What is gluten?
Gluten is a group of proteins found in wheat, rye, barley and triticale (a cross between wheat and rye). The two main proteins that make up gluten are glutenin and gliadin. When flour and water are mixed together and kneaded, these proteins bind together and form elastic strands called gluten. Gluten provides the structure and texture in baked goods like breads, cookies and cakes. Without gluten, baked goods would be crumbly and flat.
For people with celiac disease or non-celiac gluten sensitivity, gluten triggers an abnormal immune response that attacks the small intestine. This causes damage to the villi, which are tiny finger-like projections that line the small intestine and absorb nutrients from food. When the villi get damaged, nutrients cannot be absorbed properly into the body.
What are some symptoms of gluten intolerance?
There is a wide range of symptoms associated with gluten intolerance. The most common symptoms include:
- Diarrhea, constipation, vomiting
- Abdominal pain and bloating
- Fatigue and weakness
- Unintended weight loss
- Pale, foul-smelling stool
- Iron-deficiency anemia
- Failure to thrive in children
- Joint pain
- Headaches and migraines
- Skin rash (dermatitis herpetiformis)
- Tingling or numbness in hands and feet
Symptoms can range from mild to severe. Some people may have no symptoms at all. The timing and severity of symptoms can vary greatly among different people. Even trace amounts of gluten can trigger symptoms in those who are highly sensitive.
What health problems are associated with gluten?
There are several health problems linked to gluten beyond immediate digestive distress:
- Malabsorption: Damage to the intestinal villi impairs nutrient absorption, leading to malnutrition.
- Anemia: Iron and folate malabsorption can cause anemia.
- Osteoporosis: Impaired calcium and vitamin D absorption increases bone loss.
- Infertility and miscarriage: Celiac disease can cause fertility issues and miscarriage risk.
- Neurological symptoms: There may be an association between celiac disease and neurologic conditions like dementia, epilepsy and migraines.
- Cancers: There is an increased risk of several cancers, including intestinal lymphoma and small bowel cancer.
- Other autoimmune disorders: Celiac disease is linked to other autoimmune conditions like thyroid disease, rheumatoid arthritis and type 1 diabetes.
The severity of associated health issues depends on the degree of gluten intolerance and intestinal damage. Strictly eliminating gluten helps manage symptoms and prevent complications.
What is celiac disease?
Celiac disease is an inherited autoimmune disorder that affects nearly 1% of the population worldwide. When people with celiac disease eat gluten, it triggers immune system activity and inflammation in the small intestine.
Over time, this damages the finger-like villi lining the small intestine. Villi are responsible for absorbing nutrients from food into the bloodstream. When they are damaged, the body cannot properly absorb nutrients into the body.
Celiac disease is a serious genetic disease that can lead to malnourishment and a wide array of symptoms throughout the body. It is not the same as gluten sensitivity or wheat allergy.
The only treatment for celiac disease is strict adherence to a 100% gluten-free diet for life. This allows the intestinal villi to heal and nutritional deficiencies to be corrected.
What is the difference between celiac disease and non-celiac gluten sensitivity?
Celiac disease and non-celiac gluten sensitivity share similar symptoms, but there are some key differences:
| Celiac Disease | Non-Celiac Gluten Sensitivity |
|---|---|
| Autoimmune disorder | Not an autoimmune disorder |
| Cause is known (gluten) | Cause is unknown |
| Intestinal damage occurs | No intestinal damage |
| Must be gluten-free for life | Gluten-free diet may help |
| Affects 1% of population | Up to 6% of population |
While both conditions improve on a gluten-free diet, those with celiac disease must adhere to a strict gluten-free diet for life to prevent further intestinal damage. Non-celiac gluten sensitivity involves symptoms improving when gluten is removed, but the mechanism is not well understood.
What foods contain gluten?
