Gluten is so hot right now. Over the last decade, more and more people have become aware of the harmful effects that gluten can have on their health. Additionally, more men and women are discovering that they suffer from some degree of gluten intolerance. Gluten intolerance definitely appears to be on the rise and affecting more people than ever before. As a result, countless people are adopting a gluten-free diet.
Despite this, some would simply dismiss gluten-free diets or gluten-free living as yet another fad. Nevertheless, the negative effects of gluten are quite real and, despite all of the potential negative gluten-related health effects, few people actually know what gluten is.
What Is Gluten?
Gluten is simply a term for the two combined prolamin proteins naturally found in certain grains. Gliadin and glutenin are the two proteins that make up gluten. The gluten protein “gliadin” is what causes adverse reactions in some people. Some people become very sick from gluten, though not everyone does.
Gluten is a “sticky” or glue-like protein usually found in grains such as wheat (farina, spelt, farro, durum, emmer, einkorn, and khorasan wheat) rye, barley, and triticale.
Gluten is responsible for the:
- elasticity of dough and pasta
- chewiness of bread
- rising property of dough (bread/pizza) during baking
- ability of bread (and other foods) to retain its shape
- ability of cheese to spread
- smooth texture of condiments
- prevention of sauces from curdling
- thickening and filler-like properties of food products
Why Be Concerned?
People around the globe, especially in North America, eat an extraordinary amount of grains. However, prior to the agricultural revolution, which began about 10,000 years ago, mankind lived mostly on a Paleolithic diet. The transition from hunting and gathering to agriculture has occurred far too fast for our bodies to adapt to a diet full of grains, such as wheat, barley, and rye.
Because agricultural-type foods are relatively new and foreign to our bodies, based on an evolutionary timeline of hundreds of thousands of years, countless people have yet to develop a tolerance for eating gluten-laden foods such as grains. As a result, the consumption of grains, and especially wheat, can wreak havoc on the body.
It’s estimated that about 1% of the population (one in every one hundred people) suffers from celiac disease (1), an autoimmune condition triggered by gluten. For these people, the mere consumption of the gluten proteins found in wheat, barley, and rye results in damage to the small intestine and interference with the body’s ability to absorb nutrients from food.
Furthermore, the long-term consumption of gluten by people with celiac disease can result in permanent health problems, such as:
- other autoimmune conditions
- reduced bone density
Gluten Intolerance Symptoms
Although celiac disease – the most acute type of gluten intolerance – only plagues 1% of the population, the other 99% of the population is, nevertheless, susceptible to reactions and intolerances to gluten.
It’s estimated that approximately 47.8 million people (15%) in the United States are affected by gluten. Yet, because grains are so abundant in the typical North American diet, countless people endure and suffer from all sorts of reactions, yet have no idea that the culprit of their discomfort and crappy feelings is gluten.
While gluten intolerance often manifests itself through digestive symptoms, there are other symptoms and problems of varying severity. If you’re wondering what some of the specific gluten-intolerance symptoms are, read on.
Immune Response & Inflammation
Gluten intolerance is considered to be one of the most common intestinal food sensitivity diseases. For people who are gluten intolerant, the consumption of gluten sets off an immune response that causes the body to begin to fight it using antibodies and white cells. Once the body’s white cells become exhausted from fighting gluten, inflammation occurs. In fact, gluten is a major contributor to inflammation, which often is the basis of many terrible degenerative health conditions.
It is suspected that a large part of our population:
- experiences some degree of gut inflammation from gluten
- develops antibodies to fight against gluten to stop its proteins from entering the blood stream, thus subsequently triggering an immune reaction
Digestive & Gastrointestinal (GI) Distress
In the beginning, gluten intolerance can result in:
- flatulence (gas)
- recurrent constipation
- foul-smelling stools
- uncomfortable stools
- recurrent constipation
- irritable bowel syndrome
- acid reflux
- occasional vomiting
However, there are other symptoms too. A gluten intolerant individual who regularly consumes gluten, can experience long-term damage, including:
- intestinal scarring
- nutrient malabsorption
- chronic inflammation
- flattening of the intestinal lining
- impaired digestion
Lastly, an unexplained loss of weight might be a signal that you’re gluten intolerant. This could happen because your body is not absorbing nutrients from food. Furthermore, some people who are gluten intolerant might also be lactose intolerant.
