February 3, 2019

Should I Go Gluten-free?

Is going gluten-free healthful, and will it decrease my bloating?

Peter N. Landless & Zeno L. Charles-Marcel

Q:A few of my friends have gone gluten-free as a health practice. They say they feel less bloated and better overall, but their diet seems so restrictive. Is going gluten-free healthful, and will it decrease my bloating?

A:Your question is a fairly common one, and we commend your friends for not being passive regarding their health.

Current estimates are that only .5 to 13 percent of the population have a diagnosable condition that warrants eliminating gluten, namely, celiac disease, nonceliac gluten sensitivity, and wheat allergy. Household members may also adopt a gluten-free diet for solidarity, ease, and elimination of cross contamination. But when market researchers ask gluten avoiders about their reasons for this dietary choice, about 40 percent say it is better for overall health. Some 45 percent cite reasons other than gluten intolerance or sensitivity, and more than 80 percent have no substantiating medical diagnosis. So your friends are not alone in this.

People with celiac disease have an immune reaction to ingested gluten, leading to widespread inflammation and damage to the gastrointestinal (GI) tract that interferes with the absorption of nutrients from food. This results in a host of symptoms and may lead to such problems as osteoporosis, infertility, nerve damage, seizures, and an increase in the risk of intestinal cancer.

Nonceliac gluten sensitivity may cause symptoms similar to celiac disease but without intestinal damage. Celiac disease is diagnosed by a special blood test and biopsy of the intestine. Even a very small amount of gluten can cause problems for those with celiac disease, so going gluten-free is, for them, not just very helpful—it’s a must!

Gluten is actually a set of proteins found in certain grains such as wheat, rye, and barley. They are not essential to your diet, but because gluten is part of commonly used grains, eliminating it is tricky. Breads, cereals, pasta, and beer all have gluten, and it hides in sauces, “natural flavorings,” vitamin supplements, some medications, even toothpaste. Most people without celiac disease on a “gluten-free” diet are usually not strictly gluten-free.

On the other hand, about one in every five Americans suffers from bloating, or trapped intestinal gas. This is far more common than gluten sensitivity. Smoking, acid reflux, certain medications, and mouth breathing may contribute to the overinflated sensation. Unabsorbed foods, such as lactose, gluten, and processed soy, and the overeating of foods that contain FODMAPs may also be implicated. FODMAP is an acronym for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, complex names for a collection of molecules found in food that can be poorly absorbed by some people. Wheat, rye, onions, beans, and mushrooms all contain FODMAPs. (Visit the link below for a more complete list.*)

Removing or reducing FODMAPs from your diet may eliminate bloating. Since every individual’s gut is different, try avoiding them for a few weeks to see how your body responds, then add them back one by one to find the culprit(s). This is far easier than going completely gluten-free and is less dangerous. Be sure to get adequate fiber and B vitamins in your otherwise health-promoting diet and lifestyle for the health and well-being that God desires we experience.

* www.monashfodmap.com/about-fodmap-and-ibs/high-and-low-fodmap-foods/

Peter N. Landless, a board-certified nuclear cardiologist, is director of the General Conference Health Ministries Department. Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.