Gluten Intolerance & The Truth About A Gluten-Free Diet
Around 1% of the American population has Celiac Disease, while an estimated 9% more have non-celiac gluten sensitivity, and yet most people do not know what either of these conditions are, or how they differ. Nearly 30% of the total American population follow some variation of a gluten-free diet. That means that, as many as 20% of these people have either misdiagnose themselves with one of these two gluten intolerant conditions without ever having seen a doctor; or simply committed to a gluten-free diet in an attempt to live an assumed healthier lifestyle. Though this drastic lifestyle choice is often unnecessary and occasionally even unsafe.
Knowing the difference between non-celiac gluten sensitivity and Celiac Disease is important because while those with sensitivities may have adverse physical reactions to gluten ingestion, people with Celiac Disease could need medical attention following the introduction of any gluten protein to their diet. Furthermore, those without gluten sensitivities who have misdiagnosed themselves, without seeing a doctor, could have other gastrointestinal problems that need medical attention, for other reasons not pertaining to gluten proteins. Without the proper diagnosis and diet these people could continue to suffer, or even inadvertently worsen their condition.
Celiac Disease is the most severe type of gluten intolerance. It is a genetic autoimmune disorder that causes the body to attack gluten proteins as well as the lining of the small intestine, causing serious damage to the gastrointestinal tract. Due to these damages, patients with Celiac Disease have difficulties absorbing key nutrients from their foods. The diagnosis of Celiac Disease can only be made by a doctor after antibody testing and well documented symptomatic responses to a gluten free diet have been reviewed.
When diagnosed with Celiac Disease many people are found to have villous atrophy (VA) which is an erosion of the microscopic tentacles, lining the small intestine. This erosion causes the interior walls to become smooth and virtually flat. The gastrointestinal discomfort associated with Celiac Disease is hypothesized to be directly related with this process of erosion. In addition to discomfort, the destruction of the small intestine’s lining also causes improper nutrient absorption. Although Celiac Disease is the most common cause of villous atrophy, people without Celiac Disease can also suffer from it. 
If a person suffers from villous atrophy but does not test positive for Celiac Disease their symptoms are often caused by other gastrointestinal complications or diseases including: Crohn’s disease, intestinal lymphoma, small intestinal bacterial overgrowth, autoimmune enteropathy, or common variable immunodeficiency (CVID). Occasionally villous atrophy can also be caused by medications. In none of these cases, will eliminating gluten from the diet relieve symptoms in the patient.
A person living with non-celiac gluten sensitivity will have gastrointestinal symptoms that are similar to irritable bowel syndrome (IBS), caused by an adverse food-induced reaction in the digestive tract, when they consume gluten. These reactions do not affect the lining of the small intestine. There are no proven medical tests that can solidify the diagnosis of non-celiac gluten sensitivity, since it is a physiological response and not an autoimmune response. Because of this lack of scientific evidence, people suffering from this gluten intolerance are less likely to be to be diagnosed, and thus less likely to avoid gluten and more likely to continue to suffer from gastrointestinal discomfort.
Maintaining a gluten free diet is the best way for anyone suffering from either of these gluten intolerances to live a healthy, active lifestyle, without sacrificing comfort. That being said, there are many important vitamins, minerals, and other nutrients found in foods that naturally contain gluten, that are missed out on by those without gluten intolerances that follow a gluten-free diet. There are also an excess of carbohydrates, fats, calories, and sugars in many gluten-free processed foods, that individuals without sensitivities are unnecessarily exposing themselves to. This is because when gluten is removed from a food source, it must be replaced with something to maintain its original texture or taste. Often times what it’s replaced with is nutritionally inferior to the original product.
Many people think that committing to a gluten-free diet is the same as committing to a low-carb diet, but it’s not. Many gluten-free food options are actually loaded with carbohydrates, such as: beans, corn flour, quinoa, rice, bananas, potatoes, apples, and yogurt. In addition to whole foods that contain carbohydrates, many of the gluten-free packaged food substitutions, such as: breads, cereals, pastas, and cooking flours, contain the same amount, if not more carbohydrates, than the original gluten containing recipes. A gluten-free diet is necessary for people suffering from Celiac Disease and non-celiac gluten sensitivity. For the average individual however, maintaining a gluten-free diet is both unnecessary and often unhealthy.
