Is Gluten Bad For You?
Recently I have been approached by a few people regarding whether or not they should stay away from gluten. I’ve noticed an increase in products at the grocery stores labeled as gluten free and marketed as a healthier choice. Are these products really a healthier choice? Some people also claim that a gluten free diet is a healthier diet. Here is my opinion on gluten and is based upon what I have studied and read over the years.
What is gluten?
First of all, what is gluten? Well let’s start with a whole grain seed. A seed is made up of an outer skin called the bran and contains fiber, B vitamins, and antioxidants. Inside is the germ which is the plant embryo and contains B vitamins, protein, minerals, and healthy fats. Surrounding the germ is the endosperm which nourishes the germ and contains carbohydrates, protein, vitamins, and minerals. Gluten is a combination of two proteins called gliadin and glutenin found in the endosperm of wheat. To a lesser extent gluten is also found in related grains such as barley and rye. Gluten is what gives dough its elasticity and helps maintain shape in the finished product. When dough is kneaded, gluten forms little pockets that are inflated with gases produced from a leavening agent, allowing the dough to rise. Because gluten is a protein, it hardens during the heating process which allows the finished product to hold form. High gluten flours are used for products such as pasta, bagels, pretzels, and breads while some pastries use low gluten flours.
The Bad of Gluten
For most of us gluten is perfectly safe, but for people with celiac disease or have a sensitivity to gluten, it is not. The first time I heard about this disease was in an immunology course during my undergrad studies. People with celiac disease have an abnormal immune response when gluten is ingested. Their immune system actually begins to attack the villi in the small intestine. This is where nutrients from the foods we eat are absorbed into our bloodstream. As a result of this, an individual suffers from malnutrition despite the fact that they may be eating healthy foods. Symptoms and the development of the disease vary from individual to individual and it is common that the disease isn’t properly diagnosed for up to ten years. Some common symptoms in children are abdominal bloating, abdominal pain, chronic diarrhea, constipation, vomiting, and weight loss. Adults may experience symptoms such as fatigue, osteoporosis, joint pain, anemia, depression, infertility, and seizures to name a few. These would be symptoms you would expect to see with malnourishment. According to the National Foundation for Celiac Awareness, approximately 1% of the American population has celiac disease which equates to roughly 1 in 133 Americans. When I worked in a hospital laboratory for some years, doctors would often order a celiac panel blood test. This test is one of the methods involved in diagnosing someone and must be performed while the patient is on a gluten containing diet otherwise the results will remain negative. The blood tests actually look for certain autoantibodies present in the blood that will tell if the body is attacking its own tissue in response to gluten. In addition to symptoms and blood tests, a biopsy of the small intestine is needed to confirm diagnosis. Currently the only treatment for this disease is a gluten free diet and there is still a great deal of research needed. On January 1, 2006 the Food Allergen Labeling and Consumer Protection Act (FALCPA) made it mandatory for products to be clearly labeled with common food allergens such as wheat on the package if they are contained in the ingredients.
The Good of Gluten
As I stated before, only about 1% of the American population has celiac disease and needs to avoid gluten. For the rest of us grains are a necessary part of a healthy diet and at least half of all the grains you eat should be whole grains. Gluten itself doesn’t necessarily have tremendous nutritional benefits, but the grains that contain gluten are loaded with B vitamins, fiber, protein, and healthy fats that we do need. People that decide to live a gluten free lifestyle need to make up for these missing nutrients in other ways. If a product is labeled as whole grain, then all parts of the seed are included (bran, germ, and endosperm). Refined white flour is processed so that only the endosperm is used, taking away all the fiber and nutrients in the bran and germ. Fiber is important for a heart healthy diet. Studies have not only shown that whole grains improve healthy weight management, but also reduce the risk of certain health conditions such as stroke, heart disease, and type 2 diabetes. If you are not required by your physician to eat a gluten free diet, then grains should be included as a part of your healthy diet. Serving recommendations based upon your age and weight can be found at http://www.choosemyplate.gov/printpages/MyPlateFoodGroups/Grains/food-groups.grains-amount.pdf.
Wheat Flour vs Whole Wheat Flour
There are all sorts of tricks used in the labeling of products. Don’t be fooled by what is on the front label of a product. Look at the ingredients list and if the very first ingredient is labeled “whole” such as “whole grain” or “whole wheat”, then the majority of the product is most likely made from whole grain. If only the second ingredient says it is made with whole grains, then the product could be made with as little as 1% whole grains. Other ingredients that ensure whole grain are brown rice, wheatberries, and oats.
This is an excellent overview of a very controversial topic in nutrition at the moment. As a medical practitioner I often have this conversation with my patients. I thank you for reiterating the facts about gluten as there are many myths and misconceptions surrounding it.