- Is the Gluten-Free Option the Healthier Choice?
- The Basics of a Gluten-Free Diet
- What You Should Know Before You Cut Gluten
- Benefits of Eating Gluten-Free
- Drawbacks to Eating Gluten-Free
- Tips for Gluten-Free Cooking
- Celiac vs. Gluten Intolerance: Is There a Difference Between Celiac Disease and Gluten Intolerance?
- What is Celiac Disease?
- What is a Wheat Allergy?
- What is Gluten Sensitivity?
- How is Gluten Intolerance Different?
- How Do You Know What You Have?
- Getting Started with a Gluten Free Diet
- Final Thoughts
- Difference Between Gluten Free and Wheat Free
- Processed vs. Non-Processed Gluten-Free Food
- The Gluten-Free Diet: Facts and Myths
- Will Gluten-Free Foods Help You Lose Weight?
- What is Gluten?
- Processed Food is Still Processed Food
- Health Plan & Employer Demo
- What Is the Best Non-Pasta Pasta?
- Vegetable noodles are the best
- Bean-based pastas have the most fiber
- Veggie pastas aren’t necessarily worthwhile
- Thank you!
- Quinoa pasta is a good gluten-free option
- Even regular pasta can be healthy
Is the Gluten-Free Option the Healthier Choice?
As the gluten-free diet has become something of a trend and a marketing angle over the last decade, gluten-free varieties of packaged foods have hit grocery-store shelves, and even chain restaurants now offer options that don’t contain gluten.
For people with celiac disease, a genetically based autoimmune disorder, this has been good news, as the only treatment for celiac disease is a medically prescribed diet free of gluten — the protein found in wheat, rye, and barley. Wider availability of gluten-free foods is also helpful for people with non-celiac gluten sensitivity, who also want to follow a gluten-free diet in order to avoid gastrointestinal distress.
But as gluten awareness has increased, so has the idea that going gluten-free, even for people who can tolerate gluten, is healthier. There are plenty of anecdotal accounts from people who haven’t been tested for gluten sensitivity who claim to feel better and more energetic once they go gluten-free, or even just reduce their gluten intake. A gluten-free diet may result in some initial weight loss (depending on the rest of your diet); and in general, closer attention to what you eat will likely lead to smarter, more informed food choices. But current evidence tells us that going gluten-free when you don’t need to isn’t necessarily better for you.
A study published in September 2017 in Digestive Diseases and Sciences looked at the risk for heart disease and metabolic syndrome among people without celiac disease who followed a gluten-free diet. Researchers found that while there was an association between those on the diet and lower body mass index (BMI), there was no significant difference in risk for heart disease and metabolic syndrome.
And according to a study published in May 2017 in the BMJ, long-term consumption of gluten was not associated with a risk for cardiovascular disease; the study’s authors also noted that gluten-free diets should not be recommended for heart disease prevention in people without celiac disease.
The Basics of a Gluten-Free Diet
A gluten-free food is any food that does not contain any element of wheat, barley, or rye. These grains, which are basic ingredients in most breads and pastas, are obvious sources of gluten. But gluten may also be hiding in sauces or soups if one of those grains is used as a thickening agent. If you’re serious about following a gluten-free diet, you will also have to cut out soy sauce and malt products, such as beer. Keep in mind that even health supplements may contain nonobvious gluten products.
Despite what you may have heard, going gluten-free doesn’t simply mean cutting out wheat-based pastas and breads. And it’s not the same thing as a low-carb diet, says Tricia Thompson, RD, a dietitian based in Manchester, Massachusetts, who specializes in celiac disease and the gluten-free diet. Such diets can include several forms of nonwheat carbohydrates, including rice-based products, corn-based products, and naturally gluten-free grains such as teff, amaranth, millet, and quinoa.
A truly gluten-free diet requires vigilance and is not easy to maintain, but it’s a must for people with celiac disease, which is diagnosed with blood tests followed by an intestinal biopsy.
What You Should Know Before You Cut Gluten
Approximately 1 percent of Americans have celiac disease, but most people who have celiac disease have not been diagnosed, according to a study published online in October 2015 in the BMJ. “Some people who feel better on a gluten-free diet may actually feel better because they have celiac disease,” notes Thompson. “People who have this disease really want to be diagnosed because they want to have the help they need to make sure the diet is being followed the way it should be followed.”
Nonceliac gluten sensitivity is more difficult to diagnose. “It remains what we call a diagnosis of exclusion,” says Thompson. “If an individual doesn’t have celiac disease and they don’t have an allergy to wheat or barley but there’s still a suspicion that they have some type of negative response to gluten or wheat, then they can be trialed on a gluten-free diet to see whether their symptoms resolve. If they resolve on the diet, then it may be the case that the individual is gluten-sensitive.”
