As celiac disease (CD) awareness grows, more people than ever before are adopting a gluten-free diet. An estimated 3 million Americans have CD, an autoimmune digestive disorder that occurs when white blood cells react to gluten, a protein found in wheat and other grains, causing intestinal damage. On top of that, 18 million Americans experience adverse reactions (but not the immune response) when they eat gluten, a distinct condition called nonceliac gluten sensitivity. Many more people simply feel better when avoiding wheat. So should you join the millions eschewing gluten? These experts explain how to make an informed choice.

Gluten specialist
Amy Myers, MD, Austin UltraHealth, Austin, Texas

  • Know the signs. CD or gluten intolerance can trigger physical discomfort such as bloating, nausea, diarrhea, or stomach cramping; psychological issues like brain fog, memory problems, and impaired coordination; behavioral problems in children; and many other health issues.

  • Eliminate gluten. Completely cutting gluten from your diet is a good way to test sensitivity. Eliminate gluten for at least 30 days; then reintroduce it and monitor your body’s reaction. Gluten is a very large protein and can take time to clear from your system. Some people experience immediate relief, but others may not feel fully better for several weeks, as the GI tract slowly repairs itself from inflammatory damage.

  • Restore the gut. If you have CD, even though you’ve stopped eating gluten you gut will need some TLC because your intestines may not be able to properly digest proteins and fats. These partly digested nutrients can leak into the bloodstream, triggering fatigue, joint pain, and skin rash. Consider supplementing with digestive enzymes to encourage nutrient breakdown. Take one capsule containing protease, lipase, amylase, and cellulase at the beginning of each meal to aid digestion.

Registered Dietitian
Vicki Kobliner, RD, holcarenutrition.com, Wilton, Connecticut

  • Prevent cross-contamination. If you’re extremely sensitive, even small gluten traces can cause symptom flare-ups. If other members of your household eat gluten, use a separate cutting board, kitchen utensils, toaster, and area of the counter to prepare your food.

  • Replace lost nutrients. Many gluten-containing foods such as cereals and breads are fortified with vitamins and minerals—so if you’re avoiding these foods, you risk calcium, vitamin D, B vitamin, and folic acid deficiency. To compensate, focus on nutrient-rich leafy greens like spinach, kale, and beet greens. Also include crucifers like broccoli and cauliflower, and take a daily multivitamin.

  • Bone up. Those with undiagnosed CD may be at risk for osteoporosis due to compromised nutrient absorption. A gluten-free diet can help reduce risk. Eat calcium-containing foods like dark, leafy greens; and alkalizing foods like legumes, sweet potatoes, celery, and avocado—raising your blood pH helps enhance bone density.

Gluten researcher
William Davis, MD, author, Wheat Belly (Rodale, 2011)

  • Get tested. To determine if you have CD, before you stop eating gluten ask your health practitioner to schedule immunoglobulin tests (IgA and tTG) that measure blood endomysial and transglutaminase antibodies.

  • Focus on nutrition. If you go off gluten, products like gluten-free breads, pasta, crackers, and cookies make the transition easier, but they can be made with “junk carbohydrates” like refined tapioca and potato starch. Fill your diet with single- ingredient foods that are not made from wheat, such as nuts, fruits, vegetables, and eggs.

  • Understand modern wheat. Contemporary wheat is the product of many genetic changes made by using X-rays and toxic chemicals to induce mutations. Among these changes is the introduction of a complex carbohydrate called amylopectin A, a rapidly digested starch. Consequently, eating modern wheat can raise blood sugar levels even faster than table sugar. Even if you don’t experience digestive distress after eating wheat, you may want to cut it out of your diet.