A gluten-free diet is an effective therapy for those diagnosed
with celiac disease. Celiac disease is a genetic condition that results in
damaging of the small intestine due to the consumption of gluten. Symptoms of
this disease are gastrointestinal issues including flatulence, bloating,
constipation, indigestion, abdominal pain, and steatorrhea. Some other symptoms
that do not affect the gastrointestinal tract include anemia, vitamin and
mineral deficiencies, anxiety, depression, neurological conditions, and tooth
enamel decay.
Celiac disease is difficult to diagnose. Doctors can identify
possible diagnosis by performing serologic tests for three antibodies;
anti-tissue transglutaminase (tTG), endomysial (EMA) and deamidated gliadin
peptide (DGP) antibodies. It is important that patient must be on a
gluten-containing diet when taking these tests. While these tests can provide
diagnostics for sensitivity, an intestinal biopsy is required to determine a
celiac diagnosis. Again, the patient must be on a gluten-containing diet .Often
times in order to avoid an invasive procedure such as a biopsy, doctors will
encourage patient to begin a gluten-free diet if anti-body tests are positive
for genes associated with celiac disease.
“Gluten is a
protein in wheat, rye and barley that is commonly found in bread, beer, pasta,
and a wide range of other processed foods containing these grains. “ “1% of the population, eating gluten causes
celiac disease, and an intestinal condition characterized by the inability to
absorb nutrients from food.” The site also talks about “one very real danger of
following a gluten-free diet is eating too much fat and too little fiber.” Dr.
Angela Lemond, RDN in Dallas and a spokeswoman for the Academy of Nutrition and
Dietetics states that ditching gluten often means adding sugar and fat. Dr. Peter Green, M.D., director of the Celiac
Disease Center at Columbia University’s medical school states that if you are “convinced
that you have a problem with gluten, see a specialist to get a blood test to
check for certain antibodies associated with celiac disease.”
When avoiding gluten, it is possible to develop a
deficiency in certain vitamins and minerals. This is because many gluten
containing foods that are commonly eaten in the average American’s diet are
made with fortified flour. Foods like whole wheat bread, bagels, crackers, etc.
would include fortification of B vitamins like thiamin, niacin,
riboflavin, folic acid, as well as iron and calcium. Fortification of flour has
been a common practice since the 1940s because there were many people with B
Vitamin deficiencies at that time. Fortification has been effective at
preventing nutrient deficiencies and the possible side effects. For example,
adequate intake of folic acid can help prevent macrocytic anemia and aid in a
healthy pregnancy. Therefore, if you plan to cut out gluten from your diet, it
is important to monitor your intake of foods with naturally occurring B
vitamins. Some examples include lentils, nuts, green leafy vegetables, bananas,
shellfish, and avocados.
One of the most sought-out diets in
this century is the gluten-free diet. However, many people truly suffer from a
gluten intolerance, or as we know it, they have celiac disease. What most
people, not affected by gluten, do not understand is that there are several
nutrient deficiencies that come occur when a person has celiac disease. One of
the reasons so many deficiencies occur is because the small intestine is unable
to properly absorb the nutrients that the body needs. Some of the most common
nutrient deficiencies that occur are fiber,
iron, calcium, magnesium, zinc, folate, niacin, riboflavin, vitamin B12, and vitamin D. So the question is, can supplements be used? The answer is
yes. However, some patients’ small intestine recovers which allows them to be
able to properly absorb nutrients. For those patients who are not as lucky,
they should supplement. Some foods that can be eaten on a strict gluten-free
diet are not enriched, which poses a problem for the deficient person. It has
been suggested that vitamin-mineral therapy should be used. The only problem
with taking vitamins and minerals is that the labels need to be read carefully
before taken. Some of the ingredients in the product contain gluten. If someone
is deficient and is having problems balancing a proper diet, seeking out advice
from a Registered Dietitian or a physician is recommended.
Gluten is often associated with
gastrointestinal discomfort, which explains how easily claims of bowel health
have came about. Many individuals believe that by following a gluten free diet,
they can rid their irritable bowel syndrome (IBS) symptoms. According to
Vazquez-Rogue et al. (2013), this is possible in patients with a certain gene
combination (HLA-DQ2/8) that give them a higher disposition for celiac disease.
While they may not be diagnosed with true celiac disease, they may show
symptoms that mimic that diagnosis. Eating a gluten-free diet for patients
suffering from IBS can be beneficial in relieving many of the uncomfortable
side effects that accompany it.
One popular topic in the media is
that a gluten-free diet can cure autism. The theory behind this is that by
depriving the body of gluten, the person with autism is said to have
significantly improved behavior. Does this behavior change mean the autism is
cured? No. Dr. Ken Williams explains,"... until more clinical studies are
completed and more evidence of safety and benefit is available, parents who
place their child on a casein- free, gluten-free diet need to take extra steps
to ensure they do so in a safe and reliable manner" (2016). Dr. Williams
continues to explain that when considering a gluten-free diet for any reason,
especially in the case of autism, seeking counseling from a Registered
Dietitian is vital.
