Is gluten the latest villain in the battle for better health?

May 17 2010

If you've been food shopping or out to eat lately, you've probably noticed that "gluten-free" foods now claim their own grocery store shelves and dozens of national restaurant chain menus highlight "gluten-free" entrees.

Gluten, a protein found in wheat, rye, barley, and oats, can be harmful to people who are sensitive to gluten or allergic to wheat. But it can be especially harmful to persons with celiac disease who cannot digest gluten.

Nearly one out of every 133 Americans suffers from celiac disease, an autoimmune condition in which the body's immune system starts attacking normal tissue in response to eating gluten.

Gluten, a common ingredient in many foods, can be found in consumable items, ranging from medicines, stamp and envelope adhesives, and processed meats to communion wafers, potato chips, gravies and sauces, and self-basting turkeys.

Is celiac disease a side effect of too many dietary additives? Or is it now in the forefront because we are better able to diagnose and treat it?

"A little bit of both," notes Keith J. Laskin, MD, a Philadelphia area gastroenterologist and medical director of the Celiac Center at Paoli Hospital. "Celiac disease is four times more common now than it was 50 years ago and we're seeing many more non-celiac gluten-sensitive patients," adds Dr. Laskin. "Yes, we've become much better at diagnosing celiac disease, but in general, there is also greater consumption of processed foods, which are often high in gluten."

In celiacs - the term used for persons with celiac disease - even a small amount of gluten can damage the small intestine. The disease tends to run in families and interferes with the absorption of nutrients from food. It can be difficult to diagnose because its symptoms - gas, diarrhea, and abdominal pain - often mimic other aliments like irritable bowel syndrome or lactose intolerance. Patients also can experience fatigue, delayed growth, skin rashes, and even infertility.

Not everyone has symptoms.

If left untreated, the condition can lead to long-term health problems - anemia, osteoporosis, vitamin deficiencies, and intestinal cancers.

The good news for celiacs is that following a gluten-free diet can greatly improve and may even completely resolve the symptoms of celiac disease, heal existing intestinal damage, and prevent further problems.

While celiac disease, wheat allergy, and gluten-intolerance may be treated with a gluten-free diet, they are not the same conditions. It is very important for a patient to know which condition they have since celiacs are at greater risk for nutritional deficiencies, other autoimmune diseases, and gastrointestinal cancers.

"If you think you might have celiac disease, be especially careful," says Dr. Laskin. "Don't start a gluten-free diet until you've been tested. It can impact your blood tests and your physician's ability to determine whether or not you have the disease."

He also cautions that gluten-free products should not be considered as weight loss aids, because they may still be high in carbohydrates and fat, and they may register high on the glycemic index. The glycemic index describes the difference in carbohydrate foods by ranking carbohydrates according to their effect on our blood glucose levels.

The patient-doctor relationship has been the priority of the Pennsylvania Medical Society since its founding in 1848. While there are many issues being debated about health system reform, the physician members will continue to focus on better health for all Pennsylvanians. To learn more about the Pennsylvania Medical Society, visit the web site at www.pamedsoc.org.

Additional Resources:

The Celiac Disease Foundation (www.celiac.org)

The Celiac Sprue Association (www.csaceliacs.org)

American Celiac Disease Alliance (www.americanceliac.org)