If you suspect you have gluten sensitivity, it’s extremely important to get tested before going on a gluten-free diet. “If you do have celiac disease, you want to know. If you have celiac disease, your diet needs to be a strict one,” says Thompson. And diagnostic tests may not be accurate once a gluten-free diet is already being followed; you must be tested while you are still eating a nonrestricted diet.
If you’re simply curious about following a gluten-free diet — and don’t need to be on a strict one for medical reasons — it’s worth considering what you can and can’t expect to gain from it.
Benefits of Eating Gluten-Free
- People who are gluten sensitive will get relief from symptoms.
- You may find yourself enjoying more whole-grain choices and other gluten-free foods. “A wide variety of gluten-free grains are healthful,” Thompson says. Look for amaranth, quinoa, buckwheat, and millet.
- Gluten-free flours made from ingredients like quinoa, almonds, and beans offer nutritional benefits (such as protein, fiber, vitamins, and minerals), and are certainly smarter choices than the refined white flour found in many commercial baked goods, which lacks those nutrients.
Drawbacks to Eating Gluten-Free
- There is the possibility of developing nutrient deficiencies if you rely heavily on prepackaged gluten-free foods, which don’t contain the vitamins and minerals added to wheat flours.
- Replacing gluten-containing foods with processed, gluten-free alternatives can lead to weight gain — cookies, breads, and snack foods should still be consumed in moderation, whether they contain gluten or not. “Just because a food is labeled gluten-free doesn’t mean that a gluten-free cookie or gluten-free cupcake is healthier than the wheat-based product,” Thompson says. Chances are the gluten-free version is going to list white rice flour or milled corn as the first ingredient, she adds. “That isn’t any healthier.” Other gluten-free products may swap in higher calorie ingredients like nuts or dried fruits, nutrient-dense calories that can add up quickly.
- You must read labels and ask questions about how packaged foods, medications, vitamins, and other supplements have been processed.
Tips for Gluten-Free Cooking
If you’re thinking of including gluten-free foods in your or your family’s diet, you may not realize exactly how much care you must take to prevent “cross-contamination,” even while cooking healthy recipes.
“Cross-contamination can happen in a variety of places in your home,” says Thompson. It’s important, she notes, to store gluten-free food separately, if not in a designated cupboard, then at least on a shelf above wheat-based products. “Crumbs can fall, and it’s far better for the gluten-free crumbs to fall on the gluten-containing products rather than vice versa.” Always wash your utensils thoroughly and use separate utensils when preparing food. For example, if you are making gluten-free foods like pasta for yourself and “regular” pasta for the rest of your family, don’t strain them using the same strainer or serve them using the same pasta tongs. Have a dedicated toaster, if possible, and remember to clean your microwave.
But cross contact is an issue long before food even comes into your home. Cross-contamination of grains can occur in the field, during harvest, and during transport. “This is why we tell people with celiac disease that, whenever possible, they need to choose naturally gluten-free grain that is actually labeled gluten-free,” says Thompson.
There are plenty of simple-to-prepare meals that can be delicious and gluten-free, such as a meat combined with a grain (quinoa or rice) and cooked or fresh vegetables.
If you’re interested in trying gluten-free foods, avoid processed snacks and high-calorie restaurant meals and instead experiment with some of these recipes in your own kitchen:
- Chicken and Cabbage Soup This tasty, filling soup features a healthy vegetable, savory broth, and lean meat.
- Indian Lentils and Spinach This classic Indian dish, sometimes called dal saag, can be served with rice.
- Acorn Squash Bisque Serve this slightly sweet harvesttime dinner soup with a salad of greens.
- All-Star Peanut Butter Cookies Yes, you can eat these tasty cookies, but if you are making them for others, bear in mind that people with gluten sensitivities often have other food allergies, so ask about any peanut allergy before you bake.
- Flourless Honey-Almond Cake A cake you can’t resist, and it doesn’t need flour for shape or density.
Get more gluten-free recipes with Everyday Health’s free tools.
Additional reporting by Deborah Shapiro
Celiac vs. Gluten Intolerance: Is There a Difference Between Celiac Disease and Gluten Intolerance?
In recent years, the gluten free diet has gained a great deal of traction, but many people still don’t have a true understanding of what it means to go gluten free or the exact why someone would need to.
