Does this Gluten Make my Butt Look Big?
I don't know if you've heard, but going gluten-free is all the rage these days. Usually when a patient is trying to impress me with how healthy her diet is, this phrase will slip in:
"I try to eat gluten-free as much as I can - because, you know, gluten is so bad for you..."
Bread has been around since some of the earliest civilizations of man. From Bavarian pretzels to Italian pasta to New York sourdough, flour is a staple of so many cultures and cuisines. So what exactly is the deal with gluten?
What is Gluten, Anyway?
Gluten is poison! Right?
No, it's not. In fact, here is a list of things that gluten is not:
Gluten is not poison
Gluten is not crap (as Miley Cyrus claimed)
Gluten is not sugar
Gluten is not a carbohydrate
Gluten is not an additive
Gluten is not a preservative
Surprised? So were these folks when Jimmy Kimmel asked them what they think gluten is:
Okay, so what is gluten?
Gluten is a protein. It's made up of two components: glutenin and gliadin. It's found in the grains wheat, barley, and rye.
In flour, glutenin and gliadin are found as separate proteins. Once mixed with water they combine to form gluten. Glutenin is sticky; gliadin is stretchy. These properties are what give dough the ability to stick together, stretch, and ultimately allow yeast to produce air pockets, creating gluten balloons and causing bread to rise.
Gluten is an incredibly unique substance; anyone who's tried to replicate its qualities in gluten-free products understands how hard it is to make something without gluten that is simultaneously sticky, stretchy, strong, and soft.
Above: watch yeast grow! 1) Just mixed: warm water, sugar, yeast; 2) after 5 minutes; 3) after 10 minutes
Who Needs to Avoid Gluten
Celiac Disease (CD) is an autoimmune disease that affects about 1% of the population in the US. When somebody with CD eats gluten, the body (inappropriately) mounts an immune response and (incorrectly) starts to attack the cells in the small intestine.
There is no cure for CD, so people with CD have to completely eliminate gluten for their entire life. As little as 1/10th of a teaspoon of flour contains enough gluten to trigger the autoimmune process and start doing damage to the small intestine.
This means that not only do people with CD need to avoid eating products that contain gluten, but they also must avoid any foods that may have been contaminated with gluten. So: don't share toasters, wash pans thoroughly before switching to gluten-free cooking, and avoid sharing utensils that have been used with foods containing gluten.
Learn more about Celiac Disease from The Celiac Disease Foundation.
Non-Celiac Gluten Sensitivity
A slightly larger minority (possibly up to 8%) of the population does not have Celiac Disease, but still experiences unpleasant symptoms if consuming gluten. This is called Non-Celiac Gluten Sensitivity (NCGS). Unlike Celiac disease, it is NOT an immune response.
There is not a blood test to confirm or deny the diagnosis, and no damage occurs to the digestive system if gluten is ingested. NCGS is diagnosed by first ruling out Celiac disease, then doing a blinded re-introduction of gluten -- meaning that you don't know gluten has been added back. If you have NCGS you should avoid gluten because it makes you uncomfortable -- but it isn't dangerous to eat it as it is in CD.
Learn more about NCGS and the difference between it and Celiac disease here.
Somebody with a wheat allergy has a specific hypersensitivity to wheat. The symptoms of a wheat allergy can range from mild to severe (as with all other types of allergies), causing anything from a few sniffles to full-fledged ambulance-called anaphylaxis.
A wheat allergy can be diagnosed via a blood test, skin prick test, or an oral food challenge. It can be tricky to diagnose a food allergy; there can be false positives and there are a lot of odd, non-scientific ways to "diagnose" food allergies. Stay away from these and go to an allergist.
The Real Truth about Gluten and Weight Loss
Unless you have true Celiac Disease (and even then only in rare cases), gluten itself has nothing to do with weight loss.
This may be shocking if you've followed celebrities or know someone who has lost weight after going gluten-free. To be honest, many people who follow a strict gluten-free diet will lose weight - at least at first. But it has nothing to do with gluten itself and everything to do with the fact that when you cut out gluten, you eliminate a lot of calorie sources: bread, pasta, crackers, cookies, cake, and most processed food.
If you're gluten-free, you don't eat the donuts your co-worker brought into the office.
If you're gluten-free, you don't munch mindlessly on the pretzels while watching the game.
If you're gluten-free, you can't drink Bud Light with your buddies.
If you're gluten-free, you can't swing through the McDonald's drive through because everything in that place is contaminated with gluten.
It turns out for most people going gluten-free makes them more mindful of their eating habits, thus helping them cut back on overall calories and lose weight.
However, if one simply replaces regular brownies for gluten-free brownies, this effect is lost. Gluten-free flours and baking mixes are often less healthy than their wheat flour alternatives. While most refined grains are required to have nutrients added back into them, gluten-free products are not.
Gluten-free flours tend to be ultra-refined and if not careful to balance one's diet, a gluten-free diet can be deficient in zinc, iron, and some B vitamins.
Gluten's Bottom Line
(Pun referencing the title intended.)
If you're one of the few people who suffer from Celiac Disease or Non-Celiac Gluten Sensitivity you should absolutely avoid gluten.
If the above descriptions don't characterize you, there's no need to eliminate gluten from your diet. In fact, doing so may unintentionally reduce the quality of your diet if you swap whole-grain products for the refined gluten-free version.
Here's the thing: if you don't have Celiac disease, don't go to a restaurant and claim you have a "disease" when really you only have a preference. People with Celiac disease must follow an extremely strict gluten-free diet; even small amounts of contamination such as when the same oil is used to fry breaded chicken and French fries can be enough to trigger the autoimmune process.
For the sake of those who truly need to follow a gluten-free diet to remain healthy, don't water down the idea that "going gluten free" is something to be taken lightly.
For more information, talk with your doctor or dietitian. Also check out the Celiac Disease Foundation, which has a plethora of quality information and resources.
Good luck to you in your pursuit of health, whether free or full of gluten!
With love from Peas and Hoppiness.