Understanding gluten and wheat allergies
April 3, 2017 | by The Polyclinic

More often than not you’ve heard conflicting information and opinions concerning gluten. One media source says you should be eating it but then another claims you shouldn’t. What is gluten and which foods contain it? What is the difference between having a wheat allergy, celiac disease or gluten-sensitivity? Should you go gluten-free? Let’s explore what gluten is and how it can affect you and your diet.

What is gluten and which foods contain gluten?

Gluten is a protein found in grains such as wheat, rye, barley, and triticale or any products that result from cross-pollination of any of these grains.

Foods that contain gluten are those that are made from or have any form of these grains. This includes bread, baked goods and pastas, as well as less obvious packaged foods that are made with additives, preservatives or derivatives of these grains.

What is the difference between a wheat allergy, celiac disease and gluten sensitivity?

People can be intolerant to gluten in different ways that include having a wheat allergy, celiac disease, and gluten-sensitivity. The symptoms of these conditions can be similar so it is important to know the difference.

A wheat allergy is a rare type of gluten intolerance characterized by respiratory, gastrointestinal, and skin irritations, similar to other allergies. Reactions can range from mild to severe. It is important to refer to an allergist to properly receive the right education and treatment concerning allergies.

Celiac disease is an autoimmune disorder. A hallmark of celiac disease is a permanent intolerance of gluten. When people who have celiac disease eat gluten, their immune system responds by attacking and damaging the villi, hair-like structures in the small intestine. Damage can lead to an inability to absorb nutrients such as vitamin D, calcium, iron, and folate resulting in nutritional imbalances. If left untreated, celiac disease can lead to other autoimmune conditions and in atypical cases, intestinal cancer. Upon eating gluten, the symptoms of celiac disease include gastrointestinal discomfort, such as bloating, gas, diarrhea, and constipation. Other non-gastrointestinal symptoms include joint and muscle pain, headache, and fatigue. The only way to treat celiac disease is a lifelong avoidance of gluten. A gastrointestinal specialist can diagnose celiac disease. Blood work is done to observe the presence of gluten-related antibodies as well as genetic markers linked to celiac disease. To complete the diagnosis a tissue biopsy is taken from the upper intestine in order to measure the degree of damage done to the villi.

Gluten sensitivity is a condition where many of the same aforementioned symptoms of celiac disease exist but no damage to the intestine occurs. However, it is currently unknown if there are any long-term negative health consequences associated with gluten sensitivity. The amount of gluten a person can tolerate differs by the individual. There is not a standard diagnostic test to detect gluten sensitivity. Under the supervision of a registered dietitian, the method of diagnosis includes an elimination diet. If an allergy and celiac disease are ruled out, then a person may benefit from eliminating or just limiting gluten from the diet as much as tolerated. Meeting with a dietitian for meal planning, grocery shopping and dining out tips, and nutritional guidance while following a gluten-free diet can be most helpful.

Should I go gluten-free?

Unless you are experiencing any of the above conditions, it is not necessary to eat a gluten-free diet. Gluten is what gives baked goods a chewy texture. When gluten is removed, gluten-free foods often use modified and processed starches that have little to no nutritional value in an attempt to achieve a similar texture. Gluten resides in the part of the grain that also contains vitamins and minerals, and when the whole grain is not used these nutrients are lost. If you eat grains, choose whole-grain foods which offer the most fiber, nutrients and minerals as compared to non-whole grains. If you choose to eat gluten-free, there are many whole grains that don’t contain gluten you can include in your diet, such as quinoa, amaranth, millet, wild rice, brown rice, teff and gluten-free oats.

If you are interested in meeting with a dietitian at The Polyclinic, ask your health care provider for a referral and call The Polyclinic Nutrition Management services at 206-860-2208 to schedule an appointment. Check with your insurance carrier for your benefits for medical nutrition therapy.