Test Your Gluten and Celiac Knowledge

Awareness of celiac disease and gluten sensitivity has grown in recent years. Yet, despite the popularity of “gluten-free,” many people have sketchy information about gluten, gluten-related illness, and gluten-free foods. Take our quiz to find out how gluten-savvy you really are.

TEST YOUR KNOWLEDGE

1. True or False: Gluten is a type of carbohydrate that people with celiac disease or gluten sensitivity react to.
2. True or False: People who follow a gluten-free diet don’t eat wheat, rye, and barley, but they can eat foods made with spelt.
3. True or False: There is controversy about whether certified gluten-free oats are a safe food for all people with celiac disease and gluten sensitivity.
4. True or False: “Gluten-free” listed on a food label is a term that is clearly defined and regulated by the FDA.
5. True or False: Celiac disease is an autoimmune disease.
6. True or False: The symptoms of celiac disease are always lower gastrointestinal symptoms, such as diarrhea, constipation, gas, and bloating.
7. True or False: In both gluten sensitivity and celiac disease, the innate immune system reacts to gluten.
8. True or False: Gluten sensitivity can cause symptoms similar to those experienced in people who have celiac disease.

ANSWERS TO THE QUIZ

1. False. People with celiac disease or gluten sensitivity react to gluten, but gluten is a protein, not a carbohydrate.
2. False. People who avoid gluten need to avoid wheat, rye, and barley but they also should avoid spelt. Spelt is a type of wheat and contains gluten just like wheat does.
3. True. There are conflicting studies and opinions about the safety of pure, uncontaminated oats in the diet. One study found that pure oats can be accepted and tolerated by the majority of children with celiac disease, but another study found that people who ate oats experienced significantly more frequent diarrhea and more severe constipation than those on a gluten-free diet who did not. The Celiac Sprue Association recommends against eating pure oats because some celiacs develop immune responses and symptoms to them, and there are no indicators right now to determine which celiacs may have such a response.
4. False. An act passed in 2004 required the Food and Drug Administration (FDA) to develop an official definition of the term “gluten-free” for the purpose of labeling gluten-free foods. So far the FDA has completed a proposed rule on that but not a final rule. Right now it is up to manufacturers of “gluten-free” food items to define and make the gluten-free claim. That means it is up to consumers to beware of the gluten-free claim on packages of food about hidden sources of gluten and processing techniques that may contaminate the foods with gluten. Consumers also can look for two different symbols on product labels that indicate stricter standards than what the FDA proposes. They are a Certified Gluten-Free trademark symbol by the Gluten Intolerance Group or a CSA (Celiac Sprue Association) Recognition Seal. To learn more about these symbols, visit gfco.org and csaceliacs.org.
5. True. In celiac disease, the immune system attacks both gluten and the small intestine, leading to the damage in the small intestine that characterizes celiac disease. Celiac disease is classified as an autoimmune disease because the immune system attacks part of the body.
6. False. Symptoms of celiac disease sometimes show up as lower gastrointestinal symptoms, but not always. Some people either have no symptoms or non-gastrointestinal symptoms such as bone disease, anemia, or fatigue.
7. True. In people who have either gluten sensitivity or celiac disease, the innate immune system reacts to gluten. In people who have celiac disease, the adaptive immune system also reacts, setting off the autoimmune process in the small intestine that characterizes celiac disease.
8. True. Although people with gluten sensitivity do not have the damage to the gut that characterizes celiac disease, they can have similar or sometimes identical symptoms of those with celiac disease experience.