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    Everything You Wanted To Know About Gluten But Were Afraid To Ask

    For those who are afraid to look even more dumb in Whole Foods.


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    A: Gluten is a protein found in wheat, barley, and rye. It's that thing that helps dough rise, making your bagels chewy and your sandwich bread soft.


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    Gluten can set off a range of negative responses in some people's immune systems. An extreme example is celiac disease. Normally we have tiny, hair-like projections (villi) that line the small intestine like a plush carpet, absorbing vitamins, minerals and other nutrients from food. But according to the Mayo Clinic's website, celiac disease makes the inner surface of the small intestine appear more like a tile floor.

    "Celiac disease sufferers have a full fledged natural auto-immunity to the protein gluten. The gluten does not react to them directly," said Eric Sieden, director of nutrition and food services at Plainview Hospital. "What ends up happening to people with celiac disease is that the body will react to the gluten by having the white blood cells attack the intestinal wall causing inflammation and loss of nutrient absorption."

    "Most symptoms are GI (gastrointestinal) in nature, such as nausea, vomiting, abdominal pain/bloating, diarrhea or constipation, lactose intolerance, weight loss from malabsorption or above symptoms," explained Kelly O'Connor, a dietician and certified diabetes educator with Mercy Medical Center. "Also, other non-GI symptoms may occur, such as migraines, bone/joint pain, mouth ulcers, chronic fatigue, etc."


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    A: It's hard to define, exactly.

    "A gluten intolerance/allergy/sensitivity works differently with the immune system where the gluten protein itself causes the body to attack itself through inflammation in the small intestine," explained Sieden. The body starts to beat itself up, even though it's aiming for the gluten.

    Although it differs from celiac disease, experts can't exactly nail down sensitivity/intolerance as a definable problem.

    "Some researchers have labeled the intolerance/sensitivity as NCGS (non-Celiac Gluten Sensitivity). Though this is a label that researchers have put on it, physicians have not been so quick to define it as a medical condition," said Sieden. "The reason for this is that there is no defined medical test for it."

    For celiac disease, patients undergo a biopsy in order to determine a diagnosis. There's not much doctors can do in order to test for gluten sensitivity.

    Additionally, these "gluten sensitivities" might belong to a broader family of wheat-related problems. More specific tests are being developed in hopes of cutting out the "constituents of grains that make them ill."


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    Different people will display different side effects of celiac disease, but the most common symptoms are digestive issues like abdominal pain, diarrhea, and weight loss. Not everyone will show those symptoms, however; additionally, children could also show different signs of the disease. You could also suffer from fatigue, headaches, constipation, acid reflux, and other problems. The Mayo Clinic suggests to schedule a visit with your doctor "if you have diarrhea or digestive discomfort that lasts for more than two weeks."


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    A: Stay away from beer, breads, cakes...

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    Beer is made from malted barley or wheat; breads and cakes are made from wheat-based flours or other whole grains.

    ...pie, candies, cereals...

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    Pie crust and cereals are made from wheat-based flours; some candies contain wafers or other wheat-based ingredients.

    ...cookies, crackers, croutons...

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    Cookies, crackers, and croutons are made from wheat-based flours and could contain other whole grains.

    ...gravies, imitation meats/fish, matzah...

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    Flour is used to thicken gravy; imitation crab meat is made from ground white fish and a binding agent (normally the enzyme transglutaminase, but occasionally egg whites are used); matzah is an unleavened bread made from any of the five grains mentioned in the Torah: wheat, barley, spelt, rye and oats.

    ...pastas, lunch meats, salad dressings...

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    Pasta noodles are made from wheat-based flours or other grains; processed deli meats could contain seasonings that contain gluten or were combined with breadcrumbs as a filler; some salad dressings could contain gluten which acts as a thickening agent, while others could be made with soy sauce or other flavors that are derived from wheat sources.

    ...(soy) sauces, seasoned rice mixes, seasoned chips...

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    Soy sauce is normally made from fermented soy beans and wheat; seasoned rice mixes (like Zatarain's, among others) could contain wheat or barley flour; seasoned potato or tortilla chips could contain wheat or barley flour or were processed on the same equipment as other wheat-based snacks.

    ... or self-basting poultry, soups, vegetables cooked in some sauces.

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    Self-basting poultry could contain flavor enhancers or other "natural solutions" that have wheat- or gluten-based ingredients; wheat-based flours are used in some soups to thicken them; some vegetables on restaurant menus are cooked in soy-based sauces which could contain wheat.

    The key is to check ingredient labels very thoroughly for any wheat-, barley-, and rye- derived ingredients. Some ingredient labels now contain allergen information, so there's less guesswork involved.

    These flours should also be avoided: bulgur, durum flour, farina, farro, graham flour, kamut, semolina, or spelt.

    - Some ingredients that are "malted" (like some vinegars!) could be dangerous.
    - Watch out for seitan, as that is just wheat gluten.
    - Look for words like "breading" or "natural flavors," as these could be hidden gluten.

    If you're unsure if you can trust a brand, or if you'd like to doublecheck a product's ingredients, more and more websites have an FAQ that will most likely contain information about any gluten or wheat used.


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    If you're allergic/intolerant, yes. If you're fine with gluten, not necessarily.

    "It’s been proposed that simply the act of making their diet healthier (i.e., adding more fruits and veggies, (eating) less processed foods) may be what causes them to ‘feel better’ and lose weight, rather than the lack of gluten," said O'Connor.

    "While it is a current trend to ditch gluten from your diet, there are no benefits from withholding it if you do not have an intolerance," said Sieden.

    "I don't think a gluten-free diet is a healthier option for the general public," said Laura Manning, an RD in the Division of Gastroenterology at the Mount Sinai Hospital. "Overall what we need to do is eat less processed white flour products, eat more fruits and vegetables, and increase exercise."



    Some provide a necessary service to the community, others are potentially capitalizing on the popularity of the diet.

    “Today, I see manufacturers are printing ‘gluten-free’ on food products unnecessarily just to get in on the trend,” said Sieden. “I compare it to when trans fats were being banned. I remember seeing ‘trans fat-free’ on a box of raisins. Come on!”


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    Not at all.

    "(Celiac) is a serious disease and not some flavor-of-the-month diet trend," Sieden said.

    According to an article by Scientific American:

    "Despite the recent evidence that wheat sensitivities are more numerous and varied than previously realized, research has also revealed that many people who think they have such reactions do not. In a 2010 study, only 12 of 32 individuals who said they felt better on a diet that excluded gluten or other wheat proteins actually had an adverse reaction to those molecules."

    So, now you know: