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Gluten-Free Diets: Facts of the Fad

Despite food marketers' attempts to convince you otherwise, a gluten-free diet is only a healthier option for three groups of people.

Gluten Free
Your Local Health | Written by BJ Towe

Despite food marketers' attempts to convince you otherwise, a gluten-free diet is only a healthier option for three groups of people. If the number of product labels now touting “gluten-free” is any indication, America has made going gluten-free the latest diet craze. But unless you have a wheat allergy, celiac disease, or non-celiac gluten sensitivity, “Sticking with a diet that includes gluten is much healthier for you — and a lot less expensive,” says Narasimha Palagummi, M.D., an Internal Medicine physician with The Iowa Clinic.

What's gluten and why does it matter?

Gluten is one of many proteins found in wheat, rye, and barley. There are other foods (couscous, kamut, malt, and oats, for example) as well as everyday products (such as medicines, vitamins, even lip balms) that contain or have been contaminated by gluten during the growing season or in the processing plant.

For some people, ingesting gluten can lead to a host of unpleasant symptoms, damage the small intestine, and potentially lead to other health complications.

But for the vast majority of us, eliminating gluten from our diets isn't recommended. Although gluten itself doesn't have much nutritional value, many whole grains that contain gluten do. And those provide nutrients essential to good health, including fiber, iron, and calcium.

When is eliminating gluten advised?

“Some people who have voluntarily gone gluten-free report relief from symptoms such as fatigue, bloating, and depression,” says Dr. Palagummi. “They may attribute the improvement to going gluten-free, but often it's the result of eliminating highly processed, flour-based foods and snacks from their diets.”

Here are the legitimate reasons to go gluten-free:

You're Allergic to Wheat

Wheat allergies can cause itchy or watery eyes; swelling of the mouth, throat, or skin; or digestive problems. Doctors will typically want to rule out wheat allergy before testing for the more serious problems of celiac disease or gluten sensitivity.

You Have Celiac Disease

For the estimated 1 percent of Americans with celiac disease, even the tiniest bit of gluten poses a serious threat to the lining of the small intestine. This interferes with the body's ability to absorb nutrients and can make a person malnourished and very sick.

When symptoms are present, they can vary person to person and may include:

  • Diarrhea, abdominal bloating and pain, or constipation
  • Iron-deficiency anemia, fatigue
  • Arthritis, or bone or joint pain
  • Depression or anxiety
  • Itchy skin rash, usually on the elbows, knees, and buttocks

Celiac disease is very treatable. Within weeks of starting a gluten-free diet, symptoms of celiac disease begin to cease and the small intestine begins to heal — but the affected individual must avoid gluten for the rest of their life.

According to the National Institutes of Health, many adults have the disease for a decade or more before they are diagnosed.

You Have Non-Celiac Gluten Sensitivity

For years, it was believed that the only condition triggered by gluten was celiac disease. Several recent studies, including one reported by the National Institutes of Health, confirm the existence of non-celiac gluten sensitivity. Symptoms of this condition mirror celiac disease — but intestinal damage does not occur. More studies are underway.

“According to some sources, as many as 6 percent of Americans have gluten sensitivity,” says Barb Huyette, R.N., who chairs the Central Iowa Celiac Connection support group for individuals and families learning to live gluten-free. For those people, eliminating gluten from their diet should eliminate the symptoms.

However, says, Dr. Palagummi, “Some patients who have gone on gluten-free diets report some nonspecific improvement in diarrhea, joint pain, fatigue, and other manifestations of gluten sensitivity. They get excited and tell their friends to try it. Word of mouth fuels the fad, even though those improvements may have nothing to do with eliminating gluten.”

Palagummi warns, “There are so many other underlying factors that could cause symptoms, for example thyroid disease. It's extremely important to get your symptoms accurately diagnosed. If you think gluten might be a problem for you, talk with your doctor and get tested before going on a gluten-free diet regimen.”

Is Gluten a Problem for You?

The only way to know for sure is to have diagnostic tests before you eliminate gluten from your diet.

The first step is a blood test. If the presence of certain antibodies is detected, you'll need to have an endoscopic biopsy of the small intestine. If that test shows any damage to the lining, you likely have celiac disease and must completely avoid gluten. If no damage is present, you may have non-celiac gluten sensitivity and should eliminate gluten to try to eliminate symptoms.

To begin the process toward diagnosis of non-celiac gluten sensitivity or celiac disease, please contact The Iowa Clinic Internal Medicine office at 515.875.9000 or the Gastroenterology office at 515.875.9115.

Huyette Helps Others Live Gluten-Free

Barb Huyette, a retired nurse and current chair of Central Iowa Celiac Connection, inherited celiac disease. She was diagnosed about 20 years ago and today devotes much of her time to helping others adopt a
gluten-free lifestyle.

Huyette, who was diagnosed with thyroid disease in her 20s and anemic most of her adult life, didn't have the usual symptoms of celiac disease.

“I never had a stomachache. I didn't have diarrhea. I did have bloating,  but I'd always had that so that was nothing unusual for me,” she says. It wasn't until many years later that Huyette's extremely swollen index fingers eventually led doctors to suspect a connection with her digestive system and diagnose celiac disease.

“Even now, when the medical community knows so much more about celiac disease and non-celiac gluten sensitivity, it often goes undiagnosed, often because the symptoms mimic so many  other problems,” Huyette says. She encourages anyone who thinks  they may have gluten-related problems to request the simple blood test.

If it turns out that you or a family member should go gluten-free, Huyette adds, “There are so many more options for people today; by 2015, gluten-free food products are expected to account for $8 billion annually in America. Our support group includes over 900 families who share ideas and recipes.”

Support Groups for Living Gluten-Free

The Central Iowa Celiac Connection provides education and support through two groups:

Introduction to Gluten-Free Living — for those newly diagnosed with celiac disease or non-celiac gluten sensitivity.

Potluck Support Group Meetings — for patients and family members. Includes a gluten-free potluck, information sharing, and ideas for living gluten-free.

For more information, contact  Barb Huyette, R.N., at (515) 224-4145, or visit

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