Gluten is the base structure of wheat, barley and rye. Registered dietician Rachel Brandeis of Atlanta said allergic reactions stem from any grain containing the protein gliadin, which is typically found in the aforementioned three items.
There is a difference between a food allergy and food sensitivity. Brandeis explains: “You actually have antibodies that develop that basically attack your body when this protein is present in your system. With food sensitivities, you don’t have a true allergic reaction.”
People with gluten-free dietary restrictions should avoid food such as bread, cookies, cakes, crackers, soy sauce and chicken broth. She said, “Anything that’s packaged usually has some kind of wheat byproduct.”
Gas, bloating and constipation can be side effects of eating certain foods, but Brandeis said these symptoms can also be signs of something more serious. Celiac disease affects 1 out of 133 people, according to the Celiac Disease Foundation. According to its website, www.celiac.org, the disease is not a food allergy but an autoimmune disease. People can outgrow food allergies, but celiac disease is permanent.
When people with the disease eat gluten, the villi (hairlike projections in the small intestines that absorb nutrients) are damaged. The intestines are then unable to absorb basic nutrients such as proteins, carbs, fats and vitamins.
Brandeis said the average time lapse between symptoms and diagnosis is 12 years because its prevalence is underestimated. “Most people think gas and bloating that they feel all the time are normal. They don’t put two and two together,” she said.
For example, a person might eat cereal for breakfast, a sandwich for lunch, crackers as a snack and pasta for dinner. All of these food items contain wheat.
“Wheat is so prevalent in our food supply. A lot of people don’t even think about it,” she said
A blood test will screen for antibodies, but Brandeis said a small intestinal biopsy (an outpatient surgery) is the “gold standard” for a proper diagnosis. If left untreated, celiac disease puts people at increased risk for intestinal cancers, other autoimmune disorders, osteoporosis, infertility and more. “You have to be your own advocate,” she said.
For anyone concerned about having the disease, Brandeis stresses seeking advice of a medical professional instead of taking matters into one’s own hands.
“If you suspect that you have a gluten intolerance or celiac disease and you want to get tested, do not follow a gluten-free diet until after you’re tested. If you eliminate the gluten, it can give the results of any testing a false negative because your intestine will start to heal itself,” she said. Brandeis advises seeing a gastroenterologist to confirm the diagnosis, followed by seeing a registered dietician with a background in celiac disease.
The solution to celiac disease is 100 percent avoidance of foods with gluten. Brandeis said, “The only way to treat this is dietary compliance.”
Finding gluten-free products has become easier in recent years, but Brandeis said educating oneself and reading labels is still crucial for health. She said grocery stores have entire sections dedicated to gluten-free products.
The U.S. Food and Drug Administration website, www.fda.gov, indicates all packaged foods regulated under the Federal Food, Drug, and Cosmetic Act labeled on or after Jan. 1, 2006, must comply with the Food Allergen Labeling and Consumer Protection Act’s labeling requirements. Under FALCPA, a “major food allergen” is an ingredient that is one of the following five foods or from one of the following three food groups or is an ingredient that contains protein derived from wheat, milk, egg, fish, Crustacean shellfish, tree nuts, wheat, peanuts and soybeans.
Chris Daniel of Marietta was suffering from a host of gastrointestinal issues before she was diagnosed with celiac disease in 2006. Her chiropractor, who also has the disease, was suspicious of Daniel’s symptoms and encouraged her to get confirmation from a gastroenterologist.
“Everything was new,” she said. Aside from her mother having GI issues, no one in Daniel’s family had ever been diagnosed with celiac disease.
The Marietta resident and her husband, Woody, have adjusted to her dietary needs. She said they eat a lot of vegetables, fruit, chicken and fish.
“We cook it very simply. I use herbs and spices. No sauces,” she said.
Eating out is more of a challenge. “The restaurants have to know what you’re talking about in order for you to order a safe meal,” she said, noting marinades and sauces can sometimes contain gluten.
Daniel said restaurants such as Carrabba’s and Outback in Roswell are among the places she trusts. “I’m comfortable going there,” she said. “They have a gluten-free menu, therefore their kitchen staff is familiar with preparing gluten-free meals,” she said. She has called ahead at Stoney River Legendary Steaks at Cumberland mall, and they have been able to accommodate her dietary needs.
Shopping for groceries has become easier, now that grocery stores and bakeries offer items conducive to her diet. However, she said gluten-free items can be more expensive. “A loaf of bread is $5. From a bakery, it’s more like $7 up to $11,” she said. However, she stresses the importance of reading labels in order to properly adhere to gluten-free diet.
Continuing to check products, even those one buys regularly, is important. Daniel said manufacturers can change ingredients, but Betty Crocker and Kellogg have gluten-free products.
In social situations such as wedding receptions and barbecues, she either avoids eating or brings her own dish. However, events with her close friends and family are easier to navigate as they are aware of her dietary restrictions and can accommodate her.
Brandeis said many patients find it challenging to create meals with gluten-free products, but the diet is not as restrictive as some might assume. “It’s really quite healthy as long as you plan your meals and try to make up for those grains that you’re missing and substitute out the gluten-free grain,” she said.
Her example of a one-day meal plan is gluten-free oats, Greek yogurt or whole-grain granola for breakfast; a sandwich made with gluten-free bread, Boar’s Head deli meats and cheese along with veggie sticks for lunch; and grilled meat of any kind seasoned with gluten-free spices and a baked potato and salad with self-made dressing (she suggests olive oil and vinegar) or a gluten-free brand.
While living a gluten-free lifestyle is a health choice for some, others may choose it as a fad or a way to help with weight loss. Brandeis discourages this, saying, “You’re at risk for developing deficiencies. You’re at risk for not getting enough fiber, iron and B vitamins. It’s not just a diet or a lifestyle choice.”
For more information, visit www.celiac.org. To contact Brandeis, visit www.rachelrd.com or call (770) 752-4984.