If you're living gluten-free, you know it's a serious commitment that's by no means easy. "There are definitely some barriers, including cost, availability and lifestyle," says Peter H.R. Green, M.D., Professor of Clinical Medicine and Director of the Celiac Disease Center at Columbia University. "You've got to be very strict and be constantly aware."
That's because cutting out all sources of gluten - including wheat, barley and rye - can be a challenge, especially when it's hiding in places where you least expect it, like soy sauce and salad dressing. It's also somtimes found in chicken broth, ready-made soups and MSG; it can even show up in caramel coloring and imitation crab meat!
always check the label
Thankfully, it has recently become a bit easier to identify sources of gluten on labels. "If a food contains wheat, it is required by law to say so on the label," explains Melissa McLean Jory, a Master Nutrition Therapist and blogger who has Celiac Disease and follows a gluten-free diet.
"Some foods are certified as gluten-free through either the Gluten Intolerance Group of North America or the
National Celiac Sprue Association's gluten-free certification programs," she says. "These foods have been inspected and tested to insure they don't contain gluten."
Today, you can find gluten-free breads, pizzas, baking mixes, pastas, and even gluten-free doughnuts, bagels and cookies. "There are some very good bread and baked goods companies that have recently jumped on the gluten-free bandwagon, so it's not nearly as frustrating as it was ten years ago," says Melissa. "Plus, it's fun to bake and experiment with all the amazing alternative flours. It's funny, having Celiac Disease has opened a whole new world of cooking and baking for me. There's no need to feel deprived. It's an adventure!"
Just remember to check the label each time you purchase a product, as companies sometimes change their ingredients. If you're unsure whether a product contains gluten, call the company or visit their website.
plan ahead
Of course, in many cases the safest and most nutritious option is cooking at home. "It's really not that difficult to eat a healthy, gluten-free diet if you stick primarily to fresh foods that are gluten-free by default," says Melissa. Fruits, vegetables, herbs, most fresh meat, rice and beans, and even most canned chicken and fish are all naturally gluten-free. But, says Melissa, "You absolutely have to think ahead and plan accordingly. It's important not to get stuck somewhere when you're hungry and tempted, and there are no gluten-free options."
It's more than worth the effort for those with serious conditions, like Celiac Disease. "Eating gluten-free is proven to be the only effective treatment for those with Celiac Disease," says Dr. Green. That means relief from wide-ranging symptoms, including abdominal cramping or bloating, constipation or diarrhea, dehydration, muscle cramping, wight loss or weight gain, fatigue and even depression, or so-called "brain fog." However, some Celiac sufferers are completely asymptomatic.
consult your doctor
If you are unsure if you have Celiac Disease or another form of gluten sensitivity, be sure to consult a doctor and get a diagnosis before beginning a gluten-free diet. "People come to us already on the gluten-free diet and they want to know if they should stay on it, but we can't test them if they're not eating gluten," explains Dr. Green. "And while there may be a benefit for others beyond those with Celiac, there isn't a lot of scientific evidence. It's a difficult area because things are not well defined or easily diagnosable in the non-Celiac entities," he explains.
Because consuming gluten can cause serious damage to the intestinal tract in those with Celiac Disease, the long-term effects of continuing to eat a gluten-filled diet can be severe. "There are two main issues," explains Dr. Green. "One can be developing more autoimmune diseases after diagnosis, including thyroid conditions, arthritis and lupus. The other is an increased risk of malignancies, mainly lymphomas, both intestinal and non-intestinal."
Dr. Green also stresses that it's important for those on a gluten-free diet to do so under a doctor's care. "You should have regular follow-ups where antibody levels, vitamin levels and bone density are checked," he advises. 'We also encourage people to see expert nutritionists to make sure their gluten-free diet is nutritious."
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