Dr. Olga NAHAS: The Myths behind gluten-free diets

The gluten free trend keeps growing. But is it all just a hype? Does gluten sensitivity really exist? Dr. Olga NAHAS, an allergist and clinical immunologist at Mount Lebanon Hospital helps us unravel the facts from fiction.   How can we distinguish between allergy and intolerance?   Food allergy is a reaction caused by the immune system’s response to a specific food causing a range of symptoms. It implies specific IgE antibodies to protein allergens found in this food, resulting in the release of histamine and other chemicals in the body, which subsequently cause a systemic reaction. The symptoms usually appear immediately within minutes to one hour after food ingestion.  In some cases, an allergic reaction to a food can be severe or life threatening. Tests called skin prick tests or specific IgE blood test can confirm this type of allergy, when they correlate with clinical symptoms. In contrast, food intolerance reactions do not involve IgE antibodies or the immune system. Food intolerance symptoms are generally less serious and are often limited to digestive problems. If you have food intolerance, you may still be able to eat small amounts of the upsetting food without adverse reaction. Food intolerance is usually proportional to food quantity while in cases of allergy the systemic reaction will occur independently of the quantity ingested.   Is food intolerance something you are born with? Or can it be developed later in life?   In most cases, food intolerance is acquired. It can develop with age, for instance after a food poisoning or an irritable bowel syndrome case.   What is the difference between Celiac Disease, Gluten intolerance and Wheat allergy?   These days, a gluten-free lifestyle has become one of the most popular diet trends around the world. While avoiding gluten is crucial for people with celiac disease, it is as important for people to be tested by a specialist before attempting to cut out any nutrients. Diagnosis of celiac disease includes blood screening and small intestine biopsy. Non-celiac gluten sensitivity is a differential diagnosis retained after ruling out celiac disease, and wheat allergy associated with same symptoms. Diagnosis of wheat allergy, is generally done through a skin prick test or specific IgE assays.   Celiac disease is a genetic autoimmune disorder that occurs in reaction to the ingestion of gluten in genetically susceptible individuals. The reaction to gluten causes villous atrophy or flattening of the cells lining the small intestine, which can lead to malabsorption of nutrients with wide-reaching symptoms. Gluten intolerance (Non-celiac gluten sensitivity) causes the body to react gastro intestinally. This gastro-intestinal response is quite different from the immunological response that occurs in those who have celiac disease. As with most allergies, a wheat allergy include a specific immune response to a food protein considered dangerous to the body when it actually is not.   Why is it that people just started to seek help for gluten intolerance?   Gluten intolerance is not well defined. There are no tests or biomarkers to identify; it is rather a physical condition in your intestines. Reactions can begin up to 48 hours after ingesting gluten and last for much longer. Logically upon removing gluten from the diet, your gut will heal and the symptoms will disappear. Depending on the level and degree of the intolerance it may be possible to re-introduce gluten into the diet.   Can you trust gluten-free products available in the super market?   People can definitely trust gluten-free products available in supermarkets and the gluten free sections available in big bakeries but these products are usually more expensive than regular products. The reason gluten-free products are this expensive is due to the strict packaging and production cost and because it has acquired a luxury states due to today’s trend. As alternative to these products, people can choose to make their own flour mixtures, eat fresh whole foods and make other gluten free grains (like Quinoa) their main source of energy.        Leave a reply