Gluten is a type of protein found in certain grains including wheat, barley, and rye – it plays a role in binding grain-based ingredients together in recipes, and it gives bread its spongy texture. The truth is that the gluten free diet is not designed for weight loss, as many tend to believe. It is much more beneficial when used as a strict, long-term eating plan for people with celiac disease, gluten intolerance, gluten sensitivity, or wheat allergy.
In this article, we’ll explore the difference between each of these specific conditions as well as their symptoms. We’ll also take a quick look at how these conditions compare and what it really takes to follow a gluten free diet.
What is Celiac Disease?
According to the Celiac Disease Center at the University of Chicago, celiac disease affects roughly 1 in 133 people in the United States. An inherited autoimmune disorder, this condition affects the digestive process of the small intestine. When a person who has this disease consumes food that contains gluten, the immune system launches an attack against the gluten, mistakenly damaging healthy cells lining the small intestine in the process.
Over time, celiac disease-related autoimmune activity inhibits the small intestine’s ability to absorb nutrients from food which can lead to a wide variety of symptoms including chronic fatigue, brain fog, bone or joint pain, tingling in the hands or feet, and even depression or anxiety. As long as a person with celiac disease continues to consume gluten, damage can and will be done to the digestive system – a lifelong gluten free diet is the only known effective treatment for this condition.
What is a Wheat Allergy?
Gluten is just one of the hundreds of proteins found in wheat. A wheat allergy is an immune reaction to any of those proteins. When someone who has a wheat allergy consumes wheat, a certain group of white blood cells called B-cells begins to produce immunoglobulin E (IgE) antibodies which attack the wheat molecules as if they were foreign invaders. While this is happening, other tissues in the body send out chemical messengers that alert the rest of the body to the presence of a threat. The speed with which this reaction occurs can range from a few minutes to a few hours after consumption and may be accompanied by a variety of symptoms including nausea, itching, abdominal pain, swollen lips or tongue, difficulty breathing, and anaphylaxis.
A person who is allergic to wheat must avoid all forms of wheat – this is the only known treatment available for wheat allergies at this time. They may, however, be able to consume gluten from non-wheat sources such as barley or rye. It is entirely possible for someone to have a wheat allergy as well as celiac disease or a gluten sensitivity, so additional testing may be warranted if you’ve been diagnosed with a wheat allergy. Wheat is one of the 8 most common food allergies in the United States and, while children can sometimes grow out of it, wheat allergies that develop in adulthood are typically permanent.
What is Gluten Sensitivity?
Also known as non-celiac gluten sensitivity, gluten sensitivity is not a condition that is currently well-defined within the medical community. It is neither an autoimmune reaction like celiac disease or an allergic reaction in which the immune system produces antibodies. As such, diagnosis of gluten sensitivity is usually made by ruling out other conditions – there is no test or biomarker that can be used to identify this condition. If celiac disease and wheat allergy have both been ruled out, switching to a gluten free diet may be warranted and, if that results in a reduction of symptoms, a diagnosis of gluten sensitivity can then be confirmed. At this time, a gluten free diet is the only known treatment for gluten sensitivity.
How is Gluten Intolerance Different?
It is fairly common for the term gluten intolerance to be used interchangeably with gluten sensitivity. While neither of these terms are well defined within the medical community, many consider gluten sensitivity to be a milder form of gluten intolerance. For example, someone who experiences mild symptoms triggered by gluten consumption that resolve quickly may be diagnosed with gluten sensitivity. On the other hand, someone who develops serious symptoms that last for a longer period of time would likely be diagnosed with gluten intolerance.
Unlike celiac disease, both gluten sensitivity and gluten intolerance do not cause damage to the lining of the small intestine. The body does, however, identify gluten as a foreign invader which triggers the launch of an immune response. Inflammation is part of that response and can contribute to symptoms such as bloating, diarrhea, and abdominal discomfort but the symptoms and the inflammation typically resolve as soon as the gluten has been eliminated from the body via digestion. Frequent gluten consumption paired with gluten sensitivity or intolerance may contribute to other symptoms such as headaches, lethargy, hyperactivity, muscle weakness, and joint pain.
How Do You Know What You Have?
If you experience negative symptoms after eating gluten-containing foods, it is a pretty safe bet that you have some kind of disease, allergy, or sensitivity to gluten. Unfortunately, identifying the exact condition you have may not be quite so simple. The first step in diagnosing your problem is to have your doctor run a blood test which may be followed by other diagnostic tests. While running these tests, you need to continue consuming gluten-containing foods – it is only after you have a diagnosis that you should switch to a gluten free diet.
