Five years ago, most of us would’ve shrugged and shaken our heads if asked whether we’d heard of “gluten-free.” Today, everyone seems to be buzzing about it. Behind all the chatter stand the facts: 1 in every 133 Americans is diagnosed with celiac disease, and millions more are allergic to wheat. Here’s what to know about eating a wheat- or gluten-free diet.
Celiac disease vs. a wheat allergy
Celiac disease is a digestive condition triggered by the protein gluten. (Some food science 101: Foods are made up of three macronutrients—protein, carbohydrates, and fat. Gluten is the protein part of wheat, barley, and rye.) When a person with celiac disease consumes gluten, the immune system reacts by damaging (sometimes permanently) parts of the small intestine that work to absorb nutrients— often resulting in severe abdominal pain, bloating, and diarrhea. But gastrointestinal symptoms don’t always occur: “People can also experience weight loss, since the nutrients in the gluten-containing foods aren’t getting absorbed, and people aren’t absorbing other foods well, either, as a result of damaged intestines. They can feel sluggish, and kids can suffer from poor growth,” says Marion Groetch, R.D., who works at the Jaffe Food Allergy Institute at Mount Sinai School of Medicine in New York City. Celiac disease is diagnosed after a gastroenterologist takes a biopsy of a tiny piece of the small intestine. The only treatment is strict avoidance of foods containing gluten.
Wheat allergy means a person has an immune-system response to wheat only (as opposed to the gluten protein, found in wheat, barley, and rye). When a wheat-allergic person eats the offending food, he experiences symptoms that are more broadly associated with other food allergies—hives, eczema, swelling, and breathing difficulties, Groetch says.
Typically, a wheat allergy is diagnosed by an allergist. After examining a patient’s medical and dietary histories to determine any problem patterns with particular foods, the allergist will confirm the allergy with a skin prick or blood test. Like other food allergies, the only way to treat a wheat allergy is by avoiding the reactioncausing food—but there’s some good news, too. “It’s possible for children with wheat allergies to outgrow them,” says Groetch. “Continue yearly follow-ups with your allergist to assess whether this might be the case for your child.”
Eating well without wheat or gluten
Eating a diet that’s nutritious and delicious just requires some extra thought. “In most Western diets, wheat is a big source of B vitamins, iron, and folate,” says Groetch. Fortunately, the nutrients are available in many other whole grains, as well as in leafy greens, meat, and beans. “The silver lining of a celiac or wheat allergy diagnosis is that you can use it as an opportunity to learn more about nutrition and try more foods,” says Alicia Woodward, editor of the food allergy and sensitivity magazine, Living Without.
Those with celiac disease can eat any non-gluten grains including amaranth, buckwheat, corn, millet, quinoa, rice, and oats (make sure the package certifies that the oats were processed without wheat or gluten). Those with wheat allergies can eat everything from that list, along with barley and rye. Some people say they can handle spelt better than other types of wheat, since it contains less gluten. But spelt is a form of wheat, so it won’t be tolerated by those with celiac disease or wheat allergies.
Talk with a dietitian who specializes in food allergies to help create a safe, healthy diet, and learn about food shopping and label reading at celiac.org.
Reprinted from KIWI Magazine