More often than not a person interested in starting a gluten-free diet, is actually more interested in cutting out the fat causing carbohydrates from their diet, than cutting out gluten proteins. The confusion comes about because people know that gluten is found in wheat products, (the same wheat products that contain so many carbohydrates). They also know that those wheat products are the reason that they gain weight, or at least the reason that they can’t lose weight. So they equate gluten with weight gain or weight stagnation. But it isn’t the gluten responsible for the weight gain. It’s actually the carbohydrates found in those same wheat products that are causing people to pack on the extra pounds. So what these individuals are actually interested in is a low-carb diet.
A low-carb diet is often maintained to help control insulin levels. Since insulin is the hormone that controls whether fat is burned for energy or stored, often times controlling the intake of carbohydrates is a key component of controlling weight loss. A gluten-free diet often times still contains just as many, if not more carbohydrates, than a diet that allows the ingestion of gluten. On the other hand, a low-carb diet, may very well cut out many gluten containing products, but not because of the gluten present, rather, because of the high levels of carbohydrates that food contains.
While a gluten free diet is necessary for those living with Celiac disease, and highly recommended for those with non-celiac gluten sensitivity, it is clear that it is a superfluous diet choice for anyone not suffering from a gluten intolerance. Given that the gluten protein is not inherently unhealthy, and is only found in many unhealthy food choices, avoiding it all together is much less effective than simply avoiding unhealthy foods. When maintaining a healthy diet, it is best to stick with whole foods, and invest only in processed foods that have a high amount of protein and fiber, but a low amount of saturated fats and carbohydrates, as they are the true culprits of fat accumulation.
Sources:
“Percentage of U.S. Adults Trying to Cut Down or Avoid Gluten in Their Diets Reaches New High in 2013, Reports NPD.” NPD Group. March 06, 2013. Accessed January 27, 2016. https://www.npd.com/wps/portal/npd/us/news/press-releases/percentage-of-us-adults-trying-to-cut-down-or-avoid-gluten-in-their-diets-reaches-new-high-in-2013-reports-npd/.
“Gluten Sensitivity – Celiac Disease Foundation.” Celiac Disease Foundation. Accessed January 27, 2016. https://celiac.org/celiac-disease/non-celiac-gluten-sensitivity/.
“Celiac Disease vs. ‘Gluten-Sensitive'” WebMD. Accessed January 27, 2016. http://www.webmd.com/digestive-disorders/news/20131212/celiac-disease-gluten-sensitive?page=2.
Mandal, Ananya, MD. “What Is Insulin?” News-Medical.net. October 8, 2014. Accessed January 27, 2016. http://www.news-medical.net/health/What-is-Insulin.aspx.
Degaetani, Marisa, Christina A. Tennyson, Benjamin Lebwohl, Suzanne K. Lewis, Hussein Abu Daya, Carolina Arguelles-Grande, Govind Bhagat, and Peter H R Green. “Villous Atrophy and Negative Celiac Serology: A Diagnostic and Therapeutic Dilemma.” Am J Gastroenterol The American Journal of Gastroenterology 108, no. 5 (2013): 647-53. Accessed January 27, 2016. http://www.nature.com/ajg/journal/v108/n5/full/ajg201345a.html.
Catassi, Carlo, Julio C. Bai, Bruno Bonaz, Gerd Bouma, Antonio Calabrò, Antonio Carroccio, Gemma Castillejo, Carolina Ciacci, Fernanda Cristofori, Jernej Dolinsek, Ruggiero Francavilla, Luca Elli, Peter Green, Wolfgang Holtmeier, Peter Koehler, Sibylle Koletzko, Christof Meinhold, David Sanders, Michael Schumann, Detlef Schuppan, Reiner Ullrich, Andreas Vécsei, Umberto Volta, Victor Zevallos, Anna Sapone, and Alessio Fasano. “Non-Celiac Gluten Sensitivity: The New Frontier of Gluten Related Disorders.” Nutrients. October 5, 2013. Accessed January 27, 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3820047/.
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