Although it was a disruption at first, Amy Hegarty has adjusted to a gluten-free diet. Sarah Walor photo
For almost two years, Amy Hegarty suffered daily from gastrointestinal problems and acid reflux.
"I still got up and went to work every day," the 41-year-old western Henrico County resident recalls. "But it was enough to say, ‘There's something really going on that I need to understand because I shouldn't feel like this all the time.' "The first gastrointestinal specialist she saw treated her symptoms separately with a cocktail of prescription drugs. "I was like, ‘This just doesn't seem right,' " Hegarty says. "I don't want to take prescriptions forever, covering up various symptoms." Eventually, she found a general practitioner who approached her symptoms holistically, looking at stress levels, lifestyle and eating habits. In the spring of 2008, Hegarty was identified as gluten-intolerant. "It was months before my lifestyle, my diet and my food habits adjusted to eating gluten-free and feeling good about it," she says. Hegarty is among a growing number of adults who have been diagnosed with sensitivities to gluten, a protein found in wheat, barley and rye. Since 1974 in the United States, cases of celiac disease, the more serious form of the gluten-intolerant autoimmune disorder, have doubled every 15 years, according to the University of Maryland School of Medicine's Center for Celiac Disease Research. In 2003, a widely cited study conducted by the center placed the number of Americans with celiac disease at one in 133 — or more than 2.3 million people. "At least in the beginning, we interpret this increase to our better understanding about celiac disease," says Alessio Fasano, medical director at the center. "But there is definitely also the possibility that the kinds of grains that we eat nowadays are different than the ones that our grandfathers and grandmothers were eating 50 or 60 years ago." Fasano says genetic modifications to the molecular structure of the grains leads to increased gluten levels in crops. "The organoleptic characteristics [including the elasticity, taste and toughness of the bread] are changing because we want better products," Fasano says. "Not only are the products more enriched in gluten because they've been genetically modified, but also the way that we handle these products is such that we leave more toxic elements in the products that we put in our mouths." For people with celiac disease, gluten triggers the immune system to attack the small intestine. Left undiagnosed, it can lead to the development of autoimmune disorders, osteoporosis, infertility, neurological conditions and even cancer. Gluten sensitivities are less serious, but still produce uncomfortable symptoms such as abdominal pain, fatigue and headaches. The Center for Celiac Disease Research estimates that approximately 6 percent of the U.S. population, more than 18 million people, suffer from gluten sensitivity. Dr. Howard Haverty, of Richmond Gastroenterology Associates, says he has seen a sharp increase in patients with celiac disease and gluten intolerance. "I think it's awareness," Haverty says of the reason for the upsurge. "It's something that's coming down the pike and so I think the awareness is coming from the media as well as coming from gastroenterology journals." Health professionals caution against adopting a gluten-free diet without a proper diagnosis. With everyone from ultra-thin actress Gwyneth Paltrow to the buff Old Spice guy attesting to the benefits of eliminating gluten, it could be misconstrued as the latest pop-culture diet. But unless wheat-based foods are replaced with healthful grains such as brown rice, quinoa, millet and amaranth, eliminating them can reduce a person's fiber and vitamin intake and overall diet quality. In addition, some processed gluten-free products contain extra sugar and fat. Still, the increase in demand for gluten-free items has led to a boom in the market that caters to that diet. According to a Washington Post article published in April, the gluten-free market is projected to reach $2.6 billion next year, up from $100 million in 2003. Despite the drastic increase in products labeled gluten-free, the Food and Drug Administration has yet to establish a set definition for what that really means. In most cases, the standard is 20 parts per million. A product is generally understood to be gluten-free if it contains less than 0.0007 of an ounce of gluten for every 2.2 pounds of food. But without FDA regulations, consumers are in the dark as to whether the products they buy off the shelves will make them sick. "Although there is not a definite timeline for release, the FDA does understand the importance of this issue to those affected and is balancing the desire for an expedited release with the need to ensure due-diligence," says agency spokeswoman Patricia El-Hinnawy. Hegarty says that adjusting to a gluten-free diet was a huge disruption to her life initially. "Our cheap date night was a pitcher of beer and a pizza," Hegarty says. "You couldn't just do that anymore." But three years after being diagnosed, she says, doing without gluten is second nature. "If anything, it's given me the desire to eat different things and adjust my lifestyle, so I'm actually eating healthier and better." �