What is a gluten free diet exactly? A gluten free diet is a diet that excludes all foods that contain gluten. Gluten is a protein complex made up of gliadins and glutenins. It is found in grains from the wheat family, including wheat, barley, rye, triticale, kamut, and spelt. In reality, the label of gluten free means that a food contains an allegedly harmless level of gluten, not that it is guaranteed to not contain any at all. The US FDA and the international Codex Alimentarius define that level as 20 parts per million or less.
Who should follow a gluten free diet?
There are a variety of conditions which benefit from a gluten free diet, including celiac (or coeliac) disease, wheat allergy, and gluten sensitivity. There is also some suggestion that a gluten free diet may help those with lupus, dermatitis herpetiformis, irritable bowel syndrome, rheumatoid arthritis, type 1 diabetes, thyroiditis, and psoriasis. A gluten free diet has sometimes been used as a treatment for people on the autism spectrum. However, there is no evidence that it is of any use for ASD individuals who are not also suffering from some form of gluten intolerance.
A gluten free diet is the only effective treatment that exists for people with celiac disease. It is not a weight loss diet, nor is it a short-term treatment. It is a life-long eating regimen. Celiac disease is an autoimmune disorder of the small intestine. When gluten is eaten, an immune response causes inflammation in the small intestine. This leads to damage to the surface of the intestine, which in turn results in the inability to absorb nutrients. Eating and maintaining a gluten free diet will reverse this damage and relieve associated symptoms.
A wheat allergy, on the other hand, is an allergic reaction to proteins in wheat. It is most common in children. Eating wheat can cause someone with a wheat allergy to experience a range of allergy symptoms, from hives to anaphylaxis. Like peanut allergy, it is potentially fatal. Some people have an allergic reaction from eating wheat, while others can react to simply inhaling it. For these cases, keep in mind that wheat is used in non-food items such as cosmetics, lotions, and soaps. Baker’s asthma, an allergy caused by inhalation of flour, is one of the most common forms of occupational asthma.
In addition to celiac disease and wheat allergy, there is another group of people who have symptoms similar to celiac disease without having intestinal damage. This is known as non-celiac gluten sensitivity.
If you suspect you have any of these, I recommend seeing your doctor and getting tested before putting yourself on a gluten free diet. If you start the gluten free diet first and then decide to get tested, your test results will be inaccurate. You have to be consistently eating gluten at the time you have the tests. That said, you know your body best. If your doctor brushes off your concerns, find one who is willing to give you the full range of tests. Even if you test negative on the initial blood test, that does not rule out non-celiac gluten sensitivity.