Gluten free, ASAP? ‘Not so fast,’ say experts.


Kit Werner points out that persons eliminating items from their diets should take care not to elminate other important nutrients in the process. (Photo by Kenny Yoo.)

It’s not uncommon to hear a friend proclaim, “I’m on a gluten-free diet!” just as you pass the biscuits and gravy.

Or perhaps it’s a low-carbohydrate diet. Or a seaweed diet. Or they’re eating fish oil pills like candy (but not licorice – contains gluten). Or they have become vegans or vegetarians, or they are eating like a cave man.

What’s good to eat? What’s not? Who knows?

Kit Werner, clinical associate professor and nutritional sciences clinical director in the UWM College of Heath Sciences (CHS), is one of four registered dietitians in the college’s departments of biomedical sciences and kinesiology. She and her colleagues know that well-meaning friends and neighbors, not professionals in the field, communicate much information about health care.

Gluten free is big business

That’s usually how diet and nutrition trends get started. The gluten-free market alone is predicted to reach $6.2 billion by 2018.

The University of California, Berkley estimated that Americans spend $28 billion a year on nutritional supplements. The U.S. Food and Drug Administration (FDA) estimated there are 29,000 different nutritional supplements on the market.

So, it’s okay to ask Werner or her colleagues about nutrition – particularly about gluten intolerance and gluten-free diets, subjects that seem to be on a lot of lips these days.

“People often want something that will help them lose weight, feel better, have more energy, something they feel is lacking in their lives. Lots of people may see some benefit when they eliminate gluten from their diets. Unfortunately, people also want to choose one aspect of their diet and feel they have found the holy grail,” Werner said.

That inclination puts popular gluten-free diets on the same plate as other food trends (or fads, depending on your viewpoint).

Test first, eliminate second

What is celiac disease?

A lifelong condition that damages the lining of the small intestine and prevents it from absorbing nutrients in food that are important for health. The damage is due to an autoimmune reaction to gluten, which is found in wheat, barley, rye and possibly oats.

One in 133 individuals is diagnosed with celiac disease. But 97 percent of those with celiac disease have not been diagnosed…partly because symptoms are many and varied. More women than men are diagnosed with celiac disease.

-Source: Academy of Nutrition and Dietetics

“When someone suspects they have an issue with gluten, they really need to be tested by a doctor before they start restricting gluten from their diet,” Werner said.  “If you reduce gluten in your diet, then have the test, you may not be able to see the effect that gluten really had.”

The test is used to identify celiac disease, a serious condition caused by an abnormal immune response to gluten. It can damage the lining of the small intestine, which in turn can prevent the absorption of important nutrients.

A blood test is used to detect antibodies related to an abnormal immune response. If the blood test is positive, a biopsy may be performed to confirm inflammation in the lining of the small intestines.

For people with celiac disease, a gluten-free diet is essential. But for others, a gluten-free diet can have its own problems. Gluten-free foods may not contain all the nutrients you need and would normally have in your diet. Read the ingredient labels as carefully as you can.

New FDA standards on the labeling of “gluten-free” foods should help.

Many people associate a gluten-free diet with weight loss, Werner said. But eliminating gluten-rich breads from your diet may lead you to eating more corn and foods with added fats, a more concentrated source of calories. And following a gluten-free diet can be difficult and expensive, despite the proliferation of such products.

Take it slow if GF’s the way to go

Foods that may or often contain gluten

Batter-dipped foods
Breading, coating mixes
Brewer’s yeasts
Broth, soup bases
Brown rice syrup
Candy – e.g., licorice, some chocolates
Cold cuts, hot dogs, salami, sausage
Egg substitutes
Flour or cereal products
French fries
Some herbal teas
Imitation bacon and seafood
Marinades and salad dressing
Modified food starch, dextrin
Pastas, instant rice mixes
Processed luncheon meats
Pudding and pudding mix
Sauces and gravies
Seasoning mixes
Soy, Worcestershire sauces
Stuffing, dressing
Communion wafers
Herbal and nutrient supplements
Some medications
Some mouthwashes
Also, Play-Doh

Gluten intolerance does exist – with levels that may vary from person to person – as do the types and severity of symptoms.

“If you’ve had a test and there is no celiac disease, but you still feel sensitivity to gluten-containing foods, eliminate gluten for a few weeks, then gradually reintroduce some gluten. That’s the best way to determine your body’s tolerance,” Werner said.

There may be other sources for the symptoms we associate with gluten intolerance, including emotional stress and the over-ingestion of carbohydrates from highly refined foods.

Werner and her colleagues have dietary advice you may have heard: “Eating closest to the natural state is the one of the best things you can do. Stick with natural, gluten-free foods, such as fruits, vegetables, lean meats, poultry, brown rice, quinoa, beans, legumes and olive oil.”

New FDA labeling standards

The U.S. Food and Drug Administration established what the term “gluten-free” means on food labels. Manufacturers have until Aug. 5 to update their labels in compliance with these requirements. The labeling claim “gluten-free” means that any food bearing the claim in its labeling:

  • Does not contain an ingredient that is a gluten-containing grain (e.g., wheat, rye, barley or any of their crossbred hybrids).
  • Does not contain an ingredient derived from a gluten-containing grain that has not been processed to remove gluten (e.g., wheat flour)
  • Does not contain an ingredient derived from a gluten-containing grain that has been processed to remove gluten if use of that ingredient results in the presence of more than 20 parts per million (ppm) of gluten.
  • Does not contain 20 ppm or more of gluten

Voluntary gluten-free claims including “no gluten,” free of gluten,” or “without gluten” claims are allowed on any food that meets the requirements mentioned previously.