gluten free-100Check out the pasta or rice aisle of any grocery store, and you’ll be barraged by label after label marked “gluten-free” in gigantic, bold letters. This gluten-free diet trend has rapidly extended itself beyond health food and specialty stores to major chain groceries, restaurants, coffee shops, and high-end eateries. Many people aren’t even exactly sure what gluten is, but the perception when they see something labeled “gluten-free” is that it must be a healthier option, the way “fat-free” was the buzzword of the 1980’s. Of course, there are the unenviable few who were the original market for these products—folks with actual gluten sensitivities, wheat allergies, or Celiac disease. But what exactly does being gluten-sensitive or wheat allergic mean? Is gluten truly a malevolent ingredient in foods that we should avoid at all costs, or can it be beneficial to those without a sensitivity? How can you tell if it’s time to put the bagel down and embrace a gluten-free diet?

We can help you determine whether a gluten-free diet is a good choice for you by breaking down different gluten reactions and sensitivities, what they mean, and whether you should consider making some big changes to your diet.

First off—what is gluten, exactly? If you’re going to consider eliminating something from your diet, you should probably know exactly what it is and does, right? Gluten is a protein composite found in wheat and related grains like barley and rye. Gluten gives elasticity to dough, helps it keep its rise and shape, and also gives wheat products their chewy texture. It is the basis for many imitation meats, providing needed supplemental protein and variety to vegetarian diets.

However, gluten can also cause adverse health issues for those whose bodies have difficulty breaking it down. Here’s where the squeamish should put on their best med school faces and power through: symptoms of gluten sensitivity can range from light bloating, gas, and sluggishness to diarrhea, vomiting, and severe headaches. Any of this sound familiar? There’s a possibility that you may be suffering from one of the following conditions.

Non-Celiac Gluten Sensitivity

The most mysterious—and potentially confusing—form of gluten intolerance is non-Celiac gluten sensitivity. In a nutshell, this term means that you feel awful after consuming gluten, and you may even have Celiac-like symptoms (like the aforementioned bloating and gut issues, plus possible joint pain and foggy brain), but you aren’t genetically predisposed to Celiac. However, it’s possible that for these sufferers, gluten isn’t the only culprit—or perhaps even the culprit at all. Emerging research indicates that a group of sugars called FODMAPs (an acronym for fermentable oligosaccharides, disaccharides, monosaccharides and polyols) might be to blame instead. These sugars draw water into the intestinal tract and can be poorly digested or absorbed, which may produce colonic bacteria, turning into abdominal distress.

Interestingly, in a 2011 study in Nature, a group of people considered to be non-Celiac gluten sufferers still showed signs of the same symptoms even after starting a gluten-free diet, but when placed on a diet low in FODMAPs, all participants reported improvement after just two weeks. Clearly there are some scientific inroads to be made in nailing down the exact nature of this particular sensitivity, but FODMAPs does seem promising in helping folks find relief from their symptoms—and potentially eliminate confusion surrounding their relationship to gluten.

Wheat Allergy

A wheat allergy behaves the same way as any other allergy: the body’s immune system mistakenly identifies the substance—in this case, the wheat protein—as harmful. Unlike gluten sensitivity, the reaction is immediate—if you have a wheat allergy, your body treats wheat like a dangerous foreign body, and thinking that it’s under attack, it starts sending white blood cells to fight off the gluten. Though it’s not pleasant (and can lead to anaphylactic shock for those with a severe allergy) a wheat allergy s just like having a severe allergy to nuts, shellfish, or any other foods: avoid wheat and you’re good to go.

Celiac-Prone Gluten Sensitivity

According to Christin Bell, Registered Dietitian at Lifetime Fitness in Plano, Texas, diet may be to blame for gluten sensitivity showing up in the first place. “Due to lack of awareness, many people over-consume refined carbs and follow a highly processed diet, which can actually cause sensitivities to get worse,” she says. And like anyone who is genetically predisposed to develop a condition, this sensitivity over time can eventually turn into full-blown Celiac. In fact, in our fast food culture, over-consumption of carbohydrates and lack of attention to real foods (the stuff in the produce aisle) may be why there are more and more people complaining of newfound gluten sensitivity—we’re simply overdoing it.

Celiac Disease

The most famous condition on the gluten sensitivity scale is Celiac disease. An autoimmune disorder of the small intestine, Celiac can show up at any point in life, and sufferers are genetically predisposed to it. So what happens when you have Celiac? Basically, it’s the body’s adverse reaction to gliadin, a gluten protein found in wheat, which causes an inflammatory reaction.. If left unchecked or undiagnosed, Celiac can lead to serious damage of the lining of the small intestines, as well as a vitamin deficiency, as certain nutrients are unable to be absorbed by the body. Unlike the more prevalent gluten sensitivities and wheat allergies, only about 1% of Americans are actually given a Celiac diagnosis, and while there is no cure, they can live fairly symptom-free by eliminating gluten from their diets forever.

But don’t go ahead and diagnose yourself with Celiac just yet—even if you display some or all of the symptoms mentioned above when consuming gluten, that doesn’t necessarily mean you have Celiac—and even if you’re pretty sure that gluten is the culprit, the only way to truly know for sure is to visit your gastroenterologist.

The debate over whether we’d be better off on a gluten-free diet—even when we are asymptomatic for any level of intolerance—is ongoing. Some registered dietitians and doctors, like Bell, believe that we would physically feel better eliminating it from our diets completely, and relying on other starches or grains like potatoes and quinoa in substitution of wheat products. But others, like Peter H.R. Green, MD, director of the Celiac Disease Center at Columbia University, cautions that “unless people are very careful, a gluten-free diet can lack vitamins, minerals, and fiber.” That’s because despite the potential perils, gluten is rich in an array of vitamins and minerals, like B vitamins and iron, as well as fiber, and studies show that whole grain foods, as part of a healthy diet, may help lower risk of heart disease, type-2 diabetes, and some forms of cancer.

While there is a gray area for those exhibiting signs and symptoms of Celiac and gluten sensitivity, the best way to approach the gluten issue is to follow a clean diet, and to consciously engage in label-reading at the store. “Wheat is in a lot of foods that don’t actually say the word ‘wheat,’ so it’s very hard to execute a wheat-free diet. Making sure we understand all the forms of gluten is an education in itself,” Bell says, “Modified starch, for example, is a form of wheat—and most people wouldn’t know that or think of it as gluten.”

So if you’re concerned about gluten and think you may suffer from a sensitivity, take a grocery store tour with a dietician so they can point out hidden sources of gluten, read labels carefully, and do research on a gluten-free diet. Then (if you’re really serious about going gluten-free) try it out for two weeks—that’s the amount of time it takes for your body to rid itself of gluten—and see how you feel. Or, if you don’t want to completely eliminate it, just remember that moderation can be key. Avoid packaged foods and obvious sources of processed carbs as much as you can, eat clean, and exercise regularly.

The good news about gluten? All the attention turned upon it has resulted in one great thing: awareness and mindfulness about what we’re putting in our bodies.