Is Gluten a fad?

Gluten is a group of proteins that is found in most grains that we eat.  Wheat is the grain most commonly consumed that has gluten.  Gluten is what gives wheat its glue-like consistency when it is mixed with water.  Gluten can cause problems for people who have an allergy to wheat and people who have celiac disease.  For unknown reasons, the number of people with celiac disease has quadrupled since 1950.

Celiac disease is an autoimmune disease where gluten is attacked by the body when it is consumed.  Unfortunately, the gut lining is attacked as well when this happens.  This can cause nutrient deficiencies, and can also cause gastrointestinal (GI) symptoms such as bloating, diarrhea, and constipation.  The GI symptoms, however, are not always present in people with celiac disease.  Interestingly, most people with celiac disease don’t know they have this condition.

There is another group of people who have non-celiac gluten sensitivity.  A clear cut diagnosis of non-celiac gluten sensitivity does not exist, and the diagnosis is made after celiac disease and wheat allergies are eliminated.  The GI symptoms that this group of people have are very similar to those manifested by the celiac disease group.  This diagnosis is controversial, and some experts feel that the condition does not exist.  Furthermore, these experts feel that the symptoms manifested by the patients are due to another reason.

GI discomfort is the most common symptom with celiac disease.  Having trouble gaining weight, and anemia are other presentations for this condition.  You should consult your physician if you think you have this condition.  The diagnosis can be made with a blood test looking for the antibody  tTG-IgA.  If this is positive, then an intestinal biopsy is recommended.  A general surgeon or a gastroenterologist can perform the biopsy.  The other option is to eliminate gluten from the diet, and see what your symptoms do.  If the symptoms go away, then there is a good chance that you have celiac disease or non-celiac gluten sensitivity.  If the symptoms do not go away, then your symptoms are being caused by something else.

Having a gluten free diet can be difficult at first.  Many foods have wheat in them.  Most experts advise avoiding processed foods, and eating whole foods.  Read the labels on cans and containers to make sure that wheat had not been added.  Many foods do not contain gluten.  These foods include meat, eggs, vegetables, nuts, dairy products, and fruits among others.  The list of foods that are gluten free is steadily growing so people who have to avoid gluten have an increasing variety of choices.

There are short chain carbohydrates found in many foods called FODMAPs which can occur naturally or can be used as food additives.  FODMAPs include fructose, lactose, sorbitol, mannitol, FODMAPs can mimic the celiac disease and non-celiac gluten sensitivity conditions.  FODMAPs pull water into the intestine, and cause bloating.  The food then moves to the colon where the FODMAPs produce gas.  It’s likely that some people who think they have celiac disease actually have a problem with FODMAPs.  Finding FODMAP free food, however, is quite difficult.  Foods containing FODMAPs include artichokes, bananas, baked beans, figs, apples, apricots, onions, garlic, and pears to name a few.  There is a complete list of foods with FODMAPs on the internet.

Many experts feel that most people do not have to avoid gluten.  Dr. Peter Gibson from Australia, however, took a group of people with Irritable Bowel Syndrome (IBS) and placed them on a gluten free diet.  He found that the majority of people in the study had most of their symptoms improve with gluten free food.   So there is some controversy about the need of people who have not been diagnosed with celiac disease or non-celiac gluten sensitivy  to avoid gluten.  And remember that eating a gluten free food does not necessarily make it a healthy food.

My best advice, again, is to consult your physician if you feel that you have one of these conditions.

Wishing you success with your weight loss and maintenace, Pablo.

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