Q.What is gluten?

A.When people talk about gluten, they’re referring to the two proteins (gliadin and glutenin) that help to hold grain products together, like bread and pasta that gives foods like bagels and baguettes their chewiness and elasticity. Without gluten, breads and baked goods have a crumblier texture, tend to fall apart more easily, and don’t rise as well. People with gluten intolerance or sensitivity react to gliadin and glutenin, which make up 80% of gluten. These proteins are found in wheat, barley, oats, spelt, rye, kamut, malt and triticale, as well as a few other lesser known grains. And a gluten-free diet is one that avoids these ingredients entirely.

Q.What’s all the concern about gluten? Do I need to be worried?

A.The recent increase in information and concern about gluten isn’t due to some newly discovered problem or concern about the safety of gluten. Gluten has been around as long as people have been cultivating and using grain products. In fact, gluten is a terrific ingredient in terms of function and nutrition. It lends body and texture to foods and provides protein to animal cells. The concern with gluten is the rising awareness of the prevalence of people who are intolerant or sensitive to gluten. A small percentage of the population (about 1%) experiences a harmful immune system (allergic) response to the proteins in gluten. If untreated, this reaction can cause a very unpleasant set of symptoms with serious nutritional and health consequences. Most people don’t have this allergic reaction and therefore don’t need to be concerned about the presence of gluten in their food. However, if you suspect you are gluten sensitive (see How does gluten do its damage? for a list of some symptoms) then it is very important to seek help and advice from a medical professional.

Q.How do I know if I’m gluten sensitive?

A.It may be hard, at first, to know if you are allergic to the gluten proteins because the symptoms don’t always immediately follow the ingestion of gluten. In addition, the symptoms of gluten sensitivity can mimic other illnesses, or be as simple as indigestion, and some people with gluten intolerance have no symptoms at all. Many people go for years with vague and mysterious complaints that ultimately are associated with gluten sensitivity. For others, it is clear that eating gluten-containing foods causes an allergic response. A doctor must make a certain diagnosis.

Q.How does gluten do its damage?

A.In sensitive individuals, exposure to gluten causes the villi in the intestine to become flattened and inflamed, which makes it impossible to effectively absorb the nutrients in the foods they eat. Symptoms experienced by gluten sensitive people can include weight loss, diarrhea, and nutritional deficiencies, as well as other less obvious symptoms. The type and severity of the symptoms depends on how long the condition has existed and how severe the intestinal damage is. Unfortunately the symptoms of gluten sensitivity mimic a lot of other medical conditions and can therefore go undiagnosed for a long time. Gluten sensitivity is medically termed celiac disease, or more specifically Celiac Sprue. The Celiac Sprue Association has a very helpful website which lists other common symptoms of the disease. http://www.csaceliacs.org/celiac_symptoms.php

Q.How do I treat Celiac Sprue (Gluten Sensitivity)?

A.The only proven effective treatment for celiac disease is the complete and lifelong avoidance of gluten proteins from your diet. Once gluten is eliminated from the diet, the intestine heals and returns to its former state and the symptoms disappear. This means avoiding not only the grains that include gluten proteins, but also all those prepared, processed and packaged foods that have gluten-containing grains. It means cooking and baking without those grains and knowing what questions to ask to be sure that you’re not consuming gluten when eating at restaurants or friend’s houses.

Q.How do I become gluten-free?

A.The first step to going gluten-free is learning which foods contain gluten so that you can eliminate every trace of gluten from your diet. Some of these are obvious, such as wheat bread, oatmeal, many breakfast cereals, pasta, cakes, cookies, and other baked goods. And then there are the less obvious sources of gluten. Gluten is used as a food additive for flavoring, stabilizing or thickening foods such as some soups, salad dressings, seasoning mixes and sauces, puddings, ice creams and candies, and a few luncheon meats like bologna and hot dogs; and it’s a component in beer and lager, gin, whiskies and vodka distilled from grain, and is in many medicines and supplements. Read food ingredient labels carefully so that you can identify which ingredients indicate the presence of hidden gluten. Some examples of words to look for are: hydrolyzed vegetable protein, modified food starch, soy sauce, vegetable gum and natural flavoring.

