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| Around 1 in 133 people in the US, or 1% of the population, have celiac disease - a more serious form of gluten intolerance. |
Gwyneth Paltrow, Ryan Gosling and Jenny McCarthy are just some of the celebrities who have adopted a gluten-free diet - not necessarily because they have a gluten intolerance, but because they deem the diet to be healthier. As such, the diet seems to have become the latest "trend." It is estimated that around 1.6 million people in the US follow a gluten-free diet without having been diagnosed with celiac disease - a severe gluten intolerance. But does this diet really benefit our health?
Gluten is a protein found in wheat, barley, rye and
triticale (a combination of wheat and rye). It acts as a "glue" in
foods such as cereal, bread and pasta, helping them hold their shape. Gluten
can also be found in some cosmetic products, such as lip balm, and it is even
present in that nasty tasting glue on the back of stamps and envelopes.
In some individuals, consuming gluten can cause illness. It
is estimated that around 18 million people in the US have some form of gluten
intolerance - referred to as non-celiac gluten sensitivity (NCGS) - causing
symptoms such as bloating or gas, diarrhea, fatigue, headache and itchy skin
rash.
Around 1 in 133 people in the US, or 1% of the population,
have celiac disease - a more serious form of gluten intolerance. In celiac disease,
gluten triggers an immune response that attacks the lining of the small
intestine. This means the body is unable to effectively absorb nutrients into
the bloodstream, which can lead to anemia, delayed growth and weight loss.
Celiac disease can lead to other conditions, such as
multiple sclerosis (MS), osteoporosis, infertility and neurological conditions
if left untreated, and the only effective treatment for celiac disease is to
adopt a strict lifelong gluten-free diet.
What is a gluten-free diet?
For celiacs, a gluten-free diet means avoiding all foods
that contain the protein, even in the most smallest amounts.
Breads, beer, candies, cereals, cakes and pies, french
fries, pastas, processed meats and soups are among some of the foods that
should be avoided, unless they are specifically labeled gluten free. Oats can
come into contact with wheat during production stages, so unless labeled gluten
free, they should also be avoided.
There are many foods that are naturally gluten free,
including fruits and vegetables, fresh eggs, fresh meats, fish and poultry (not
marinated, breaded or batter-coated), unprocessed beans, seeds and nuts, and
the majority of dairy products.
Many grains and starches are allowed as part of a gluten-free
diet, including buckwheat, corn and cornmeal, flax, quinoa, rice, soy,
arrowroot and millet. Celiacs should be careful, however, that these grains
have not been mixed or processed with grains, preservatives or additives that
contain gluten.
Following a gluten-free diet may have been challenging a
decade ago, given that many of our staple foods contain the protein. But
grocery stores are now stocked with an array of gluten-free alternatives,
albeit at a higher price than gluten-containing products.
While the availability of gluten-free foods is great for
people with gluten sensitivity, more and more of us without such an intolerance
are turning to gluten-free products. Why? Many of us believe gluten is bad for
us, even when there is very little scientific evidence suggesting it is.
'Gluten is only bad for your health if you are a celiac'
According to a survey from market research company NPD
Group, almost 30% of adults in the US claim to be reducing their gluten intake
or cutting the protein out completely - a proportion that is much higher than
the number of people who have celiac disease.
But there seems to be limited evidence that - outside of
celiac disease - gluten is bad for our health. A 2011 study, conducted by Peter
Gibson and colleagues from Monash University in Australia, claimed that NCGS
may be a legitimate disorder, after finding participants that consumed gluten
experienced increased bloating and fatigue.
A 2013 study from the same research team, however,
overturned their previous findings. "We found no evidence of specific or
dose-dependent effects of gluten in patients with NCGS," the team
concluded. In fact, the researchers found the bloating previously identified
may be attributable to consumption of carbohydrates called FODMAPs (fermentable,
oligo-, di-, monosaccharides, and polyols).
And in November 2014, Medical News Today reported on a study
published in the Journal of Proteome Research, in which investigators found
non-gluten wheat proteins - serpins, purinins, α-amylase/protease inhibitors,
globulins and farinins - may be triggers involved in celiac disease.
Gaynor Bussell, a dietitian and spokesperson for the UK's
Association for Nutrition, told Medical News Today: "Gluten is only bad
for health if you are a celiac."
Lisa Cimperman, a clinical dietitian at the University
Hospitals Case Medical Center in Cleveland, OH, and a spokesperson for the
Academy of Nutrition and Dietetics, added: "Gluten is neither essential
not detrimental to one's health or quality of diet."
