I only eat gluten-free foods, Oh, I can’t eat that. It has gluten, Gluten is so bad for you. These are some of the comments I have heard repeatedly from patients and friends in the last couple of years.
Gluten free pizzas, breads, pastas, soups, baked goods and alcohol have recently popped up in all grocery stores and restaurants. This is great for people who actually need to avoid gluten; however, what does this mean for people who don’t need to eliminate gluten for their health?
What exactly is gluten?
It is a protein that makes up a portion of most grains. You can find it in these four grains: wheat, rye oats and barley. These grains are found in most breads, baked goods, soups, pastas, salad dressings, cereals, food colorings, beer and even some medications.
Why the big craze on avoiding gluten all of a sudden?
In the past few years, eliminating gluten from the diet has become very popular for various reasons. Some people avoid it because they think it’s healthier, they think it will cause weight loss, for general health, they have a gluten sensitivity, or because they actually have celiac disease.
Many weight-loss patients, who have had Roux en Y gastric bypass surgery or other bariatric procedures, like gastric sleeve lap band and other surgeries performed by bariatric doctors in Dallas, Texas develop gluten intolerance. It can cause diarrhea, weight loss and nutritional difficulties. Many patients develop celiac disease and are at greater risk for developing gastrointestinal cancer.
Celiac disease is an autoimmune disorder that can occur in genetically predisposed people where the ingestion of gluten leads to damage to the small intestines. Experts estimate 1 in 100 individuals suffer from this disease. Our small intestines have finger like projections called villi. This is where absorption of nutrients occurs. When people with celiac disease consume gluten, their body initiates an immune response that attacks the small intestine. These attacks lead to damage on the villi, which promote nutrient absorption. When the villi get damaged, nutrients cannot be absorbed properly into the body.
For people suffering from this autoimmune disorder, it is crucial they avoid gluten from the diet to prevent intestinal damage. However, for anyone else avoiding gluten in the diet, they are at risk for many vitamin and mineral deficiencies.
Iron is an essential mineral found and even enriched in gluten containing products. It is part of hemoglobin, a protein, found in all the body’s red blood cells. Hemoglobin supplies muscles and other organs with enough oxygen and helps the body convert carbohydrates and fat into energy. The Recommended Dietary Allowance of iron for adult women is 18 milligrams (mg) a day and 8 mg for adult men. For post-bariatric surgery patients, the recommended amount is 45-60 mg daily. If one wants to eliminate gluten from the diet, they will need to add more meats, leafy green vegetables, fish and shellfish for additional iron.
Folic Acid, also known as folate, is a B vitamin also found in gluten containing foods. It is critical for new cell production and prevention of birth defects of a baby’s brain and spine. Federal law requires manufacturers to add folic acid to wheat-based breads, cereals, flours, corn meals, pastas, rice and other grain products to prevent birth defects in women who aren’t consuming adequate amounts of the vitamin in their typical diet, but this is not required for gluten-free products. If one chooses to eat only gluten-free foods, then green leafy vegetables, asparagus, broccoli, cauliflower, beets and lentils are other foods that can be added to the diet to get adequate amounts of folic acid.
Fiber is found in almost all grain-based foods. It helps the body slow absorption of sugar in the blood, improves digestion and provides a feeling of fullness or satiety. Gluten-free breads, pastas and cereals are usually very low in fiber. Current guidelines recommend 25 mg of fiber per day for women and 35 grams for men. Anyone who decides to eliminate gluten products from their diet can always eat other foods with fiber, such as beans, fruits, vegetables and nuts.
Besides missing essential nutrients, most gluten-free packaged foods are more expensive than the products containing gluten. For anyone deciding to cut gluten from the diet for health reasons or as a personal choice, it is highly recommended to have variety in the diet to avoid any nutritional deficiencies.
When shopping at the grocery store, try to avoid processed gluten-free products, and eat more whole foods. Adding more fruits, vegetables, lean meats, poultry, fish, eggs, dairy, beans and nuts will provide adequate amounts of essential nutrients.
If you have any more questions about diets or what to eat post-bariatric surgery, please call our dietitians at My Bariatric Solutions toll free at 888-686-6971 or in the Dallas/Fort Worth or north Texas area call 940-249-9009.