Gluten is mainly found in grains like wheat, barley and rye. Many common foods contain these gluten-containing grains:
- Bread, pasta, crackers, baked goods
- Beer
- Cereals
- Malt vinegar
- Soy sauce
- Salad dressings, sauces and soups
- Processed meat products like hot dogs
- Some candies and snacks
- Imitation meats
- French fries or roasted potatoes (may be cross contaminated)
Additionally, foods can become cross-contaminated with gluten if they come into contact with gluten-containing grains during processing and manufacturing.
What foods are gluten-free?
Many healthy and delicious foods are naturally gluten-free:
- Fruits and vegetables
- Fresh meats, fish and poultry
- Rice
- Quinoa
- Potatoes
- Beans, legumes
- Nuts and seeds
- Eggs
- Milk and dairy products
- Corn and corn products
- Gluten-free grains like millet, sorghum, teff
When grocery shopping, look for gluten-free labeled foods. Be aware of cross-contamination with gluten-containing foods during processing. Some grains like oats may be contaminated if processed in facilities with wheat.
What are some tips for following a gluten-free diet?
Following a strict lifelong gluten-free diet for medical reasons requires diligence and lifestyle adjustments. Here are some tips for living gluten-free:
- Eliminate obvious sources of gluten like bread, pasta, baked goods.
- Read food labels closely to identify hidden sources of gluten.
- Watch out for cross-contamination when eating out.
- Choose certified gluten-free labeled foods when available.
- Cook more meals at home using gluten-free ingredients.
- Find healthy gluten-free swaps like brown rice pasta, almond flour.
- Try naturally gluten-free whole foods like fruits, veggies, lean proteins.
- Request gluten-free menu options when dining out.
- Bring safe gluten-free snacks when traveling.
- Check medications and supplements for gluten fillers.
Following a gluten-free diet requires extra diligence, but becomes more comfortable over time as you learn how to find safe gluten-free options.
What are some myths about gluten?
There are many myths and misconceptions about gluten and gluten-free diets. Here are some common gluten myths:
Myth: A gluten-free diet is healthier for everyone.
Fact: A gluten-free diet is required for managing celiac disease and gluten sensitivity. For others, whole grains with gluten can fit into a healthy diet.
Myth: The gluten-free label means a food is healthy.
Fact: Gluten-free junk food is still junk food. Check if it’s high in sugar, salt and processed ingredients.
Myth: There’s no nutritional downside to going gluten-free.
Fact: Gluten-free versions of bread, pasta and cereals often lack whole grains, fiber, B vitamins and iron found in gluten-containing varieties.
Myth: Most people are sensitive to gluten.
Fact: Only about 1% of people have celiac disease. Up to 6% have non-celiac gluten sensitivity. Most can tolerate gluten.
Myth: Gluten doesn’t affect brain health.
Fact: There is some evidence linking celiac disease and gluten sensitivity to issues like anxiety, depression and foggy thinking.
Myth: Rice and corn are always gluten-free.
Fact: While rice and corn don’t naturally contain gluten, they could be cross-contaminated during processing. Opt for certified gluten-free.
It’s important to consult with a registered dietitian to get personalized advice rather than relying on myths when considering a gluten-free diet.
What are some gluten-free baking substitutions?
Baking delicious gluten-free treats requires substituting wheat flour with gluten-free flours and starches. Here are some common gluten-free baking substitutions:
| Instead of | Substitute |
|---|---|
| All-purpose flour | Gluten-free all-purpose flour blend |
| Whole wheat flour | Brown rice flour, Teff flour |
| Bread flour | Gluten-free bread flour blend |
| Cake flour | Gluten-free cake flour blend |
| Rolled oats | Certified gluten-free oats |
| Wheat germ | Quinoa flakes |
| Breadcrumbs | Gluten-free breadcrumbs or Panko |
| Pasta | Gluten-free pasta |
Gluten-free flours typically combine ingredients like brown rice flour, tapioca starch, potato starch and xanthan gum to mimic the properties of wheat flour. Using the appropriate blend helps achieve the right texture in gluten-free baked goods.
What are some gluten-free whole grains?
