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Everything You Want to Know about Gluten Sensitivity

By Kathleen M. Zelman, MPH, RD

There has been an ongoing debate whether gluten sensitivity exists or is a media driven condition driving sales of gluten-free products by promoting to dieters.

Historically, gluten was only thought to pose problems for about 1-2 percent of the population who suffer from the autoimmune celiac disease for which the cornerstone of treatment is a strict gluten-free diet. Today, gluten-free diets are the hottest diet trend for a long list of conditions, including weight loss.

Even though most of the conditions are not backed with scientific evidence, emerging research suggests that certain people improve their specific condition when gluten is removed from their diet.

One of the most common is called non-celiac gluten sensitivity, also known as “celiac-lite,” that presents with similar symptoms to celiac disease. It is a relatively new condition without an established definition. It is neither celiac disease nor a wheat allergy, but it does cause symptoms when gluten containing foods are eaten.

Solving the Gluten Puzzle

For years, researchers have been trying to understand the role of gluten in people who do not have celiac disease. These people feel better on a gluten-free diet, but do not test positive for celiac disease or have any of the celiac disease complications.

It is a rapidly growing condition, yet it remains controversial because there are no tests to confirm the condition. The symptoms vary among patients, and currently, there are only a few studies on the subject.

Detecting Gluten Sensitivity

Without tests to confirm gluten sensitivity, it is considered a diagnosis of exclusion. It is estimated that roughly 6 percent of the population feels better when gluten is removed from their diets, according to National Center for Biotechnology Information. The overall prevalence is unknown mainly because many patients are self-diagnosed and adopt a gluten-free diet without medical advice or consultation.

If you suspect you have gluten sensitivity, it is important that you talk with your doctor, who will want to rule out other related conditions such as irritable bowel syndrome, wheat sensitivity, wheat allergy and celiac disease. After other conditions are ruled out, patients are usually challenged with a gluten-containing diet to assess symptoms after which, gluten is removed to see improvement. Symptoms appear within hours or a few days after gluten ingestion and disappear with gluten withdrawal.

Reintroducing gluten is best done when you feel well and with simple foods like matzo or soda crackers, which are pure wheat.

Symptoms of gluten sensitivity may include gastrointestinal symptoms such as diarrhea, abdominal discomfort, pain, bloating and flatulence. Other symptoms include fatigue, headache, brain fog and lethargy. These symptoms typically occur after eating gluten and improve after gluten withdrawal. Sensitivity to gluten can occur at any age and to people who have previously tolerated gluten.

Going Gluten Free

Whether fact or fiction, Americans are shunning gluten for numerous reasons namely because it is endorsed by celebrities, has a health halo as better-for-you, promises to be good for weight loss, eliminates bad-for-you wheat and can resolve gastrointestinal symptoms.

According to experts, the number of people going gluten free outnumbers the number of people who truly have a problem tolerating gluten. Roughly 29 percent of American adults are cutting down or avoiding gluten in their diets, according to The NPD Group.

If people feel better when gluten is eliminated, for whatever reason, there is no cause for concern. Choosing gluten-free grains over other grains can be more challenging, but with the explosion of gluten-free products at grocery stores and restaurants, it is becoming easier to go gluten free.

Gluten-free products have increased 63% over the last two years, according to Mintel, a market research company. They estimate $10.5 billion was spent on gluten-free products in 2015 and predict it will reach $15.6 in 2016.

The U.S. Food and Drug Administration has also come to the rescue by defining what a “gluten-free” label on a food package really means after years of consideration.

Some gluten free products can be higher in fat, calories, sugar and sodium, so be sure to read the labels carefully.

What Causes Gluten Sensitivity?

It does not appear to be genetics. It is not well understood and may be different for individuals. Some theories suggest it may be the result of gastrointestinal malfunction and the microbiome. The microbiome is the community of bacteria, good and bad, that live inside our bodies.

Experts are questioning whether it is gluten or some other component of the grain, like the fiber, that is responsible for the symptoms. New varieties of wheat that have been introduced over the past 40 years have been ruled out as causing an increase in the condition.

Bottom Line

Gluten sensitivity could be explained as a spectrum of tolerance to gluten that improves when gluten is removed from the diet.

Experts agree, many people feel better on a gluten-free diet for a variety of reasons, including believing it is healthier. If your gluten-free diet is nutritionally adequate and you are feeling better (since you are eating less junk and processed food), there may be no reason to change your diet. 

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