Updated: Sep 5
There is a lot of enthusiasm about cutting gluten out of the diet with all kinds of claims about what it can and can’t do.
Some of it is factual and unfortunately A LOT of is well intentioned misinformation. Here we will review the facts as it pertains to gluten.
What is gluten?
This is a common protein found in wheat, rye, barley, and some oats. Many common foods such as pizza, pasta, bread, cereal, and crackers have gluten.
What is a gluten free diet?
This is a diet that eliminates all sources of gluten from the diet.
What is gluten sensitivity?
Gluten sensitive enteropathy and non typical sprue, more commonly referred to as Celiac disease was first described in 1888 by Samuel Gee.
The association between gluten consumption and these symptoms was recognized by a Dutch pediatrician.
The celiac lesion in the first portion of the small intestine was first described in 1954.
The classic symptoms of celiac disease include symptoms of malabsorption, weight loss, or other signs of nutrient or vitamin deficiency. There is symptom resolution upon eliminating gluten from the diet, usually within a few weeks to months.
It is a medical disease that has a diagnosis, and treatment. Tissue transglutaminase (tTG)-IgA antibody is the single preferred test for detection of celiac disease in adults.
The treatment is simple, a gluten free diet.
Should you cut gluten out of your diet?
If you have celiac disease you should be on a gluten-free diet.
Celiac disease is a condition that affects the body's ability to break down certain foods.
People with celiac disease get sick if they eat foods with gluten. They need to be on a strict gluten free diet for their whole life. This is the treatment for this disease.
However, more and more people without celiac disease are eating a gluten-free diet.
They might have heard that this diet can help them lose weight or feel better. While it is true that a gluten free diet can be healthy, it can also prevent you from getting all the nutrition you need.
Cutting gluten out of your diet without clear indication is a personal choice, but please ask your doctor if it's a good choice for you.
What about those with Autism Spectrum Disorder (ASD)?
Much has been said and many speculations have been made about cutting gluten out of the diet of children with ASD. Some based on fact, some based on “alternate facts.”
Let’s go over what data shows regarding this.
Based on no evidence, many families choose to follow a gluten free diet for their child with ASD.
It is important to know that if you are 100% gluten free you may not have adequate vitamin D, calcium and protein intake.
So why follow a gluten free diet for a child on the spectrum?
This is based on the hypothesis that increased gut permeability allows gluten and casein peptides to leak from the gut, causing excessive opioid activity and resulting in some of the problem behaviors seen in kids on the spectrum.
Anecdotally we have noticed a behavior difference in our son.
However, children with ASD have neither increased rates of celiac disease nor excessive amounts of opioid-like compounds in their urine when tested.
All studies that have evaluated a gluten free diet in children with ASD (but not celiac disease) have concluded that the evidence of benefit is at best limited and weak.
The American Academy of Pediatrics has autism guidelines, recommending parents avoid using gluten and casein
free diets as treatments. Such elimination diets do not improve autism symptoms.
So strictly going based on the level of evidence based on the studies available, a gluten free diet is NOT recommended for children with ASD unless there is evidence of celiac disease or true gluten sensitivity.
The American Academy of Pediatrics has autism guidelines, recommending parents avoid using gluten and casein free diets as treatments. Such elimination diets do not improve autism symptoms.
There is no proven benefit and may be associated with nutritional deficiencies that require close monitoring.
Still want to cut gluten out of your diet?
Here is how.
Educate yourself about which foods are fine to eat and which foods you should avoid. Make sure you plan your meals so that you get the nutrition you need. You will need to find gluten free substitutes for your favorite food and snacks.
Fortunately, this is pretty easy since there has been such a craze over gluten free foods. You will pay a premium for it at the register.
If you’re determined to go gluten free you may also want to start taking a gluten free multivitamin supplement.
Going gluten free is a personal choice and you will have to adapt to the new taste of foods that lack gluten.
Just remember, it is a choice you have the privilege of making. For those with celiac disease, a gluten free diet is not a choice, it is a treatment for medical condition. Be sensitive to the fact that they have to deal with the restrictive diet and the expense associated with it. For the rest of us, it is a choice based mostly on theory and not fact.
Please remember that medical information provided by us must be considered an educational service only. This blog should not be relied upon as medical judgement and does not replace your physician’s independent judgement. This is NOT medical advice. Please seek the advice of your physician.