Gluten-free

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At its most basic, the diet means cutting out any source of gluten, primarily wheat, barley and rye. Kamut and spelt are "ancient" forms of wheat that still contain gluten.
 
At its most basic, the diet means cutting out any source of gluten, primarily wheat, barley and rye. Kamut and spelt are "ancient" forms of wheat that still contain gluten.
  
The most obvious sources of gluten would be bread, biscuits and some cakes. But many foods have unexpected gluten. <ref>[http://www.webmd.com/a-to-z-guides/hidden-gluten-topic-overview WebMD: Hidden Gluten - Topic Overview]</ref> Wheat flour is often used as a thickener and starch. Pseudo grains such as millet, buckwheat, quinoa are fine, as are potatoes, rice and corn. Oats are frequently contaminated due to their similar appearance to wheat, but there are brands which are tested and certified free from contamination. Wheat gluten is often used in meat substitutes, and sausages may contain biscuit rusk.
+
The most obvious sources of gluten would be bread, biscuits and some cakes. But many foods have unexpected gluten.<ref>[http://www.webmd.com/a-to-z-guides/hidden-gluten-topic-overview WebMD: Hidden Gluten - Topic Overview]</ref> Wheat flour is often used as a thickener and starch, meaning that most restaurant soups and many sauces will contain gluten. Pseudo grains such as millet, buckwheat, quinoa are fine, as are potatoes, rice and corn. Oats are frequently contaminated due to their similar appearance to wheat, but there are brands which are tested and certified free from contamination. Wheat gluten is often used in meat substitutes, and sausages may contain biscuit rusk.
  
 
Some foods or food ingredients, like monosodium glutamate or "glutinous rice", are safe despite their similar names.<ref>[http://www.celiac.com/articles/181/1/Safe-Gluten-Free-Food-List-Safe-Ingredients/Page1.html Celiac.com's list of safe ingredients]</ref>
 
Some foods or food ingredients, like monosodium glutamate or "glutinous rice", are safe despite their similar names.<ref>[http://www.celiac.com/articles/181/1/Safe-Gluten-Free-Food-List-Safe-Ingredients/Page1.html Celiac.com's list of safe ingredients]</ref>

Revision as of 15:23, 8 November 2012

Deliciously edible!

Food and Diet

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Dubious diets
Food woo

Gluten-free refers to a diet that excludes sources of gluten, a protein found in wheat, barley, spelt, kamut, rye and derivatives thereof such as flour, malt extract, wheat starch etc. Gluten gives bread its elasticity and shape, and is used as a stabilizing agent in other foods.

The gluten-free diet can be adopted as a treatment for legitimate medical conditions, but it has also been embraced as a fad diet, weight loss gimmick, and purported autism cure.

Contents

Reasons for adoption

While the diet is used to treat celiac disease and related disorders, some people adopt a gluten-free diet for a different imagined health benefit. Because of the constraints the diet imposes, doing so may be detrimental to their health. [1]

Celiac disease

Celiac disease (or coeliac outside of the US) is an autoimmune disorder which interferes with digestion. The immune system responds to gluten peptides absorbed in the small intestine, causing inflammation and damage to the gut and a variety of unpleasant symptoms. Even a small amount of gluten (e.g. a small crumb or dusting of flour) can trigger an attack. Symptoms of being "glutened" range from person to person but typically include lethargy, nausea, vomiting, and diarrhea. Over the long term, effects include failure to thrive (in children), chronic digestive problems and even cancer.

The condition has been recognized since at least the first century CE, and was described by Aretaeus of Cappadocia. [2] Greater understanding and research has only occurred more recently. Like autism, this has led some people to think that celiac is a modern disease. The reality is that even ancient forms of wheat such as spelt and kamut trigger an attack as easily as any modern wheat variety. It is more likely that better recognition of the symptoms accounts for the higher rates of diagnosis.

Diagnosis of celiac disease normally consists of a blood test followed by a biopsy that examines the intestine lining for damage. It is not possible to self-diagnose celiac disease. The only proven treatment is a completely gluten-free diet which allows the intestine to heal, absorb nutrients and function normally. [3] However, there are some early vaccine trials that are attempting to desensitize the body's immune response to gluten peptides.[4][5] There has also been some preliminary evidence that Helminthic therapy might be an effective treatment.

Wheat allergy or gluten sensitivity

Aside from celiac disease, many people have a less-intense but still real sensitivity to gluten. Levels of sensitivity can vary from person to person. Still other people have a wheat allergy, which is not the same as celiac disease or gluten sensitivity. Because of the lifestyle changes a gluten-free diet imposes, and because advanced cases of celiac sometimes need additional immunosuppressant or steroid treatments, it's important to be examined by a competent medical professional when someone has concerns about their intake of gluten.

