People with celiac disease must eliminate gluten from their diets, for example swapping pizza dough for a rice crust. (Canadian Press)

To the ever-growing list of dietary no-no's, which demands trans fats must be cut, sweets limited, sodium lowered and carbs checked, many health-conscious consumers are adding gluten — a protein found in wheat, barley, and rye.

For people with celiac disease — an autoimmune disorder that causes damage to the small intestine — cutting gluten can relieve a host of symptoms, including bloating, cramps, nausea, anemia, irritability and depression.

But many other people who haven't been diagnosed with the intolerance are jumping on the gluten-free bandwagon, bypassing the dinner rolls and bagels in search of a cure for fatigue and digestion ailments.

"I think we're finding now, especially [among those with an] eastern European background, that gluten sensitivity is probably a lot more common than we thought it was," said Doug Cook, a Toronto-based registered dietitian.

"Some people who give up gluten or cut back on a lot of wheat-based products feel better," he said.

Cook says scaling back or eliminating gluten completely from a diet doesn't pose any health dangers to people who don't have celiac disease. He says while he's never been diagnosed with the disorder, he limits his own gluten intake.

"I don't eat a lot of wheat because I [find] when I cut out wheat I just feel better," he said. "Most of my carbohydrates come from fruits and vegetables and rice."

Gluten-free substitutes for pastas and breads include quinoa, pictured above, millet, potato starch and tapioca. (Larry Crowe/Associated Press)

Gluten-free selection grows

Increasingly, restaurants and manufacturers are tapping the gluten-free market, expanding a selection that was once limited and often unpalatable. In place of dense loaves of gluten-free bread, diners can now choose from gluten-free pizzas and brown rice pastas. Stores are also stocking gluten-free soaps and makeup.

"It is difficult but there are good things out there they can eat. They can eat rice, they can eat rice pastas and then there's this group of — we call them 'pseudo grains' because they're cooked and eaten like grains but they tend to be seeds — like quinoa, millet and buckwheat, et cetera," Cook said.

To people with celiac disease — which affects about one in 133 Canadians — the greater availability of products is surely welcome. People with the digestive disorder must scrutinize all foods carefully, as gluten can be found in everything from frozen yogurt to dried fruits to salad dressings. Failing to follow a gluten-free diet could cause other health problems later in life, including osteoporosis, infertility and other autoimmune diseases.

There has been some debate as to whether people with the digestive intolerance can eat oats. Some say oats are safe as long as they haven't been processed in a mill that uses the same equipment for other grains that contain gluten. Others suggest, however, that oats may harm the small intestine. Research in this area continues.

Cutting gluten may prevent proper diagnosis, expert warns

But first, getting a proper diagnosis is crucial, health experts say. Diagnosing celiac disease can be a lengthy process, sometimes taking doctors as long as 10 years to pinpoint the problem. Dr. Suzanne Dupuis-Blanchard, a nursing professor at the Université de Moncton, notes people should not self-diagnose because it may extend the process even longer.

Searching for gluten-free fare

While the availability of gluten-free foods has certainly improved, it would be fair to say the market isn't exactly saturated. To begin, try looking in the organic sections in supermarkets, health food stores, and bulk food stores for specialty items.

Many independent restaurants touting healthy eating offer gluten-free dishes, as do some chains. In larger establishments, including Dairy Queen, Baskin-Robins, Il Fornello and Swiss Chalet, offer gluten-free options. If unsure, ask the server for more information or request an allergy fact sheet.

Bloggers also offer many restaurant and shopping recommendations, as well as product reviews, cooking advice and coping tips.

"The danger is if they do cut [gluten] out without proper diagnosis they will never get that proper diagnosis because gluten needs to be present in the diet for celiac disease to be diagnosed," said Dupuis-Blanchard.

"What happens is, the gluten affects the small [intestine] and the only way to diagnose celiac for sure is to have a small bowel biopsy. If the gluten isn't in the diet, if they do take it out before getting a diagnosis, when that small [intestine] biopsy is done it looks OK, so it gives a false negative."

People with a family history of celiac disease are more susceptible, health experts say, noting that sometimes surgery, pregnancy or stress can trigger the onset of the disease.

If a person is diagnosed with celiac disease, doctors will recommend they eliminate products containing gluten completely from their diets for the rest of their lives. About 70 per cent of people report feeling better within two weeks, and the intestine completes healing within a year.

However, until that diagnosis is made Dupuis-Blanchard says people should not change their diets, noting the restrictions may in fact be needless for many.

"I think people are becoming more aware, which is good. But if they don't have to follow that diet, which is very restrictive, why do it?" she said. "It's quite expensive as well because it's special food and the way it's processed is different, so there's an additional cost to that."

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