May is Celiac Awareness Month and you may be surprised to know it has expanded to include Non-Celiac Gluten Sensitivities (NCGS) - a disorder that affects nearly 18 million people. Because nearly one-third of the American population is avoiding gluten for a variety of health reasons, understanding the facts about these conditions and how to safely eliminate the common ingredient from your diet is essential.
Celiac disease is an autoimmune response to gluten - a protein found in wheat - in which the small intestine has trouble digesting food. The disease affects approximately one in 133 Americans and it's estimated that a staggering 83% of those who suffer from Celiac are undiagnosed or misdiagnosed. On the other hand, NCGS is classified as a sensitivity (i.e. not an allergy or autoimmune response), but those diagnosed with it show similar symptoms without the intestinal damage and antibodies associated with Celiac disease.
(Sidenote: A recent study questioned the legitimacy of the NCGS diagnosis noting sensitivities may not be related to gluten at all and instead may be associated with poorly digestible short-chain carbohydrates. Oddly enough, the doctor who originally validated Non-Celiac Gluten Sensitivities in 2011 is the same doctor who published this new finding.)
Joining the gluten-free craze, like any fad diet or dietary restriction, can be harmful if done without the proper knowledge. But safely implementing a gluten-free diet can relieve symptoms for Celiac sufferers and possibly even those with NCGS.
So what do you need to know to responsibly eliminate gluten from your diet?
Eliminating gluten is NOT recommended as a weight loss method. In fact, eating gluten is an important part of a balanced diet as that is where the carbohydrates are found.
DO NOT eliminate gluten before speaking with a medical professional. Gluten must be present in order to accurately test for celiac disease. If you prematurely eliminate gluten the test will not be accurate. In the case of NCGS, speak with your medical professional about an elimination diet which eliminates a trigger food entirely for a few weeks and then reintroduces it to monitor symptoms.
Understand the symptoms. Symptoms can manifest in many ways including abdominal pain, bloating and constipation/diarrhea. Lesser-known symptoms may include skin irritation, joint pain, headaches, mood disorders and more. Celiac disease alone has over 300 known symptoms and some of them, like reflux, are often treated/masked with medications before understanding the cause.
Pay attention to your body. With mindfulness comes an attention to detail that can truly change the way we think about our health. If you take the time to listen, you will find that our body has a lot to tell you. If you and your medical profession decide that eliminating gluten is the right plan for you, pay attention to your body, your symptoms, and even journal about how eliminating gluten changes (or doesn't change) the way you feel.
If you and your doctor have already decided that a gluten-free diet is the right course of action:
Consult a dietician. Take the time to learn how to plan a healthy, balanced, gluten free diet which starts with understanding gluten-containing foods and their healthful substitutes.
Don't trade crap for crap. It's not healthier to eat a slew of processed foods like gluten-free pretzels, breads and cookies just because they are gluten free. I once had a client who decided to eliminate gluten and was surviving solely on potato chips. Processed foods can contain hidden forms of wheat and are generally less healthy to begin with.
Eat real foods. Many real foods like fruits, fresh and frozen vegetables, meat, fish and poultry are naturally gluten free. And don't feel limited to rice at every meal! There are many whole grains (choose them in their natural, unprocessed form) like millet, quinoa, amaranth and sorghum that are naturally gluten free. Nuts, seeds and beans which are available whole and in other forms like butters and flours can also be fun cooking ingredients.
Cook. Preparing your own meals is a sensible way to control the foods you eat and ensure you are making healthy, balanced choices.