Fitness Files: Inside the medical wheat field

“Do you see ‘Complaint Department’ written across my forehead in flashing neon?” I asked my husband as I hung up from my niece’s call. She was in pain as usual, bloated, cramping and working in a very small space. “Co-workers can hear every bathroom noise!” she wailed.

Paul and I agreed she was a hypochondriac but still, from 2,000 miles across country, I tried very hard to figure out where she could find a private bathroom.

Then my niece’s health complaints stopped.

She eliminated gluten.

Whoops, our hypochondriac cured herself.

Her turnaround made me confront my own judgmental nature and read about gluten.

I found that there are two medical conditions associated with gluten intolerance.

First, celiac disease is an established diagnosis with identifiable genetic markers.

According to the Mayo Clinic, celiac disease is an immune reaction to eating foods containing wheat, barley and rye gluten. Gluten triggers an immune response in the small intestine that produces inflammation with potential to damage the lining of the small intestine, preventing absorption of some nutrients. WebMD names the nutrients as fat, calcium, iron and folate. In a separate article, WebMD says that, left untreated, complications such as iron deficiency, osteoporosis and lymphomas of the small intestine can occur.

Testing for nutritional deficiencies through blood tests, stool samples or endoscopy can diagnose celiac disease.

The second group of people reporting reactions to eating gluten has lately been labeled as “gluten sensitive.”

Katherine Kam’s WebMD article quotes Dr. Stefano Guandalini from the University of Chicago as saying, “[G]luten sensitivity is a condition that doctors once dismissed but now recognize as legitimate.”

Since it is important to separate those with celiac disease from those with gluten sensitivity, Guandalini warns against starting a gluten-free diet without being tested for celiac disease. Going gluten-free can eradicate the antibodies found in the tests, thus delaying diagnosis of celiac disease and treatment of its dangerous complications.

Kenneth Chang’s 2013 New York Times article says gluten sensitivity is “less a diagnosis than a description — someone who does not have celiac disease but whose health improves on a gluten-free diet, worsening again if gluten is eaten.”

The above may seem academic, but both celiac disease and the new diagnosis of gluten sensitivity are on the rise, according to Guandalini, who spent the last 40 years studying gluten-related diseases.

Estimated to affect 1% of the population, a $1.5-billion industry fills grocery shelves with products labeled “gluten-free.”

Besides cautioning people against self-diagnosis, health professionals agree that going gluten-free is not a healthier option for 99% of the population who can digest gluten. Writing for ScientificAmerican.com, Rachel Rettner quotes dietitian Katherine Tallmadge: “Whole grains which contain gluten are a good source of fiber, vitamins and minerals.” Gluten-free packaged products often have less fiber and few nutrients.

And, repeating my mantra of past articles, Rettner says skipping the packaged foods but eating fruits, vegetables and small amounts of lean protein equals a healthy gluten-free diet.

In my next article, I will return to Guandalini, who puts on his myth-busting persona and comes to a surprising thesis regarding what is causing so many to have problems with gluten.

As for my niece, I shared my research with her. She’s ignoring it. First, her insurance does not cover gluten testing, and second, she feels so much better, she will never return to wheat.

In the meantime, I send her garbanzo-flour raspberry muffins, which everybody likes.

Next week: Wide disagreement over causes of problems digesting gluten.

Newport Beach resident CARRIE LUGER SLAYBACK is a retired teacher who ran the Los Angeles Marathon at age 70, winning first place in her age group. Her blog is lazyracer@blogspot.com.