Gluten-free: What does it mean?

“Gluten-free” has been a hot topic lately, especially when it comes to families trying to make healthier choices in the diet.  But, many aren’t quite sure what it actually means.  Katelyn Wolfe, MS, RD, a Le Bonheur dietitian, shares helpful information for families.

What is gluten?
Gluten is one of many proteins found in food.  It is specifically only found in wheat, rye, barley or products that have a component of one of those ingredients -- or products that have been processed on equipment around wheat, rye, or barley.  For instance, oats are naturally gluten-free but may be processed on the same machinery or in the same facility as wheat. 

What is celiac disease?
Celiac disease is a condition in which a patient has an autoimmune reaction to gluten within the small intestines.  As a result, the cells that line the small intestines become damaged overtime and are less able to digest and absorb nutrients appropriately, causing inadequate absorption of nutrients such as calcium, vitamin D, iron and folate.  Diarrhea, abdominal pain and gas can also be common side effects when gluten is ingested in a patient with celiac.

Why am I hearing so much about gluten-free diets now?
You probably have heard more about celiac disease in the last couple of years because it has caught the media’s attention and because many food manufacturers and restaurants now offer “gluten-free” products or menu items.  Specifically for restaurants, it is important to understand that a gluten-free food may still have come into contact with gluten during the food preparation process.  For example, if a gluten-free pizza is baked in the same oven as a regular pizza, it will most likely come into contact with wheat flour particles that remained in place from previous wheat-containing pizzas. 

Is celiac disease common?
It is estimated that about one in 133 people have celiac disease.  Many of those people are undiagnosed but may not even be experiencing physical symptoms at the time.  As a result of media attention, more people are getting diagnosed or at least “self-diagnosing” with celiac.  For someone that is wondering if they have celiac, a doctor can screen for it by one of the following blood tests: immunoglobulin A (IgA), antihuman tissue transglutaminase, or IgA endomysial antibody immunofluorescence.  Further testing by biopsy of the small intestine is the gold standard for diagnosis.  Once diagnosed, the person would need to practice a gluten-free diet for life in order to prevent further damage to the lining of the small intestine.

Why do some people follow a gluten-free diet even if they don’t have celiac disease?
Some people choose to practice a gluten-free diet without having celiac or even suspecting celiac.  While there may not be any true benefit to someone without celiac, some people find that GI symptoms such as pain, gas, bloating and irregular bowel movements improve over time on a gluten free diet.  This is evident in some patients with IBS (Irritable Bowel Syndrome).  They often may have some form of “gluten intolerance” without actual celiac diagnosis. 

What do I do if I think I have celiac disease?
If you are thinking about getting tested for celiac disease, it is important to not practice a gluten-free diet before getting the blood work.   If you are practicing a gluten-free diet when tested, your results may state that you do not have celiac disease when you in fact could be positive for the disease.