These days, it seems that you cannot pick up a magazine, go to the grocery store or turn on the television without seeing information on the gluten-free diet. Randy Yanda, M.D., a gastroenterologist at Piedmont, discusses why gluten-free diets have become so popular in the United States, and who should go gluten-free.

What is gluten?

“Gluten is a protein contained in certain grains, such as wheat, barley, rye and possibly oat,” Dr. Yanda explains. "It is the common culprit in celiac disease, a condition where the body has an immune reaction to gluten that causes injury to the small intestine."

What is celiac disease?

• The condition typically affects people of European descent but has also been shown to affect Hispanic, African-American and Asian populations as well.

• Celiac disease can be diagnosed through blood tests and intestinal biopsies.

• A gluten-free diet is currently the only treatment for celiac disease.

• In addition to gluten-free bread and pasta, foods allowed in a gluten-free diet include fresh meats, fish and poultry, fruits, most dairy products, potatoes, rice, vegetables, wine and distilled liquors.

• Gluten can be found in non-food products such as lipstick and lip balm, play dough, toothpaste, and food additives like malt flavoring and modified food starch. Check product ingredients if you have a gluten allergy.

How common is celiac disease?

While the number of celiac disease diagnoses has increased lately, Dr. Yanda says it is hard to know whether the disease is increasing in incidence or if people are more aware of the condition, causing doctors to test more people. In the United States, at least one in 133 people have the disease.

“Some experts believe it’s related to our development, the foods we ate when we were younger and not being exposed to certain antigens in the environment because the environment was cleaner when we were younger," he says. “As people get older and introduce these foods into their diets, their bodies have some kind of reaction to it.”

He adds that when people eliminate foods with gluten from their diets, their symptoms seem to improve.

The difference between gluten sensitivity and celiac disease

Even if celiac disease is ruled out, people can still suffer from gluten sensitivity.

“I think there likely is a condition where people are sensitive to gluten – it is hard to prove or disprove – but we certainly have people come into the office who have symptoms, but do not have celiac disease, and who seem to respond to a gluten-free diet in regards to their symptoms.”

The downsides of going gluten-free

There are some important downsides to consider when going gluten-free. Dr. Yanda says those on a gluten-free diet could potentially become deficient in certain vitamins commonly found in grains, like vitamin D, B vitamins and iron.

“If you are on a strict gluten-free diet, you could develop a vitamin D deficiency, which could put you at risk for osteoporosis,” he adds.

When to try a gluten-free diet

“If you are having symptoms of bloating, gas or abdominal discomfort, and your doctor has ruled out other conditions, then at that point, I would say give a gluten-free diet a try," Dr. Yanda says. "It may eliminate all of those symptoms if you are gluten-sensitive.”

Remember, before going on a gluten-free diet, be sure to check with your doctor.

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