A gluten-free diet is salvation for an estimated 18 million Americans living with celiac disease, though another 16 million choose to lose that particular protein because it upsets their tummies.

Those Mayo Clinic statistics, from a report this summer, suggest the reason it is so much simpler to identify and buy gluten-free foods than it was a decade ago.

Gluten, a protein found in the grains that swell America’s bread basket — wheat, rye, barley and semolina, a grain in many spaghettis — has the disquieting ability to destroy the celiac lining of the small intestines in some people. That’s where hairlike villi absorb the nutrients that food delivers.

“And when they’re gone, we get no nutrients from our food,” said Betty Barfield, president of the Gluten Intolerance Group of North Texas. “We can eat like a horse and starve to death, because we are not getting the nutrients from our food.”

That condition, in turn, leads to other ailments that can include diabetes, osteoporosis, migraine headaches and memory loss, she said.

Gluten-free eating pops up occasionally as a fad diet. But is being gluten-free healthier even if you don’t have gluten intolerance or celiac disease?

“Unless they have a true celiac disease, we don’t recommend people to go on a gluten-free diet,” said Robyn Wilson, a nutritionist with Longview Regional Medical Center. “It’s a very limited diet. It’s probably one of the hardest diets to work, because there are so many foods you cannot have.”

Dr. Julian Deese, medical director at Good Shepherd Medical Center’s Institute for Healthy Living, says to keep it simple, avoid processed foods.

“You might be able to lose weight as you’re walking up and down grocery store aisles looking for gluten-free products,” he quipped. “Keep it simple, because whole foods are gluten free. ... Packaged foods sneak in gluten and wheat products as filler.”

Deese, and Good Shepherd Medical Center Weight Management Director Laurie Beck, offer five parameters and five pearls on the gluten topic:

Five facts

Gluten sensitivity is rare;

It often masquerades as abdominal cramping, bloating, constipation and diarrhea (remember, “ABCD”);

Manifestations overlap into skin diseases and other ailments;

Intolerance is not the same as an allergy;

Wheat and soy are the most common food allergies, followed by shellfish, nuts and milk.

Five pearls

Avoid pre-packaged foods;

Watch for cross-contamination, foods that wouldn’t seem to have anything to do with wheat often use it as filler;

Avoid processed foods, including all condiments;

Eat more whole foods such as fruit, vegetables, nuts, beans, fish and poultry;

Symptoms of milk intolerance and gluten intolerance can resemble each other, so it’s easier to first go without milk for 60 days to see if that helps.

Barfield, whose group has about 500 members in Fort Worth and Dallas chapters, said it’s becoming easier to go gluten free than when she was diagnosed in 1989.

“People diagnosed nowadays don’t realize how fortunate they are, because there are so many products on the market and so many restaurants on board now,” Barfield said, describing the challenges traveling always brought as she asked waiters about gluten-free fare. “And nobody knew what it meant.”

Many health food shops now color-code the shelf tags of gluten-free products, which by their nature can’t logically be grouped on one aisle.

Jack Bode, the namesake of Jack’s Natural Foods in Longview, said products that have passed the RS-Elisa certification will sport a wheat kernel inside the proverbial circle with a bar across it.

And there are alternate grains and other staples with which to create breads and other alternatives to gluten-based foods. Those include qui noa, (pronounced, “keen-wah”), an ancient Inca grain enjoying revival in healthy menus.

“You can go with buckwheat, garbanzo (beans), millet, potato flour, soy, oats — all of them are gluten free,” Bode said. “It’s a pretty big field, gluten free.”