{"id":10586,"date":"2025-04-22T09:00:16","date_gmt":"2025-04-22T15:00:16","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=10586"},"modified":"2025-04-29T06:38:18","modified_gmt":"2025-04-29T12:38:18","slug":"who-needs-to-be-gluten-free","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/who-needs-to-be-gluten-free\/","title":{"rendered":"Who needs to be gluten free?"},"content":{"rendered":"
<\/div>
\"People
People choose gluten-free diets for many reasons, but it’s important to talk with your doctor first, as significant changes in your diet can carry risks. Source: Getty Images.<\/figcaption><\/figure>\n

There they are on the store shelves. Mixes for gluten-free cakes, cookies, muffins \u2014 you name it. Restaurant menus mark items \u201cgluten-free\u201d with stars or happy faces. It\u2019s everywhere.<\/p>\n

When did we all go gluten free? Is it an epidemic?<\/p>\n

A lot of articles and a few books have created a trend, said Dr. Ann Klein<\/a>, a family physician and primary care doctor who works in the WISH clinic <\/a>(Women\u2019s Integrative Services in Health) at the UCHealth University of Colorado Hospital in Aurora.<\/p>\n

\u201cCertainly, this gluten-free craze has affected a lot of people,\u201d she said.<\/p>\n

To understand what\u2019s going on, she starts with the basics.<\/p>\n

Celiac disease vs. gluten intolerance<\/strong><\/h2>\n

\u201cGluten is a protein that\u2019s in not just wheat, but also barley and rye \u2013 it allows bread to rise and get that chewy consistency,\u201d Klein said.<\/p>\n

But bread isn\u2019t the staff of life for everyone.<\/p>\n

\u201cAbout 1% of the population has celiac disease<\/a>, where they are actually allergic to gluten,\u201d she said. \u201cIt\u2019s a pretty significant disease because it causes inflammation along the lining of the intestines, so people don\u2019t absorb important nutrients. That\u2019s when it becomes dangerous \u2013 causing bone loss, bleeding\/anemia and vitamin deficiencies. They can have significant symptoms \u2013 abdominal pain, diarrhea and weight loss, even blood in their stool.\u201d<\/p>\n

A second and less serious condition is called gluten intolerance<\/a>.<\/p>\n

\"headshot
Dr. Ann Klein, a family physician and primary care doctor who works in the WISH clinic (Women’s Integrative Services in Health) at the UCHealth University of Colorado Hospital in Aurora.<\/figcaption><\/figure>\n

\u201cThere\u2019s a blood test for celiac,\u201d she said. \u201cBut there\u2019s no test for intolerance. So, that\u2019s diagnosed based on symptoms. (Patients) can have the same symptoms (as with celiac disease), such as bloating, headaches, constipation, bone or joint pain. There\u2019s even talk of depression or other mental problems.\u201d<\/p>\n

Symptoms can vary quite a bit from patient to patient.<\/p>\n

\u201cAbdominal pain and bloating are almost ubiquitous,\u201d Klein said. \u201cBut some people have almost no symptoms at all, except maybe rashes or a stuffy nose.\u201d<\/p>\n

Nobody should go gluten-free without seeing a doctor and getting the blood test for celiac, Klein added. \u201cAnd don\u2019t quit eating wheat first and then get the blood test because then it won\u2019t do you any good as there can be false negatives.\u201d<\/p>\n

Other illnesses, such as Crohn\u2019s disease and ulcerative colitis, can also have those symptoms, so it is important to see a doctor to rule these out.<\/p>\n

\u201cThey are much more dangerous, so you don\u2019t want to miss that,\u201d she said. Irritable bowel syndrome is another less serious but no less painful syndrome with similar symptoms.<\/p>\n

If a person needs to go gluten free because of celiac disease, what food should they avoid?<\/strong><\/h2>\n

If a person has celiac disease, and indeed does need to go gluten free, what foods should they avoid?<\/p>\n

Besides wheat, barley and rye, many other foods contain hidden gluten. These include many processed foods and sauces\u2014even soy sauce. Soups and salad dressings have thickeners that might contain gluten, too.<\/p>\n

There are lots of other options, Klein said. Tapioca flour, rice flour and almond flour are popular substitutes. Potatoes, quinoa and rice can substitute for other starches in the daily diet, but \u201cof course, not all that is healthy for you, either.\u201d<\/p>\n

Here in Colorado, it\u2019s easy to eat gluten free, she said, because there are a lot of restaurants that offer gluten-free options. \u201cEven banquets offer gluten-free choices.\u201d<\/p>\n

No medication or treatment can lessen the negative effects of gluten for someone who has celiac disease or who is intolerant of it.<\/p>\n

