Is Gluten Free Healthier for Everyone??

Yesterday I appeared on Paula Sands Live! and she asked me point blank should someone who doesn't have a gluten sensitivity or Celiac Disease eat a gluten free diet. The short answer I gave her is no. The long answer requires a little more discussion. While eating a completely gluten free menu isn't going to harm you, if you don't need to eat gluten free, you shouldn't go out of your way to do so. The bottom line is that in recent years Gluten Free has become somewhat of a fad diet and many people are jumping on the band wagon without proper diagnosis, without a gluten sensitivity or intolerance and without considering the long term health benefits/detriments.

1 in approximately 133 individuals is affected with Celiac Disease. Celiac disease is defined as someone who cannot tolerate gluten. The gluten attacks the villi in their small intestine, which are the small hairlike protrusions that actually help to absorb nutrients, causing them to shrivel up and thus instigating a host of medical ailments ranging from gastro-intestinal problems to iron deficiencies to skin rashes to migraines. These individuals when taken off of a diet including gluten can regrow the villi and resume a normal life sans symptoms.

Wheat allergies, intolerances and sensitivities are not necessarily related to Celiac disease but are legitimate allergies nonetheless which also require an individual to remain on a gluten free diet. Symptoms again can range from mild skin irritations and stomach discomfort to full anaphylaxis. The bottom line is, the need to live gluten free exists. BUT, that being said, many believe that eating gluten free is somehow healthier for you. They equate gluten free with low fat, low carb, low glycemic or low sugar. This is often not the case. Many of the carbohydrates that are often included in a gluten free diet, i.e. rice, potatoes and corn, can often be higher in starches and sugars than flour and may in fact cause weight gain, not loss.

There is also a significant problem with many gluten free products that are being marketed to consumers. Gluten free is big business and many manufacturers see it as an opportunity to make money. While these products may be gluten free, they are not made with your overall health and wellness in mind. If you actively read labels you'll notice that often pre-packaged gluten free foods and snacks are actually quite high in fat, sugar, sodium and carbohydrates as well as a host of other ingredients that are included to create a certain mouth feel or texture people associate with like products with gluten in them. You might not get sick, but you may in fact create a myriad of other problems by eating these products like hypertension, diabetes and obesity.

I think the rule of thumb is that you should not self diagnose. You should consult a medical practitioner to determine if you have a legitimate allergy or Celiac disease before restricting anything from your diet. A simple blood test is needed to identify if you have a preponderance toward Celiac Disease, after which an endoscopy or biopsy may be performed to confirm the disease. One quick note: if you have already begun eating gluten free, you may test with a false negative even if you have it. You must be consuming gluten for the test to be accurate. As far as a wheat/gluten allergy, intolerance or sensitivity, there are various skin prick tests that can be performed to confirm such an allergy, but often a doctor will recommend you do an elimination diet to test your sensitivity to wheat or gluten.

Eating gluten free is not a diet plan. Case in point. Last year I attended a fairly well known Gluten Free Expo where a registered dietition was appearing as an expert in eating gluten free. The dietition was well over what I consider to be a healthy weight and if indeed she was practicing what she preaches, she was the poster child for the fact that consuming gluten free foods without need or without consideration of overall health and wellness will not make you lose weight. If you think you are doing something good for you by eating an entire bag of gluten free pretzels over the non gluten free ones because you think they won't make you gain weight, think again. Ultimately you have to read labels, know your body and know that there is no miracle short cut to losing weight, especially not a gluten free one. I always say, moderation is key, exercise is a must and knowledge about what you are putting into your body is necessary. Disappointing I know, but if it sounds too good to be true, it is, especially when it comes to losing weight.

Chef Monika is the author of "Let's Party: Gluten Free Entertaining for Everyone"

Diagnosing Celiac Disease: A Work In Progress

I am currently reading yet another book about Julia Child called "As Always, Julia" by Joan Reardon. This is a collection of a series of letters written between Julia Child and her friend Avis Devoto. In one letter, Avis Devoto describes having suffered from anemia for twenty-five years. As I was reading this a red flag flew up in my mind which had celiac disease written all over it. Let me explain. My mother in law, who was finally diagnosed with celiac disease in 1997 suffered from chronic anemia to the point that she was getting recurrent iron shots which didn't seem to really help her. As it turns out, the anemia was a symptom of celiac disease but because doctors were not aware of or not accustomed to testing for this disease, they missed it and so she suffered for years without a real explanation.

Other very common symptoms that went misdiagnosed for years because of lack of knowledge were gastrointestinal problems, such as IBS, skin irritations, migraines, failure to thrive, fibromyalgia, neuralgia and any number of other diseases which involved lack of energy, stomach discomfort and a general sense of feeling ill. Many of these individuals went on to take medications for these ailments, which gave them only minimum relief and mostly just resulted in a sense of despair, a feeling that they would never feel "right" again.

I hear these stories over and over from those who have spent years getting a proper diagnosis. Ironically, most, if not all, feel an immediate sense of relief as soon as they eliminate wheat gluten from their diets. For some, these symptoms may not have appeared in their youth, but later in life. This represents basically two kinds of celiacs, those who are immediately affected and those whose effects are cumulative, meaning the build up of exposure to gluten over a period of time will eventually cause discomfort. My mother in law is the first kind. She knows within minutes and has violent reactions.

So what is celiac disease exactly?? Essentially the proteins in wheat gluten cause inflammation of the villi or hairlike projections in the intestine. These hairlike projectsions are largely responsible for absorbing the nutrients ingested from food. When they become inflamed, they shrivel up and the end result is essentially malnourishment which manifests itself in the above mentioned symptoms. These villi will grow back once gluten is eliminated from the diet and therefore celiac disease is perfectly managed through diet, not requiring any medication for most.

It is important to mention that celiac disease should not be called an allergy in the true sense of the word but rather an intolerance. An allergy by definition creates a histamine response, which causes inflammation in the whole body rapidly and may result in not only rashes, but anaphylactic shock where ones throat will close up causing them the inability to breathe. These kinds of responses can be severe and can result in death. There ARE those who do suffer from wheat allergies. An intolerance like celiac disease may result in death over the long term, mostly from lack of absorption of nutrients, but is not immediately deadly. It also cannot be treated with medication, such as an epipen, to alleviate symptoms.

Diagnosis is simple but not foolproof. Usually it begins with a simple blood test to determine a preponderance toward celiac disease. Once a preponderance has been confirmed an endoscopy is required to confirm the damage to the villi for a true diagnosis to be made. Part of the problem that has been encountered by some is that once they receive a positive blood test they eliminate gluten from their diet and then have an endoscopy. Since the villi will grow back after the removal of gluten, they will show a false negative from the endoscopy.

There is also the issue of self-diagnosis. Celiac disease and wheat intolerances have become somewhat of a fad lately. Many are jumping on the band wagon so to speak, attempting to treat a number of different ailments with the assumption that they must suffer from a gluten intolerance. This is not to say that they won't feel better, as many will actually reap the benefits of eating more whole foods and less processed foods, but the result may not actually dictate the cause. In my mind, how you feel is enough to encourage you to continue on a wheat free diet, but to truly be sure, one should discuss this with a trained medical practitioner and particularly one who is familiar with testing for and diagnosing celiac disease.

For more information on how to eat gluten free, check out my cookbook "Let's Party: Gluten Free Entertaining for Everyone." The book was inspired by and tested on my mother in law. Log onto www.chestnut-inn.com/retail.