Gluten Sensitivity vs. Celiac Disease

Gluten SensitivityThese days, no matter where you go—from restaurants to grocery stores—the words “gluten free” are prominent, always it seems with the implication of overall health. But gluten free is a very specific need, for a specific problem. This problem is celiac disease, and in a much lesser form, gluten sensitivity.

According to the National Foundation for Celiac Awareness (NFCA), celiac disease is a genetic autoimmune disease that damages the villi of the small intestine and interferes with absorption of nutrients from food. An estimated one in 133 Americans, or about one percent of the population, has celiac disease. Celiac disease can affect men and women across all ages and races. It is estimated that 83 percent of Americans who have celiac disease are undiagnosed or misdiagnosed with other conditions.

The other condition, which is more commonly claimed, is non-celiac gluten sensitivity, or gluten intolerance. It causes the body to mount a stress response (often GI symptoms) different from the immunological response that occurs in those who have celiac disease (which most often causes intestinal tissue damage).

As with most allergies, a non-celiac gluten sensitivity, basically a wheat allergy, causes the immune system to respond to a food protein because it considers it dangerous to the body when it actually isn’t. This immune response is often time-limited and does not cause lasting harm to body tissues.

According to Dr. Alan Gingold of Digestive Healthcare Center in New Jersey. “Those with gluten sensitivity can experience symptoms such as “foggy mind”, depression, ADHD-like behavior, abdominal pain, bloating, diarrhea, constipation, headaches, bone or joint pain, and chronic fatigue when they have gluten in their diet, but other symptoms are also possible. While these are also common symptoms of celiac disease, these individuals do not test positive for celiac disease or for a wheat allergy.” There is also no test for gluten sensitivity.

Celiac disease is diagnosed by testing. Digestive Healthcare determines celiac disease with blood tests, which can reveal the presence of antibodies in the bloodstream that are produced by the body in response to gluten ingestion. The other procedure is an upper endoscopy to evaluate the lining and shape of the stomach and upper small intestine. In addition, biopsies of the first portion of the small intestine can be performed to check for the presence of celiac disease.

What exactly is gluten? Gluten is a specific type of protein, but not the one in meat or eggs. Instead, gluten is found in wheat, rye, and barley. Going gluten-free means avoiding these grains. A gluten-free diet is essential for most people with gluten allergies or celiac disease.

There are no pharmaceutical cures for celiac disease. A 100 percent gluten-free diet is the only existing treatment for celiac today. In addition, gluten-free is big business. According to the National Foundation for Celiac Awareness, Gluten-free sales reached more than $2.6 billion by the end of 2010 and are now expected to exceed more than $5 billion by 2015. (Source: Packaged Facts, 2011)

According to Dr. Gingold, “Those with celiac disease (or gluten sensitivity) can control their condition by eating a gluten free diet. Due to the popularity of this diet, it is estimated that up to 30 percent of the population is interested in avoiding or cutting down on gluten. However, for those who really need the diet, it is not just a fad, it is vital.”

Below is a list of gluten free foods. These are inherently gluten free, while some gluten containing foods are manufactured in gluten free versions, using substitute grains or flours, for example.

  • Beans, seeds and nuts in their natural, unprocessed form
  • Fresh eggs
  • Fresh meats, fish and poultry (not breaded, batter-coated or marinated)
  • Fruits and vegetables
  • Most dairy products

It’s important to make sure that foods are not processed or mixed with gluten-containing grains, additives or preservatives. Many grains and starches can be part of a gluten-free diet, such as:

  • Amaranth
  • Arrowroot
  • Buckwheat
  • Corn and cornmeal
  • Flax
  • Gluten-free flours (rice, soy, corn, potato, bean)
  • Hominy (corn)
  • Millet
  • Quinoa
  • Rice
  • Sorghum
  • Soy
  • Tapioca
  • Teff

How do you know if a food product is gluten free? While there is no requirement that gluten free foods must be labeled “gluten free”, the Food and Drug Administration (FDA) created a gluten free food labeling rule. According to the rule, when a manufacturer chooses to advertise “gluten-free” on food packaging, the item must comply with the new FDA definition of the term – less than 20 parts per million (ppm) of gluten. Any food product conforming to the standard may be labeled “gluten free” even if it is naturally gluten-free (i.e., water or fruits and vegetables).