Should Everyone Go Gluten Free?

Two Charlotte nutritional experts cut through the noise and outline the facts of celiac disease and gluten sensitivity

IT IS RARE to go through an entire day without hearing or seeing the words “gluten free” emblazoned across products in the grocery store aisles, blasted over the airwaves, or discussed on the latest television show. The deafening buzz surrounding the gluten-free-food trend and lifestyle leaves the general public saturated with information and with few resources for distilling facts from marketing hype.

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Gluten refers to proteins found in grains like wheat, barley, and rye. Grains derived from wheat include durum, emmer, spelt, farina, einkorn, and kamut.

Gluten is responsible for the elasticity factor in baked goods and acts as the “glue” that holds food together.

It is widely known that people with celiac disease, an autoimmune disorder that affects one percent of the American population, should avoid gluten.

When those with celiac disease ingest gluten, even in trace amounts, the body triggers an autoimmune response that mounts an attack against itself, specifically on the walls of the small intestine. The villi, finger-like projections protruding from the wall of the small intestine that promote nutrient absorption in a healthy individual, are flattened inside the intestinal walls of a person affected with celiac disease, creating a condition known as malabsorption.

Things get more complicated with people who are not diagnosed with celiac disease but have an adverse reaction to gluten. The nutritional community calls this condition non-celiac gluten sensitivity or gluten intolerance. Gluten intolerance affects six percent of the American population.

To cut through the noise and confusion surrounding the subject, we consulted two experts in the Charlotte nutritional community.

Carolyn Erickson
Carolyn Erickson is a gluten-intolerant mother to a daughter with celiac disease and a gluten-intolerant son, and wife to a gluten-intolerant husband. On her journey to discovering her family’s issues with gluten, Erickson stumbled upon a passion for food and became a “real-food advocate.” She is the co-leader of the Charlotte chapter of the Weston A. Price Foundation, a nonprofit nutrition education organization. She also teaches healthy cooking classes based on traditional foods. 

How did you develop this approach to wellness for you and your family? 
Throughout my whole life, I depended upon conventional medical wisdom, but once my daughter’s gastroenterologist sent her to a gluten-free nutritionist, who directed her to mostly processed gluten-free products, I decided to look elsewhere. I tried nonconventional testing and became my family’s advocate. When I added nutrient-dense, nourishing foods and removed the gluten, my family experienced fast, powerful reversals in their overall health. 

When you say “nutrient-dense, nourishing foods,” what do you mean?
I’ve learned about ancestral foods, which are the foods people ate before industrialization and the advent of packaged, highly processed foods. That includes humanely raised proteins (including the odd bits), wild-caught seafood, plenty of vegetables, whole fats, fermented foods, and nourishing broths. These are naturally gluten free, too, and don’t require reading a nutritional label. 

What are some of the most common misconceptions about going gluten free? 
I think people just think that gluten free is just a fad diet. I’ve had servers in restaurants who have told me, “It’s a made-up thing.” However, I have experienced the very serious medical repercussions of celiac [disease] through my daughter, and I can tell you it’s not a made-up thing. It’s hard to navigate sometimes, but we just try to educate people and stay patient when people are flippant about it. 

Also, society wants convenience, which is why we’ve seen an increase in processed food-like products that are also gluten free. I encourage people to be nutrient seekers rather than pursue a gluten-free diet only. It’s not quick and easy to prepare your own foods; it takes a shift in priorities, but it is life changing and enriching. 

What resources do you recommend for people wanting more information about gluten issues? 
I especially like the resources available at chriskresser.com. Chris Kresser is a functional and integrative medicine practitioner who focuses on identifying the underlying causes of health issues. For gluten-free cooking, my favorite books are Practical Paleo by Diane Sanfilippo, The Ancestral Table by Russ Crandall, and The Paleo Approach Cookbook by Sarah Ballantyne. Of course, I love the information on nutrient-dense traditional foods offered by the Weston A. Price Foundation (westonaprice.org), but the site is not specifically geared for those who need to maintain a strict gluten-free diet.

Michelle Ray
Michelle Ray, a registered dietitian with Novant Health Heart & Vascular Institute, discusses her approach to working with patients dealing with gluten issues. Ray receives referrals from physicians who send patients to Novant Health when they are in need of nutritional counsel.

What is your role when working with patients who have gluten disorders? 
I walk the patient through the ins and outs of a gluten-free diet. We go over which foods contain gluten and which do not, as well as talk about where gluten may be hidden. We also talk about reading labels. Working with a registered dietitian can help people with gluten issues reach their dietary goals. I help people see that they have choices instead of only focusing on what they can’t have. 

How do you diagnose a patient with celiac or gluten sensitivity?
I do not diagnose the patient. If celiac [disease] is suspected, I refer the patient back to his or her primary-care physician for further testing. Testing includes blood work and a biopsy of the intestinal wall to determine whether the small intestine has been affected. There is no clinical diagnosis for [nonceliac] gluten sensitivity, but I have worked with people who have done their research, kept a diligent food diary, and established accurate recall of how gluten affects them when ingested. For those patients, I might suggest going gluten free to see if it helps them.

What are some of the most common misconceptions about going gluten free? 
People think it is the latest and greatest way to lose weight, and going gluten free is not a weight-loss program. I want to stress that healthy weight management can include gluten if you do not have celiac or nonceliac gluten sensitivity.

What resources do you recommend for people wanting more information about gluten issues? 
I would be careful about Googling stuff but recommend the website for the Celiac Disease Foundation (celiac.org) and the Academy of Nutrition and Dietetics (eatright.org).