A blood test cannot confirm a diagnosis of celiac disease, but it can reveal the presence of immunoglobulin E antibodies which would suggest some kind of autoimmune or allergic reaction to gluten. If your blood test comes back positive for IgE antibodies, your doctor may recommend an endoscopy to check the small intestine for damage – damage to the lining of the small intestine would confirm a diagnosis of celiac disease while a lack of damage would suggest wheat allergy, non-celiac gluten sensitivity, or gluten intolerance. To confirm a wheat allergy, your doctor may want to perform a RAST or skin prick test.
Getting Started with a Gluten Free Diet
The first step in switching to a gluten free diet is learning to identify foods that contain gluten. The next step is to begin incorporating gluten free foods into your diet. The best way to identify gluten free foods is to simply look for the “gluten free” label on the package, as you’ll see on every single Schär product. Another way to identify gluten-containing foods is to check the allergen warning on the food label – if it lists wheat, there is a good chance that the product also contains gluten. There are, however, gluten-containing ingredients that do not contain wheat, so you’ll have to be very careful when choosing foods that aren’t labeled “gluten free”.
Here are some of the different words that suggest a food contains gluten:
- Wheat (ex: wheat flour)
- Wheat protein
- Wheat starch
- Wheat germ oil
- Wheat germ extract
Other foods and food ingredients that may contain gluten include things like hydrolyzed vegetable proteins, modified food starch, natural or artificial flavors, seasonings, and flavorings. You should also keep in mind that even if a food product doesn’t contain gluten-specific ingredients, it could still be cross-contaminated if it was produced on equipment that is also used to produce gluten-containing foods. This is primarily a concern for people with celiac disease but could also affect people with wheat allergies or severe gluten intolerance. The only way to ensure your food is truly 100% gluten free is to buy from a reputable gluten free company that labels their products “gluten free” and manufactures their products in a strictly gluten free environment.
If you have been diagnosed with celiac disease or a wheat allergy, you need to switch to a gluten free diet immediately for relief. For gluten sensitivity and gluten intolerance, you might still be able to consume regular amounts of gluten as long as your symptoms are mild and manageable, but you may find that it isn’t worth the side effects.
Wherever you land on the spectrum, you’ll be glad to know that there are more gluten free foods out there than ever before. You may not even have to give up your favorite foods – you’ll just have to switch to their gluten free counterparts.
Difference Between Gluten Free and Wheat Free
There are a few differences between gluten free and wheat free. One note to make is that it is possible for someone to be on a wheat free diet and not need to be on a gluten free diet. However, if someone is on a gluten free diet for health issues, it is also necessary for them to be on a wheat free diet. ALL wheat has gluten in it.
See full recipe here
A gluten free diet is necessary for people suffering from Crohn’s Disease, Celiac Disease, Irritable Bowel Syndrome (IBS), bloating, gas, and allergic reactions to gluten. A wheat free diet is usually associated with an allergic reaction to wheat itself. A wheat allergy might include skin irritations, rashes, hives, nasal congestion, and digestive tract issues among other symptoms.
Because gluten is in all wheat products, anyone with digestive problems related to gluten should also avoid wheat products. Some of the benefits of going gluten free and wheat free are better digestion, weight loss, more energy, and a potential reduction in inflammation caused by rheumatoid arthritis and fibromyalgia. A gluten free diet has also been shown to help some children with autism.
Gluten Free Products from Food for Life
Food for Life has many gluten free and wheat free products available. Some of the most popular Gluten Free and Wheat Free foods include:
- Gluten Free Rice Almond Bread
- Gluten Free Rice Millet Bread
- Gluten Free Rice Pecan Bread
- Gluten Free Yeast Free Multi Seed Rice Bread
- Brown Rice Tortillas
- Sprouted Whole Grain Multi Seed English Muffins
- Sprouted Whole Grain Brown Rice English Muffins
Other products available from Food for Life include cereals, pasta, tortillas, pocket breads and waffles.
Only the freshest sprouted certified organic whole grains and seeds are used in Food for Life products, which helps your body digest more of the nutrients found in the grains. No flour is used in Food for Life sprouted grain products. In addition, no preservatives or shortenings, no refined sugars (making them low glycemic foods) or genetically modified organisms are used in any Food for Life products. And the best part is all the Food for Life products taste great!
Processed vs. Non-Processed Gluten-Free Food
Over the past decade, more people than ever have gained awareness and insight to the health problems associated with foods with gluten. Hundreds of thousands of individuals have benefited from reworking their diet to be gluten-free (or gluten-less), including those with celiac disease to the simply gluten-sensitive. Last year, gluten-free product sales reached an all time high of $23 billion per year!
