Body Talk
Perspective on Celiac Disease & Non-Celiac Gluten Intolerance
Gluten seems to find its way into all sorts of foods you wouldn’t suspect and pops up in conversations about food, diet, and nutrition with similar frequency. With so much discussion about avoiding or eliminating gluten, we thought it was time to check in with an expert on the subject. We connected with Dr. Alexa Weingarden, MD, PhD Gastroenterologist and Assistant Professor, Division of Gastroenterology, Hepatology, and Nutrition in the Department of Medicine at the University of Minnesota to get some perspective on the hot topic.
Exactly what is Gluten?
According to the Celiac Disease Foundation, gluten is “a general name for the proteins found in wheat, rye, barley, and triticale.” It naturally occurs in these foods but is also found in many processed foods. In food, gluten acts as a kind of “glue” that holds food together and gives it shape.
Celiac Disease? Gluten Intolerance? What’s the Difference?
This is where the rubber meets the road, and the facts are really important. The difference between celiac disease and non-celiac gluten intolerance can appear the same on the surface, with similar symptoms presenting in both. As Dr. Weingarden puts it, “Both groups of patients might feel better by avoiding gluten from wheat/barley/rye, but in celiac disease, we can detect inflammation in the intestines which leads to issues with malnutrition, bone density problems, liver and skin inflammation, and more.” Patients with celiac disease must be very strict about avoiding gluten, whereas patients with non-celiac gluten intolerance may be fine with small amounts of gluten in their diet. Unfortunately, for those intolerant patients, it’s difficult to know how much gluten causes problems. That said, they don’t experience the same long-term health effects as those with true celiac disease.
I’m Concerned That Gluten and I Might Not Be Friends Anymore. What Should I Do?
“Start with your primary care provider” was what Dr. Weingarden said without hesitation. You might know someone who’s self-diagnosed themselves in either of the categories we’ve mentioned. The problem with folks who cut gluten out of their diets without proper diagnosis is that they’re missing out on a considerable amount of fiber. Additionally, as the doctor mentioned, “fat or sugar is usually taking the place of gluten” in these modified diets. So, it’s good to start with your primary care provider, and they can get you the tests that might be needed and perhaps connect you with a gastroenterologist.
Are you already diagnosed with celiac disease? Do you know someone with celiac disease? Dr. Weingarden is leading a study to understand how patients’ immune systems interact with gut microbes and whether this could trigger the disease. If interested in participating, email celiac@umn.edu to learn more.