To gluten or not to gluten?

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April 19, 2019

In recent years the term gluten-free has become more well known than ever before. From gluten-free goods becoming regularly available in grocery stores to gluten-free options being added to restaurant menus, what was once a costly, niche label has become widespread.

In the International Food Information Council Foundation’s 2018 Food and HealthSurvey, gluten-free eating ranked among the top three diets followed by respondents. Globally, the gluten-free products market is expected to have a Compound annual growth rate of 7.5% from 2016 to 2022, according to Allied Market Research.

Part of the growth in market demand for gluten-free foods can be attributed to people who cannot eat wheat for health reasons, such as those with Celiac disease.

Celiacs disease is “an inherited chronic inflammatory autoimmune disorder that is estimated to affect up to 3 million Americans,” according to the Food and Drug Administration(FDA). “For people who have celiac disease, consumption of gluten results in the destruction of the lining of the small intestine and the risk of other serious health conditions.”

However, going gluten-free has been touted as a healthy diet change for people for whom gluten has no such negative effects. Proponents of clean eating claim it is simply healthier, or that humans are not designed to eat wheat. Others claim a gluten-free diet is a treatment for autism, fatigue or various medical conditions.

According to the Celiac Disease Foundation (CDF), gluten is a general name for proteins found various grains, such as wheat, barley and rye, which acts as a binding agent and helps foods maintain their shape.

Gluten-free usually refers to one of two things. First, some foods by their nature do not contain gluten, like rice, meat or vegetables. These foods are sometimes labeled as naturally gluten-free, because they simply exist as such but are not made specifically to be safe for people with celiac.

Rice, for example, is naturally gluten-free, and could be labeled as such to capitalize on the growing health food trend.

However, as of 2015, the FDA requires all foods bearing the gluten-free label to be tested to contain less than 20 parts per million (ppm) of gluten in the food. This is the threshold amount that is generally safe for people with celiacs.

The second type of gluten-free food is produced specifically to be a substitute for foods which typically contain the protein. These foods, which include gluten-free bread, breading and pastries, are manufactured with alternative flours and use various fillers and flavorings to replicate the taste and texture of the foods they are made to replace.

As a result, such foods are often higher in calories, carbohydrates, fats and sugars than their gluten filled counterparts.

While the rising popularity of gluten-free foods makes them cheaper and more accessible for people with celiacs or wheat allergies, most people driving the growth of this market do not have a health condition that requires them to stop eating gluten.

Some people may genuinely feel better after stopping gluten consumption. While this could be due to an undiagnosed gluten intolerance, it is also likely to be due to the fact that cutting out gluten also cuts out or reduces the intake of refined starches and sugary foods, such as white bread, cake and cereals.

The fact that eating less refined carbohydrates and more fruits and vegetables is healthier and can aid with weight loss is well known. However, these dietary changes are not specific to gluten, they are about processed foods and carbohydrates. Eating less sweets or white bread overall is one thing, replacing regular bread with gluten-free processed carbohydrates is another.

Currently there are no studies tosupport the fact that elimination of gluten alone has health benefits, or that it is beneficial for symptoms of autism or unrelated medical conditions.

According to the Celiac Disease Foundation, autistic people do have a higher rate of gluten sensitivity than the general population, however, so an autistic child who stops eating gluten may feel better due to an alleviation of unrecognized illness due to gluten sensitivity.

There is no definitive evidence that going gluten-free is beneficial to all autistic children, or people without celiacs. The reality is, unless you have an adverse reaction to gluten, eliminating it from your diet is more likely to cause problems than solve anything.

Today’s wheat products are typically enriched with vitamins and nutrients, which their gluten-free counterparts are not. As a result, sudden removal of these vitamin sources on a gluten-free diet can lead to nutritional deficiencies, according to astudy published by the National Institute of Health (NIH).

The study found that gluten-free foods are lower in fiber and micronutrients, in particular Vitamin D, B12 and folate, and minerals such as iron, zinc, magnesium and calcium.

Such deficiencies can cause health problems both immediately and long term. While they are avoidable or minimizable with supplements and careful attention to nutrition and diet, it is a noteworthy risk to gluten-free diets. While it is worth it for people who cannot eat wheat for health reasons, simply deciding to stop eating gluten independently is likely to have either no effect, or cause health problems long term.

Dr. Daniel A. Leffler is the director of clinical research at the Celiac Center at Beth Israel Deaconess Medical Center in Boston. In an article by Harvard Medical school, Dr. Leffer criticized the trend of equating gluten-free with healthiness.

“People who are sensitive to gluten may feel better, but a larger portion will derive no significant benefit from the practice. They’ll simply waste their money, because these products are expensive,” Leffler said.

For people with gluten sensitivities of any kind, going gluten-free is worth the difficulties, and is often the only treatment for their symptoms. Such people are also usually monitored and advised by doctors about the potential complications of such a diet.

Going gluten-free without a doctors advice or supervision, however, is likely to do nothing at best, and actually cause problems at worst. For those without gluten intolerances, there is simply no point.

Celiac disease and gluten allergies are detectable through medical testing, and going gluten-free prior to such testing can actually make the diseases harder to detect, because of the lessened symptoms. To avoid complications, anyone suspecting a gluten issue should consult with their doctor, at least so they are fully informed of the risks of such a dietary change.

Going gluten-free is an important step to getting healthy for many people. However, going gluten-free without medical reason is comparable to taking aspirin for a nonexistent headache.

There will always be new trends and diets being touted as a cure for any problem one may have, but it is your choice to be informed before blindly following them.


To gluten or not to gluten? was published on April 19, 2019 in Sports & Health

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