Top Ten Myths About a Gluten-Free Diet

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Lately I’ve been bombarded by people telling me I just have to read some new blog post or online article that I look up only to discover that it’s perpetuating one of these top ten myths about a gluten-free diet! Not only are such posts less than accurate, they often take on a tone of hostility and condescension.

I’ve also run across a few people of late who claim to have begun to eat gluten-free because the food is healthier, but in the midst of the conversation inadvertently reveal that they do not understand what gluten-free means. Perhaps similar conversations are the reason for the tone of hostility I’ve noticed in the other articles.

With all of the finger pointing and misinformation flying around, it seems like a good time to address the top gluten-free myths inundating the internet.

Myth #1
You are not sensitive to gluten unless you have been diagnosed with celiac disease.
According to the University of Chicago Celiac Disease Center, based on a prevalence study published in 2014, 83% of the 3,000,000 people with celiac disease in the US remain undiagnosed. That means there are about 2,490,000 gluten sensitive people in the US who are not identified as celiac that will, without question, benefit from a gluten-free diet.

Under current medical protocol, celiac disease is only diagnosable as end stage disease. In other words, a person with celiac disease has an autoimmune response to gluten that over time damages the villi in the small intestine to the degree that the damage can be detected by a biopsy and a blood test that shows positive celiac disease serology. Without both of these, a patient will not meet the gold standard for diagnosis of celiac disease in the US.

Because the damage happens over time, or may manifest in the skin as dermatitis herpetiformis with or without the characteristic intestinal damage, gluten may be causing symptoms and damage in a patient prior to the patient meeting the criteria for celiac diagnosis. Beginning a gluten-free diet can reverse the process and prevent the development of diagnosable celiac disease.

Beginning the diet sooner also removes the added risk of the gluten sensitive patient developing celiac related cancer, malignant lymphomas, small-bowel neoplasia, oropharyngeal tumors, renal disease, neuropathy, osteoporosis, and unexplained infertility.

Myth #2
A gluten-free diet is difficult to follow.
This myth is often perpetuated within the medical community. Doctors, nurses, and nutritionists frequently state this as fact in research articles. If a medical professional tells you it will be difficult to follow this eating regimen, why would you think it would be easy?

While it is true that eating lots of prepackaged, processed, and restaurant food will require additional effort to research, read labels, communicate with chefs, and find acceptable choices, the process is not difficult or overly cumbersome once you get the hang of it. It just sounds that way on the surface.

Cooking gluten-free food is no more difficult than cooking regular food. Gluten-free baking presents more challenges. With the right ingredients and a great recipe, these are surmountable. If you love baking, you’ll find the learning process fun. If you hate baking, the choices of available gluten-free baked goods for purchase grows larger all the time and many options are available on the internet.

Myth #3
No gluten-free food tastes as good as gluten-containing food.
If you love homemade ice cream, potato salad, coleslaw, barbecue ribs, grilled steak, baked pork tenderloin, chicken & rice, fried catfish, chili, baked potatoes, sautéd zucchini and summer squash, french fries, baked sweet potatoes, fresh green beans with new potatoes, black-eyed peas, turnip greens, corn-on-the-cob, pickles, carrot & raisin salad, cornbread, and fudge you already love a bunch of foods that are typically gluten-free. In fact, you can make any of these items just like my grandmother made them and they are automatically gluten-free.*

Perhaps this myth is usually stated with substitute foods in mind like gluten-free vs not gluten-free cake, pie, pancakes, bread, pizza, pasta, etc. This is understandable if you are in the habit of buying packaged food. There are many terrible packaged products on the market. It is extremely frustrating to pay a premium for something that tastes so bad you end up throwing it away. Of course, like anything, there are also good products available.

If you cook the food yourself using recipes that are not only created gluten-free, but rigorously tested for both taste and texture, you’ll be amazed at the quality of the “substitute” foods. At Cooking2Thrive, our standard is that the recipes we create will be tested at least 3 times and result in a product that is approved by tasters with a discerning palette who are NOT gluten-free.

Myth #4
Only foods labeled gluten-free are allowed on a gluten-free diet.
Fresh fruit, vegetables, beans, herbs, spices, nuts, seeds, meat, seafood, poultry, milk, honey, sugar, corn, rice, buckwheat, tapioca, quinoa and distilled alcohol are all naturally gluten-free and remain so unless something containing gluten is added to them.