But not all gluten-free products are good for you. In fact, many people make some common, health-harmful mistakes when trying to make their diet gluten-free. Specifically, “the gluten-free specialty food aisle contains some of the most heavily processed food in the grocery store that won’t do your body any favors,” as one blogger noted.
Processed gluten-free foods are not good for you, despite the lack of gluten. Why not? These foods usually contain some or many of the following bad-for-you ingredients:
- Refined/GMO sugars
- Inflammatory oils such as canola, soy and cottonseed oil
Most gluten-free foods are also often not organic. “If you go completely gluten-free without the guidance of a nutritionist, you can develop deficiencies pretty quickly,” said Laura Moore, R.D., a dietitian at the University of Texas Health Science Center at Houston, in a Consumer Reports review.
This is because many processed gluten-free foods are often made with replacement flours and/or starches that don’t bring any nutritional benefit. These include tapioca starch, potato starch, corn, soy lecithin/soybean oil or rice flour. When used alone, as many gluten-free food makers do, these flours and starches make seemingly healthy gluten-free foods unhealthy, and full of empty calories.
Tapioca starch, for starters, is high in carbs but has hardly any protein, fiber, vitamins or minerals. Without being balanced with whole grains and nutrient-rich flours, the empty calories in tapioca and the other starchy flours will likely spike your blood sugar — sometimes even more than refined sugar! High insulin levels follow, which blocks mobilization of fat and encourages inflammation so you will actually gain weight, instead of losing it.
In contrast to what many gluten-free food makers do, Manini’s balances our gluten-free products with lots of Ancient Grains, which are full of important vitamins, minerals, and protein. Your Manini’s pasta and bread products are excellent sources for protein, fiber, and key minerals like calcium, iron, potassium, magnesium and zinc. In fact, every serving of Manini’s pasta contains 6 grams of protein and 3 grams of fiber, and the buns and rolls are high in both as well.
Also, while many gluten-free foods are made with processed sugars that contain GMOs, Manini’s uses non-GMO, organic cane sugars. Don’t be fooled! If sugar is listed on the nutritional label, it’s probably processed sugar that contains GMOs, unless it’s specified as ‘cane sugar’.
Worse than processed sugars or empty calories, approximately half of gluten-free products today contain rice in some form, which has reportedly been found to contain measurable levels of arsenic. Not only is arsenic poisonous, it’s a potent carcinogen. This is why Manini’s doesn’t use rice in our gluten-free products, so you can trust that they are arsenic-free as well as being gluten-free!
So what to do? Stick with whole, clean, unprocessed gluten-free foods. Examples include vegetables and fruits (no surprises there), beans, seeds, lentils and nuts. Other tips for effectively and healthfully eating a gluten free diet are as follows:
- Bake with nutrient-rich flour substitutes such as almond meal, buckwheat flour, quinoa flour, chickpea flour, sorghum flour, coconut flour, or teff flour.
- Choose only the gluten-free pastas that are made from beans or lentils (or the flours listed above, like Manini’s gluten-free pastas!).
- Make your own veggie pastas from zucchini or spaghetti squash.
- Use quinoa instead of rice for dishes that normally call for rice.
- Buy gluten-free breads (if you can’t make your own), such as Manini’s buns and rolls with nutrient-rich grains such as teff, millet, amaranth, buckwheat, or quinoa (avoid ones with brown rice).
- Use butter lettuce or collard greens instead of corn tortillas.
- Make your own pizza crusts with cauliflower.
- Choose raw/clean snack foods with organic seeds, dried fruit, and/or nuts.
- Here are some additional tips for a healthy gluten-free diet.
Manini’s gluten-free pastas, breads and rolls, flours and other products are all made with our custom-blended flour from nutrient-rich Ancient Grains. We use five primary grains, including amaranth, millet, teff, sorghum and quinoa — instead of less nutritious gluten-free grains like corn and rice. When you enjoy our gluten-free products, your body will thank you for the good-for-you protein, fiber, and minerals that our pastas and bread products naturally contain.
Featured photo source: .com
The Gluten-Free Diet: Facts and Myths
Gluten-free diet and celiac disease (CD):
- A strict, life-long gluten-free diet is required for health reasons.
- Ingestion of gluten causes an adverse reaction which damages intestinal cells and can lead to serious health problems.
Gluten-free diet and non-celiac gluten sensitivity (also known as “gluten sensitivity”):
- Individuals with non-celiac gluten sensitivity (NCGS) require a gluten-free diet to avoid adverse health effects.
- When people with NCGS consume gluten their intestinal cells are not damaged, but they may experience many of the same symptoms as do people with celiac disease.
