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Diets & Nutrition > Diet List > Gluten free diet

Overview

Gluten free diet

A gluten free diet is a diet completely free of ingredients containing gluten, a protein found in wheat (including kamut and spelt), barley, rye and triticale. Gluten constitutes about 80% of the proteins contained in wheat and is responsible for the flexibility of kneaded dough. Those with celiac disease (CD) and dermatitis herpetiformis (DH- the skin manifestation of CD characterized by chronic, extremely itchy rash consisting of bumps and blisters), who are gluten intolerant, must strictly follow this diet.

Celiac disease is a genetic disorder that affects one in 133 Americans. The disease seems to most affect people of European (especially Northern European) descent, but recent studies show that it may also affect Hispanic, Black and Asian populations. Those affected suffer damage to regions of their intestines if they consume gluten. Oats have traditionally been considered to be toxic to celiacs, but recent scientific studies have shown otherwise. This research is ongoing and it is too early to draw any firm conclusions.

A gluten free diet may also be helpful for persons with multiple sclerosis (MS) and other autoimmune disorders, although currently there are no high quality human trials available to support this claim.

Theory/evidence

Gluten intolerance is the result of an immune-mediated response to the ingestion of gluten that damages the small intestine, usually through inflammation and/or swelling. Nutrients quickly pass through the small intestine rather than being absorbed. To develop celiac disease, three conditions must be present: an individual must inherit the gene, the individual must consume gluten and the gene must be triggered. Common triggers may include stress, trauma (surgeries, pregnancy, etc.) and viral infections. Approximately 1 in 20 first-degree relatives could have celiac disease triggered in their lifetime. The disease is permanent and damage to the small intestine will occur every time gluten is consumed, regardless if symptoms are present.

Celiac disease (CD): Following a strict, gluten free diet is the only known treatment for celiac disease. Celiac disease may appear at any time in a person's life. The disease can be triggered for the first time after surgery, viral infection, severe emotional stress, pregnancy or childbirth. CD is a multi-system, multi-symptom disorder. Symptoms are extremely varied and can often imitate other bowel disorders. Infants, toddlers, and children often exhibit growth failure, vomiting, bloated abdomen and behavioral changes. Some people with CD report no symptoms at all. Physical symptoms may include: abdominal cramping/bloating, abdominal distention, acidosis, appetite (cravings), back pain, bloating, bone or joint pain, constipation, decreased ability to clot blood, dehydration, diarrhea, distention, dry skin, edema, electrolyte depletion, energy loss, fatigue, gas, gluten ataxia (lack of coordination or unsteadiness), infertility, mouth sores, muscle cramping, night blindness, osteopenia, osteoporosis, steatorrhea (fatty stools), tooth enamel defects, weakness and weight loss. Emotional symptoms may include: depression, concentration issues, disinterest, irritability or moods swings.

When working with a physician to diagnose and/or confirm CD, three steps are taken. First, a thorough physical examination is conducted including a series of blood tests sometimes referred to as the Celiac Blood Panel. Second, a duodenal biopsy is performed with multiple samples from multiple locations in the small intestine. Third, a gluten free diet is followed. A person seeking initial diagnosis must be consuming gluten. Specific antibody blood tests are used to identify the presence of CD and are the initial step in screening. Blood tests include: anti-Gliadin (aGa) IgA, (aGa) IgG, anti-Endomysial (EMa) IgA, anti-tissue transglutaminase (tTG) and total serum Iga.

Dermatitis herpetiformis (DH): The skin manifestation of celiac disease. It is diagnosed by a biopsy of a skin lesion and staining for Iga in the tissues.

The legal definition of the phrase "gluten free" varies from country to country. Current research suggests that for persons with celiac disease, the maximum safe level of gluten in a finished product is probably less than 0.02% and possibly as little as 0.002%. Ordinary wheat flour contains approximately 12% gluten.

Related Terms

Autoimmune disorders, barley, bowel disorders, CD, celiac, celiac disease, celiac sprue, dermatitis herpetiformis, DH, gluten intolerance, gluten-intolerance, kamut, rye, small intestine, triticale, vegetarian diet, wheat, wheat-free diet.

Natural Standard Bottom Line Monograph, Copyright © 2009 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intendedfor informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

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Gluten free diet

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