You probably know someone who's following a gluten-free diet. Perhaps he or she has celiac disease, gluten sensitivity, is trying to lose weight or needs to resolve a medical condition. Oftentimes folks self-diagnose their need for gluten restriction, which may be unnecessary. Here's a look at five common misconceptions about going gluten-free.
Myth No. 1: Celiac disease and gluten intolerance are the same thing.
These two terms are often used interchangeably. To make things even more confusing, the term "gluten sensitivity" is also thrown into the mix. However, these terms are not the same thing. Rachel Begun, a food and nutrition consultant and gluten-free expert based in Boulder, Colo., explains that "an international group of celiac disease and gluten-related experts got together a couple of years ago to come to an agreement on terminology, so that everyone is speaking the same language. The scientifically accurate terminology is non-celiac gluten sensitivity, although many use the more informal term gluten sensitivity." The term gluten intolerance is no longer used in the medical community, though many folks still use this term.
Begun clarifies: "Celiac disease and gluten sensitivity are two unique conditions. Gluten sensitivity is not a precursor to celiac disease, nor a mild form of it." Celiac disease is an autoimmune disease where the body triggers an attack on the intestines every time gluten is eaten, whereas there's not enough research about gluten sensitivity to fully understand it. "What we do know is that gluten sensitivity is not an autoimmune disorder," Begun says. "Gluten antibodies are not produced, as in the case with celiac disease, and the intestines are not damaged. The similarity lies in the symptoms." There is an overlap between the symptoms over celiac disease and gluten sensitivity.
Myth No. 2: It's okay to self-diagnose celiac disease and go gluten-free.
Putting yourself on a gluten-free diet because you think you have celiac disease or gluten sensitivity isn't a smart way to approach the issue. As Begun explains, "It's highly recommended that people not self-diagnose, for many reasons. Knowing whether you have celiac disease or gluten sensitivity determines treatment. While a gluten-free diet is medically necessary for both, a 100-percent strict gluten-free diet is required with celiac disease in order to prevent long-term health issues. We don't know yet if eating small amounts of gluten causes damage to those with gluten sensitivity. Because of that, it is up to the individual with gluten sensitivity whether they avoid even small amounts of gluten from cross-contact. This is a big difference in how one goes about their day-to-day eating."
Another reason to avoid cutting gluten before getting tested is that this will cause test results to be inaccurate. If you think you have an issue with gluten, see your doctor and get tested. Once a proper diagnosis is made, the appropriate dietary protocol can be followed. "I've seen many clients who self-diagnose only to find that a gluten-free diet is not making them feel better," Begun says. "They've lost precious time getting a proper diagnosis."
Myth No. 3: Go gluten-free to lose weight.
If much of your diet comes from baked goods and large portions of wheat-based foods (like pasta or bread), then you will probably lose weight if you cut all that out. But following a gluten-free diet doesn't necessarily guarantee a slimmer waistline. Many gluten-free products are loaded with more sugar and fat than their gluten-filled counterparts. Large portions of potato chips, rice, gluten-free breads, and other gluten-free processed foods can pack on the pounds too.
Myth No. 4: Going gluten-free can alleviate other medical conditions.
Although many folks claim that a gluten-free diet can help those with autism and certain autoimmune disorders (like rheumatoid arthritis, thyroid disease and multiple sclerosis), the research doesn't support it. Begun recommends folks with these conditions work with both their medical doctors and registered dietitians to see if a gluten free diet is beneficial for them.
Myth No. 5: It's impossible to dine out when following a gluten-free diet.
Although dining out while following a gluten-free diet can be tough, it is possible. Begun says "the questions to ask at a restaurant all depends on what is being ordered. The important thing to remember is to ask about each and every ingredient in the dish, as the menu usually only lists some ingredients." It is also important to ask how the dish is being prepared--for example, was the same oil used to fry the French fries that was used for the mozzarella sticks or onion rings-- a classic case of cross contact. And don't forget to ask about the surfaces, equipment and utensils the dish came in contact with - for example, was the same surface used for the gluten-free wraps used to make the whole wheat sandwich. Looking ahead at the menu also helps alleviate some of the stress when dining out. It takes time and some practice to know which questions are the right ones to ask.
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Toby Amidor , MS, RD, CDN, is the owner of Toby Amidor Nutrition and author of the forthcoming cookbook "The Greek Yogurt Kitchen" (Grand Central Publishing 2014). She consults and blogs for various organizations including FoodNetwork.com's Healthy Eats Blog and Sears' FitStudio.