Imagine a life in which your favorite comfort foods, such as pasta, bread, cereal and cookies, could cause you to become violently ill. This is reality for an estimated 3 million Americans who have been diagnosed with celiac disease, an autoimmune disorder that involves a severe reaction to foods containing gluten.
Growing awareness of the condition, combined with consumer demand, has brought an increasing number of gluten-free products to store shelves in recent years. While people with celiac disease have little choice but to avoid gluten, others may be avoiding gluten in an effort to trim pounds. That may work -- but it may not be the best way to lose weight.
Where Gluten Hides
Gluten is the common name for the proteins found in specific grains, and it is found in all forms of wheat. Ashley Koff, a Los Angeles-based registered dietitian, uses the acronym "BROW" (barley, rye, oat and wheat) to help clients remember where gluten is found.
Examples of gluten-containing foods include breads, cookies, crackers, cake mixes, cereal, ice cream, packaged meats and cold cuts, pasta and even soup broths and bouillon cubes. Koff says anyone with celiac disease must also be cautious about purchasing products that were manufactured in facilities that also process gluten products. They're often labeled with statements such as "contains wheat ingredients" or "made on shared equipment that also processes wheat."
Oats do not naturally contain gluten, but they're on Koff's "BROW" list for a reason. They're often grown near fields of wheat and rye, and farmers may rotate the fields, said Marlisa Brown, a registered dietitian in New York and author of "Gluten-Free, Hassle Free" and "Easy, Gluten-Free." She recommends that people who need to avoid gluten eat oats only if the oats are from certified gluten-free sources.
A Battle Within the Body
When a person with celiac disease eats foods containing gluten, his immune system attacks the small intestine. The resulting damage to the small intestine impairs the body's ability to absorb certain nutrients. The condition can cause fatigue, weight loss, abdominal pain, bloating, constipation or diarrhea.
In addition to those with full-blown celiac disease, some people have non-celiac gluten sensitivity. "Symptoms can be the same as someone with celiac, with the most typical symptoms being gas, bloating and irritable bowel syndrome," Brown said. "It is estimated that there are more than 20 million [people] with a non-celiac gluten sensitivity."
Other conditions may also involve a gluten reaction, at least in some individuals. "Diseases in the autoimmune class, such as fibromyalgia, Type 1 diabetes, Crohn's disease, ulcerative colitis and rheumatoid arthritis, have also shown positive results when removing gluten from the diet, so many now follow that protocol," said Koff, adding that anyone suffering from irritable bowel syndrome might also want to consider a gluten-free diet.
No Weight-Loss Magic
With all the talk of gluten's negative aspects, people who aren't particularly sensitive to it but are simply looking to lose weight may give up foods containing gluten in hopes of shedding pounds. But does a gluten-free lifestyle automatically mean a smaller waistline? Experts say it depends on what gluten-free foods you eat.
Brown says that if a person goes on a gluten-free diet, giving up all pasta, packaged foods, cereal, desserts, bread and thickening agents such as gravy, and opts instead to consume more fruits, vegetables, lean meats, fish and low-fat dairy products, then, yes, weight loss could result.
But she points out that if someone just substitutes gluten-free versions of typical gluten-heavy foods (such as waffles, cereal, dessert mixes or baked goods), long-term weight loss is unlikely. In addition, many gluten-free foods are lower in vitamins and fiber than the foods they're replacing. When you're looking for gluten-free alternatives, consider adding healthful choices such as amaranth, buckwheat, legumes, teff, quinoa and sorghum.
Koff recommends replacing what she calls resistant-starch content (such as certain types of rice and potatoes) with whole foods for a greater chance of dropping pounds.
It Isn't All Bad
If you don't have a medical condition that requires you to avoid gluten, keeping gluten in your diet while improving the quality of foods you eat will make eating out and shopping for foods a lot easier. Some pros of gluten include being able to eat whole-grain breads and cereals that offer necessary fiber and nutrients such as B vitamins.
Bonnie Modugno, a registered dietitian in private practice in Santa Monica, California, points out the challenges of eating a gluten-free diet if you don't have to.
"You'll spend a lot of time reading food labels," she said. "You might get the same effect by limiting your starches and sugars. Moderation takes a lot of skill and discipline. My recommendation is to stick closer to the earth with beans, legumes, starchy vegetables, nuts and seeds."
By Renee Roberson
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