YANKTON, S.D. (AP) - In recent years, "gluten-free" options have swept into grocery and specialty stores across the country.
But what does gluten-free mean? Grains such as wheat, barley, rye and triticale all contain a protein known as gluten. There's also some debate among medical professionals that oats, depending on type and processing, may also trigger gluten-related issues. The protein cannot be tolerated in the doses normally seen in grain-based foods by those afflicted with celiac disease. It's been estimated that up to 1 percent of the population in the U.S. suffers from the disease, according to a study conducted by the Center for Celiac Research at the University of Maryland School of Medicine in 2003.
One store stocking up on gluten-free offerings is the Bodyguard at the Yankton Mall. Owner Karen Wieseler said demand has necessitated a special section dedicated to gluten-free products as well as producing their own.
"We have a whole section that is just gluten-free," Wieseler said. "In our bakery, we have gluten-free cookies, we do gluten-free brownies, we've got all kinds of little snacks we do gluten-free."
Additionally, the store makes buns, soups, sandwiches, bread and wraps for their restaurant that are gluten-free.
Doralynne Jarvis, registered dietitian and nutrition services director at Avera Sacred Heart Hospital, said understanding of the disease has been relatively recent.
"Celiac disease has historically been a more difficult disease to get diagnosed," Jarvis said. "It's become more common knowledge in the last five years or so with physicians. Many people in the past would go from doctor to doctor, and on average would take 10 years for diagnosis, so it's something that's gone more mainstream for awareness. Even having gluten-free foods available at standard grocery stores is something you didn't see even five or six years ago."
The disease is genetic and the only known treatment is a gluten-free diet.
Those suffering from gluten intolerance due to allergy also have to take precautions with the foods they buy.
Wieseler said in some cases, bakeries have to take special precautions in order to avoid contamination of gluten-free products.
"Some of the bakeries have to be certified gluten-free to the point that they can't have any other types of gluten flours in the bakery," she said. "They have to have separate pans that they bake with that have not baked gluten products. It's a touchy situation."
She added that the rise in gluten intolerance may stem from a better understanding of the problem, as well as modern farming practices.
"I think it's probably been there for a long time - people just didn't really realize what it was when they had a lot of upset stomachs," she said. "Partially, maybe, the epidemic is in our genetically engineered foods. They're possibly tracing it back to that. (Wheat grains) have been so genetically modified that they now have at least 50 percent more gluten in a single grain than they did 30 or 40 years ago."
Jarvis said those diagnosed with celiac or gluten intolerance should consult with a dietitian to learn the steps they need to take.
"The best thing you can do is have an out-patient consultation with a registered dietitian," she said. "There's a lot of information out there between the news and Internet and different brochures ... It's really complex to learn how to read the labels until you have that education of what to look for on the nutrition label, so the best thing you could do is spend some time learning the basics with a dietitian and then going to the grocery store yourself and getting comfortable with the foods that are safe to eat."
Jarvis also said it's best to limit the intake of processed foods before starting with a gluten-free diet.
"The patients I have worked with over the years really feel their best when they're eating fruits, vegetables, grains, meats and unprocessed foods, and once they get to that point where they're feeling good and healthy, then they start to incorporate some of the gluten-free breads or gluten-free pastas," she said.
As for people unaffected by gluten intolerance, Jarvis said there's not much benefit to starting a gluten-free diet.
"There have been some fad diets going around the last couple of years promoting gluten-free diets," she said. "Unless you have a specific need, there's really no benefit to following a gluten-free diet because they tend to be (lower) in fiber than a traditional diet."
Information from: Yankton Press and Dakotan, http://www.yankton.net/