A gluten allergy is the body's inability to digest or break down the gluten protein found in wheat and some other grains.
A gluten intolerance (also known as a gluten sensitivity) can range from a mild sensitivity to gluten to full-blown celiac disease, according to Alessio Fasano, MD, director of the University of Maryland Center for Celiac Research.
Approximately one in seven Americans may have some form of gluten allergy or intolerance according to some estimates. In addition, nearly 1 percent of people suffer from celiac disease, a severe autoimmune disorder in which a person's immune system attacks gluten in the small intestine. The numbers of people with gluten allergies, intolerances, and celiac disease has been on the rise since 1950, according to nutritionist Melissa Diane Smith, author of the books Going Against the Grain and Gluten Free Throughout the Year.
Although researchers aren't sure of the exact cause of the increase in gluten intolerance, most theories revolve around changes in the way that wheat is grown and processed. For instance, one theory states that wheat is higher in gluten than it once was because it makes bread "springier" and easier to slice. Another centers on the ways in which wheat is bred to produce higher yields or to make it disease resistant.
Whatever the reasons, gluten intolerance is becoming so common that, for many people, special diets are no longer special at all.
For those with celiac disease, gluten intolerance is not just an inconvenience—it can be debilitating. People with celiac disease cannot eat any foods containing gluten without causing long-term damage to their health due to inflammation in the small intestine and nutrient deficiencies. Currently there are no known cures or effective treatments for celiac disease. An individual with a gluten allergy or sensitivity may choose to eat some or no gluten-containing foods depending on her tolerance or the severity of his or her symptoms.
A simple blood test that measures levels of antibodies associated with celiac disease can reveal if a person has the condition. However, tests for gluten intolerance often come back negative, prompting someone who may be mildly allergic or sensitive to think that it okay to eat gluten, even though it may causing symptoms such as fatigue or irritability.
What to Avoid
Wheat is one of the main staples of a Western diet and therefore is public enemy number one for those with gluten allergies. In addition to wheat, all of its forms are off limits for sufferers including:
- wheat starch
- wheat bran
- wheat germ
- cracked wheat
- fu (common in Asian foods)
- graham flour
The list of gluten-containing grains doesn't end at wheat however. Other offenders are:
- oats (oats themselves don't contain gluten, but are often processed in plants that produce gluten-containing grains and may be contaminated)
- triticale and Mir (a cross between wheat and rye)
- veggie burgers (if not specified gluten-free)
Gluten may also show up as ingredients in barley malt, chicken broth, malt vinegar, some salad dressings, soy sauce, as well as in many common seasonings and spice mixes. Therefore, gluten-free cooking presents many challenges.
What to Eat
The list of off-limits items may seem daunting but, thankfully, there are plenty of replacements on the menu. Lots of foods are naturally gluten-free, including fruits and vegetables, beans, seeds, legumes, nuts, potatoes, eggs, dairy products, corn, rice, fish, and meats. Many other grains and foods are gluten free as well, including:
At first, it may seem daunting to go gluten-free but, for many, the advantages far outweigh the inconvenience.
The first step is to get rid of all the gluten-containing products in your kitchen and stock it with alternatives such as gluten-free breads, pasta, crackers, and cereals. For baking, substitute flours like buckwheat, corn, millet, rice, sorghum, or quinoa. You'll need xanthan gum or guar gum as a substitute for gluten when baking. Sticking to unprocessed, fresh, whole foods will naturally keep a person's diet gluten-free, as well as help heal the intestinal tract of any existing gluten damage that may have occurred.
A Note About Eating Out
Eating in restaurants can be a particular challenge for people with gluten allergies, but if an individual sticks to the above items, such as grilled meats and steamed vegetables, she should be able to dodge the gluten bullet.
Foods to avoid in restaurants include fried foods, certain sauces, or anything that has been fried in the same pan with a gluten-containing food.
Those with celiac disease must be especially cautious when eating out and make sure that dietary restrictions are communicated to the chef in advance. Certain restaurants are almost certainly out of question for those on a gluten-free diet, including fast food restaurants, buffets, salad bars, and most bakeries.