Aaron Chy, BSc General, PharmD Student
Gluten-free: the New Fat-Free?
If you’ve spent any time on social media or just been keeping up with the times, no doubt you’ve heard a thing or two about avoiding gluten. Just about every recipe, product line, and restaurant these days seems to be pushing gluten-free, or low-gluten options. But for all the talk that goes on out there about avoiding gluten in your diet, not so much light is shed on why it may actually be a good idea. I’ve met countless people who go out of their way to avoid gluten, but don’t actually have many reasons to do so. Most of them just seem to be following the trend or assuming they’re doing themselves a favour. Let’s do something about that.
What is Gluten?1,2
A quick science lesson: gluten is a protein often found in wheat, rye, or barley. Like anything else, gluten moves into our intestines after a meal to be broken down and digested. However, gluten is unique in that it’s notoriously hard to digest and tends to stay intact as it travels through the gut. For most people, gluten travels harmlessly through the gut and is eventually lost when the body gets rid of waste. However, in certain individuals, different amounts of gluten pass through the walls of the intestine where the immune system reacts as if there was an infection present. Individuals who experience this are known to have Celiac Disease.
The actions of the immune system cause inflammation, damage and breakdown of the intestine, in what’s called an auto-immune reaction. Ongoing attacks like this by the immune system eventually breaks down structures in the intestine called villi (small finger-like projections), which are mainly responsible for absorbing nutrients and energy from the food we eat. Therefore, intestinal damage and malnutrition are the two main outcomes of Celiac Disease. Unsurprisingly, some of the classic symptoms of Celiac Disease include the following, which can occur immediately or shortly after consuming gluten-containing foods:
- Bloating
- Constipation
- Abdominal pain
- Chronic Diarrhea
- Irritability
- Vomiting
- Fatigue
- Numbness of the hands or feet
- Depression or anxiety
- Arthritis
- Anemia
Typically, children with celiac disease experience symptoms mostly related to their guts: vomiting, constipation, and foul-smelling, fatty-looking stools. On the other hand, adults are more likely to experience symptoms such as depression, fatigue and anemia.
How are Individuals Diagnosed With Celiac Disease?1
Before we jump any further, it’s important to talk about the dangers of self-diagnosing. It’s easy to read something on the internet and apply it to yourself. But doing so can be dangerous. You could end up mistreating yourself for something you don’t have, or fail to identify a real medical condition that goes untreated and develops into something worse. Celiac Disease is no exception and is diagnosed based on a number of blood and serum tests ordered by a healthcare practitioner. In most cases, individuals who experience the above symptoms or anything else unusual that’s related to gluten are referred by a clinician for these tests before any conclusions are made.
In addition, people who have a first-degree relative (that means a sibling, parent, or child) with Celiac Disease have about a 1 in 10 chance of having the condition themselves. These people may want to consider chatting with a clinician about possibly screening for Celiac Disease, especially if they’ve experienced any symptoms in the past.
Should Non-celiac People Avoid Gluten?2
In theory, it is possible that individuals who don’t have Celiac Disease may still experience minor, or hardly noticeable symptoms that relate to gluten consumption. While the reason for this is still unexplained, it’s known that small amounts of gluten can pass through the gut wall for some people without Celiac Disease. Typically, the amount is very small and has no effect, but this might have something to do with what’s known as Gluten Sensitivity.
Again, only proper screening and tests can identify Gluten Sensitivity, and it’s important to undergo the right process to ensure the right diagnosis. This is especially important considering many of the symptoms we’ve talked about today can easily belong to other illnesses like Irritable Bowel Disease or food allergies.
How Do You Treat Celiac Disease?1,2
Right now, the only approach is to simply move towards a completely gluten-free diet. This means learning a thing or two about which foods are gluten-free, and which ones aren’t. For starters, the following list can be used as an easy rule of thumb:
That said, knowing which foods to avoid is still only half the battle. Any time you visit a restaurant or food outlet, there’s the risk of your food being prepared on the same equipment previously exposed to gluten. Not to mention, food-service staffs may not always know themselves whether or not there’s any gluten in the food you eat. Sometimes, gluten-containing ingredients may be used in your meal that aren’t fully made clear. Lastly, for those of you who prepare your own meals; certain gluten-free or low-gluten products still test positive for having significant trace amounts of gluten.
I’ve experienced similar problems myself as someone who is allergic to peanuts. I couldn’t tell you the number of times I’ve been served (and ended up eating) foods that did contain peanuts despite being told otherwise.
Unfortunately, it’s a process of trial-and-error, but knowing what to look out for, as well as what to expect can only help.
The Bottom Line: Should You Avoid Gluten?
In certain individuals, gluten causes a reaction from the immune system that causes damage to the intestines. People with a confirmed sensitivity to gluten or diagnosis of Celiac Disease should do everything they can to avoid gluten. However, there’s little to no reason why healthy individuals should pursue a gluten-free diet; in fact, you’d be likely to do more harm than good if you were to try. As anyone with Celiac Disease can attest, pursuing a gluten-free diet is extremely difficult; if done wrong, it can lead to unintentional nutritional deficiencies.
If you do experience symptoms or have a family history of bad reactions to gluten, then speaking to a health care provider is your best bet. If not, feel free to indulge in the same foods you’ve always enjoyed.
We hope you took away something valuable from this piece. Although different diets and various lifestyle changes can certainly make a positive difference in your life. It’s important to know what you’re doing, and have the right information to back it up. If you have any questions or concerns regarding this article or others, feel free to reach out to us on Instagram, Facebook, or at ask@orbishealth.ca with your feedback. We’d love to hear from you.
RESOURCES
- The Celiac Disease Foundation, accessible at: https://celiac.org/
- Shord SS, Cordes LM. Cancer Treatment and Chemotherapy. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey L. eds. Pharmacotherapy: A Pathophysiologic Approach, 10e New York, NY: McGraw-Hill; . http://accesspharmacy.mhmedical.com.login.ezproxy.library.ualberta.ca/content.aspx?bookid=1861§ionid=146074145. Accessed August 12, 2018.
