Even as recent as a decade ago, it was rare to hear the word “gluten” in our everyday lives. Today, we see grocery stores with entire gluten-free sections, restaurants offering gluten-free menus, and food packaging adorned with the “Certified Gluten-Free” label. While eating a gluten-free diet may be trendy for some, for others, their health and well-being depends upon it. The most severe form of gluten intolerance, celiac disease, affects 1 in 100 people worldwide and an estimated 2.5 million Americans remain undiagnosed. Celiac disease is an autoimmune disease in which ingestion of gluten causes the body to attack the lining of the small intestine, leading to digestive distress, malnutrition, anemia, neurological and nervous system disorders, and even infertility and miscarriage. The only treatment for celiac disease is nutrition therapy, in this case a lifetime avoidance of gluten consumption. Unfortunately, and for reasons unbeknownst to scientists, the rate of celiac disease appears to be on the rise.
Those who suffer from other autoimmune diseases such as Hashimoto’s thyroiditis, lupus, or multiple sclerosis may also benefit from removing gluten from their diets. Studies have shown that gluten can trigger a reaction that leads to leaky gut (also known as intestinal permeability), which contributes to inflammation and sometimes an autoimmune response. Removing gluten from the diet has allowed many people to reduce the severity of their symptoms and in some cases even reverse the progression of their autoimmune disease. Dr. Izabella Wentz, a clinical pharmacist and New York Times bestselling author who suffers from Hashimoto’s thyroiditis, has conducted studies with her own patients and found that of 2,232 people with Hashimoto’s, 88% of them felt better on a gluten-free diet, while only 3.5% of them had celiac disease.
In addition to those with celiac and other autoimmune diseases, non-celiac gluten sensitivity is estimated to affect 18 million Americans and causes symptoms such as brain fog, bloating and other gastrointestinal symptoms, as well as numbness, joint pain, or headaches. Only until recently has this condition been identified and diagnosed, and sometimes a trial elimination of gluten is the only way to determine if it is the culprit behind one’s symptoms. So, it’s easy to see why many people turn to a holistic health approach and adopt a gluten-free diet when conventional medicine has failed to identify the root cause of their symptoms.
While committing to a gluten-free diet is the first step, there are some common pitfalls that many people run into when adopting this lifestyle. If you have decided to “go gluten free,” here are some tips to help ensure your success.
Know which foods contain gluten
The main food sources of gluten are wheat (including spelt, farro, and farina) barley, and rye. Wheat is found in bread, crackers, baked goods, pancakes/waffles, cereals, and pastas (including couscous and gnocchi), but keep in mind that flour is also used for breading fried and sautéed foods, thickening sauces and soups, and bread crumbs are often used as a binder in foods like meatballs, meatloaf, and hamburgers. Barley can be found in soups, malt (think vinegar, malted milkshakes), beer, and Brewer’s yeast. Rye is mostly found in rye and pumpernickel breads. By memorizing these top gluten-containing ingredients, you’ll be able to scrutinize food labels and menus with ease.
Watch out for sneaky sources of gluten
In addition to the obvious sources of gluten, it can also be found in foods you least expect. One that may surprise you is soy sauce, which is commonly added to teriyaki, stir-fries, fried rice, barbeque sauce, marinades, and dressings. It can be difficult to eat at Asian restaurants because soy sauce may already be added to the dishes. Another less than obvious source of gluten is licorice candy, both the red and black varieties, which contain wheat flour as a main ingredient. Oats and oatmeal are another food to watch out for if you’re avoiding gluten. While oats are inherently gluten-free, they are often grown and processed alongside wheat, which makes cross-contamination highly likely. The good news is that it is becoming easier to find certified gluten-free oats so you can continue to enjoy this breakfast staple. Lastly, be sure to carefully read labels or call the manufacturer of any nutritional supplements or medications you may be taking, as many contain wheat starch as an ingredient.
Learn to ask the right questions when eating out
It’s one thing to avoid gluten when you are preparing all of your own foods at home and can read labels for yourself, but what about eating at restaurants? While some restaurants are very much aware of gluten and provide gluten-free options (check glutenfreepassport.com for a list of restaurants who offer gluten-free menus), there are many others who lack an understanding of what gluten is or fail to properly train their staff on ingredients used in their food. It isn’t enough to ask, “Is this gluten-free?” because many people do not know which foods contain gluten. Take it a step further by asking if any flour was added to the sauce or soup, if the meat was marinated in soy sauce, or if the chicken is breaded before being cooked. In many cases, it will be easy for the kitchen to modify their recipe to leave out gluten-containing ingredients, but in others, foods may be prepared in advance and they cannot remove the offending ingredient. When in doubt, opt for meals you know won’t contain gluten, such as un-marinated meats, poultry, or fish, a salad with olive oil and balsamic vinegar, or steamed vegetables.
Keep snacks with you, especially while traveling
Since there may be times when your food options are limited and it’s difficult to find any food without gluten, start making it a habit to keep non-perishable snacks with you just in case. This is where knowledge of holistic nutrition or the help of a nutrition therapy practitioner is very useful. A qualified practitioner can help with creating meal plans and shopping lists, deciphering nutrition facts labels, and providing guidance and recipes that suit your dietary requirements. Instead of shopping for replacement products that are labeled gluten-free but are loaded with other refined grains and fillers, look for products that are naturally gluten-free. Nuts and seeds, dried fruits and vegetables, jerky (check the ingredient list for soy sauce), seaweed snacks, or kale chips make great emergency snacks. Or if you’re out for the day, take an apple or banana and some nut butter with you in case you get hungry and can’t find gluten-free foods. A little bit of planning can help avoid major panic and stress!
Cadie Berrian, BA, MNT