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Demystifying the gluten-free diet

For The Baltimore Sun

Nutritionists from the University of Maryland Medical System regularly contribute guest posts to The Baltimore Sun's Picture of Health blog. The latest post is from Stacy Pelekhaty.

The most frequently asked question I receive as a registered dietitian is, "What is gluten and why is it so bad for me?" So here I am to demystify gluten, and help you make healthy food choices.

What is gluten anyway?

Gluten is a protein found in grains, such as wheat, barley and rye. These grains have two proteins, gliadin and glutenin, and when beaten, kneaded or mixed they combine to form gluten. Gluten is stretchy and strong, and gives foods like bread and pasta their signature chewy texture. It also makes pancakes and muffins tough, that's why those recipes warn against over mixing.

Why is gluten so bad for us?

It might not be. When people with celiac disease, wheat allergies and non-celiac gluten sensitivity eat gluten they experience symptoms like rashes or hives, bloating, cramping and constipation or diarrhea. The only way to manage the symptoms is to avoid gluten, including foods that come into contact with gluten-containing foods through cross-contamination. An example of cross-contamination would be using a knife and cutting board to slice bread, then using that same knife and cutting board to chop vegetables. Those vegetables could now trigger symptoms in a sensitive person.

What if I don't have any of the conditions, is gluten still bad?

No.

If a food is labeled gluten-free, does that mean it's healthier?

Maybe, but probably not; it all depends on what the food is. Gluten-free cupcakes, pastries, breads, etc. are no healthier for you than their gluten-containing counterparts. Since gluten contributes to the texture of those products, you may find gluten-free options less satisfying, which can lead to overeating. Also, gluten-free baked goods tend to be more heavily processed, higher in refined carbohydrates and lower in vitamins, minerals and fiber. Many naturally gluten-free products like fruits, vegetables, lean meats, fatty fish, plain yogurt, nuts and beans are very healthy choices. Oats may or may not be gluten- free depending on how they're processed, but whether or not they're gluten-free doesn't impact their health benefits.

Should I try a gluten-free diet?

If you are concerned that you may have a wheat allergy, celiac disease or non-celiac gluten sensitivity, you should see your health care provider for a referral to a specialist to discuss your symptoms. Since the symptoms of these conditions resolve with a gluten-free diet, putting yourself on a restricted diet BEFORE you see a specialist can actually make it harder to get an accurate diagnosis. And I'm a firm believer that no one should follow a restricted diet unless necessary.

Can a gluten-free diet help me lose weight and eat healthier?

Maintaining a healthy weight and lifestyle can help prevent or minimize the symptoms of many chronic diseases. When it comes to the role gluten plays in this, I think there's a lot of confusion. Fruits, vegetables, nuts and beans, lean meats, fatty fish, oils like olive and canola, brown rice, and plain low-fat dairy are all foods that support a healthy weight and lifestyle, especially when you throw physical activity into the mix. When selecting less-processed versions of these foods, they all happen to be gluten-free. Whole-grain foods like oatmeal and whole wheat bread and pasta, which do contain gluten, are also part of a healthy diet and shouldn't be eliminated unless there's a medical reason. Whole grains are high in iron, fiber, and B vitamins (especially important for women who may become pregnant). My 4 basic rules for a healthy lifestyle don't mention gluten at all! They are:

1. Focus on eating mostly fruits and vegetables, with some lean protein, low-fat dairy and whole grains

2. Save sweets and fatty meats for special occasions

3. Eat the least processed versions of food that you can

4. Move your body at least 30 minutes a day.

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