In addition, many packaged, processed foods that include no ingredients containing gluten are acceptable for gluten sensitive people. If those products are made on equipment that also processes wheat, rye, or barley, they should probably be avoided. If they are made in a facility that processes wheat, rye, or barley (but not on the same equipment), they come with some risk, but may be well tolerated on a gluten-free diet.

Myth #5
You can’t be gluten-free and eat out in restaurants.
While eating food prepared in a kitchen other than your own inherently brings some risk, most people with celiac disease have good success finding gluten-free options in locally owned restaurants where they can easily communicate with the chef and the staff.

Depending on your level of sensitivity, you may also be fine eating at a fast food or chain restaurant. Many offer a gluten-free menu upon request, identify gluten-free choices on the regular menu, or list nutritional information on their website. If you use lemon slices rather than salad dressing and make sure to order without croutons, restaurant salads are often gluten-free even in the most remote, rural locations.

I hate feeling bad and never want to unintentionally eat gluten. I also hate feeling isolated and I love an adventure. I’ll go to any restaurant at least once. If I feel really uncomfortable with every single choice once I get there, I will drink something, enjoy the conversation, and eat later. If I know the restaurant choice in advance, I’ll see if there’s a menu posted online. If I don’t feel comfortable with the menu, I can eat a snack before we go so I won’t get too hungry if the options listed prove to be the only ones offered.

Even traveling from one end of I-40 to the other this year, I can’t think of a single time I had difficulty finding an acceptable choice in a restaurant.

Myth #6
A gluten-free diet is inherently healthy.
I really don’t know where this idea comes from. If the idea is that a gluten-free diet means you don’t eat any bread, cake, pasta, cookies, muffins, and pie, then I guess it could be considered healthier than the average diet. If you choose to bake your own cake, pie, muffins, and cookies and thereby eliminate some chemicals and gums from your diet, I suppose that’s healthier. If you choose to get in the kitchen and cook more fresh food, it definitely can be healthy, but I don’t think that’s the usual reference.

In fact, this misconception sometimes amuses me. I took some cookies to a party a few months ago. I listed all the ingredients on a card and identified them as gluten-free. Lots of people ate them. As they stuck their hand in the bucket to grab a cookie, I kept hearing people say they were choosing them because they were healthy. These delicious cookies are full of butter and sugar and while they may be healthier than a prepackaged cookie, they are by no means healthy. They are a dessert designed to be consumed rarely and in small quantities.

While the specifics vary, most gluten-free flours are more dense than wheat flour so when you eat the typical gluten-free bagel, brownie, muffin, or slice of bread, you ingest more calories and carbs per serving than in the equivalent sized wheat flour version. It is not uncommon for packaged foods to rely on additional sugar to enhance the flavor and counteract the bitterness of some GF flours. Of course, this sugar adds even more carbs.

The bottom line is that, like any diet, a gluten-free regimen will be as healthy as the choices you make. It is not inherently anything other than gluten-free which is healthier for some people.

Myth #7
You will lose weight on a gluten-free diet.
While some people may lose weight initially because they eliminate junk or fast food from their diet, often the opposite is true.

Once a person with celiac disease becomes too sick to absorb nutrition, they can begin to lose weight and waste away. Adherence to a gluten-free diet will reverse this process and weight gain often occurs. For a person who is unaffected by gluten, substituting the higher calorie counts of gluten-free breads, crackers, muffins, pancakes, cakes, and crusts can contribute to weight gain rather than weight loss.

Myth #8
Eliminating gluten from your diet will deprive you of essential nutrients and fiber.
Most people think of eliminating bread when they think of eliminating gluten and most of us were taught by the old food pyramid that carbohydrates like bread are the basis for a healthy diet. That representation grossly overrepresented the importance of grain based carbohydrates to a healthy diet and left many people with the idea that giving up bread is tantamount to starving yourself of nutrition.

On its own the processed wheat flour used for commercially produced bread does not contain many nutrients, but in the US, by law, wheat flour must be enriched with folic acid, riboflavin, niacin, thiamine, and iron. You can also get these nutrients from other foods. Folate is found in many foods including: spinach, collard greens, turnip greens, mustard greens, romaine lettuce, asparagus, broccoli, citrus fruits, beans, peas, and lentils. Riboflavin is available from foods including: mushrooms, spinach, and pork. Sources of niacin include: tuna, salmon, halibut, chicken, turkey, pork, and peanuts. Thiamine is available from: tuna, trout, salmon, walleye, mussels, pork loin, beans, peas, lentils, peanuts, eggs, sunflower seeds, and wild rice. Iron can be found in: spinach, Swiss chard, cumin, parsley, turmeric, greens, asparagus, romaine lettuce, soybeans, lentils, seeds, beans, peas, brussels sprouts, beets, kale, broccoli, cabbage, and liver.