The Brain, Psychology & Mood Swings
Although many of the primary symptoms and signs of gluten intolerance tend to manifest themselves within the body’s digestive tract, it’s believed that the human nervous system can also exhibit symptoms and signs of gluten intolerance.
Studies suggest a possible connection between the functioning of the brain and the following:
- the body’s malabsorption of gluten
- autoimmune reactions triggered by gluten
- gluten’s interference with protein absorption
The body’s nervous system dictates a person’s mood, perception, and quality of life. If gluten causes any deterioration of the nervous system, a person’s quality of life also undergoes deterioration.
Possible indicators include but are not limited to the following:
- mood disturbances
- difficulty concentrating
- migraines and headaches
In addition to the above, research has shown a correlation between gluten sensitivity and the following:
- attention deficit hyperactivity disorder (ADHD)
- attention deficit disorder (ADD)
- multiple sclerosis (MS)
- Alzheimer’s disease (AD)
Those with a gluten intolerance or sensitivity can also experience the following skin conditions:
- skin rashes
- canker sores
Bones & Joints
Gluten intolerance can also cause or worsen the following symptoms and conditions:
- joint inflammation
- rheumatoid arthritis
- joint pain
- early onset osteoporosis
- bone loss (due to decreased calcium absorption)
- tooth enamel erosion
Other Possible Symptoms
There’s a growing amount of evidence that suggests that food allergies, food sensitivities, and gluten intolerance might also contribute to a wide range of other undesirable symptoms, as well as complicate certain pre-existing conditions. A gluten-free lifestyle might just be the cure. A gluten-free diet may help to:
- prevent diabetes
- assist in stabilizing blood sugar levels
- stimulate weight loss
- reduce food cravings
- decrease the risk of infertility, stillbirth, and early menopause
- lessen the chances of iron-deficiency anemia
- reduce the chances of atherosclerosis and other cardiovascular diseases
Altogether, this is a very long list of possible symptoms of gluten intolerance. Later on in this article, I’ll give you a way to work out whether or not you’re gluten intolerant, but first it’s important that you become aware of the obvious and not so obvious foods and products that contain gluten.
Which Foods Contain Gluten? (The Obvious And The Not So Obvious)
Gluten is everywhere. It can be found in everything from the obvious to the not so obvious. It’s likely that all processed foods contain gluten.
We’ll start with obvious sources of gluten, such as wheat, barley, and rye. It’s important to realize that wheat includes all forms of wheat, including:
- triticale (a wheat/rye mixture)
- cake flour
- matzo (or matzah)
You should also be aware of foods containing ingredients with names that contain “wheat,” including:
- wheat starch
- hydrolyzed wheat protein
- modified wheat starch
- pre-gelatinized wheat protein
As mentioned above, barley also contains gluten. And malt typically contains gluten because it is often made from barley. In fact, malted grain is used to make:
- malt syrup
- malt extract
- malt flavoring
- malt vinegar
- malted shakes
- malt load
- Rich Tea biscuits
Rye is a grain that’s very similar to barley and wheat. It’s often found in the following:
- rye bread
- pumpernickel bread
- crisp bread
- rye beer
- whiskey (some)
- vodka (some)
In addition, many types of grains, such as oats, are frequently processed near gluten-filled grains and are subsequently cross-contaminated with gluten. However, there are many food manufacturers who now produce gluten-free oats, which are specifically labeled “gluten-free.”
In principle, some kind of gluten can likely be found in any type of grain, not just wheat, barely, and rye. However, it’s those three types of grains that are responsible for the majority of gluten-related health issues.
You should realize that if gluten is in wheat, gluten is in flour. As mentioned earlier, it’s gluten’s elastic properties that make it possible for flour to be transformed into products such as:
- pizza dough
Therefore, all the above foods or items are highly likely to contain gluten.
Additionally, floured or breaded seafood, poultry, meat, and vegetables will also contain gluten. Furthermore, you should be aware that any poultry, meat, or vegetables with sauces (soy and teriyaki) or marinades are likely to contain gluten.
Gluten can also be found in many unlikely places, such as:
- chewing gum
- salad dressing
- imitation crab meat
- many processed foods
Lastly, here’s a list of foods or products that might contain gluten:
- Food flavorings are more often than not gluten-free, however, in very rare instances, some flavorings may contain barley or wheat. Legally, food flavoring containing wheat must be labeled accordingly. Flavoring with barley is typically labeled as “malt flavoring.”