Gluten has been 'popularized as a dietary villain'
As such, some nutritionists believe following a gluten-free
diet without having received a diagnosis of celiac disease does not offer
health benefits, but the unwarranted praise for the diet makes us believe it does.
Cimperman told us:
"There are no beneficial health effects [to a
gluten-free diet]. Wheat and gluten have recently become popularized as dietary
villains by a number of books and media outlets.
Unfortunately, talk show hosts and celebrities are able to
amplify such messages while having little to no health or nutrition
credentials. There is no research to support gluten-free diets for anyone other
than those affected by celiac disease."
In fact, some experts claim following a gluten-free diet in
the absence of celiac disease may actually be detrimental to health, as it can
lack the nutrients needed to maintain a healthy, balanced diet. According to
the Mayo Clinic, a gluten-free diet may lead to lower levels of iron, calcium,
fiber, folate, thiamin, riboflavin and niacin.
Rafe Bundy, a nutritionist and spokesperson for the
Association for Nutrition, disagrees, claiming it is possible to get all the
nutrients you need with a gluten-free diet.
"There are many people around the world that consume a
diet which is naturally gluten free or low in gluten," she said. "A
good example is most of Asia, where the main staple food is rice, not wheat.
It's perfectly possible to have a healthy diet which is also gluten-free diet
using most standard dietary advice."
Another point that goes against a gluten-free diet, however,
is that many processed gluten-free products can be higher in fat, sugar and
calories than their gluten-free alternatives, which can lead to weight gain.
"'Gluten free' has achieved health halo status,"
Cimperman told MNT. "People believe that this term absolves the food of
any other negative characteristics. The reality is that gluten-free junk food
or desserts are certainly no healthier than their gluten-containing
counterparts."
Are we being 'duped' into believing gluten-free is healthy?
But if this is the case, why do the non-gluten intolerant
public continue to pile up their shopping baskets with gluten-free products? A
survey conducted by consumer research company Nielsen revealed that sales of
gluten-free products in the US rose by 16.4% in 2013-14, reaching $23.3
billion.
In sync with the earlier statement made by Cimperman,
Bussell told us: "They have been duped by popular but poorly informed
celebrities and media."
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| A survey revealed that sales of gluten-free products in the US rose by 16.4% in 2013-14, reaching $23.3 billion. |
When you have celebrities like Paltrow and McCarthy openly
talking about how going gluten free has changed their lives, while promoting
numerous books on how to make your own delicious gluten free meals at home, it
is hard not to take notice.
It is also hard not to notice the increasing array of
gluten-free products available in grocery stores. But is this because the
stores are bowing to the consumer demand? Or are they simply jumping on the
gluten-free hype in an attempt to make more money? Bussell believes it may be a
bit of both.
"It's true that grocery stores will try and bow to
demand," she said. "It's a vicious circle as they may try and sell
more by promoting gluten free as a good myth. On the other hand it does give a
true celiac more choice other than what they can get on prescription."
Some nutritionists believe that the focus on gluten-free
diets and the growing availability of gluten-free foods may also be driving
awareness of celiac disease.
"Increased awareness of the gluten-free diet hopefully
provides an opportunity for increasing awareness of celiac disease, the
symptoms of celiac disease, the diagnosis process and the associated health
implications of undiagnosed celiac disease," a spokesperson from Coeliac
UK told MNT.
But is there also a worry that a gluten-free diet will be
seen as nothing more than a "fad," distracting from the seriousness
of celiac disease?
"There is the possibility that those who remain unaware
of celiac disease fail to appreciate the seriousness of the disease," said
Cimperman. "My hope is that people with celiac disease and other
knowledgeable individuals will see this as an opportunity to educate."
Talk to your doctor or dietitian before adopting a
gluten-free diet
From the evidence presented in this feature, it is clear
that the pros and cons of a gluten-free diet among non-celiacs need to be
investigated further.
For now, it seems the gluten-free trend is set to continue.
But before you go scrapping the protein from your diet - whether due to gastrointestinal
problems or the desire for a change in food intake - Cimperman offers a word of
advice:
"Any gastrointestinal symptoms, such as chronic or
severe abdominal pain, bloating or diarrhea should be discussed with a doctor.
Your doctor will need to assess for many other conditions that may be causing
symptoms. Self-treating may delay proper treatment.
In addition, it is important to continue consuming gluten
prior to being tested for celiac disease - following a gluten-free diet prior
to being tested may result in a false negative. If you still want to follow a
gluten-free diet after celiac disease or any other health problems have been
ruled out, talk to a dietitian to make sure your diet contains all the
essential nutrients."
Our Knowledge Center article - "What is gluten
intolerance? What is celiac disease?" - provides further information on
these conditions.
Written by Honor Whiteman


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