Whole grain bread is not the only, or even the best, source of fiber. Two slices of whole wheat bread contain 3.8 grams of fiber. In comparison, black beans contain 15 grams of fiber per cup, lentils have 15.6 grams per cup, an avocado has about 10 grams, edamame has about 9 grams per half cup, frozen peas have 8.8 grams per cup, a pear has about 5.5 grams, and brown rice has 3.5 grams per cup.

Myth #9
If you don’t immediately feel better after beginning a gluten-free diet, you should go back to a regular diet.
While some people may see a reduction in symptoms immediately, it can take weeks, months, or years in the case of dermatitis herpetiformis for a gluten sensitive person’s body to fully heal from the autoimmune attack unleashed by exposure to gluten. According to the University of Chicago Celiac Disease Center, in the US in 2014 the average length of diagnosis for a symptomatic patient was 4 years. That’s 4 years from the time the patient seeks help. The disease process may have started years before that.

It is unrealistic to believe that the damage accumulated across 4 years or more would dissipate in a matter of days. If you’ve ever broken anything, sprained anything, or had surgery, you know that the healing process takes time. It often is a series of forward progress followed by a return of symptoms followed by more forward progress. Many experts estimate that it takes about a year to heal the damage done by a single ingestion of gluten.

While your doctor may not suggest it, a full year of strict adherence to a gluten-free regimen will give you a more realistic idea whether the diet will be beneficial. There’s nothing inherently dangerous in eating gluten-free, so you can eat healthily on the regimen as long as you make balanced choices.

Myth #10
What we know about gluten’s effects right now is absolutely all there is to know and therefore irrefutable truth.
As with all scientific exploration, what we know about gluten’s effects on humans right now is the knowledge that we’ve gathered up to this moment. It is not the be all end all of knowledge in this area.

In fact, we’re early in this area of study. As new scientific studies are conducted and new facts emerge, some of the information may appear to conflict with what we already know. Gradually, the overall picture will become more clear. Eventually, this can lead to a change in medical protocol. This is how the process normally works.

Hopefully, recognizing that none of us currently have the facts that we will have ten years from now can serve to soften the rhetoric of condemnation generated from both sides of the gluten sensitivity issue.

There is no reason to condemn someone who has not been diagnosed celiac for following a gluten-free diet if it makes them feel better because there is a chance that they fall into the 83% of undiagnosed celiacs who will benefit from the diet.

Those who adopt the diet just because they believe it’s inherently healthier will benefit from being more mindful of their food choices and learning about nutrition. This is a step in the right direction, even if it’s sometimes misguided, that can afford the knowledgable friend an opportunity to share additional facts and resources.

However you view a gluten-free diet, it is my wish that we all dial down the finger pointing and condescension and focus on being respectful, kind, well informed, open to new ideas, and interested in new facts as they are revealed through scientific research. That sounds like a great learning environment to me and I love to learn!

*In this GF list, the cornmeal breading for the catfish does not have added flour nor does the cornbread. The potato salad was made using Miracle Whip, and the coleslaw is vinegar based.

References:
http://www.worldgastroenterology.org/assets/downloads/en/pdf/guidelines/04_celiac_disease.pdf

http://www.ncbi.nlm.nih.gov/pubmed/21813475

http://www.cureceliacdisease.org/wp-content/uploads/2011/09/0410CeliacCtr_News.pdf

http://www.cureceliacdisease.org/wp-content/uploads/2014/06/CeliacDiseaseFactsAndFigures0614.pdf

http://www.supermarketguru.com/articles/top-5-reasons-not-to-go-gluten-free.html

http://gi.org/guideline/diagnosis-and-management-of-celiac-disease/

http://www.eatright.org/resource/food/nutrition/vegetarian-and-special-diets/does-my-child-need-a-gluten-free-diet

http://health.clevelandclinic.org/2014/04/the-surprising-truth-about-gluten-free-food-and-weight-loss/

https://www.law.cornell.edu/cfr/text/21/137.165

http://www.globalhealingcenter.com/natural-health/folic-acid-foods/

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