Q. Are there health benefits to reducing or eliminating gluten from a diet – even if you don’t have celiac disease?
Gluten-free foods are popping up everywhere and the gluten-free diet is being promoted for everything that ails you. In order to separate the “wheat from the chaff” let’s look at the facts.
Gluten is a protein found in wheat, rye and barley. For those with celiac disease, gluten damages the lining of the small intestine causing a wide range of symptoms such as bloating, abdominal pain, diarrhea, constipation, gas, fatigue, migraines, depression, mouth ulcers, and bone and joint pain. Left untreated, the disease can lead to osteoporosis, anemia, infertility and even cancer. The only current treatment for celiac disease is a strict gluten-free diet for life.
Recent research has revealed that some people may have non-celiac gluten sensitivity (GS). This condition can result in gastrointestinal symptoms such as bloating, gas and diarrhea (which also can occur in celiac disease). However, GS does not lead to nutritional deficiencies or the development of other complications. The prevalence of GS is unknown and the only way to diagnosis it is by ruling out celiac disease and wheat allergy. If tests for these are negative, a trial gluten-free diet, along with a symptom diary, may help to determine whether GS is causing the symptoms. Like celiac disease, the treatment of GS is a strict gluten-free diet.
For those with wheat allergy, consumption of wheat triggers the release of IgE antibodies from various cells in the body. This causes an allergic reaction, with symptoms that can include hives, tingling of the mouth, abdominal pain, vomiting or diarrhea and a drop in blood pressure and breathing difficulties, which can be life-threatening in some cases. It is essential to eliminate wheat but, with an allergy, the other gluten-containing grains, rye and barley, can be consumed (as long as there is no “may contain” warning about the presence of wheat). The good news is that many children will outgrow a wheat allergy.
Autism Spectrum Disorders
The gluten-free, casein- free (a protein found in milk) diet, also known as the “GFCF diet”, has been advocated for those with autism spectrum disorders (ASD). Anecdotal reports from parents claim that the GFCF diet improves their child’s communication skills, reduces or eliminates gastrointestinal symptoms and/or improves their overall well-being. However, there is limited scientific evidence supporting the use of the diet for ASD. A recent report in the medical journal Pediatrics recommended that further research needs to be conducted, as only one placebo-controlled study of the GFCF diet in 15 children with ASD has been published. This study did not find any differences in measures of severity of ASD symptoms, communication and social responsiveness in those on the diet.
Nevertheless, the Pediatrics report also indicated there is a possibility that a subgroup of individuals with ASD may respond to various dietary interventions, which is why well-designed studies over an extended period of time are essential to answer the questions. As the GFCF diet is complex and difficult to follow, especially since many children with ASD are picky eaters and have other food sensory issues, it is critical that families work with a registered dietitian to prevent nutritional inadequacies if they choose to put their child on the diet.
A gluten-free diet has also been recommended by celebrities and others for weight loss. This is ironic because many processed gluten-free foods are higher in sugar, fat and calories. Healthy gluten-free whole-grains such as amaranth, buckwheat, millet, quinoa, sorghum, teff and brown rice can be part of a weight loss diet, but eating entirely gluten-free is not necessary, and can also be quite expensive.
Individuals with celiac disease and gluten sensitivity need to follow a strict gluten-free diet for life. Whether the diet should be used for other conditions is controversial. Regardless of the health concerns, it is important to incorporate more nutritious gluten-free whole grains in the diet because many gluten-free packaged foods are made with refined flours and starches which are low in iron, B vitamins and fibre. Also it is essential to consult with a registered dietitian with expertise in the gluten-free diet to ensure that your diet is not only healthy, but safe. For more information see www.glutenfreediet.ca.
Shelley Case, RD, is an international celiac nutrition expert, consulting dietitian and author of Gluten-Free Diet: A Comprehensive Resource Guide. Shelley Case is on the advisory boards of the Canadian Celiac Association, the Celiac Disease Foundation and the Gluten-Free Intolerance Group. The editors at Allergic Living additionally highly recommend her book Gluten-Free Diet, a vital resource for those interested in celiac disease and living gluten-free.