Beyond the Basics

When you hear the term “gluten sensitivity,” you probably associate it with digestive issues-gas, bloating, irritable bowel, diarrhea, or maybe constipation. But that’s not always the case. For Miranda Hughes, who credits a gluten-free diet with a vast improvement in her health, the problem was literally in her mind.

Whenever Miranda ate gluten-containing foods, she would have difficulty concentrating, experience tingling in her arms and legs, and become depressed. For years, doctors encouraged her to take antidepressants, but to her amazement, she found that when she cut gluten out of her diet, her depression, recurrent lack of mental focus, and other baffling symptoms simply went away. And they’ve continued to stay away as long as she strictly avoids gluten.

“I’ve really learned firsthand about the incredible health benefits of the gluten-free diet,” Miranda says. “I feel focused, positive, and healthy. The diet has really given me a new lease on life.”

The Prevalence of Non-Digestive Symptoms
Because celiac disease is an autoimmune reaction to gluten in the small intestine, most people assume that gluten sensitivities involve gastrointestinal (GI) problems. But those types of symptoms are actually the exception, rather than the rule. Research has revealed that:

• Almost 50 percent of new patients diagnosed with celiac disease do not have GI symptoms. In adults, common symptoms include anemia, bone disease, or neurologic issues.
• Children older than age three who are diagnosed with celiac disease are more likely to have non-GI conditions, including type 1 diabetes, thyroid disease, Down syndrome, iron-deficiency anemia, short stature, or mood disorders.
• Individuals with non-celiac gluten sensitivity-a non-autoimmune reaction to gluten that causes similar symptoms, but doesn’t lead to the gut damage caused by celiac disease-have a prevalence of non-GI symptoms, such as headache, foggy thinking, joint pain, and numbness in the legs.
• Many other non-GI, gluten-related diseases appear to benefit from a gluten-free diet, including schizophrenia, epilepsy, multiple sclerosis, autism spectrum disorders, and skin conditions including dermatitis and psoriasis.

Elimination Test
While there are medical tests for celiac disease, no one has yet come up with a definitive test for non-celiac gluten sensitivity. So how do you know if a gluten-free diet could help you-especially when you consider the wide variety of conditions related to gluten sensitivity?

Most experts agree that the best test is to try eliminating gluten from your diet, and see if your symptoms-gastrointestinal or not-improve. If they do, you have firsthand proof that a gluten-free diet is your best medicine.

One caution, though: You might not notice a difference in how you feel going gluten free if you have silent celiac disease, a condition in which there is damage to the gut but few or no clear-cut symptoms. If you have a condition that is a common complication of celiac disease-such as iron-deficiency anemia, osteoporosis, infertility, or an autoimmune disease-it’s best to act from a place of knowledge and get the blood tests to screen for celiac disease first before eliminating gluten from your diet. Determining if you have celiac disease or not will make it much easier for your doctor to knowledgeably monitor and effectively treat those conditions.

Beet and Radish Salad with Tahini Green Goddess Dressing*

Serves 4
Both recipes can be made a day in advance. The salad can store in the refrigerator for 2-3 days and the dressing can store for up to 5. You may need to add a little lemon juice and/or water to the dressing before serving, as the tahini tends to thicken over time.

Salad

4 small organic beets

4 radishes

2 oranges

1 Tbs. finely chopped fresh mint

¼ cup lemon juice

¼ cup organic extra virgin olive oil

Unrefined sea salt

Black pepper

2 cups thinly sliced arugula or spinach

2 avocados

Dressing:

¼ cup fresh mint leaves

¼ cup fresh cilantro

¼ cup lemon juice

¼ cup tahini (sesame seed butter)

¼ cup organic extra virgin olive oil

¼ cup water

1 large clove garlic

1 tsp. agave nectar or sweetener of choice

½ tsp. unrefined sea salt

1. To Make Salad: Slice beets and radishes with mandoline slicer, and transfer to bowl. Peel oranges, making sure white part is removed. Slice oranges into thin segments, and add to bowl. Add mint, lemon juice, olive oil, and salt and pepper to taste. Mix well, and allow to marinate 30 minutes.
   
2. To Make Dressing: Combine dressing ingredients in food processor or blender, and blend until smooth and creamy. If mixture is too thick, add water until desired consistency is reached.
   
3. To Serve: Place arugula and 2 Tbs. dressing into mixing bowl, and mix well. Transfer to 4 serving plates. Layer salad mixture-about ½ cup per plate-on top of greens. Drizzle with remaining dressing, and top with avocado slices.

PER SERVING: 571 cal; 7g pro; 51g total fat (7g sat fat); 28g carb; 0mg chol; 293mg sod; 1g fiber; 12g sugars

*Recipe courtesy The Tasteful Kitchen restaurant, Tucson, Ariz.

Melissa Diane Smith, a nationally known writer and holistic nutritionist who specializes in personalizing the gluten-free diet, offers long-distance telephone counseling and coaching services to clients across the country. She is the author of Going Against the Grain and Gluten Free Throughout the Year: A Two-Year, Month-to-Month Guide for Healthy Eating. To learn about her books, long-distance consultations, nutrition coaching programs, or speaking, visit her websites melissadianesmith.com and againstthegrainnutrition.com.