To Be or Not To Be Gluten-Free?

The Goods on Gluten

Gluten is part of a protein found in three grains -- wheat, rye and barley -- which lends elasticity and chew to products like bread and pizza dough. In healthy individuals, these foods pose no problem. But in those with wheat sensitivities or allergies, gluten damages parts of the small intestine called villi, finger-like projections lining the gut that absorb nutrients. "Imagine your gut is lined with a shag rug," Bazilian suggests. "Those are the villi. Over time, Celiac disease flattens the rug, making it smooth like linoleum, so they can't hang on to nutrients."

Unfortunately, wheat is such a prominent part of the American diet that it can be extremely difficult to eradicate. Besides obvious culprits, like wheat bread, gluten hides out in soy sauce, malt vinegar, couscous, beer and wine, licorice, certain broths and energy bars, even communion wafers. Cousins of wheat, including spelt, kamut, farrow, durum, semolina and triticale, will also trigger allergies. Oats don't contain gluten but may be contaminated during processing.

If you're gluten intolerant, you'll know it, experiencing nasty GI symptoms almost immediately after ingesting wheat, barley or rye. Celiac disease, on the other hand, may or may not result in bloating, gassiness, constipation or diarrhea. Instead, you may be irritable or depressed, or experience joint pain, a skin rash, anemia, mouth sores or weight loss. A gastroenterologist or internist can diagnose gluten allergies through an intestinal biopsy and blood work. The next step is to meet with a dietitian who can help you chart out a meal plan.