- In some cases, other components of gluten-containing foods may cause adverse reactions in people with NCGS.
If you think you may have a gluten-related disorder (CD or NCGS) it is very important to have testing done before removing gluten from your diet. Otherwise testing may not yield valid results.
“A gluten-free diet is healthier.”
- This is not true EXCEPT for people who have celiac disease, gluten sensitivity, or other gluten-related disorders.
- For the general population, the presence or absence of gluten alone is not related to diet quality. What’s important are the overall food choices made within a diet, whether it is gluten-free or not.
- If an individual whose diet contains large amounts of breads, pastas and cookies (especially those made from refined flours) switches to a gluten-free diet which eliminates these foods while increasing fruits, vegetables and other healthful gluten-free foods, the resulting diet would likely be healthier.
- On the other hand, this same person could easily substitute gluten-free breads, pastas and cookies into the diet, without increasing intake of healthful gluten-free foods like vegetables and fruits. In this case a person may experience a reduction in diet quality, since many gluten-free processed foods are lower in fiber, vitamins, and minerals than their gluten-containing counterparts.
“A gluten-free diet is good for weight loss.”
- Whether or not a diet promotes weight loss is not related to the presence or absence of gluten. As explained above, a gluten-free diet could either be higher in vegetables and fruits (and therefore potentially lead to weight loss), or it could rely heavily on processed gluten-free foods that are high in fat and sugar (which could potentially lead to weight gain).
“Surely a few crumbs of bread can’t hurt.”
- Even tiny amounts of gluten can damage the intestinal cells of a person with celiac disease, even if there are no obvious immediate symptoms.
- Tiny amounts of gluten can be problematic for people with gluten sensitivity, too. But since non-celiac gluten sensitivity is less well understood than CD, it is unknown whether or not some people with GS may be able to tolerate small amounts of gluten. Unless otherwise indicated, even someone who does not have celiac disease but is on a “gluten-free” diet for health reasons should avoid even tiny amounts of gluten contamination.
Symptoms which could indicate the need for a gluten-free diet
Symptoms of celiac disease and gluten sensitivity are similar and may include: recurring abdominal pain, chronic diarrhea/constipation, tingling/numbness in hands and feet, chronic fatigue, joint pain, unexplained infertility and low bone density (osteopenia or osteoporosis). There are approximately 200 potential symptoms, many of which are also symptoms of other conditions.
What to do if you think gluten may be causing your symptoms
Consult with your personal physician/health care provider before giving up gluten. This is very important because the standard blood testing done as a first step to diagnosing these conditions is not meaningful unless gluten is being consumed for a significant period of time before testing. It is also important to consult with your healthcare provider in order to evaluate other possible causes of symptoms.
How are celiac disease and non-celiac gluten sensitivity diagnosed?
The first step is a panel of blood tests looking for an antibody response to gluten. If these tests are positive, the next step is an endoscopy. If the endoscopy shows the intestinal cell damage characteristic of celiac disease, this is considered the gold standard of celiac disease diagnosis.
There is currently no specific diagnostic test for non-celiac gluten sensitivity; instead, it is a “rule out” diagnosis. Consequently, the celiac disease testing described above would be done. In addition, wheat allergy and other potential causes of symptoms should be ruled out. If all of these conditions have been ruled out and the patient responds positively to a gluten-free diet, then the diagnosis of non-celiac gluten sensitivity may be made.
How many people have gluten-related disorders?
It is estimated that approximately 1 in 100 people worldwide have celiac disease. The prevalence of non-celiac gluten sensitivity is not established but may be significantly higher.
The majority of people with gluten-related disorders remain undiagnosed.
What is a gluten-free diet?
Gluten refers to the proteins found in wheat, rye and barley which cause an adverse reaction in people with gluten-related disorders. On a gluten-free diet, these grains and any foods or ingredients derived from them must be removed from the diet. This includes the obvious breads, pastas and baked goods made with gluten-containing flours, but may also include less obvious foods such as sauces, salad dressings, soups and other processed foods, since these can contain small amounts of ingredients derived from gluten-containing grains. (Oats are naturally gluten-free, but are often contaminated with wheat in growing and/or processing, so only oats which are certified gluten-free are acceptable on a gluten-free diet.)
Will Gluten-Free Foods Help You Lose Weight?
If you have gone shopping, picked up a magazine or read a blog recently, you are likely to have seen “gluten-free” promoted for weight loss, improved health or enhanced performance. Gluten-free has become the newest diet trend and gluten-free food sales are booming with a threefold increase in the past five years. The burning question is: Will gluten-free help you lose weight?
