Should You Go without Gluten?

August 14, 2014 Brigham and Women's Hospital

Should you avoid eating grains that contain gluten?

Today’s post is written by Caitlin Hosmer Kirby, RD, a nutritional health coach at the Osher Clinical Center for Integrative Medicine at Brigham and Women’s Hospital, led by Dr. Donald B. Levy, Medical Director.

You’ve probably noticed an increased number of food items marked as “gluten free.” Gluten is a protein found in wheat, barley, rye, certain forms of oats, and in many processed foods.  Many people are becoming increasingly concerned about eating foods containing gluten. Gluten is responsible for the reaction that damages the lining of the small intestine in celiac disease. It also has been linked to less serious gastrointestinal complaints, such as diarrhea and bloating. Today’s post looks at how gluten can affect your health and what the benefits are of avoiding it.

An Overview of Celiac Disease

Celiac disease is a condition in which gluten is not processed adequately by the body and instead causes a harmful reaction. The actual cause of celiac disease is unknown. However, we do know that this reaction damages the finger-like projections within the small intestine, known as villi. Villi increase the surface area of the intestines and are important in the absorption of nutrients. Damaging them can lead to malnourishment over time. The inability to absorb nutrients also causes a number of other symptoms, including diarrhea, fatigue, cramping, and skin rashes. Untreated celiac disease can lead to lactose intolerance. Patients with celiac disease must avoiding eating gluten to allow the villi to heal so they can be adequately nourished.

Non-Celiac Gluten Sensitivity

During the past year, our nutrition team has worked with a number of people who do not have celiac disease, but feel better after eliminating gluten from their diet. These people may be experiencing a condition called non-celiac gluten sensitivity. While much remains unknown about this condition, including specific symptoms and diagnostic criteria, it is estimated that anywhere from one to six percent of the U.S. population, or as many as 20 million people, may be gluten sensitive.

Going Gluten Free without Disease?

Avoiding gluten may be a good choice even if you don’t have celiac disease or non-celiac gluten sensitivity. Eating “gluten free” can help you avoid wheat-based baked goods, breads, crackers, pastas, and other processed foods that are low in nutrients and high in calories and additives. If you choose whole foods without gluten (including plenty of vegetables, fruits, nuts, and gluten-free grains and seeds, such as quinoa, brown rice, millet, and amaranth), you may be feeling better (and lose weight) because the quality of your diet has dramatically improved. Other gluten-free choices include meat, poultry, seafood, dairy, eggs, beans, rice, potatoes, corn, and fats.

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