There are many nutritious and satisfying gluten-free whole grains to incorporate into a gluten-free diet:
- Brown Rice: Brown rice flour can be used to create gluten-free breads, cookies and muffins. Brown rice pasta is a popular wheat pasta alternative.
- Quinoa: Cooked quinoa can be used similarly to rice, and quinoa flakes can substitute for oats in baking.
- Buckwheat: Despite the name, buckwheat is gluten-free and has a tart, nutty flavor. Use buckwheat flour for pancakes or soba noodles.
- Millet: Cooked millet has a fluffy consistency similar to couscous. Millet flour works well in quick breads and cookies.
- Sorghum: Sorghum flour has a slightly sweet flavor profile. Use it in gluten-free baked goods or eat popped sorghum like popcorn.
- Teff: The tiny teff grain yields a dark, nutty flour perfect for injera flatbread or robust baked goods.
- Amaranth: Amaranth has an earthy flavor and pairs well with molasses, honey, chocolate and vanilla.
- Corn: Naturally gluten-free cornmeal and cornstarch are pantry staples with many uses in gluten-free cooking.
Pairing gluten-free whole grains with lean proteins, fruits, veggies, nuts and seeds provides balanced nutrition in a gluten-free diet.
What are America’s Test Kitchen’s top tips for gluten-free cooking?
America’s Test Kitchen has thoroughly tested recipes and techniques for delicious gluten-free cooking. Here are their top tips:
- Use a blend of gluten-free flours and starches like brown rice flour, potato starch and tapioca starch to replicate the binding qualities of gluten.
- Add a little more liquid to account for the absence of gluten. Gluten-free doughs are thicker than traditional doughs.
- Use extra leaveners like baking soda or baking powder to get lift and rise.
- Encourage binding by letting batter sit before baking to hydrate the flours.
- Prevent crumbling and dryness by including xanthan gum and eggs.
- Allow gluten-free baked goods to cool completely before slicing to set the crumb.
- Store gluten-free baked goods in the refrigerator or freezer, since they stale faster than traditional baked goods.
- Use a pizza stone and spritz of water when baking gluten-free pizza to crispen the crust.
- Substitute regular soy sauce with tamari to avoid wheat.
- Prevent sticking by preparing gluten-free doughs and batter in well-greased pans.
With care, creativity and techniques like these, you can achieve delicious gluten-free baking success in your own kitchen.
What are some kid-friendly tips for following a gluten-free diet?
Following a gluten-free diet can be especially challenging for children and teens. Here are kid-friendly tips for living gluten-free:
- Involve kids in meal planning and cooking so they feel invested.
- Make favorite gluten-containing foods with gluten-free swaps.
- Focus on naturally gluten-free whole foods like produce, lean protein, dairy.
- Look for gluten-free versions of popular snacks like chicken nuggets, mac and cheese, cereals.
- Pack safe gluten-free treats for school lunches and parties.
- Let kids read labels and identify gluten risks to educate them.
- Explain to friends and family that gluten exposure makes them sick.
- If kids feel deprived, give them safe gluten-free treats.
- Find gluten-free support groups for kids to connect with peers.
- Set a good example by having a positive attitude about gluten-free living.
With creativity and care, parents can raise healthy, happy gluten-free kids without feeling deprived. Focus on all the wonderful foods they can eat.
Conclusion
Following a lifelong gluten-free diet is challenging but manageable with knowledge and planning. For those with celiac disease or gluten sensitivity, strictly avoiding gluten is crucial for managing symptoms and preventing severe complications. Luckily, there are more gluten-free options available now than ever before. With care reading labels, stocking the kitchen, cooking at home and dining out, leading a full, nutritious gluten-free life is certainly possible. America’s Test Kitchen has devoted extensive effort toward creating foolproof recipes and tips for gluten-free success in the kitchen. With some adjustments to habits and techniques, you can still enjoy delicious bakery treats, pasta, pizza and more on a gluten-free diet.