The Cooper Institute
 

Founded in 1970 by the "Father of Aerobics"
Kenneth H. Cooper MD, MPH

 
 
 

Gluten: Facts and Fallacies

Posted in

Friday, May 03, 2019

Diet trends may come and go, but there are some basic facts about nutrition that never change no matter how the general population interprets them. Take gluten for example. Many people are going to great lengths to avoid gluten in their diets with food manufacturers and some restaurants touting their ‘gluten-free’ products as part of a healthy lifestyle.

According to a survey by U.S. News and World Report, 41% of U.S. adults believe that gluten-free foods are beneficial for everyone. Is this true? Before we all jump on the ‘gluten-free’ bandwagon, let’s look at some basic facts.

Gluten and Celiac Disease. 

Gluten is a protein that is found in grains such as wheat, barley, and rye. Only about 1% of the U.S. population suffers from celiac disease, which is a type of autoimmune disease where gluten causes the production of antibodies. These antibodies cause inflammation and damage to the lining of the small intestine. This makes it more difficult to absorb nutrients through the intestinal wall and into the bloodstream.

People with celiac disease are extremely sensitive to gluten-containing grains with symptoms that may include bloating, gas, and diarrhea. It makes sense then that avoiding gluten-grains like wheat, barley and rye is part of the standard care for patients with this disease.

Celiac disease can only be accurately diagnosed via blood tests and a small intestine biopsy. There are many other conditions that can cause similar symptoms, so do not try to self-diagnose. A board-certified gastroenterologist is best-qualified to diagnose this and other related conditions.

Gluten Sensitivity. 

Gluten sensitivity is not the same thing as celiac disease. Approximately 6.5% of the U.S. population may be gluten-sensitive.  While gluten sensitivity can trigger the same unpleasant symptoms as celiac disease, there is no antibody production and no damage to the lining of the small intestine. Just like with celiac disease, only a qualified medical professional can diagnosis this condition. A recent study of patients who self-diagnosed as gluten sensitive proved how mistaken self-diagnosis can be.

In the study, a group of 392 patients in Italy were followed over a two-year period. At baseline, all patients believed that they either had celiac disease or were gluten-sensitive. After six months on a gluten-free diet, followed by one month where gluten was reintroduced into the diet, 6.6% of the patients were found to have celiac disease, 7% were found to have gluten-sensitivity, and 0.5% was found to have wheat allergy. The remaining 86% did not have any of these conditions and their symptoms did not change with a gluten-free diet.  

What about the Other 92% of the U.S. Population?

There is no doubt that people with celiac disease, gluten sensitivity, or wheat allergies should avoid gluten-containing foods, but these people make up only 8% of the U.S. population. There is no evidence that gluten is harmful in any way for the remaining 92% of the population. In fact, increased consumption of whole grains is one of many effective strategies for decreasing the risk of future type 2 diabetes, cardiovascular disease, metabolic syndrome, and colorectal cancer.

Not all Gluten-Free Foods are Healthy. 

The good news for these patients is that gluten-free foods are more readily available and easily labeled. The bad news is that many foods are labeled gluten-free as part of dieting marketing hype. Just because a food or beverage is gluten-free does not mean that it is a healthy food choice. Many snack foods like cookies and chips are also now gluten-free, but provide only empty calories. Soda has always been gluten-free, but it’s obviously not a good choice either. And gluten-free bacon is still high in saturated fat, sodium and nitrates. Don’t fall for the hype.

Thankfully, this is one trend that most of us don’t have to worry about. Going gluten-free is important if you have a condition diagnosed by a qualified medical professional. But self-diagnosing any condition can be dangerous and may cause you to miss treatment for another underlying condition.

Reference

Capannolo, A., Barkad, V.A., Ciccone, V.G., Melideo, D., Frieri, G.,  & Latella, G. (2015).  Non-celiac gluten sensitivity among patients perceiving gluten-related symptoms. Digestion, 30:92(1), 8-13.