What is Gluten?
Gluten is a protein found in wheat, barley and rye. A gluten-free diet would be devoid of all foods containing wheat, barely and rye. According to the National Foundation for Celiac Awarness, about 3 million Americans have celiac disease, which is an autoimmune digestive disorder; however, of the 3 million only 150,000 have been properly diagnosed. The only treatment for celiac disease is a gluten-free diet. In addition to people with celiac, those with wheat allergies or non-celiac gluten sensitivity benefit from a gluten-free diet. There are still more people with inflammatory conditions that feel a benefit from limiting or limiting gluten from their diet.
For those who follow a gluten-free diet out of medical necessity, the abundance of gluten-free foods on the market are dreams come true; however, a market research firm Packaged Facts recently found only 10 percent of the people buying gluten-free foods have diagnosed reason to follow a gluten-free diet. So why is everyone eating gluten-free foods? Can gluten-free really result in weight loss?
Processed Food is Still Processed Food
Often gluten-free foods are thought to be healthier and are associated with weight loss. The current trend is to believe that a gluten-free bread or pasta is superior to the traditional gluten-containing product. The problem is that whether it is gluten-free or gluten containing, it is still a processed food. Breads, pastas, crackers, cookies, and pancakes are all made from flour and sugar; gluten-free refers only to the type of flour used.
When you compare gluten-free products to gluten-containing foods you will see that they could not promote weight loss or be healthier. Gluten-free processed foods tend to be higher in calories, fat, and sugar and lower in fiber.
Let’s compare the most popular gluten-free bread with a 100 percent whole-wheat bread:
Nature’s Own (gluten-containing)
2 g fat
1 g fat
.5 g fiber
2 g fiber
1.5 g sugar
1 g sugar
1.5 g protein
4 g protein
Additionally, the gluten-free bread is denser, which means that you are getting more calories in a smaller piece of bread. This is the opposite of what you want for successful weight loss. In fact, it is for these reasons that those who must follow a gluten-free diet out of medical necessity often struggle with their weight when they rely on these processed foods.
Health Plan & Employer Demo
By Natalie Stein, BS Food Science, BS Nutritional Sciences, MS Human Nutrition, MPH Public Health
Gluten-free foods are everywhere these days, and you may already be enjoying the gluten-free breads, cookies, pastas, and even take-out pizzas if you are on a gluten-free diet. If not, you may be wondering whether you should be. Gluten-free veteran or gluten-free skeptic, you should know the facts so you can make the best choices about your diet for weight loss and health. To get started, here are some common misconceptions about gluten-free foods, and the truth.
“Gluten-free” means “low-carb.” No way! “Gluten-free” means there is no wheat, rye, or any other gluten-containing grain, but the food can still have grain, and grains have carbohydrates. Foods such as gluten-free bread or pasta may be made with gluten-free, high-carb flour, such as rice flour, potato flour, or cornmeal. Gluten-free cereals can be based on rice, corn, or oats – all grains, and all high-carb foods.
Take a look at the carbohydrate comparisons between certain gluten-containing and gluten-free foods. As you can see, the carb counts are similar, and so are the effects on your blood sugar.
Food with Gluten (Carbohydrates per Serving)
Gluten-Free Version (Carbohydrates per Serving)
1 slice whole-wheat bread (13 grams)
1 slice gluten-free, whole-grain bread (11 grams)
1 1-oz packet cream of wheat (20 grams)
1 1-oz packet cream of rice (22 grams)
1 ounce whole-wheat pasta (21 grams)
1 ounce whole-grain, gluten-free pasta (23 grams)
1 small whole-wheat tortilla (21 grams)
1 small gluten-free corn tortilla (18 grams)
1. “Gluten-free” foods are always healthy. Nope! Just like foods with wheat, gluten-free foods can be healthy, or they can be unhealthy. Whole-grain brown rice, oatmeal, quinoa, and black bean pasta are gluten-free foods that tend to be on the healthier side. They are sources of fiber, vitamins, and minerals, and are low in sugar.
Sweetened rice cereal, gluten-free brownies and cookies, and gluten-free pizza are at the other end of the spectrum. They are likely to have highly processed refined grains instead of whole grains, and can be high in sugar, salt, and/or fat. Have too many foods in this category, and you are likely to have a little more trouble hitting your weight loss and blood sugar goals.
2. “Gluten-free” is better than whole-grain. Whole grains are where you will find the superfood grains. Whole grains are less processed versions of refined grains. They are natural sources of fiber, antioxidants, iron, and B vitamins.
