Question: I have noticed that some food packages are labeled "gluten-free." What exactly is gluten, and why is it on the label?
Answer: Gluten is a protein found in wheat, rye, and barley. Most people have no problems eating gluten. However, gluten should be avoided by people who have an autoimmune condition known as celiac disease. In celiac disease, gluten prompts the body to produce antibodies that attack the small intestine. Injury to the intestine causes symptoms such as abdominal pain or discomfort. The injury keeps the intestine from working properly often leading to poor absorption of nutrients. People who have celiac disease may then have weak bones from not absorbing enough calcium. They may also have difficulty absorbing enough iron resulting in anemia or a low number of red blood cells which are needed to carry oxygen in the body. Children with celiac disease may have difficulty gaining weight and growing well. People with celiac disease may have problems with constipation or with diarrhea. Celiac disease that is untreated also increases the risk of certain types of cancer.
About one in 130 people have celiac disease. Celiac disease often runs in families. If a person is diagnosed with celiac disease, his immediate family members such as his parents and siblings should be screened as well. Screening is done with a blood test. If the blood test is abnormal, then the diagnosis of celiac disease is confirmed by upper gastrointestinal endoscopy which is also known as an esophagogastroduodenoscopy (EGD). During this procedure, biopsies or small tissue samples of the intestine are obtained to look for the telltale signs of celiac disease. Certain conditions are associated with a higher risk of celiac disease including Type I diabetes, Turner's syndrome, and Down's syndrome. People with these conditions should also be screened for celiac disease.
The treatment for celiac disease is a gluten-free diet. Anyone with celiac disease should avoid wheat, rye, and barley. Oats should also be avoided because they are usually processed on equipment that is contaminated by gluten containing grains. Reading food labels is essential for anyone who has celiac disease. The FDA is currently working on stricter guidelines regarding when the label "gluten-free" can be applied. These guidelines should be available in 2008.
People with celiac disease also need to be vigilant at restaurants or social gatherings where it may be difficult to determine the ingredients the food that is served. Many people who have celiac disease report that the loss of the spontaneity of eating at any restaurant or going to a party without having to ensure that there are gluten-free items is one of the most difficult aspects of living with the disorder. Some restaurants offer gluten-free menus which is a welcome option for those with celiac disease.