What's a gluten-free diet?

Recently, when I went to see my doctor, he suggested I try a gluten-free diet. He said to monitor some symptoms I’m having to see if I could detect a difference.

I’m trying the experiment, but a gluten-free diet is difficult. When I traveled on an airplane recently, Delta Airlines gave me rice cakes.

I asked Amy Ratner, associate editor of the magazine "Gluten-Free Living," to give me some tips in an e-mail interview on this special diet.

Rita: What is celiac disease?

Amy: Celiac disease is an autoimmune disorder in which the body mistakenly reacts to gluten, a protein found in wheat, barley, and rye, as if it were a poison. It affects one in 133 people, although most have not been diagnosed. When someone with celiac disease consumes gluten their immune system reacts by destroying the part of the small intestine that absorbs vital nutrients. This malabsorption can lead to serious illness.

Rita: What are its symptoms?

Amy: Symptoms of celiac disease can include bloating, gas, diarrhea, weight loss or gain, constant fatigue or weakness, headaches, infertility, depression that doesn’t respond to medication, abdominal pain, bone pain, and anemia. For children, symptoms include failure to thrive, short stature, distended abdomen, dental enamel defects, and unusual behavior changes.

Celiac disease is tricky, however, and sometimes has no outward symptoms. Since it is a genetic disease, relatives of those who have been diagnosed have an increased risk.

Rita: How is it diagnosed?

Amy: Blood tests are the first step to diagnosing celiac disease. If the tests show a high level of anti-tissue transglutaminase antibodies, tTGA, or anti-endomysium antibodies, EMA, a biopsy of the small intestine would likely be the next step. A biopsy that shows flattening of the absorbing finger-like projections, called villi, would lead to a diagnosis of celiac disease. Once a gluten-free diet is started, symptoms should disappear and the villi should return to normal. The diet must be followed for life.

Rita: What kinds of grains and flours can you eat on a gluten-free diet?

Amy: Many grains and the flours made from them are safe on the gluten-free diet. These include amaranth, buckwheat or kasha, corn, Montina, millet, quinoa, teff, rice, sorghum, and soy. A number of starches are also safe including arrowroot, corn, potato, and tapioca.

Rita: What about corn? Is it allowed?

Amy: Corn is allowed on the gluten-free diet. Confusion about corn sometimes comes up because corn contains its own kind of gluten. However, corn gluten doesn’t have the protein harmful to those who have celiac disease.

Rita: What are some surprising items that contain gluten?

Amy: You might be surprised to find gluten in soy sauce, licorice, and some corn and rice-based cereals. Soy sauce is usually made with wheat, licorice contains wheat flour, and the cereals often include barley malt flavoring. In all cases, wheat or malt is in the ingredients list, so while surprising, the gluten isn’t hidden.

Rita: Can you make muffins that don't contain gluten or nut flours? I’ll allergic to almonds and most of the recipes I’ve seen for gluten-free muffins call for almond flour.

Amy: Yes, there are numerous recipes for muffins that are gluten-free and don’t use nut flours. And there are many gluten-free mixes and ready-made muffins now on the market.

Rita: Is there anything else you’d like to add?

Amy: Gluten-free has become big business. Packaged Facts, a market research firm, says U.S. sales are expected to reach $5.5 billion by 2015.

Rita: Thank you. 

Copyright 2011, Rita R. Robison, Consumer Specialist