of the small intestine in people with celiac disease. “It’s crucial to impart to patients with celiac disease that the mainstay of treatment is a lifelong, strict gluten-free diet,” says Dr. Balzora. “Strict avoidance of gluten allows the small intestine to heal and alleviates symptoms.”