I’m just back from a visit to the Gluten Free Allergen Free Expo, a traveling convention of “free-from” food and beverage marketers whose products cater to the growing ranks of people following restricted diets. I was there to teach a class called “Beyond Gluten/Dairy Free: Meet the Low FODMAP diet,” but naturally, I lingered afterwards to sample the gluten-free wares. And in between lecturing, schmoozing and noshing, I managed to make several observations I thought were worth sharing.
[Read: What is Gluten, Anyway? ]
— Good news: Gluten-free diets are getting back to normal. The most compelling moments I had at the show were overheard tidbits of conversation that signified people with celiac disease were having opportunities to feel “normal” again. There was the mom telling her young daughter “everything here is gluten-free — you can eat anything you want, and you don’t even have to ask whether it has gluten” (cue Tamara, reaching into her purse for a Kleenex); and, upon encountering a gluten-free version of Oreo cookies, the middle-aged lady excitedly telling her adult daughters, “Now I can make my famous Oreo cheesecake again!” As awareness of the gluten-free diet spreads — and with it, more gluten-free foods become available — people with celiac disease may be feeling less socially alienated and less disconnected from their previous selves due to their medically-necessary gluten restriction.
— Bad news: Gluten-free diets are getting back to normal. Once upon a time, being diagnosed with celiac disease necessitated the type of dietary changes that typically cleaned up the quality of one’s diet — like it or not. At home, cookies, snack cakes and pizzas disappeared from the pantry. When dining out, salads were typically the only “safe” thing to order at a restaurant. Not so anymore, though. At the show, I encountered very good gluten-free knockoffs of everything from Oreo cookies and Nilla Wafers to Girl Scout Thin Mints and Kit Kat bars. And the frozen food aisle is now home to a growing number of gluten-free chicken nuggets, fish sticks, pizzas and TV dinners. In other words, it is becoming temptingly easy to recast a junky, processed food diet into a gluten-free junky, processed food diet. As one attendee admitted to me after my talk: “It’s fun to sample all these foods, but most of them are just carbs and sugar — and honestly, I feel much better when I avoid all this stuff, gluten-free or not.” Amen!
— Good news: Whole grains are making their way into gluten-free foods. While the healthiest foods in life don’t come in a box or plastic wrapper, the reality is that we gluten-free eaters need to rely on some convenience foods unless we’ve got time to be baking gluten-free bread loaves from scratch every week. In that regard, I was pleased to note that there are increasingly more nutrient-dense options being offered in the next generation of gluten-free products. Historically, nutrient-poor, high-glycemic ingredients such as tapioca starch, potato starch, corn starch and rice flour predominated the ingredient lists of most gluten-free crackers, dough mixes, breads, cereals and pastas. But increasingly, more nutritious, higher-fiber whole grains (and pseudo grains, such as buckwheat, amaranth and quinoa) are making their way to the top of ingredient lists. Cases in point: Buckwheat flour topped the ingredient list of an amazingly rustic, crusty bread I sampled that was made from Luce’s Artisan Gluten Free Bold Buckwheat bread mix; amaranth, teff and sorghum predominate in the Smart Flour line of buns and pizzas; and Nature’s Path Qi’a cereal features a medley of chia seed, buckwheat and hemp to create among the highest fiber breakfast cereal options available to the gluten-free breakfast crowd. These pioneering products are demonstrating that there’s so much more potential for nutritional diversity in a gluten-free diet than that offered by the starchy reigning triumvirate of corn, rice and potato.
— Bad news: Too many gluten-free dieters don’t understand the nature of their troubled relationship with wheat. Many of the gluten-free dieters I spoke to at the show — not unlike many of the patients who show up at my office on a self-prescribed gluten-free diet — simply don’t know whether they have celiac disease, nor are they under the care of a qualified gastroenterologist who can help them navigate toward a reliable diagnosis. This is not good news, particularly because so many of them continue to suffer from digestive symptoms despite eliminating gluten from their diets.
[Read: Is a Gluten-Free Diet Smart for Weight Loss? ]
My talk at the expo dealt with a topic I’ve written about previously about: the likelihood that many people who feel better on a gluten-free diet may do so because of a “fructan” (carbohydrate) intolerance rather than a gluten (protein) intolerance. This distinction matters tremendously, as it has implications for how strictly one must abide by the wheat-free diet: Can you safely consume wheat-derived foods typically eaten in very small portions — like soy sauce? What about foods typically cross-contaminated with trace amounts of wheat, like conventional oats? Can you safely consume a gluten-containing grain like spelt that’s naturally low in fructans? Is “cheating” on the gluten-free diet for a special occasion safe and permissible? The answer to all these questions is different for someone with immune system responses to gluten (celiac disease or wheat allergy) compared to someone with a digestive sensitivity to certain carbohydrates found in wheat.
[Read: Are Gluten-Free Cosmetics Necessary? ]
There are a variety of ways that clinicians can help patients who are already on a gluten-free diet gain clarity into the nature of their wheat sensitivity; these range from blood tests that evaluate genetic likelihood of having celiac disease to monitoring blood antibody levels before and after an eight-week gluten challenge. (I increasingly like to use spelt foods for such challenges to provide further clues into the relative tolerability of gluten-containing grains in patients who may wind up not having celiac disease.) As for wheat-sensitive patients who are committed to a strict gluten-free diet for life under the presumption of celiac disease and do not wish to pursue further diagnostic testing, it still may be prudent to have a qualified dietitian review your diet to ensure it is indeed as strictly gluten-free as you believe it to be.
The author has no material affiliations with any of the companies whose products are mentioned in this article.
More from U.S. News
How to Make a Healthy, Tasty Sandwich
Tasty, Healthy Ways to Use Raw Cacao
Dispatches From the Frontier of Gluten-Free Living originally appeared on usnews.com
