Understanding Nutrition

Everything You Need to Know About Gluten

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By Bethany Thayer, MS, RDN

In recent years, gluten has become something of a buzzword in nutrition circles. Fortunately, most people tolerate gluten just fine. However, there is a small subset of the population in which consuming gluten can lead to significant health problems.

One out of every 100 Americans suffers from an autoimmune condition called celiac disease. If you have celiac disease, your immune system responds to gluten by damaging the small intestines, making it difficult for your body to absorb nutrients. An additional six out of 100 people have something called gluten sensitivity. This is not an autoimmune condition, but the symptoms mimic celiac disease. People who have gluten sensitivity may suffer from tummy troubles like bloating, diarrhea and constipation when they eat gluten.

Your Gluten Questions Answered

If you’re shopping for groceries, dining in a restaurant or attending a backyard barbecue, gluten is likely to be there, too. Here, I answer your most pressing questions about this group of proteins found in certain grains.

Q: What is gluten?

A: Gluten is a type of protein found in wheat, rye and barley and related grains such as farro, kamut and spelt. There are many ingredients that contain wheat, barley or rye, including malt, soy sauce and brewer’s yeast, which means gluten pops up in some unexpected places. Products ranging from seasoned potato chips to medications can contain gluten.

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Q: What are the complications of eating gluten?

A: For most people, eating gluten-containing foods isn’t a problem. In fact, foods including whole wheat, rye and barley boast plenty of important nutrients. But for people with celiac, even a microscopic amount of gluten — as little as 20 parts per million — can trigger a reaction and prevent the body from absorbing nutrients. This malabsorption may cause gastrointestinal symptoms such as bloating, cramps and gas. Unfortunately, about half of all people with celiac disease do not have these symptoms. Without signs to let them know they have inadvertently consumed gluten, they have to be even more vigilant. If celiac disease is left untreated, these people may suffer from serious complications ranging from anemia and osteoporosis to cancer and infertility.

Q: How do I know if I have celiac disease or gluten sensitivity?

A: See a doctor to get tested — before starting a gluten-free diet on your own. If you abstain from gluten-containing foods, your test results will be inaccurate. Unfortunately, there is no test available for gluten sensitivity. If you think you may be sensitive to gluten, see your doctor to ensure you’re absorbing nutrients properly.

 Q: Is gluten listed on food labels?

A: You will not find gluten listed in the ingredients or on the Nutrition Facts panel. Ingredients are listed on food labels, so it is up to the consumer to know which ingredients may have gluten and then scour the ingredient list to be sure a product is gluten-free. Even then, it’s not a sure thing. Many kinds of fillers and additives contain gluten and it’s not always easy to figure out what’s gluten-free and what isn’t. For example, if “modified starch” is listed in the ingredients and is not specifically identified as coming from a non-gluten source, it’s best to avoid that food.

Q: Are there any labeling laws for gluten?

A: The Food and Drug Administration (FDA) requires manufacturers to list whether a product has one of eight common allergens, which include wheat. But just because a product is wheat-free does not mean it’s also gluten-free. To make it easier to identify gluten-free products, the FDA released standards for voluntary labeling. If a product says it is “gluten-free,” it must contain less than 20 parts per million of gluten. But manufacturers of food and medications are not required to identify if their products are gluten-free or not.

Q: How can I avoid gluten?

A: It can be difficult, particularly if you dine in restaurants or eat pre-prepared foods. While increasing awareness about gluten means there are more gluten-free choices available today than ever before, you still have to be vigilant and ask lots of questions. You also need to be wary of cross-contamination. Items made with gluten-free ingredients but prepared in the same kitchen or facility with gluten-containing ingredients become contaminated with gluten and can trigger a reaction in sensitive people. Select restaurants that are gluten-free friendly and be sure to speak up about your needs before you sit down.

Q: Are there certain words I should look for on labels that signify gluten?

A: In addition to wheat, rye and barley, you should check the ingredient list for certain terms. Malt and maltodextrins contain gluten. Modified food starch may also contain gluten. Premade mixes, soy sauces, marinades, salad dressings and other packaged convenience foods may contain gluten, unless otherwise specified. Even medications and supplements may contain gluten as a binder. When in doubt, ask the manufacturer.

Choose plain whole foods that are naturally gluten-free, such as fruits, vegetables, milk, yogurt, nuts, legumes, poultry, fish and eggs. If you’re craving grains, try corn, brown rice or some ancient grains, such as amaranth, quinoa, buckwheat and millet, which are all gluten-free.

To get tested for celiac disease or learn strategies to avoid gluten, see your doctor. To find a doctor at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936).

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