04 Oct Gluten-Free 101
By: Rachael Hartley, RD, LD, CDE, CLT of Avocado a Day Nutrition
In recent years, gluten free diets have surged in popularity, with many people turning to a gluten free diet to treat a wide variety of health conditions, for weight loss or to promote general health. This is a huge change from 30 years ago, when celiac disease was almost unheard of in the general public and it was rare to find a grocery store with more than a few specialty gluten free items.
Even though there’s more information and research on gluten available to the general public, there’s also more confusion. Many people are needlessly avoiding gluten or are using gluten free diets for things it may not be beneficial for, like weight loss. So we’re here to discuss what gluten is, who might benefit from going gluten free, and how to enjoy a gluten free diet.
WHAT IS GLUTEN?
Gluten is the name for a family of proteins found in wheat, barley, rye and triticale (a cross between wheat and rye). It is also found in ancient and heirloom forms of wheat, including farro, graham, durum, spelt, eikorn, kamut, emmer, durum and semolina. The two main proteins in gluten are glutenin and gliadin, with gliadin being responsible for most of the negative health effects associated with gluten.
Gluten gives wheat it’s elasticity, an important characteristic for baking. If you’ve ever made playdough from flour or baked your own bread or pizza dough, then you’re familiar with how gluten adds strength, stickiness and stretchiness to dough, important qualities that give baked goods structure, chew and crispness.
Any food made from gluten-containing flour will contain gluten, including most breads, pasta, baked goods, cereals, soups and sauces where flour is used as a thickener, and convenience meals with these foods as ingredients. Gluten may also be found in unexpected places, such as spice mixes, beer, salad dressings, and vegan meat substitutes, as ingredients made from gluten containing grains are commonly used in the food supply.
WHY GO GLUTEN FREE?
The gluten free diet was originally developed as a treatment for celiac disease, a severe autoimmune disease where the body attacks gluten as a foreign invader, and in the process, damages the lining of the gut. This leads to severe injury to the microvilli lining the gut wall, which are microscopic finger-like projects that help the body digest and absorb nutrients from food. This can lead to micronutrient deficiencies and digestive symptoms, including chronic diarrhea, constipation, bloating, and abdominal pain. There are some people however who do not experience digestive symptoms, but may suffer from other symptoms, like depression, fatigue, anemia, unexplained weight loss, rashes, infertility, osteoporosis, and headaches. It is estimated that 1% of the population suffers from celiac and 80% of those who suffer may not know it.
With celiac disease, the reaction to gluten is so severe that even the smallest amount can trigger a reaction. Think a pinch of flour on a plate, bread crumbs in butter from after it was spread on toast, or cross contamination from cooking equipment or cooking oils.
Another group of people who benefit from going gluten free are those who suffer from non-celiac gluten sensitivity. These people do not test positive for celiac disease, but react negatively to gluten and symptoms resolve after following a gluten free diet. It is less understood than celiac disease and there are still some health experts who do not believe it is a real diagnosis. However, recent research has shown there are some people with increased intestinal permeability, often called “leaky gut,” who experience a body-wide inflammatory immune response to gluten containing grains. Non-celiac gluten sensitivity is also estimated to affect 1% of the population.
Some people with irritable bowel syndrome may also notice an improvement in symptoms after removing or limiting gluten in their diet. Interestingly, unless their symptoms are due to undiagnosed celiac or non-gluten sensitivity, it’s not actually the gluten but rather a type of carbohydrate found in wheat and many other foods that is the likely culprit. FODMAP is an acronym for certain types of carbohydrates that are poorly absorbed and quickly fermented in the gut, leading to a rapid expansion of gasses (bloating) which overstimulates nerves in the gut, thereby triggering pain and discomfort in those who are more sensitive. Symptoms are dose dependent and there are many other foods containing FODMAPs that may or may not trigger symptoms, so it’s important to work with a dietitian trained in FODMAPS if you suspect this is an issue for you.
Otherwise, unless you are diagnosed with a wheat allergy, gluten is safe for you to consume.
HOW DO I GET DIAGNOSED WITH CELIAC DISEASE?
Celiac disease is diagnosed in one of two ways. The first way is a blood test which screens for antibodies that show the body is attacking gluten. If you take this test, it’s important not to remove gluten from your diet first, as this will likely result in a false negative.
The other way to diagnose celiac disease is with a biopsy, a small tissue sample taken from the small intestine. The small intestine of someone with celiac disease will show extensive damage to the gut wall.
WHAT ARE HIDDEN SOURCES OF GLUTEN?
People who are diagnosed with celiac disease must eliminate all traces of gluten. This includes gluten that may be found in medications, cosmetics, and other household products. It also involves carefully reading for gluten containing ingredients on the food label. Here is a list of some common ingredients that always or may contain gluten:
- Malt syrup, extract or vinegar
- Modified starch
- Soy sauce
- Brewers yeast
- Hydrolyzed vegetable protein
- Smoke flavor
WHAT ARE SOME COMMON GLUTEN FREE SUBSITUTIONS?
There are many nutritious, naturally gluten free sources of carbohydrates that can be substituted for gluten containing foods, including starchy vegetables like potatoes or winter squash, beans, and gluten free grains, like rice, quinoa, millet, teff, buckwheat and oats.
Earth Fare carries a wide variety of gluten free flours which can be used in baking, such as oat flour, garbanzo bean flour, buckwheat flour, rice flour, almond meal, and coconut flour. You can also find multiple brands of gluten free all purpose flours, which are perfect for baking bread, making muffins, pancakes or waffles.
Although it’s hard to replicate the exact taste and texture of baked goods made with gluten, you may be surprised to find that gluten free baked goods are just as tasty, but in a unique and different way! Almond meal makes cookies taste dense, crumbly and nutty. Buckwheat flour lends a rich, almost rye-like taste to muffins. You can use coconut flour to make extra light and fluffy pancakes!
You can also find a variety of gluten free pastas and breads at Earth Fare. For pasta, enjoy buckwheat noodles in Asian dishes, rice noodles, or new pastas made from bean flours. For bread, try sandwich bread made from rice flour or bake it yourself using a gluten free blend. There is also a wide variety of specialty foods, like cereal, pizza crust, cookies, frozen meals, dressings and seasoned side dishes. With all the options, there’s no need to be limited by your gluten free diet!
Rachael Hartley is a private practice dietitian and food and wellness blogger at Avocado A Day Nutrition. She believes loving every bite of food is central to living a happy and healthy life. Through her practice and blog, Rachael inspires clients and readers to rediscover the joy of eating with nourishment, not deprivation, and to nurture a healthy relationship with food. Follow along on Instagram, Facebook and Twitter.