By Michael Lasalandra, BIDMC Correspondent

Gluten free diets are becoming all the rage these days. Companies are making more and more gluten free foods and they are selling like mad. Gluten free “expos” are being held all over the country and are drawing huge crowds. Even some athletes are saying they perform better when they stay away from wheat.

Photo: BIDMC

Photo: BIDMC

So should everybody go gluten free?

“Absolutely not,” says Melinda Dennis, MS, RD, LDN, Nutrition Coordinator at the Celiac Center at Beth Israel Deaconess Medical Center.

Gluten is a composite of starch and proteins found in certain grassy grains such as wheat, barely and rye.

“There is no reason for most people to entirely avoid gluten,” she says. “Wheat gives us a lot of fiber, iron, B vitamins and protein. If a person has no sensitivity to wheat, it can be a healthy part of one’s diet.”

It is estimated that as many as 18 million Americans have some degree of gluten sensitivity. But there are certain people who must avoid gluten to stay healthy and others who should avoid it to feel better, she says.

For those with celiac disease, gluten is hard to tolerate. The undigested gluten causes the body’s own immune system to attack itself, damaging the lining of the small intestine. It can lead to bloating, diarrhea, constipation, gas and in some cases joint pain, rashes and serious weight loss. Almost all systems of the body may be affected by celiac disease.

People can find out for sure if they have celiac disease by a series of blood tests or a biopsy of the small intestine if necessary. There is also a genetic test.

If the disease is confirmed, those with it must go gluten free.

Karen Elbing was one of the lucky ones. Her celiac disease came on fast, but she was diagnosed quickly and the condition is now completely under control thanks to a gluten-free diet.

Elbing, 51, a patent attorney from Wayland, said she never had any symptoms until last December when she started suffering severe stomach pains pretty much every time she ate.

It went on for about a month until she mentioned her symptoms to a co-worker who told her that her son had suffered the same thing until he stopped eating wheat and other products with gluten in them. The co-worker suggested Elbing stop eating wheat for a while to see if it would have any effect.

“So I stopped eating things like bread and cereal for a couple of weeks and the pain went away,” she says.

She went in for a blood test and it showed she did indeed suffer from celiac disease. Now, she goes completely gluten-free. “I read labels obsessively and I grill the waiters at restaurants,” she says.

“I have no more stomach pains,” she says. “I feel better than I ever have.”

Elbing says she has no idea why her celiac symptoms came on so late in life or why she only had one of many possible symptoms, but is just glad she figured it out quickly.

“Undiagnosed celiac disease can lead to malnurishment,” she says.

Then there are those with what is known as non-celiac gluten sensitivity. If tests rule out celiac disease, but they have reactions to gluten, they probably have this condition. It is diagnosed by exclusion of celiac disease and whether they still have bad reactions to ingesting gluten. It is not an autoimmune disorder and damage to the intestines is not detected. But the symptoms, such as gas, bloating and diarrhea, can be the same. The people in this group will feel better if they go gluten free.

A third condition is a wheat, barley or rye allergy, according to Dennis. This can be determined by allergy testing. Those with such an allergy may suffer symptoms such as throat swelling and rashes and should carefully avoid the known allergen.

“Everyone is eating far more wheat than they used to,” she says. “Hydrolyzed wheat protein is commonly found in snack foods, seasonings, and processed meat products. Even soy sauce is brewed with wheat. It can go in anything. It is a common filler.

“There is no problem with anyone cutting down if they choose to, but there is no recommendation to cut out wheat entirely if there is no health reason for it,” she adds.

However, it you suspect you are having problems tolerating gluten, you should be tested, she notes.

“Your doctor can support you in getting the right diagnosis and your dietician can support you in following the right diet,” she says.

There are many more gluten free food options out available now and many of them taste good, she notes.

A 2012 poll found that the top two reasons people gave for buying gluten free food was that they believed it was healthier and would help them manage their weight.

But experts say there is no evidence that such foods necessarily help with weight loss.

In fact, some people who go gluten free start gaining weight, according to Dennis. She says that is because some gluten free foods use inferior lower-fiber flours as well as fats and sugars to help mimic the texture of wheat. And calorie counts tend to be higher too.

“So you have to choose carefully,” she says. “The good news is that companies are getting on board and are using labeled gluten free whole grains such as millet and quinoa instead of wheat and are not filling the products with fats and sugars.”

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted September 2013