Gluten-free cuisine: is avoiding the protein better for us?

While perusing the lunch offerings at a local health food store recently, I overheard the chef say to a customer: "You have to try my vegetarian lasagna. It is gluten-free, which is better for you, of course." I had heard that wheat and gluten sensitivities could cause health problems for some people, but calling these foods unhealthy surprised me. Could gluten actually be bad for us?

Gluten is the elastic, water-insoluble protein found in wheat and other grains such as rye, barley, kamut, spelt and oats. It is also found in a surprising number of products on supermarket shelves. Gluten is used as a thickener and binder in thousands of such products as soups, sauces (including soy sauce), candy, artificial cheese, pharmaceuticals and even envelope glue. In the typical Western diet, wheat is the primary source.

Glutenous Maxims

For someone suffering from celiac disease, also called celiac sprue or celiac enteropathy, all forms of gluten are toxic to the digestive system. This means sufferers must avoid gluten in every form. The protein causes an immunological reaction in the small intestine, resulting in the disintegration of the finger-like villi that facilitate the absorption of nutrients. People who have been afflicted with this condition for extended periods of time lose their ability to process food normally, thereby leading to potentially severe health problems.

Long misdiagnosed, due to a lack of education, new studies suggest that up to one in 133 people are afflicted with celiac disease. People can also go years without being diagnosed due to the multifaceted symptoms, which include diarrhea, gas, bloating, weight loss, water retention, constipation and dermatitis. Long-term effects of the condition are anemia, malnutrition, osteoporosis and cancer. Some people also suffer an immediate allergic reaction to wheat or gluten, and others say they just feel better without it. But to deem gluten simply unhealthy seems to be a stretch.

For some consumers of organic and healthy foods, a generous chunk of whole grain bread can be the cornerstone of a nutritious meal, a staple bordering on iconic. Bleached white bread is rightfully condemned for its lack of nutritional value, but whole grains have long been praised as a good natural source of nutrition and fiber. The notion that wheat is unhealthy is definitely not the norm, but in the era of Atkins and South Beach anti-carb diets, people may be tending to think of wheat as junk food. Some are choosing to minimize starches altogether, while others partake in a gluten-free diet that allows more complex carbohydrates. Many are losing weight on these higher-protein, higher-vegetable diets, but nutritionists caution they may be missing out on important nutrients once grains are removed, such as B vitamins that are found in whole grain wheat.

Some people experience gluten sensitivity without knowing it. Melissa Diane Smith, a nutritionist and author of the book Going Against The Grain, warns that glutenous grains might be wreaking havoc on our health. "Gluten sensitivity is a hidden health problem that many Americans don't know they have," says Smith. "When a gluten-free diet is strictly followed, long-standing health problems clear up." This is obvious for those with celiac disease, but for the people who suffer subtler forms of intolerance, it could take years to discover sensitivity.

Claire Williamson, a nutritional scientist at the British Nutrition Foundation, disagrees that gluten sensitivity is more common than currently believed, and she stresses that wheat is an important part of the daily diet. "We would not recommend a wheat/gluten-free diet for a non-celiac sufferer," says Williamson. "Wheat forms a staple part of the diet, and avoidance of wheat is far from an easy task," she says. Most Western physicians and dietitians believe that in the absence of strong symptoms of intolerance, a gluten-free diet is unnecessary.

It may be a good idea to get checked for intolerance if you experience chronic digestive disorders that have gone undiagnosed, however. In a 2002 article in the peer-reviewed American Family Physician, Dr. David A. Nelson, Jr. of the University of Arkansas for Medical Sciences concluded, "Gluten-sensitive enteropathy commonly manifests as 'silent' celiac disease (i.e., minimal or no symptoms)." A blood test can determine if you have the antibodies that signify the disease is present. An intestinal biopsy verifies the presence of the problem. A gluten-flee diet promises relief.

Getting Out the Gluten

A gluten-free diet is demanding and typically requires much more time and energy in food preparation than one that contains more processed foods. Celiacs have no choice but to adhere to the regimen, but some are choosing this type of cuisine whether they suffer the agonizing pain of the disease or not. They claim higher energy levels and overall wellness. There is still carbohydrate intake for those eating gluten-flee foods. The primary sources of flour, for example, are potato, buckwheat, corn, rice and quinoa, all of which contain high amounts of carbs. These carbohydrates are balanced by a sufficient intake of flesh organic vegetables, particularly dense leafy greens.

According to Dr. Chaitan Kholsa of Stanford University, "After sugar, gluten is the second-most prevalent food substance in Western civilization." Having experienced the disease firsthand with his own son, Khosla has been studying pharmacological ways of treating the condition to allow people to consume the grains safely. "Our goals are to understand the biochemical basis of celiac sprue, and to translate these insights into pharmacological agents that could allow patients to safely reincorporate these otherwise nutritious and extremely common food grains into their diet," he says. While a medication may eventually prove effective, at present a gluten-flee diet is the only known treatment.

An easy way to find out if you might have an allergy or intolerance to gluten is to try a week without it. Once you start to reincorporate the food back into your diet you will be able to tell if your body is responding negatively. Obvious signs such as diarrhea, bloating and digestive discomfort are telltale symptoms of sensitivity.

A Wealth of Resources

There are many resources available to allow a beginner to whip up delicious meals without any gluten. In her book More From The Gluten-Free Gourmet (Henry Holt & Company), Bette Hagman, a celiac sufferer, pours herself into recipes for the wheat-deprived, including breads, pies, pastries, cakes, cookies and entrees. From almond orange biscotti to Italian herb sourdough, Bette makes the gluten-free experience a tasty feast, outshining the sense of loss that some feel when told they can never eat anything containing gluten again.

At www.glutenfreemall.com, there are hundreds of products ranging from brown rice pizza dough to Bette Hagman's own four-flour blend for multi-purpose baking. This site is directly linked to the information center celiac.com.

Whether you suffer from celiac disease or are simply intolerant to gluten, there are many ways to keep the dining experience exciting and healthful, If you think you might be suffering some sort of intolerance it is important that you notify your primary physician immediately. Long-term intolerance, undiagnosed, can cause serious health problems. CONTACT: The Celiac Disease Foundation, [phone], www.celiac.org; Columbia University Celiac Disease Center, [phone], www.celiacdiseasecenter.columbia.edu; Celiac Sprue Association, (877)CSA-4CSA, www.csa celiacs.org; The Gluten-Free Mall, www.glutenfreemall.com.

KIMBERLY JORDAN ALLEN is a freelance writer.