Gluten-Free: What's The Big Deal?

So you can’t get through a day right now without hearing something about gluten? Whether it’s a great health food product your friend told you about, the new gluten-free options at your favorite restaurant, an interview with the latest celebrity endorser or even (gasp!) another magazine article discussing the benefits of going gluten free.  Hype?  Hooey?

At the risk of contributing yet another gluten-free article to the already saturated ‘market’, I thought it a good idea to attempt to clear up some of the misinformation surrounding this increasingly popular movement. In many respects gluten has been vilified as a toxic substance that has no place in a healthy diet, but is this actually the reality?

What is a gluten-free diet?

As its name implies, it is a diet where gluten-containing foods are eliminated. . Gluten is a protein primarily found in wheat, rye and barley. While oats do not contain gluten, they are also generally avoided as they are regularly cross-contaminated with wheat during production. Functionally, gluten is the component of flour that gives dough and breads their elasticity.

People following a gluten-free diet must rely on other grains, like rice and corn, as well as starchy roots, such as potatoes, as their major sources of carbohydrates. Many traditional processed foods are made using wheat flour or other wheat by-products (ex. crackers, breads, pasta, cakes, beer, condiments, cookies, etc.) so they are generally avoided or non-gluten alternatives must be found.

Aside from the lack of wheat containing products, a gluten-free diet looks quite similar to general healthy eating recommendations, that is a diet built around a variety of fresh, whole foods, including plenty of fruits and vegetables, whole grains (minus wheat, rye, barley & oats) and lean sources of protein.

Gluten-related disorders

There are several gluten-related disorders where the ingestion of gluten is known to cause problems. The first is celiac disease, which is also known as gluten-sensitive enteropathy or celiac sprue. Celiac disease is an autoimmune condition where gluten triggers the inflammation of the intestinal wall, causing symptoms of nutrient malabsorption, abdominal discomfort/pain, diarrhea, headaches and lethargy. If left untreated permanent intestinal damage can occur. Celiac disease can only be diagnosed through a blood test or a biopsy.

Another gluten-related disorder is wheat allergy, which is distinct from celiac disease. Individuals with wheat allergy are sensitive to many proteins found in wheat, one of which is gluten. While some symptoms may be similar to celiac disease, wheat allergies elicit an allergic response that is primarily respiratory (ie. difficulty breathing). Individuals with wheat allergy do not see damage to their intestinal wall and thus do not exhibit any difficulties absorbing nutrients.

A third condition, which is relatively new and slowly being recognized by the medical community, is called Non-Celiac Gluten Sensitivity (NCGS). The prevalence of NCGS in the general population appears to vary greatly, but has been estimated to range from about 0.6% to 6%. Sufferers of NCGS have had celiac disease and wheat allergies ruled out via blood tests and/or biopsies. Their symptoms tend to overlap with that of irritable bowel syndrome (IBS) and include abdominal discomfort, bloating, flatulence, diarrhea and headaches. Individuals with NCGS show improvement in their symptoms when gluten is removed from their diet and the subsequent return of symptoms if gluten is reintroduced. There is still much research to do on this condition as the mechanism for NCGS is not understood.

Do gluten-free diets have any other health benefits?

In recent years celebrities and opportunistic health professionals have jumped on the gluten-free bandwagon claiming the potential benefits of following a gluten-free diet include better sleep, increased energy, thinner thighs, faster weight loss, clearer skin, and the improvement of medical conditions such as autism and rheumatoid arthritis. Virtually all of these claims have little truth to them, at least not in terms of the role gluten has in contributing to these problems.

Perhaps the most well-known of these proponents is Dr. William Davis, author of Wheat Belly. In his book Dr. Davis argues that grains, particularly wheat, were only introduced into human’s diets approximately 10,000 years ago with the advent of agriculture and that we, as a species, have not had adequate time to adapt to the specific contents of wheat from an evolutionary perspective. This has resulted in many negative consequences to our health, including the current obesity epidemic.

There is little support for Dr. Davis’ theory among the scientific community. There have been hundreds, if not thousands, of studies demonstrating that a healthy, balanced diet can include whole grains as a major component. Unless you suffer from a gluten-related disorder, there is no long-term evidence to suggest that avoiding wheat is any healthier than diets that include it.

So is a gluten-free diet right for you?

If you have celiac disease, the answer is unequivocally yes. For celiacs, gluten intolerance is a lifelong condition, where the only treatment is the complete avoidance of gluten-containing foods.

After that, thing gets a little more complicated.

If you have a wheat allergy, obviously wheat must be avoided, but other gluten-containing grains, like rye or barley are okay to eat. If you’ve been diagnosed with or suspect you have NCGS you may wish to try a gluten-free diet. I would recommend doing so under the supervision of your doctor and/or nutritionist. Make note whether or not your symptoms improve when you remove gluten from your diet. As tolerance levels to gluten can vary, following the elimination of gluten from your diet you can try to slowly reintroduce gluten-containing foods to see what you’re able to handle without the symptoms coming back. It may take a bit of trial and error but there’s no point avoiding foods you enjoy if you don’t need to.