The gluten-free diet, once only known to a group of gluten-sensitive people, has gained a lot of public attention recently. As of September, the gluten-free food market had recorded $8.8 billion in sales in 2014, says Mintel, a global market research firm.
Increased awareness of this diet has likely led to more gluten-free food items on menus and in grocery stores. Mintel predicts sales could reach over $14 billion in 2017.
With this recent spike in popularity, the US Food and Drug Administration (FDA) released new gluten-free labeling rules in early August 2014. The guidelines for packaged food labeling are meant to help shoppers identify which foods are safe to eat on a gluten-free diet.
But before you march down to the local supermarket and fill your cart with gluten-free goodies, take some time to learn about gluten and the gluten-free diet.
Which Foods Have Gluten?
Gluten is a protein that is difficult for some people to digest. It is found in grains like wheat, barley and rye, but it is added to many other foods to improve taste and texture. It can be found in cookies, French fries, salad dressings and soups — to name a few. Food additives like malt flavoring and modified food starch are also gluten products.
Foods that are naturally free of gluten include eggs, seeds, beans, unprocessed nuts, fresh meat, poultry, fish, fruits, vegetables and most dairy products.
Now, foods must meet certain requirements in order to be labeled gluten-free. They must be naturally free of gluten, or any presence of gluten in a product must be less than 20 parts per million — or 0.002 percent. The FDA deemed this the maximum level celiac disease patients could safely consume.
The labeling of packaged foods is voluntary, though — not required. There is no universal image or phrase to indicate a product is gluten-free, but the recent FDA rules require any product that does make that claim to adhere to FDA guidelines for gluten levels.
Who Needs a Gluten-Free Diet?
The most common purpose of a gluten-free diet is to treat celiac disease. Celiac disease, which affects about 3 million Americans, can develop at any age. Patients cannot process gluten, which results in intestinal damage. Over time, the digestive tract can become so impaired that nutrients are poorly absorbed and discomfort ensues. This can lead to more severe conditions like malnutrition, infertility, cancer and bone loss.
Symptoms of this disorder vary for children and adults. Many children experience bloating, diarrhea, constipation, vomiting and weight loss. Adults are less likely to show these symptoms. They may instead have fatigue, depression, anxiety, joint pain and migraines.
Celiac disease cannot be simply diagnosed through a blood or saliva test. An endoscopy, which uses a tube and light to examine the digestive tract, can give a better diagnosis.
A gluten-free diet may also treat gluten sensitivity, a lesser-known condition. This condition is less severe than celiac disease, but a gluten-sensitive person may feel similar symptoms like bloating, headaches and fatigue.
Deborah Gordon, MD, a nutrition expert and operator of an integrative medical practice based in Ashland, Oregon, told dailyRx News that not all gluten sensitivities cause these celiac-like symptoms.
"Just as we have learned that all heart attacks don't feel like an elephant on the chest, we know that all gluten sensitivity doesn't lead to the classic symptoms of celiac disease," Dr. Gordon said. "I have seen improvement in symptoms as seemingly disparate as sinusitis and chronic fatigue respond well to avoidance."
Dr. Gordon explained that responses to gluten may differ from person to person, depending on their condition. "Most people find, once they are 90 percent gluten-free, that 90 percent is sufficient. An occasional gluten ingestion causes no problems," she said. "On the other hand, those who are truly celiac often find that some gluten-free products that meet FDA labeling requirements still contain sufficient gluten to cause gastrointestinal distress."
Is the Diet Beneficial for Everyone?
Mintel surveyed 2,000 Internet users over the age of 18 and found that, of those who ate gluten-free foods, 82 percent were not diagnosed with celiac disease.
Some people choose gluten-free foods because they believe they are more natural and healthier overall. Others may think these foods can help them lose weight. With a wider selection of gluten-free groceries today, gluten-free does not necessarily mean fewer calories, though.
Cutting out certain grains and foods may result in nutrient deficiencies as well. Many packaged foods that contain gluten or wheat products are enriched with B vitamins, iron, calcium and magnesium. People who are going gluten-free should make sure they get these nutrients from other sources.
Before committing to any specific diet, talk to a registered dietitian. These professionals can determine the best, safest diet for you.
What Is It Like to Eat Gluten-Free?
For some people, the thought of eating a gluten-free diet seems like a difficult task. However, there are plenty of foods without gluten and substitutes for foods that normally contain gluten.
"What at first seems daunting — 'I can't live without my cheese sandwiches!' — becomes effortless if one's chronic symptoms are relieved," said Dr. Gordon.
Examples of foods that are naturally gluten-free include unprocessed beans, seeds and nuts, fresh eggs, fresh meats, fish and poultry, fruits and vegetables, and most dairy products. Certain grains and starches — such as corn, flax, rice and quinoa — may also be included in a gluten-free diet.
"Although some folks choose gluten-free substitutes, many seem to just drift away from grains in their diet," Dr. Gordon said. "Ham and cheese on a mixed salad are actually more nutritious than ham and cheese on two slabs of bread. The vitamins added to grains (on their own, they are very low in nutrients) are easily replaced if one eats meat, cheese and eggs. The fiber of whole grains is replaced with greater diversity by a generous array of vegetables on your plate."
How Much Does It Cost?
Wheat is a major staple of the American diet — and it's cheap. Removing wheat from grocery lists may be easier now with the variety of gluten-free items, but it comes with a cost.
Consumers will find that many packaged gluten-free food items are more than double the cost of regular foods — 242 percent more expensive on average, reports a 2013 article in Time magazine.
A tax deduction is available, however, for shoppers who have an official diagnosis from their doctor. Celiac disease patients can save their grocery receipts each year, list the costs of gluten-free purchases and compare them to the costs of regular food items. They can then find the differences between those prices and file a claim with the IRS.