Why Go Gluten-Free

Chances are you're already careful about what you eat. (You did, after all, pick up Taste for Life!) But can you imagine having to scrutinize every single label, which may or may not be accurate, for ingredients that contain hidden gluten? For more than 1.5 million Americans with celiac disease, choosing the right foods can be a guessing game that may ultimately wreak havoc with the digestive system. While there's no known cure for celiac disease, it can be controlled by adhering to a gluten-free diet.

What is Celiac Disease?
A lifelong autoimmune intestinal disorder, celiac disease is genetic and may affect several family members. It's also fairly common-in fact, it's as prevalent as hereditary high cholesterol. When people with this disease eat foods or use products that contain gluten (a protein found in wheat and related grains), their immune systems respond by treating this substance like a foreign invader, damaging the lining of the small intestine. This damage interferes with the absorption of nutrients, so the person becomes malnourished, despite an adequate diet.

Some people with celiac disease live symptom free, while others may experience a variety of symptoms. Celiac disease can appear at any time in a person's life, though it's sometimes triggered initially by pregnancy or childbirth, severe emotional stress, or even surgery. Since the symptoms are extremely varied and a number of bodily systems may be affected, it's tough to identify celiac disease-especially since it often mimics other intestinal disorders, such as irritable bowel syndrome, gastric ulcers, and anemia.

The classic symptoms include chronic diarrhea and/or constipation, abdominal pain, gas, bloating, and weakness. The lining of the gastrointestinal tract may become so damaged that large molecules escape, causing problems associated with leaky gut syndrome, including allergies, a taxed liver, and more. Arthritis, depression, brain fog, and fibromyalgia are less common symptoms.

An Accurate Diagnosis
Since its symptoms are so diverse, celiac disease is frequently misdiagnosed or undiagnosed. Recent studies show that this disease affects about one in every 100 people, and 97 percent of them are undiagnosed. In the U.S., it takes an average of nine years-which, according to experts, is about eight years too long-for a diagnosis. "Symptoms tend to be dismissed by physicians as psycho-somatic or attributed to a number of other conditions," says Cynthia Kupper, RD, CD, executive director of the Gluten Intolerance Group.

The most at-risk individuals include those with a family history of celiac disease, anyone with Type 1 diabetes, people with multiple endocrine disorders (diabetes, thyroid, and Addison's diseases), both women and men with fertility problems, and people with other autoimmune disorders (lupus, rheumatoid arthritis, and Sjogren's syndrome). "Be persistent in asking for screening blood tests, especially if you fit in one of the at-risk categories or present with symptoms suggestive of celiac disease," recommends Kupper.

In addition to blood tests, a small-bowel biopsy can determine intestinal damage and, later, monitor the healing progress. Since the body may be trying to cope with long-term malnourishment, it's also important to measure blood levels of iron, folic acid, vitamin B12, and calcium.

What to Avoid
For people with celiac disease, gluten will damage the small intestine each time it's ingested, so going gluten free is a permanent lifestyle change. Avoid any products containing barley, oats, rye, or wheat.

Reading labels carefully is crucial. It's important to watch for "hidden" sources of gluten, such as hydrolyzed vegetable protein, textured vegetable protein, and hydrolyzed plant protein. Also look for all derivatives of wheat, rye, oats, and barley, including malt, modified food starch, grain vinegars, some soy sauces, plus binders and fillers found in many foods and even medications and seasonings.

What Can You Eat?
Eating gluten free need not mean the end of dining out, travel, or dining with friends," says Kupper. "It does, however, take some preplanning. Stay focused on what you can eat, learn to modify meals that you already enjoy, and incorporate gluten-free special products in your diet.

Enjoy foods made from corn, beans, rice, potatoes, and special grains and seeds. Quinoa, buckwheat, amaranth, teff, Montina, sorghum, and millet are safe choices. Look for un-processed meats, poultry, eggs, and fish. Some dairy products (milk, cheese, and plain yogurt) may be okay. However, about half the people with celiac disease are also lactose intolerant at the time of diagnosis. After sticking to a gluten-free diet and allowing the intestinal lining to heal, you may be able to tolerate dairy products.

For most people, going gluten free will stop symptoms, heal intestinal damage, and prevent further damage. Check out your favorite natural products store for gluten-free breads, soups, and spices, and try some of the recipes on pages 56-57.

Selected Sources Celiac Disease: A Hidden Epidemic by Peter H. R. Green, MD, and Rory Jones ($22.95, HarperCollins, 2006)  Celiac Disease Foundation, www.celiac.org  Going Against the Grain by Melissa Diane Smith ($14.95, Contemporary Books, 2002)  Optimal Digestive Health: A Complete Guide, edited by Trent W. Nichols, MD, and Nancy Faass, MSW, MPH ($19.95, Healing Arts Press, 2005)  Wheat Free, Worry Free by Danna Korn ($14.95, Hay House, 2002)  "Taste for Life Expert Advice: Gluten Intolerance" by Cynthia Kupper, RD, CD, volume 14

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