Gluten-free" is a hot marketing message on more and more food labels. Is this just advertising hype, or should you care whether a food product has gluten in it? The short answer is maybe. It depends on your body.
QUESTION: What is gluten?
ANSWER: Gluten is a protein found naturally in wheat, barley, rye and triticale (a genetic cross between wheat and rye). Gluten also is present in some other grains and can be found in trace amounts in grain products that are processed with the same equipment as wheat. Gluten is the component that gives foods like bread and pasta their special stretch and "chew" consistency. The chewy pull of sourdough or French bread and pasta is largely due to the gluten content of the wheat flour used to make the bread.
Q: Why do some people want gluten-free foods?
A: Over the last decade or so, there have been an increasing number of individuals who have adverse reactions to gluten. These reactions may be a result of celiac disease, wheat allergy, or a newly recognized condition called nonceliac gluten sensitivity.
Q: What is the difference between celiac disease, wheat allergy and nonceliac gluten sensitivity?
A: For people with celiac disease, "gluten-free" is not a fad. Avoiding gluten is a necessity. Celiac disease is typically characterized by serious intestinal pain, diarrhea and damage to the absorptive cells lining the small intestine. This disease is more complicated than just an allergy to gluten. It occurs in genetically sensitive individuals. The body’s response to gluten is linked with what is called an autoimmune response in which immune cells attack some of the body’s own cellular components. Essentially, the body is attacking itself. Consequently, celiac disease in some people can affect various parts of the body. Blistering skin rashes and even brain damage have been linked to celiac. A gluten-free diet is essential for treating celiac disease.
Wheat allergy differs from celiac because the person’s reaction is specific to a protein component in wheat. Consequently, someone with a wheat allergy might not need to avoid foods like rye or barley. Also, allergic reactions occur within minutes or hours of wheat consumption.
Nonceliac gluten sensitivity is diagnosed when the diagnostic criteria for celiac or wheat allergy are not present, but elimination of gluten from the diet relieves an individual’s symptoms.
Q: Besides the grains wheat, barley, rye and triticale, what foods typically contain gluten?
A: Many food products contain ingredients from wheat that might not be obvious. Bulgur, farina, graham flour, Kamut (Khorasan wheat), semolina and spelt are all forms of wheat. Foods and beverages made from malt (including most beer) likely contain gluten. Unless labeled as gluten-free, the following foods should be avoided: batter-fried foods, beer, breads, cakes, cereals, cookies, crackers, croutons, imitation meat or seafood, pastas, processed luncheon meats, soups, sauces, gravies and many vegetarian meat substitutes.
Q: What foods do not naturally contain gluten?
A: There are many unprocessed foods that are naturally gluten-free such as beans, seeds and nuts, eggs, fresh meats, poultry and fish, fruits and vegetables, and most dairy products. Gluten-free grains or grainlike foods include amaranth, arrowroot, buckwheat, corn, flax, millet, quinoa, rice, soy, sorghum, tapioca and "teff." For processed foods, look on the label for the "contains: wheat" statement below the ingredients list.
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Alan Titchenal, Ph.D., C.N.S., and Joannie Dobbs, Ph.D., C.N.S., are nutritionists in the Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources at the University of Hawaii at Manoa. Dobbs also works with University Health Services.