There are far more foods that are naturally gluten-free than those that contain gluten. If you focus on them, you won’t feel deprived. In fact, you may even discover new foods you like. Develop a wide variety of recipes that are gluten-free. Identify which restaurants are responsive to your questions and able to provide choices that are guaranteed gluten-free. Help friends and family to learn about your dietary needs so that they can support you.

Finally, take advantage of all the wonderful gluten-free products available to you from The Hain Celestial Group. These products use non-gluten containing grains and innovative methods to make breads, cakes, cookies and pastas that fill the gap, replacing those foods that typically contain gluten.

Q.What’s apt to be the most difficult challenge living with gluten sensitivity?

A.A celiac diet impacts many aspects of your lifestyle. A study published in the Journal of The American Dietetic Association indicates that the most challenging areas for people with celiac disease are travel, dining out, and family life (probably due to the stress of creating and cooking foods that suit the whole family). There is no doubt that dealing with gluten sensitivity has its challenges. Once you’ve identified the problems and challenges you can plan solutions.

Q.What are some tactics for dealing effectively with gluten sensitivity?

A.There are many tactics, and as with any lifelong medical condition, you will learn with time what works best for you. Other gluten sensitive folks have already figured out some tactics you may find helpful. The first and most important tactic is to become as educated as you can about your condition. Knowledge is power and will provide you with control over your condition and the ability to prioritize your efforts. The second most important tactic is to have an optimistic attitude. Armed with knowledge and a positive ‘can-do’ attitude, you will be able to manage your gluten sensitivity with minimal interference to your everyday life.

Some other tactics you may find helpful include:

1. Find a support network. There are many on-line communities you can search for. Parents raising kids gluten-free can find a local chapter of R.O.C.K. (Raising Our Celiac Kids - link) for support and the Celiac Sprue Association also has chapters nationwide.
2. Find a store that stocks a large variety of gluten-free products. Many natural food and health food stores devote entire sections to gluten-free products.
3. Alter your favorite recipes to be gluten-free.
4. Be prepared to ask questions whenever and wherever you eat out in order to learn which dishes do and don’t have gluten.
5. Plan ahead whenever possible. When traveling pack gluten-free food.
6. Organize your kitchen so that you have a specific place to keep only gluten-free products. That way, when you want to just quickly grab something to eat, you are assured it’s gluten-free.
7. Expand your ethnic foods choices to include options that are naturally gluten-free.

Q.Will I suffer from nutritional deficiencies if I can’t eat gluten?

A.No. The main nutritional contribution that gluten makes to your diet is protein. There are so many other sources of protein that not eating gluten will not impact your ability to get adequate protein. In fact, for most folks, the protein in gluten is only a very small part of their daily protein intake.

Of more consequence, nutritionally, is missing out on the many nutrients in the foods that contain gluten. For example, breads and cereals that contain gluten also contain important vitamins and minerals such as iron, B vitamins, folic acid, and fiber. Fortunately, there are many other gluten-free foods out there with the same nutritional content—look for whole grain and enriched gluten-free cereals and breads, and get in the habit of reading labels.

Q.Will I need to take supplements?

A.When you are first diagnosed with gluten sensitivity, discuss supplements with your physician, as you may need to take some to help recover from deficiencies caused by the malabsorption of nutrients. Certain blood tests will help to pinpoint where your deficiencies may lie. Once you are avoiding gluten-containing foods and your intestine has recovered, a supplement may no longer be necessary as long as you are eating an otherwise varied and healthy diet.

Q.Do I need to worry about cross contamination?

A.This is something you need to be aware of if you have severe gluten sensitivity. While many foods may not have any gluten-containing ingredients, the processing of the food may result in some cross-contamination from other foods in the production facility. For example, a corn flake cereal may be made in the same facility as a wheat flake cereal, and some wheat dust residual may contaminate the corn cereal. Or a conveyor belt or drying drum may have been dusted with wheat flour to prevent sticking of a non-gluten-containing product. The good new is, if a packaged food says “gluten-free” or has the gluten-free symbol, then you can be assured there is no cross contamination. However, cross contamination can happen in your own kitchen so take precautions to prepare gluten-free foods in an area reserved specifically for them.