The Scientist: Lisa Cimperman, MS, RDN, LD, a clinical dietician at University Hospitals of Cleveland Case Medical Center
The Answer: “Gluten intolerance” is a phrase typically considered to be synonymous with celiac disease. Celiac is an autoimmune disease that results in significant damage in the cells lining the gastrointestinal (GI) tract when you eat gluten. Your digestive system simply cannot tolerate gluten. If you think you may have celiac — symptoms include abdominal pain, bloating, gas, diarrhea, anemia (low iron levels), missed periods, muscle cramps or joint pain — go see your doctor. There’s a simple blood test they can do, and treatment is simple: follow a gluten-free diet. If you think you need to be tested, wait to cut out gluten until you do — otherwise you could get a false negative.
The idea of “gluten sensitivity” has become trendy in the past few years, because there are some people who do feel better when they cut gluten out of their diets. This “non-celiac gluten sensitivity” can manifest itself as discomfort (abdominal pain, cramping, bloating), but the symptoms are not nearly as extreme as celiac. And eating gluten will not have severely damage your GI cells. But there is no test to find out if you have this. In fact, it may not even exist.
A study published a few years back concluded that people reporting non-celiac gluten sensitivity outnumbered those with celiac, and that the numbers may be increasing. But a followup study found that these self-proclaimed gluten-sensitive people saw improvement in symptoms when they eliminated FODMAPs (an acronym for a group of highly fermentable carbohydrates), and not gluten. FODMAPs can be found in any food that contains carbohydrates, from grains, to vegetables, and even dairy.
READ MORE: The Worst Gluten Outrage of 2014
The only way to really know if you are sensitive to gluten (or FODMAPs, or any food, really) is to try an elimination diet. If this is something you’re serious about, you should have doctor or dietician help you through the process to make sure you’re still getting the right nutrients. You’ll need to cut out mostly everything, and slowly reintroduce one food at a time. This way you can nail down exactly what foods are causing your discomfort, and the exact threshold of how much you’re able to consume before it starts to bother you. You may end up finding it’s not the gluten at all, but some other food that’s causing your stomach problems.
Bottom line: If you feel better eliminating gluten from your diet, that’s fine. Gluten is not essential to survive, but it’s also not really detrimental to your body unless you have celiac. At the end of the day, you should be eating what makes you feel good and keeps your body functioning correctly, not foods that make you uncomfortable every time you eat them. Just make sure you’re getting the nutrients you need whenever you cut one food completely out of your diet.
Also! Gluten-free cookies are still cookies. Don’t let the health halo of a gluten-free label cloud your judgment — if you feel fine eating a regular gluten-filled cookie, there’s no good reason to switch to one without it.
READ MORE: 3 Gluten-Free Chocolate Desserts (Recipes)