- Modified food starch is usually gluten-free. You can spot the exceptions by looking at the labels. The starch with gluten will usually be labeled as “modified wheat starch.” Also, an obvious indication that it contains wheat is the phrase “includes wheat.”
- Pharmaceuticals and medications might also contain gluten, however, most meds are gluten-free. If you’re gluten sensitive or intolerant, you can simply check whether or not gluten is used in your meds with the company that manufactures them.
- Processed cheese, such as “spray cheese,” may also contain gluten. However, you need not worry about real cheese, as it is free of gluten.
- Seasoning mixes might contain gluten, but it’s required by law that the seasoning mix labels say if the seasoning contains wheat.
How To Know Whether Or Not You’re Gluten Intolerant
Because gluten intolerance has such a wide range of symptoms, you might be curious to know how to know whether or not you’re gluten intolerant. Well, it can be a bit of challenge to diagnose gluten intolerance. Nevertheless, if you understand that gluten intolerance is essentially a systemic and broad range inflammatory response, you can make better sense out of its wide range of symptoms.
That said, you essentially have a two choices for determining whether or not you’re gluten intolerant:
- gluten elimination diet
Your doctor can have tests done to help you determine whether or not you’re gluten intolerant. There’s also a home test available that you can do yourself and then send to a lab. Usually the at home test consists of both a saliva sample and stool sample.
If your physician has you tested, in addition to a stool sample, he or she will likely order a wide range of blood tests to find out about your antibodies.
The tests may or may not include the following:
- anti-gliadin antibodies (AGA) test
- anti-endomysial antibodies (EMA) test
- anti-tissue transglutaminase Antibody (tTG) test
- anti-reticulin antibodies (ARA) test
Testing for the above antibodies is helpful in identifying whether or not you’re gluten intolerant because your body produces antibodies in response to harmful substances and invaders. The above tests vary in terms of reliability and gluten detection sensitivity. Often, in addition to these antibody tests, your physician may also request a full blood count, which is usually for checking out other potential symptoms, such as renal function, liver enzymes, anemia, etc.
Gluten Elimination Diet
A highly recommended and useful tool for determining whether or not you’re gluten intolerant is the gluten elimination diet. This approach targets your unique needs and is thus very beneficial to the people who try it. Also, it’s fun because you get to observe and research yourself. What’s more, this approach doesn’t require any expensive blood testing or stool samples.
For many years, elimination diets have been generally accepted as a standard method for detecting a wide variety of food sensitivities. Of course, if you decide you want complete testing for gluten intolerance, you’ll want to postpone your gluten elimination diet until after you’ve completed any tests.
OK. So how would you go about starting a gluten elimination diet?
Foods and Products to Remove
For a list of foods and products to remove, refer to the previous section, “Which Foods Contain Gluten? (The Obvious And The Not So Obvious)”
Next, select a period of time that you’d be comfortable eliminating all gluten products from. For example, you might opt to eliminate all gluten from your diet during a single week. Other people opt to eliminate all gluten-containing food and products for a two- or four-week period. It’s totally up to you.
To stick to the diet, it’s important that you focus on the foods you can enjoy, instead of on those you’re temporarily removing from your diet.
Foods To Enjoy
- beans and legumes (not paleo)
- milk (dairy is not paleo)
- grass-fed butter (primal, not paleo)
- grass-fed real cheese (prima, not paleol)
- vegetable oils (canola included) (not paleo)
- fresh fruits (fresh, frozen, and canned)
- fresh vegetables (fresh, frozen, and canned)
Gluten-free foods that are made from or with grains:
Important note: Most of the foods below are not considered paleo. If going gluten-free and 100% paleo is a priority for you, please consult the paleo food chart.
- corn (all forms) such as corn meal, corn flour, grits, etc.
- rice (all forms) such as brown, white, enriched, and basmati
- buckwheat (kasha)
- plain spices
- silicon dioxide
- glucose syrup
- oat gum
- starch (including food starch)
- vinegar (not malt vinegar)
- malic, citric, and lactic acids
- dextrose, sucrose, and lactose
Gluten-free baking products:
- xanthan gums
- tapioca flour (or starch)
- potato starch and/or flour
Other gluten-free items:
- pure spices (the only ingredient is the spice itself)
- distilled vinegar
- monoglyceride fats and diglycerides fats
- distilled alcoholic beverages (unless ingredients with gluten are added to the beverages after the distillation process)
Length of Time
The duration of a gluten elimination diet depends upon two factors: (1) age and (2) symptom severity.
