Gluten-free – Eating without gluten

Gluten is a protein found in many types of grain: wheat, barley, oats, spelt, and rye – to name the most well-known. However, one in 500 Germans suffers from a gluten intolerance. While it can manifest in many different ways, the treatment is always the same: avoiding foods that contain gluten. For World Celiac Day on May 16th, here is an overview of the most important information.

Celiac disease: When the gut goes on strike

Your small intestine performs an important task: it breaks down the food you consume into its components. Nutrients enter the bloodstream through the lining of the small intestine. If you suffer from a gluten intolerance, this can lead to a chronic disease of the small intestine. Specifically, gliadin (a component of gluten) damages your gut, causing inflammation of the intestinal lining and, in the long term, the regression of the intestinal villi. The result: the surface area of the small intestine decreases. Your body no longer absorbs enough nutrients, leading to deficiency symptoms.

Which foods contain gluten?

A gluten intolerance can occur in infancy and childhood, as well as in adults. In the worst cases, it leads to a chronic disease of the small intestine, which in adults is also called sprue. If you have a gluten intolerance, your small intestine cannot tolerate foods containing this protein. It is primarily found in the well-known types of grain mentioned above. Therefore, many types of bread, pasta, pizza dough, muesli, and baked goods are problematic for those affected, as are bulgur, couscous, seitan, and (malt) beer. Unexpectedly, gluten is also found in breaded foods, potato-based dough products like gnocchi, and highly processed fish and meat products such as sausages or fish/meat patties. In general, highly processed foods like ready meals, instant sauces, or low-fat products often contain the problematic protein, as it is used industrially to bind flavors or as a carrier substance.

How do I know if I have a gluten intolerance?

Many people affected suffer from classic symptoms such as bloating, abdominal cramps, diarrhea, nausea, and fatty stools. In the long term, weight loss can also occur. An intolerance can also manifest through more non-specific symptoms such as fatigue, lack of drive, headaches, and loss of appetite. Type 1 diabetics are frequently affected. The risk group also includes people suffering from osteoporosis, lactose intolerance, or thyroid diseases.

Reliably diagnosing celiac disease

Only in a few cases does celiac disease present with clear symptoms immediately. The majority of those affected (80-90%) suffer from few or no symptoms at all, which could also have a variety of other causes. Therefore, it is not easy to detect celiac disease. It can be very revealing to go without all gluten-containing foods for 30 days. Celiac disease can be detected even more reliably through a blood test at your GP. For this, the blood is first examined for antibodies. If the result is negative, there is a 95% chance that you do not have celiac disease. If you want to be one hundred percent sure, a specialist can take a tissue sample during a small intestine biopsy.

Therapy: Living without gluten

Celiac disease is a chronic condition. For those affected, the only therapy is to follow a gluten-free diet for life, as they cannot tolerate even the smallest amounts of gluten. Although symptoms do not appear immediately, the immune system and the lining of the small intestine react to even a single exposure to gluten. This is why people with gluten allergies are advised to avoid all foods that might contain the protein entirely. The small intestine recovers within a few weeks of changing one's diet and can then resume its function. Often, this conscious approach to nutrition has other positive effects on health, even if a change is naturally experienced as a restriction at first.

Gluten-free foods

The good news is that the range of gluten-free foods in supermarkets has grown steadily in recent years. Look for the crossed-out wheat symbol. And, of course, there are plenty of foods that naturally contain no gluten. These include, for example, "staple side dishes" like rice, potatoes, polenta, corn, rice noodles, legumes such as lentils or chickpeas, sweet potatoes, Jerusalem artichokes, and glass or soy noodles. Possible grains or grain substitutes include amaranth, buckwheat, millet, quinoa, cornmeal, potato flour, chickpea flour, rice flour, soy flour, and soy flakes. You can find more information on the topic of gluten at the DZG (Deutsche Zöliakie Gesellschaft e.V.).