Autism quackery

Gluten-free diets are sometimes promoted by anti-vaccination types such as Jenny McCarthy as a means to treat or "cure" autism. [6] [7] There is no known basis for this assertion, and in fact a gluten-free diet can make you worse off if you aren't somehow making up for lost nutrients. [8]

ABC News reported in 2010 on a study that showed a gluten-free, casein-free diet had no effect on autism. [9][10]

A study presented at the International Meeting for Autism Research showed that 18% of children with autism, Asperger disorder, or PDD-NOS had been put on a "special diet" advocated by alternative medicine, and among those, 47-50% had been put on a gluten-free diet. Families discontinued the use of special diets at a rate of 5-10% per year, indicating a strong adherence to the idea despite a lack of results. [11]

Weight loss quackery

Diet woo for weight loss has jumped on this one! Here is the reason you're fat: it's gluten.[12] Few medical experts or professional dieticians have ever found any reason to suggest a gluten-free diet aids in weight loss, but seemingly it fits so well into the "low-carb" "paleo diet" world.

Discussions about gluten free diets are found in the comment sections of many weight loss sites, even when the diet doesn't specifically blame gluten for weight gain.[13][14]

The gluten-free lifestyle

The gluten-free diet is difficult to stick with and unless you are medically required to you probably shouldn't bother.

If you have a partner who is highly sensitive to cross-contamination, you may end up on a gluten-free diet yourself, depending on their sensitivity. Learn to love rice pasta, millet bread and sorghum beer.[15] Wine, cider and distilled alcoholic beverages are safe too.

Safe and unsafe foods

At its most basic, the diet means cutting out any source of gluten, primarily wheat, barley and rye. Kamut and spelt are "ancient" forms of wheat that still contain gluten.

The most obvious sources of gluten would be bread, biscuits and some cakes. But many foods have unexpected gluten.[16] Wheat flour is often used as a thickener and starch, meaning that most restaurant soups and many sauces will contain gluten. Pseudo grains such as millet, buckwheat, quinoa are fine, as are potatoes, rice and corn. Oats are frequently contaminated due to their similar appearance to wheat, but there are brands which are tested and certified free from contamination. Wheat gluten is often used in meat substitutes, and sausages may contain biscuit rusk.

Some foods or food ingredients, like monosodium glutamate or "glutinous rice", are safe despite their similar names.[17]

Highly processed grain derived products such as maltodextrin, grain alcohol (yay) and malt vinegar are usually gluten free. Some gluten free products will use highly processed wheat starch which is also gluten free.

In short it is vital to inspect the ingredients extremely carefully and if in any doubt, don't buy. It is common to find that one brand of a product (e.g. ketchup) is safe while another brand is not.

Gluten-free alternatives

Many gluten-free substitute foods are available, such as bread and pasta made from rice & corn flour.[18] The quality of bread varies widely based on the ingredients and preparation involved. The biggest problem is that bread tends to fall or part or squash because it is not elastic. Some gluten free mixes use additives to preserve the shelf life of the product, with cellulose being a common ingredient.

Grocery shopping outlets such as QFC and Fred Meyer,[19] and home-delivery services such as Amazon Fresh,[20] have special sections for gluten-free foods. Many restaurants have a gluten-free alternate menu, or mark gluten-free items on the menu itself or in a nutrition guide.

Food regulation

A danger to genuine celiacs is that if gluten-free is perceived as a "lifestyle" choice that many food preparers may not educate themselves or treat the condition with the seriousness that it deserves, e.g. not bothering to prepare food separate from sources of contamination that won't harm people on some GF fad diet but can cause serious harm to a celiac sufferer. Because of this, gluten-free labeling is regulated in many parts of the world.

Europe has instituted new regulations that require food advertised as gluten free to possess less than 20 parts per million (ppm) of gluten. A second category of food possessing less than 100ppm may be advertised as very low gluten. [21] Some products may be "naturally gluten free" which means there is nothing to imply gluten (e.g. a bag of carrots is naturally gluten free) but no formal testing has been done to know for sure and in the case of some grains occasional contamination does occur. Many products also show a gluten free symbol of some kind (usually a wheat ear with a red line through it) but not all of them. Most products are required to list allergens but if wheat is listed in the ingredients it might not be listed separately in the allergens box. To the consternation of many celiacs, labelling and packaging is still notoriously vague and variable.

See also

External links

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