Regarding age, the general duration for the diet is as follows:
- Children – seven to ten days
- Adults – three to four weeks
Regarding severity, most people with more severe symptoms seem to enjoy remaining on the diet. Adults with more severe symptoms might want to remain on the diet for an entire four weeks.
Gradual Or Immediate Elimination of Gluten
The gluten elimination process can occur over a period of anywhere from two to four weeks. During the initial phase, you either gradually or immediately eliminate all gluten from your diet. Once you’ve eliminated all gluten-containing foods and ingredients from your diet, you’ll then remain on the diet for the suggested period of time as mentioned above. So an adult would then remain on the gluten-free diet for a period of three to four weeks.
During this time, you should judge how you feel, and observe whether or not your symptoms have lessened or gone away completely. It’s important to monitor things such as your:
- bowel habits
You might also consider keeping a simple journal after you’ve totally eliminated gluten from your diet. A journal is a great tool to help you track mental, physical, and emotional symptoms and signs.
If you discover that you feel better during this gluten-free period (better mood, energy, digestion, sleep, etc.), that might be a good indication that some, if not all, gluten-containing foods, ingredients, and products were the cause of the problems you were experiencing. If you do feel better with gluten out of your diet and life, you simply proceed to live a gluten-free lifestyle.
Keeping it Simple
Regardless of the duration you choose, avoid making things overly complicated or difficult. It’s best to keep it simple by enjoying the gluten-free foods and items above. Last but not least, be sure that you drink plenty of water – ideally, sixty to 120 ounces per day. That’s about five to ten twelve-ounce glasses of water each day.
Reintroducing Gluten Into Your Diet
Some people choose to re-introduce foods with gluten back into their diets. If you choose to do this, be sure to pay attention to how you feel as you reintroduce these foods back into your diet. Be on the lookout for negative symptoms or reactions, such as:
- fatigue (reduction in energy)
- brain fog
- respiratory or sinus issues
- joint pain or inflammation
- skin rashes or breakouts
- headaches (migraines included)
- gastrointestinal (GI) pain
- bowel changes
Also, you might want to consider reintroducing no more than one or two foods back into your diet at a time (one per day) instead doing sort of a free-for-all re-introduction.
The benefit of doing a gradual re-introduction is that you’ll be able to observe and identify which changes are related to which foods. Any unpleasant changes you experience during the reintroduction phase could suggest that you have a gluten intolerance.
For some people, the gluten elimination diet is easy. For others, it can pose a slight challenge. However, it’s not that difficult if you follow these tips:
- Prepare: Devote one week, prior to beginning the gluten elimination process, to finding gluten-free recipes.
- Clear away the gluten: Rid your kitchen and home of gluten-containing foods and items. Don’t try to rely on willpower.
- Stock your home: Purchase the gluten-free foods you’ll need before you begin.
- Cook in advance: Prepare large amounts or multiple servings of gluten-free foods (veggies, protein, etc.) with the necessary seasonings to avoid becoming hungry and to make it more likely that you’ll stick to the gluten elimination diet.
Lastly, remember that this is only temporary, but that the knowledge and understanding about your diet and health that you’ll get from the experience will last you a lifetime.
What To Do If You’re Gluten Intolerant
So, let’s say that you’ve completed a test for gluten intolerance, or you’ve completed the gluten elimination diet, and you’ve determined that you’re gluten intolerant. Where do you go from there? What can you do? Perhaps the best thing to do is to live a gluten-free lifestyle. Yes, that means cutting gluten out of your life.
How To Live A Gluten-Free Lifestyle
Before you venture down the road of gluten-free living, it’s a good idea to understand both the pros and cons of doing this.
The Potential Benefits Of Living Gluten-Free
Many of the benefits of gluten-free living are probably obvious to you at this point, now that you know about the health problems gluten can cause.
However, here’s a short list of some of the benefits of living gluten-free:
- elimination of most unhealthy foods and junk foods from your diet and life
- healthier and more nutritious diet
- reduced chances of getting celiac disease
- easier weight management
- fewer unwanted food cravings
Most notably, living gluten free is known for providing gluten intolerant people with benefits such as:
- better and healthier skin
- increased energy levels (less fatigue)
- improved digestion
- relief from gastrointestinal (GI) distress (diarrhea, gas, bloating, etc.)