There
are many of examples of association between disease of the skin and digestive
system. Psoriasis is a chronic autoimmune disease whose symptoms appear on the
surface of the skin. Patches of dry, scaly skin form caused by the rapid
build-up of cells (in days rather than weeks) on the on the skin. Psoriatic
pain may also effect the joints and erode the nails. Some psoriasis patients
have IgG and/or IgA antibodies to gliadin, which means they display a
sensitivity to gluten. Research has shown that these type of individuals who
followed a gluten free diet saw a gradual decline in their psoriatic symptoms.
Some patients were said to see changes in their symptoms as early as three
months are following a gluten free diet. While following a gluten free diet
involves paying close attention to detail on nutrition labels, a closer look
could potentially afford more comfortable lifestyle.
Have
you been looking for the diet that will help you feel better, lose weight, gain
energy or all of the above? If you’ve been taking advice from popular titles
like Grain Brain and Wheat Belly you’ve probably been told
that eliminating grains or gluten will be your ticket to success! You and
roughly 30% of the US population are part of a growing fad looking to partially
or fully eliminate gluten from their diets, according to a 2013 conducted by
the NDP group for consumer research. (1) This is quite a large number
considering only 1.4% of those people actually need to follow gluten-free diets
to alleviate symptoms of celiac disease or doctor-diagnosed wheat allergies. (1)
Let’s
face it- with those kinds of numbers we all know someone who has tried gluten-free
living or maybe even tried it ourselves despite not having a medical condition
requiring it. But have you ever been exposed to someone who takes gluten-free
living to the extremes? Gluten-free dieting as well as other fad diet trends
such as “clean eating” and “the paleo diet” have brought forth what many may
consider a new brand of eating disorder. Patterns seen in people taking these
plans to the extreme show vast similarities with those found in
avoidant-restrictive food intake disorder cases. Some of these symptoms include
having a limited range of food preferences that becomes narrower over time, not
eating with friends or family due to severe avoidance behaviors with certain
foods or ingredients, and having no significant body image distortion or fear
of weight gain but rather fixation on the ingredients of foods.(2)
While
elimination diets may seem like the miracle cure-all for the problem you’re
trying to solve it’s best to take them with a grain of salt. If you find
yourself curious to try one be sure to proceed with caution and be self-aware
of how much effort you’re putting into it. If you’ve started taking a different
route to work to avoid walking past the local pizzeria so you won’t breathe
gluten-contaminated air…it may be time to step back from the plan. A good
alternative would be to visit your local Registered Dietitian who can help you
find healthier alternatives to weight loss and, as surprising as this may
sound, let you eat any foods you want including pizza and bread(scary concept these
days, I know). Think you may know someone who’s taken their gluten-free or
other elimination diet to the extreme? You can visit www.nationaleatingdisorders.org for more information on
symptoms and warning signs of a disorder.
References:
1. 9
Things You Should Know Before Going Gluten-Free - Celiac Disease Foundation.
(2014). Retrieved April 14, 2016, from
https://celiac.org/blog/2014/02/9-things-you-should-know-before-going-gluten-free/
2. Avoidant-Restrictive
Food Intake Disorder (ARFID) | National Eating Disorders Association. (n.d.).
Retrieved April 14, 2016, from
https://www.nationaleatingdisorders.org/avoidant-restrictive-food-intake-disorder-arfid
De Lourdes
Samaniego-Vaesken, M., Alonso-Aperte, E., & Varela-Moreiras, G. (2012).
Vitamin food fortification today. Food & Nutrition Research, 56,
10.3402/fnr.v56i0.5459. http://doi.org/10.3402/fnr.v56i0.5459
Williams,
K. (2016). How helpful is the casein-gluten-free diet. Autism Speaks. Retrieved
from: https://www.autismspeaks.org/node/112986
Vazquez-Roque,
M., Camilleri, M., Smyrk, T., Murray, J., Marietta, E., O'Neill, J., . . .
Zinsmeister, A. (2013). A controlled trial of gluten-free diet in patients with
irritable bowel syndrome-diarrhea: Effects on bowel frequency and intestinal
function. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23357715
Scanlon
SA, Murray JA. Update on celiac disease—etiology, differential diagnosis, drug
targets, and management advances. Clinical and Experimental Gastroenterology. 2011;4:297–311.
Michaëlsson,
G., Gerdén, B., Hagforsen, E., Nilsson, B., Pihl-Lundin, I., Kraaz, W., &
Lööf, L. (2000). Psoriasis patients with
antibodies to gliadin can be improved by a gluten-free
diet. British
Journal Of Dermatology, 142(1), 44-51.
doi:10.1046/j.1365- 2133.2000.03240.x
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