Do you really need to shun all things gluten-containing?
It used to be thought that you were either in our out. That is, you either could have gluten with no problem, or you simply could not. Why? Because you had celiac disease. End of story. Nowadays, that’s not the thinking. See, science really is an ever-evolving thing, happily!
Do you have celiac disease or something else?
If you or your physician believe you have an issue with gluten in your diet, and you are sent to be tested for celiac disease, you either find out you do or your don’t, but that’s not really the end of the story. See, you might still have a sensitivity to gluten, but not have the immune response that’s required for a diagnosis of celiac disease. A CNN physician-columnist covered this a while back, interviewing Dr. Joseph Murray from the Mayo Clinic (click here for the article), and basically the current thinking is that non-celiac sensitivity is a real health problem that affects more people than celiac disease. The problem is that there is no exact test for it. If one finds out that one does not have celiac disease, and yet removing gluten from the diet improves symptoms while putting gluten back into the diet worsens them, well then there you go—you likely have non-celiac gluten sensitivity or a gluten intolerance. (For the record, you would probably also be tested for other things like Crohn’s disease or a wheat allergy.)
Is complete elimination of gluten necessary for you?
Dr. Arthur Agatston, author of the South Beach Diet Gluten Solution, wrote a nice, neat summary of some important points about the gluten-free diet (also on CNNHealth, read it here). I like this article for the following reason: it reinforces that, while celiac disease is indeed a reason to completely avoid all gluten in the diet (including in supplements), the majority of people who have gluten issues may not need to be as compliant with the gluten-free diet in order to experience the benefits of giving up gluten. Non-celiac gluten sensitivity, or a gluten intolerance obviously is a reason to make moves to remove gluten from your diet, but it may not require the level of diligence that is necessary for a person with celiac disease. Gluten sensitivity is not a one-size-fits-all health issue.
Bottom Line: If you think gluten is an issue for you, go and get a diagnosed before playing around too much with your diet. Taking gluten out of your diet and then seeking a diagnosis makes it much harder to obtain an accurate diagnosis. Once you have the information you need, you can then begin to move ahead with appropriate adjustments to your diet. Consulting a dietitian is recommended for advice on making dietary changes without short-changing yourself nutritionally.
—Kit Broihier, MS, RD, LD
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