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Q: I see “gluten free diet” advertised in magazines and online, as a healthier option, and even grocery aisles are full of gluten free products. Is this a fad, or is gluten free diet really healthier?
A: I agree. Gluten free diet is everywhere, and it is a relatively recent phenomenon. It is very important to know what a gluten free diet is, and who would really benefit from this diet.
What is Gluten?
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.
Can gluten cause disease?
Yes, for about 1% of the population, gluten causes celiac disease (CD). This is an acquired autoimmune disease that occurs in genetically predisposed individuals. Patients with celiac disease, who ingest gluten, will develop intestinal inflammation that causes destruction of the villous structures and malabsorption of nutrients. Common symptoms include diarrhea, bone pain, anemia and skin rash. Patients with untreated CD are also at increased risk of certain cancers, such as non-Hodgkin’s lymphoma.
Celiac disease is diagnosed through blood tests, but a duodenal biopsy is the gold standard test for diagnosis.
People with Celiac Disease get tremendous relief from a gluten free diet.
What is “non-celiac gluten sensitivity”?
This is a relatively new disease making its way through the medical literature. This includes patients who just feel better on a gluten free diet, but do not have celiac disease. The symptoms that patients describe are vague, and include diarrhea, abdominal cramping, bloating, headaches, fatigue (similar to those of irritable bowel syndrome, fibromyalgia or chronic fatigue syndrome). Once these patients start on a gluten free diet, their symptoms improve; however, the jury is still out on the exact cause of Non Celiac Gluten Sensitivity. It has been postulated by some that many symptoms attributed to gluten may actually be caused by sensitivity to other components of wheat flour or other ingredients found in wheat-based foods.
The true prevalence of gluten sensitivity is not known.
Can Gluten free diet be Dangerous?
Gluten free diet is a specific nutritional therapy for people with celiac disease and gluten sensitivity. For everyone else, it may not make a lot of sense.
In fact, gluten free packaged products (breads, cakes, pasta etc) have a higher glycemic index, and can induce insulin resistance and weight gain. They also have less fiber than wheat based flours, and may lack important vitamins and minerals.
Gluten free products are more widely available than ever, and that is great for people with celiac disease. But, patients need to make smart choices. The basis of a healthy gluten-free diet, as with any diet, should be natural foods. Lean meats, chicken and fish, fruits and vegetables, nuts and low-fat dairy products are all safe for people with celiac disease.
This information is strictly an opinion of Dr. Prakash, and is not intended to replace the advice of your doctor. Dr Chris Prakash is a contributing columnist, and author of eParisExtra’s “The Doctor is In” column. He is a medical oncologist at Texas Oncology Paris. He is board certified in Internal Medicine, Oncology and Hematology. He lives in Paris, Texas with his wife and two children, and can be reached at 903.785.0031, or Sucharu.firstname.lastname@example.org