\u201cGoing gluten free is the main option,\u201d she said. \u201cBut there is some thought that it is not really gluten intolerance, but that some people actually are intolerant of certain short-chain carbohydrates, of which gluten is one.<\/p>\n

\u201cIt\u2019s being studied. Some think it\u2019s actually the short-chain carbs that cause the problems.\u201d<\/p>\n

The low-FODMAP diet \u2013 which stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols \u2013 is being evaluated for some patients.<\/p>\n

\u201cIt eliminates those problematic carbs, and it has shown some effectiveness,\u201d Klein said. \u201cYou must avoid things like onions, garlic, apples, milk, ice cream, soft cheese and blackberries (but not other berries). It\u2019s a strange mix.\u201d<\/p>\n

Growing problem or gluten-free fad?<\/strong><\/h2>\n

Why, all of a sudden, do so many people say they need to be gluten-free? Is it a growing problem or just a fad?<\/p>\n

\u201cI think part of it is trendy,\u201d she said. \u201cThere\u2019s a lot of press out there, a lot of books on the subject.\u201d<\/p>\n

She also thinks, \u201cA lot of people have stomach problems, but I don\u2019t know if it\u2019s so much gluten as just a bad diet. Eating more whole, unprocessed foods may help. A lot of people don\u2019t get enough fiber. But gluten-free is also low-fiber. That\u2019s not healthy for you.\u201d<\/p>\n

If someone does decide to try a gluten-free diet, they \u00a0\u201cneed to add such things as flax seed, chia seed, leafy greens and fruits and vegetables.\u201d<\/p>\n

Is there a lot of self-diagnosis going on?<\/p>\n

\u201cYes,\u201d she said. \u201cThere\u2019s quite a bit.\u201d Besides self-diagnosis, she\u2019s heard of chiropractors, psychiatrists, even personal trainers, suggesting their patients go gluten-free.<\/p>\n

\u201cBut unless you are tested for celiac, there\u2019s no real evidence that it\u2019s the problem,\u201d Klein said.<\/p>\n

Who needs to be on a gluten-free diet?<\/strong><\/h2>\n

Still, people are going gluten-free on their own every day.<\/p>\n

\u201cIf they\u2019re not feeling well, having stomach upset, or diagnosed with irritable bowel syndrome, they\u2019d be better following the low-FODMAP diet,\u201d she said. \u201cThey might just feel better and have less bloating, diarrhea and abdominal pain.<\/p>\n

Some people do it to lose weight, \u201cwhich is a bad idea,\u201d she said. \u201cWhat they usually do is substitute one bad thing for another. They get a gluten-free muffin instead of a regular one \u2013 sometimes they have even more sugar, which is bad for you.\u201d<\/p>\n

Going gluten-free without checking with a physician or dietitian first can be risky, she said.<\/p>\n

\u201cIt can be dangerous if you don\u2019t do it the right way. If you eat mostly whole foods, veggies and fruits, lean protein and some starches, and if you don\u2019t overdo it with the gluten-free carbs and make sure you\u2019re getting enough fiber, then it\u2019s fine to do. It won\u2019t harm you. Just make sure you\u2019re getting all your nutrients.\u201d<\/p>\n

This type of gluten-free diet \u201cis kind of like what we all should do. We all should be eating those things, with only occasional treats like muffins or cookies or whatever. It\u2019s just not something you should be doing all the time.\u201d<\/p>\n

Anyone interested in the low-FODMAP diet can find it on the internet, she said.<\/p>\n

Monash University<\/a> in Australia has a lot of information on it, as does Stanford University<\/a>.<\/p>\n

\u201cBut I do recommend that if you\u2019re going to do the low-FODMAP diet, you also talk to your physician or a dietitian. You can lose a lot of nutrients with it. Don\u2019t do it without professional help.<\/p>\n

\u201cAnd if you just feel better on a gluten-free diet, go for it,\u201d she added. \u201cJust do it the right way.\u201d<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

There they are on the store shelves. Mixes for gluten-free cakes, cookies, muffins \u2014 you name it. Restaurant menus mark items \u201cgluten-free\u201d with stars or happy faces. It\u2019s everywhere. When did we all go gluten free? Is it an epidemic? A lot of articles and a few books have created a trend, said Dr. Ann […]<\/p>\n","protected":false},"author":18,"featured_media":82099,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[6],"tags":[276,9187],"class_list":["post-10586","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthy-living","tag-nutrition-services","tag-readysetco"],"acf":[],"yoast_head":"\nWho needs to be gluten free - UCHealth Today<\/title>\n<meta name=\"description\" content=\"If you have a condition that requires you to be gluten free, or if you just feel better on a gluten-free diet, then go for it. 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