- fewer headaches (migraines included)
- less chance of iron-deficiency anemia
- reduced joint inflammation and pain
- improved mood
- better focus
- clearer thinking
- less “brain fog”
- lower blood sugar levels
The Potential Downsides Of Living Gluten-Free
The downsides of living a gluten-free lifestyle can essentially be boiled down into two issues.
#1 Assuming That The “Gluten-Free” Food Label Equals “Healthy”
In August of 2013, The Food and Drug Administration (FDA) decided to standardize the official definition of “gluten-free” for food-industry compliance and consumer awareness. The FDA “requires that for a food manufacturer to “use the term “gluten-free” on its label, a food must meet all the requirements of the above definition, which means the food must contain less than 20 parts per million of gluten.” This includes other labels and food claims, such as:
- “no gluten”
- “free of gluten”
- “without gluten”
That said, it’s important to realize that a food being labeled “gluten-free” is not necessarily healthy. Nor does living a gluten-free lifestyle provide you with a license to ignore portion size guidelines, stop eating whole (real) foods, or follow a diet with an unhealthy balance of macro nutrients.
Furthermore, simply swapping all of your gluten-containing foods for gluten-free foods will only set you up for issues such as possible weight gain and nutritional deficiencies.
#2 Failing To Get Sufficient Nutrients, Vitamins & Minerals
First and foremost, it’s important to understand that eating gluten-free is safe. The only downside is for those people who fail to eat a well-rounded and healthy diet with all the necessary nutrients.
The reason that nutritional deficiency can be a concern with a gluten-free diet is that most wheat products contain fiber and are fortified with minerals and vitamins (such as B vitamins, folic acid, iron, thiamin, riboflavin, and niacin). Not many gluten-free foods and products are enriched or fortified with the same nutrients as wheat and other gluten-containing foods.
However, as long as you take care to consume other foods with the necessary nutrients, you have no reason to be concerned. Gluten-free living is nutritionally safe if you are mindful of eating a balanced diet and a range of foods, including:
You can get all the nutrients necessary as long as you focus on “real” or “whole” foods instead of on processed foods.
Going gluten-free is a real lifestyle change. Gluten is everywhere. In fact, most “comfort foods” are loaded with gluten. Nevertheless, it’s important to realize that if you’re gluten intolerant, gluten is doing damage to your body, mind, and health each time you consume it. When you take into consideration the damage gluten can do to your body, you should be happy to permanently dump gluten in favor of a better and healthier diet.
Note: For those who are gluten intolerant, even a little gluten can cause big problems. The only way to steer clear of the nasty effects of gluten is to avoid it every day.
No Magic Bullet
A common mistake that some people make with gluten-free living is to assume that it’s some sort of magic bullet. However, good health always requires some work and effort. There are no magic bullets.
For the maximum nutritional and health benefits, be sure to do the following:
- embrace a gluten-free diet that’s packed with a variety of real, whole foods such as veggies, lean proteins, and fruits
- avoid processed foods
- keep your consumption of refined sugar to a minimum
- practice portion control and moderation daily
- exercise daily
- drink plenty of water
Last, but not least, it’s important to understand that a gluten-free lifestyle or diet is no substitute or replacement for a physician’s diagnosis, consultation, or recommendation. It’s always important to seek the advice and approval of your physician or a trained healthcare provider before making changes that may affect your health. Healthcare professionals and dieticians can play a significant role in helping you to reach your goals safely.
Resources & References
- Celiac Disease: On the Rise
- Painter K. Gluten free diets gaining in popularity. USA Today. August 2008.
- Gluten-free diets gaining in popularity
- Bush VK. The Glories of Gluten Free. QSR Feature. 2009.
- Hadjivassiliou M, et al. Does cryptic gluten sensitivity play a part in neurological illness? Lancet 1996; 347:369-371
- Hadjivassiliou, et al. 2002. Gluten sensitivity as a neurological illness. J Neurol Neurosurg Psychiatry 72: 560-3
- Sandberg DH, McLeod TF, Strauss J. Renal disease related to hypersensitivity to foods. In: Food allergy: new perspectives. (Gerrard JW, ed.), Springfield: Charles C Thomas, 1980; 144.
- Gluten Free Living
- FDA news release on definition of gluten free
- Gluten causes GI disturbances in people without celiacs.
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