8 Things You Need to Know Before Going Gluten-Free
Editor’s note: This post is a Care2 Favorite. It was originally published on February 14, 2013. Enjoy!
You’ve heard the success stories on TV. You’ve seen the celebrity endorsements. You might even know someone who’s tried it and can’t say enough good things about it.
I’m speaking, of course, about the gluten-free diet. And I’m here to tell you, before you commit to trying out this “new” diet that seems to be all the rage… not so fast! You’re about to make a very serious commitment, and there are a few things you need to know before you hop on the gluten-free bandwagon. (I only wish someone had told me what I was getting into when I decided to make the change.)
For many people — about 1 in 133 Americans — going gluten-free is truly a life-changing experience. Celiac disease and gluten sensitivity can cause a†wide range of complications and symptoms, including persistent digestive issues, skin rashes, hormonal problems, depression or anxiety, and even chronic pain. Once treated with a gluten-free diet, these health issues largely vanish.
But for most people, that’s just not the case. And in fact, in many cases the “benefits” of the gluten-free diet for ordinary people have been grossly exaggerated. Let’s start by busting the major myth you’ve probably heard all over the media lately…
1. The truth is you probably arenít going to lose weight on a gluten-free diet.
Itís not impossible, of course — some people do lose weight when they make the switch. Thatís because a damaged digestive system and chronic inflammation can actually make people with celiac overweight.
But for the 90-95% of people who have no problem processing gluten, itís not going to make a big difference. In fact, because so many commercial gluten-free goods are higher in carbs and lower in fiber than their conventional counterparts, lots of people actually gain weight after adopting a gluten-free lifestyle.
2. You may be giving up an accurate diagnosis if you go gluten-free without a doctorís supervision.
If you suspect you may have celiac disease, you really should talk to a doctor before going gluten-free if at all possible. That’s because the blood tests most doctors use to screen for celiac are only accurate if youíre actively consuming gluten on a regular basis. Not only that, but the biopsy a gastroenterologist will perform to look for celiac-related intestinal damage requires you to consume gluten for at least 6 weeks before the test.
Now, you might be thinking, “Well, if I seem to improve on a gluten-free diet, I’ll just go back on gluten to have the testing done.” The problem is that usually doesn’t work. Most people with a gluten intolerance actually become more sensitive to gluten once theyíre not constantly being bombarded with it. That means that after being gluten-free for a few months, it can be impossible to go back on a normal diet long enough to get an accurate diagnosis – it may simply make you too sick.
Unfortunately, many well-intentioned medical professionals just don’t know much about celiac disease, and may tell you just to “give it a try” instead of testing you. It happened to me. I’m 99% sure I have celiac (between my symptoms and family history) but I’ll never know for sure because my doctors screwed up. Please learn from my mistakes and insist on being tested first.
3. Thereís a difference between celiac and gluten sensitivity.
Itís also possible to have a condition called ďgluten sensitivity,Ē which doesnít cause the extensive intestinal damage normally seen with celiac. It does cause similar digestive symptoms, which improve when the patient introduces a gluten-free diet. In the case of gluten sensitivity, the patientís response to a gluten-free diet is the diagnosis. But itís important to rule out the more serious complications that come with celiac disease before trying to resolve your symptoms by cutting out gluten.
4. You canít ďcheatĒ if youíre truly gluten intolerant.
Itís important to realize that a gluten-free diet isnít the same as a weight-loss diet — itís okay to slip up and eat fast food sometimes if youíre trying to eat healthy meals, but being ďmostlyĒ gluten-free isnít good enough. Thatís because gluten-free isnít a fad if you have celiac; itís a medical treatment.
If you actually have celiac, a single breadcrumb can contain enough gluten to cause damage to your small intestine. (Yes, I mean that literally.) And it can take weeks or months for such damage to completely heal, causing unpleasant ongoing symptoms and potentially causing malnutrition in the meantime.
Of course, most people who have a reaction to gluten wonít be tempted to cheat once they realize how much better they feel on the GF diet. When even a bite of wheat bread can land you trapped in the bathroom for the rest of the day, you overcome your cravings for familiar comfort foods pretty quickly.
5. It’s about more than just avoiding wheat.
Wheat isnít the only potential source of gluten in your diet. In fact, youíll need to cut out rye and barley completely (unfortunately, that means most†beer). Since oats are usually contaminated with wheat, youíll need to stick strictly to oats that are certified gluten-free.
Gluten also has a tendency to pop up in unexpected foods — so always read ingredient labels to check for potential gluten ingredients. Soy sauce, for example, is usually wheat-based. Some spice mixes use flour to prevent clumping. And lots of packaged foods use wheat as a filler.
