Are you gluten intolerant?
Unlike a food allergy, which is an immune system response than can result in a serious reaction, a food intolerance is a gastrointestinal system response. Certain foods, such as those that contain gluten, either irritate the digestive system or cannot be fully broken down. When your digestive system isn’t functioning properly, it can make you feel sick (e.g., GI symptoms or general malaise). The good news? A food intolerance is dose dependent, meaning you might be able to enjoy soy sauce on your lo mein or a bite of cake now and then without experiencing unpleasant side effects. The “dose” varies by individual. For people with celiac disease, blood tests and intestinal lining biopsies provide an accurate diagnosis. But for gluten intolerance, no specific test exists; feeling sick after consuming foods that contain gluten is a sign you may be intolerant, but celiac disease must be ruled out first. (Do not eliminate dietary gluten before being tested for celiac. If you do, lab tests won’t be able to accurately detect the disease.) If you test negative for celiac disease, your doctor will recommend you avoid all gluten in your diet for two weeks. “I diagnose someone as gluten sensitive if he or she reports symptoms while ingesting gluten and sees improvement [i.e., symptoms disappear] when it’s eliminated,” says Sonia Kupfer, M.D., assistant professor of gastroenterology at the University of Chicago School of Medicine.
If you discover that you have celiac disease or a gluten intolerance, you’ll need to become an avid label reader. While those with a sensitivity may be able to ingest small doses of gluten, people with celiac disease must avoid all foods that list any of these gluten red flags as an ingredient: barley, bulgar, malt (made from barley), rye, triticale, wheat, durham, graham, kamut, farina, semolina, spelt, matzo meal, modified food starch and caramel. Additionally, “flavor” or “flavoring” can be a substance that may contain gluten. So to be safe, it’s best to avoid products that list these as ingredients. Oats, too, should be shunned because they’re often processed and cross-contaminated with wheat, barley or rye. You also must forgo processed meals and snacks and most fast food, and be careful when dining in restaurants. (For gluten-free menu options at national chains such as Applebee’s, California Pizza Kitchen, Chili’s or P.F. Chang’s, visit gfrestaurants.com.) If you’re a beer lover, you’ll have to switch to wine or distilled liquors. And beware of nonfood gluten sources; some lipstick and lip balms, toothpaste and even medications and vitamin supplements use gluten as a binding agent. Note: Not all cosmetic companies list product ingredients, so if you have celiac, it’s best to buy from those that specifically advertise gluten-free products. To check your meds, visit glutenfreedrugs.com.
The effects of going gluten-free
Truth be told, most people probably feel great and even lose weight on a gluten-free diet because they’re eating more healthfully. “Many processed foods are loaded with additives and preservatives,” says Esrailian. “On a gluten-free diet, people are often eating food straight from the plant or animal without the middleman.” However, there are no scientifically proven benefits to a gluten-free diet for those not diagnosed with either celiac disease or a gluten intolerance. In fact, many health care experts believe a gluten-free diet could be lacking in B vitamins (essential for helping your body form red blood cells and generating energy from the foods you eat) and fiber, which are abundant in whole grains that contain gluten. “Moreover, gluten-free products may be higher in carbohydrates, fats and sodium,” says Kupfer. (See “Are ‘Gluten- Free’ Foods Healthier?” below.) The bottom line? The much-touted feel-good effect of gluten-free eating could be due to simple diet mindfulness rather than gluten avoidance. By eliminating processed foods and upping your intake of whole foods like fruits, veggies, beans and nongluten whole grains, you’ll feel healthier, happier and lighter—whether your system can tolerate gluten or not.
Are “gluten-free” foods healthier?
Just because a product is labeled “gluten-free” doesn’t mean it’s good for you. Without gluten to bind pretzels, bagels or pizza crust, manufacturers sometimes use more fat or sugar to make them palatable—and some gluten-free products contain more calories than their gluten-filled brethren. For example, 1 ounce of gluten-free pretzels has 140 calories versus 107 calories for 1 ounce of regular pretzels. Gluten-free bagels, too, get a bit of a bump: A plain bagel has 260 calories while a plain gluten-free bagel contains 280. Here’s the thing: You don’t need the processed gluten-free cookies and crackers. Naturally gluten-free whole grains such as quinoa, brown rice, millet, buckwheat and amaranth are chock-full of healthpromoting B vitamins, minerals, fiber, lignans and antioxidants. Fruits, vegetables, legumes, meat, eggs, nuts and most dairy products are also gluten-free. “You can forgo the gluten-free aisles at the grocery store,” says Robin Foroutan, M.S., R.D., H.H.C, an integrative medicine nutritionist practicing in New York and Morristown, N.J. “Eat whole foods that are naturally gluten-free instead.”