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Gluten - Who really needs to avoid it?

December 8, 2015

Gluten is a general term for the proteins found in wheat. Gluten is made of two different types of proteins: gliadin and glutenin. The type of protein most people are referring to when they talk about gluten is "gliadin". Different types of wheat or grains that contain gluten are listed below:

Atta
Durum
Matzoh (matzo)
Barley
Einkorn
Bulgur
Emmer
Semolina
Commercial oat products, including oat gum and oat hull fibre
Farina
Faro (faro)
Tabouli
Couscous
Graham flour
Triticale
Kamut
Wheat
Dinkel
Spelt
Rye


Celiac Disease
People with Celiac disease have a serious autoimmune reaction to gluten which causes intestinal damage. An estimated 1 in 133 people (or 1% of the population) have Celiac disease. Unfortunately, it often Celiac disease is diagnosed only with a small bowel biopsy, where a doctor takes out and examines a tiny piece of your tissue. If someone with Celiac disease eats any amount of gluten, they can have immediate stomach discomfort or pain, extreme fatigue, and constipation or diarrhea. In the long-term, people with untreated Celiac Disease are at risk for severe malnutrition, certain cancers and some intestinal diseases. They must eliminate gluten entirely from their diet, kitchen, and even beauty products.

Non-celiac Gluten Sensitivity (NCGS)
If someone has tested negative for Celiac disease but still has gastrointestinal or lifestyle-related symptoms when eating gluten, NCGS may be the culprit. Current research shows that about 5% of Americans may have gluten sensitivity to some extent. It is very important to rule out other possible diagnoses such as Celiac Disease, Irritable Bowel Disease, and Irritable Bowel Syndrome before self-diagnosing with gluten sensitivity. If you have been avoiding gluten, your test for Celiac disease may show up as a false negative. This means even if you have Celiac disease, the biopsy will look like you don't have it. People with NCGS will avoid gluten according to their symptoms. Some people can tolerate quite a bit of gluten, while others can tolerate very little before symptoms arise.

Does eating less gluten help me to lose weight or be healthier?
Gluten-free or low gluten diets are not scientifically proven to lead to weight loss or decreased gut or lifestyle-related symptoms if a person does not have gluten sensitivity or Celiac disease. Often, prepared gluten-free products will have higher calories, sugar and saturated fat. If people lose weight by eating less gluten, most likely that they are eating less refined carbohydrates, a wider variety of whole grains, and/or other healthy foods. The best diet for a healthy body for life is one rich in high-fiber whole grains, vegetables, fruits, and lean proteins.

Thank you to Emily Fleming and Brenna Wasylenki for their contributions to this post.

References:
http://www.albertahealthservices.ca/hp/if-hp-ed-cdm-ns-5-3-2-gluten-free-diet.pdf
http://www.celiacedmonton.ca/
http://www.celiacedmonton.ca/about-celiac-disease/myths-about-celiac-disease/
http://www.badgut.org/information-centre/a-z-digestive-topics/celiac-disease/

 

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