Now, any product with wheat in it (at least in the U.S.), will have it clearly marked on the label as a potential allergen. The problem is that barley and rye are not recognized as major allergens, so ingredients derived from those grains may not be clearly labeled. It’s also not always obvious when prescription and OTV drugs contain wheat and gluten ingredients, so check with your doctor or pharmacist before taking any new medications.
One more thing: you canít always trust food labels. Foods labeled gluten-free might still contain traces of gluten that can make you sick — either because naturally gluten-free ingredients are contaminated during the manufacturing process, or because the level of gluten is lower than 20 parts per million. (While most people with celiac can tolerate this amount of gluten without a reaction, others will still become very ill from these trace amounts.)
There are plenty of databases online detailing which brands are known to be safe, so youíll want to do a little research before you start your diet. If youíre ever in doubt about a productís safety, call or email their customer support to ask if they can guarantee their product is gluten-free.
6. If you do keep gluten in your diet despite a celiac diagnosis, youíre risking your long-term health.
Untreated celiac disease is no joke. People who continue to eat gluten despite their diagnosis arenít just risking a little intestinal upset. Theyíre actually risking serious vitamin deficiencies, infertility, osteoporosis, lymphoma, nerve damage and bowel cancer. The good news is that once you go completely gluten-free, your risk of developing these serious illnesses is the same as the risk to the general population.
Thatís why itís so important to get an accurate diagnosis if at all possible — because if you’re merely gluten sensitive, you don’t have the same increased health risks as a diagnosed celiac. While you still probably don’t want to eat small amounts of gluten on a regular basis, you’re not risking the same kind of long-term health problems if you’re accidentally exposed to it. Which brings us to…
7. You need to constantly watch out for cross contamination.
Do you live with family members who are still eating gluten? Do you share a kitchen or break room at work? Then you need to be extra careful to avoid cross-contamination in the kitchen. Never cook gluten-free food in the same pot or pan as gluten-containing food, and never use a utensil on ďunsafeĒ food and then on gluten-free food. (For example, if you spread peanut butter on wheat bread and then stick the knife back into the jar for another scoop, you have contaminated the entire jar with gluten.)
Some of the easiest ways to accidentally contaminate your gluten-free food arenít what youíd necessarily think — shared kitchen sponges are probably the worst offender. Crumbs will get caught in the sponge and spread gluten over everything you wash, so always have a separate sponge for your own dishes, and wash any dishes which may be contaminated with gluten before using them.
You also need to know that thereís a lot of cookware thatís impossible to clean once glutenís gotten into it. Colanders, strainers, cutting boards and wooden utensils all have to go. Even nonstick pans with scratched lining might be hiding small amounts of gluten that are almost impossible to remove. Youíll need to replace these items or buy your own designated gluten-free cookware that you keep in a separate part of the kitchen.
8. Don’t just assume if your order at a restaurant will be gluten-free.
Remember all those guidelines about cross-contamination in the kitchen? They apply when eating out, too. Always be sure to ask kitchen staff how they handle food in the kitchen and what measures they take to prevent cross-contamination. Ask specifically if they have a gluten-free menu available. You can even ask to speak directly to the chef or manager before ordering anything if you feel unsure about the restaurant. (And if you’re still worried about cross-contamination, don’t feel bad about leaving and finding another restaurant.)
Just remember: even if a food should be naturally gluten-free doesn’t mean it’s safe. I’ve heard restaurant horror stories about rice pasta being boiled in the same water as wheat pasta, or crumbs from regular pastries falling onto gluten-free pastries in a display case. An otherwise gluten-free salad will be unsafe if croutons are added on top — and just picking them off probably isn’t good enough to prevent you from getting sick. Likewise, french fries are often fried in the same oil as items that have been breaded, making them unsafe for a gluten intolerant person.
To sum everything up…
By now you should have a pretty clear idea of the pros and cons of going gluten-free. In short: the upside is that if you suffer from celiac or gluten sensitivity, you’re going to feel a whole lot better than you did before. And who doesn’t want to feel healthier, have more energy and lower their lifetime risk for serious health problems?
The downside: eating truly gluten-free is difficult and often incredibly frustrating. It can be even more difficult if you live in a household with family members who still eat a regular diet. You can feel depressed and isolated when going out to eat or attending social events, where there may not be anything safe for you to eat. It’s not a diet I’d recommend to anyone who doesn’t truly need to avoid gluten for health reasons.
In the end, it’s a deeply personal decision that you’ll need to make with the support of your doctor.
Photo credit: Moyann Brenn via Flickr