Gluten-free products are only whole grain if they say so on their packages. Check the label for a claim that they are “whole-grain,” and read the list of ingredients to be sure that a whole grain is listed before a refined grain.
3. Gluten is a toxin. Gluten is dangerous if you have celiac disease, gluten sensitivity or intolerance, or gluten ataxia, or a wheat allergy. Otherwise, there is not much evidence that gluten is not harmful. You are best off asking your doctor if you suspect that you are sensitive to gluten, since going gluten-free when there is no need could even make you miss out on a more nutritious diet. For example, if you choose gluten-free potato bread instead of whole-wheat bread, you will be missing out on a whole grain opportunity.
4. All foods with gluten are obvious. Regular bread, cereal, pasta, and baked goods are easy to spot as sources of wheat, so you probably already knew to choose gluten-free versions. Less obvious sources of gluten are some processed foods, such as the following.
Soy sauce, gravies, and salad dressings.
Soups and bouillons.
Luncheon meat and imitation crab.
Flavored potato and tortilla chips.
When you are following, or considering following, a gluten-free diet, it is important not to make some of the same mistakes that many people do. When you know the truth behind some of the common misperceptions, you can put yourself on a faster track to better health and weight loss. Gluten-free or not, you can get tips for a healthier diet every day with your Lark Health Coach!
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What Is the Best Non-Pasta Pasta?
Non-flour pastas are having a moment: You can now eat pasta made from brown rice, quinoa, lentils, chickpeas and more. But are they really healthier than the real deal? Here’s what nutrition experts have to say about which pasta alternatives are actually good for you.
Vegetable noodles are the best
Fresh vegetables used in the place of noodles are clearly the healthiest option. One popular way to make veggies like sweet potato, cucumber or zucchini look like noodles is to spiralize them, or use a machine to slice them into long, curly strands. You can then cook these so-called “zoodles,” if you wish, by boiling or sautéeing them. Other stringy veggies like spaghetti squash naturally have a similar pasta-like look.
“From a nutritional standpoint, it’s terrific,” says Keith Ayoob, associate professor of pediatrics at Albert Einstein College of Medicine and Montefiore Health System. “It’s just a lot more work, and you will need equipment.” Another downside is that fresh vegetable pastas can’t be stored like regular pasta, and it goes bad more quickly. The biggest con of all: vegetables taste nothing like real noodles.
MORE: Should I Eat Whole Wheat Pasta?
Bean-based pastas have the most fiber
Dried pastas made from chickpeas, lentils or black beans have more protein and fiber than regular pasta. That’s because this type of pasta is made from beans. It can be made in different ways; sometimes the bean is ground into a flour and combined with thickening agents like tapioca or xanthan gum, and sometimes the bean powder is just combined with water.
One popular type of bean pasta, Banza, uses chickpeas in place of wheat. It has twice the protein and four times the fiber of regular pasta, with fewer carbs. It’s also gluten free—but it’s not always much lighter. A two-ounce serving of Banza is about 190 calories, while penne packs about 200.
Veggie pastas aren’t necessarily worthwhile
Don’t be fooled by pastas that say they contain vegetables in their ingredients, like green spinach pasta or red tomato pasta. Spinach pasta is just regular pasta made with a bit of spinach, often in powder or puree form. “It’s basically fun and games with pasta,” says Ayoob. “It has great eye appeal.” Though some companies claim their veggie pastas contain a full serving of vegetables, Ayoob says it’s no substitute for a real vegetable dish, since spinach pasta might not have all the nutrients you would otherwise expect from spinach.
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Quinoa pasta is a good gluten-free option
Veggie or legume-based pastas are often gluten free, but quinoa is an especially popular choice since it doesn’t get mushy when it’s cooked. It tends to be higher in protein than other gluten-free varieties, and it contains high amounts of fiber, and iron. Another plus: it cooks quickly.
Even regular pasta can be healthy
The healthfulness of any type of pasta, regular or alternative, depends largely on what you serve with it. “Pasta is a great vehicle for other food,” says Ayoob. Usually, that means ground beef or heavy, creamy sauces. “Alfredo is one of the highest calorie pastas you can eat,” says Ayoob. “It’s what I call ‘once a year’ pasta.” Instead, top yours with tomato-based sauces, vegetables or yesterday’s leftovers.
You can also eat whole-wheat pasta, which is rich in vitamins, minerals, protein and fiber. Try serving it as a side dish, rather than a main, to cut down on portion sizes. “Pasta, including refined-flour pasta, is not a new food—it’s been around long before the obesity crisis,” Ayoob says. “Pasta is not a matter of yes or no, it’s a matter of how much and how often.”
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