Should I go Gluten Free?

Should I go Gluten Free? 

"It seems that everyone is going gluten free these days. What are the benefits of a gluten free diet for those of us who don't have a gluten allergy?"

Some people require a gluten-free diet. People who require a gluten-free diet are those with celiac disease, gluten sensitivity, wheat allergy, or a condition that could benefit from a gluten-free diet. If you don’t have a condition that requires a gluten-free diet, then the benefits of a gluten-free diet would be related to the potential reduction in inflammation that comes from reducing gluten intake, as well as the improved food choices you could make. Once you have started a gluten-free diet, testing for celiac disease becomes complicated and unreliable; therefore you should consider your risk for celiac disease before starting a gluten-free diet

Who Might Have Celiac Disease?

Regardless of your intention to follow a gluten-free diet, you should be tested for celiac disease if you have symptoms of celiac disease. A few common symptoms are: fatigue, joint pain, mouth sores (aka canker sores), anemia, digestive complaints (e.g. gas, nausea, bloating, constipation, loose stools, reflux, etc) or irritable bowel syndrome. A complete list of symptoms can be found here.

There are people with celiac disease that don’t have any noticeable symptoms, thus if you are at a high genetic risk then you should be tested for celiac disease regardless of your symptoms or lack of symptoms. In the general population 1 in 133 people have celiac disease. But in people who have a close family member with celiac disease the rate of celiac disease is 1 in 22.  Therefore, if you have a first-degree relative (parent, sibling or child) or second-degree relative (grandparent, aunt or uncle) with celiac disease then you are at high genetic risk and should be tested.

Thyroid disease, osteoporosis, infertility, and all autoimmune diseases are conditions closely related to celiac disease. If you have a related condition to celiac disease you should be tested for celiac disease regardless of your symptoms.

Do I Really Need to Get Tested?

The treatment of celiac disease is a 100% gluten-free diet for life. If you have signs or symptoms of celiac disease or a related condition, or if you have a family member with celiac disease, then you are at high risk for celiac disease and you absolutely need to be tested for celiac disease before you start a gluten free diet so that you know what you are dealing with. Here’s a common scenario that demonstrates the importance of testing for celiac disease before starting a gluten-free diet:

A person with undiagnosed celiac disease starts a gluten-free diet as a part of a 30-day challenge and unknowingly treats their condition with the gluten-free diet. During this month they feel amazing, with more energy, better exercise recovery, less muscle stiffness, better mood and improved digestion. That’s great! But let’s face it, a “diet” doesn’t always stick and with every cheat or accidental exposure to gluten when eating out, the person with celiac disease causes an autoimmune attack on his or her body. This person feels better overall but they still have health or wellness complaints, and their risk for infertility, bone disease, thyroid disease and other related conditions remains high because they are not following a strict gluten-free diet 100% of the time.

Additionally, people with celiac disease need to inform family members that they have it so that their family members can be tested. When a gluten-free diet is initiated prior to testing for celiac disease, or if testing is not pursued because a gluten-free diet seems to resolve complaints, a clear diagnosis of celiac disease may become unobtainable. This often makes it difficult for family members to understand their risk for celiac disease.

Bottom Line: Get tested. If you’ve already started a gluten-free diet and are now wondering if you might have celiac disease, contact me and I’ll help you decide how to proceed with further testing, if necessary.

I’m Sure I Don’t Have Celiac Disease, but the Gluten-Free Diet Totally Works For Me!

Gluten sensitivity is another immune condition that is treated with a strict lifelong gluten-free diet. The signs and symptoms of gluten sensitivity are very similar to celiac disease, thus the starting point in identifying gluten sensitivity is to test for and rule out celiac disease. Once celiac disease is eliminated as a possible cause of symptoms, then one would follow a strict gluten-free diet to evaluate for changes in their symptoms. If their symptoms subside on a gluten-free diet, and if they can stimulate symptoms by eating gluten again, then they may have gluten sensitivity, for which the treatment is a strict lifelong gluten-free diet.

A gluten-free diet is also very helpful in treating irritable bowel syndrome (IBS) inflammatory bowel disease (IBD), and altered intestinal bacteria. These are related conditions to celiac disease, which means that testing for celiac disease should be completed. If it is determined that you don’t have celiac disease then a gluten-free diet can be helpful in managing the symptoms of these gastrointestinal conditions and the strictness of the diet would be based on the individual. The reasons that a gluten-free diet “works” for IBS and IBD is totally different from celiac disease and gluten sensitivity and it is essential that you consider these first.

Nope, No Celiac, No Bowel Disorder, No Gluten Sensitivity…Should I Eat Gluten Free?

If you are sure that you don’t have celiac disease, gluten sensitivity, a celiac disease related condition, IBS, IBD or any other health reason to eat gluten free, then you could try a gluten-free diet to reduce systemic inflammation for enhancement of exercise performance.

Gluten is a protein found in wheat, barley, rye and oats. Gluten is a difficult to digest compound and will cause intestinal inflammation in every human. The extent of one’s ability to recover from this inflammatory insult is dependent on ones genes, diet, sleep habits, stress management abilities, dietary supplements, other health conditions and exercise regimen. Inflammation is known to cause muscle soreness, fatigue, increased insulin resistance, and increased risk of injury related to exercise. A gluten-free diet that decreases inflammation may lead to many health benefits and there is a huge potential for improved exercise performance.

Another reason that a gluten-free diet may have a positive impact on your health and exercise performance is that common sources of gluten include breads, pasta, crackers, cookies, pastries and other processed foods that are not nutrient dense and may add to your inflammatory fire with added oils, sugars and additives. Choosing gluten-free options for these foods doesn’t really help as you are still choosing processed foods. Thus for the most anti-inflammatory impact, transitioning to a naturally gluten-free diet is the goal. Here are some ideas:

• Instead of breakfast cereal, make hot quinoa cereal with nuts and fruit or have scrambled eggs with beans and salsa.
• Instead of a sandwich for lunch, have bean and chicken “tacos” on lettuce or kale leaves
• Instead of pasta for dinner, have a baked sweet potato topped with ground turkey, beef or tofu smothered with marinara or pesto sauce.

 Transitioning to a whole foods diet will lower gluten in your diet and boost essential nutrients. That’s something everyone can benefit from.

The information in this article has been simplified. Gluten-free diets and the conditions discussed here are complex. Please contact me with questions about the information found in this article.

Please remember that the information contained in this article is provided for informational purposes only. It is general information that may not apply to you as an individual, and is not a substitute for personalized nutrition advice or healthcare. Never disregard medical or nutritional advice or delay seeking medical care because of something you have read or accessed through this article.

Hana A. Feeney, MS, RD is an open-minded, progressive dietitian that blends evidence based nutritional science with the principals of intuitive eating and cutting-edge functional medicine. Hana specializes in sport nutrition, digestive health, fertility, hormonal health and eating disorders. Visit www.NourishingRestuls.com to explore, read, cook and reach out!