by Jessica DeCostole
Gluten-free labels in the grocery store have become as familiar as the “0 grams Trans Fat” labels. But while everyone can benefit from a trans fat-free diet, a gluten-free diet is only medically prescribed for individuals diagnosed with Celiac disease. Celiac disease is an autoimmune disorder in which the protein gluten (found in wheat, barely, rye and some oats) sets off an autoimmune reaction in the small intestine leading to damage of the mucosal lining, resulting in nutrient malabsorption and symptoms such as bloating, gas, diarrhea, and constipation. The incidence of celiac disease, once put at 1 in 10,000, is now believed to effect as many as 1 in 133 people.(1) The growing market for gluten-free foods, estimated at 2.6 billion dollars last year, has created the idea in many consumers’ heads that gluten-free equals healthy.
A gluten sensitivity is usually diagnosed when symptoms such as abdominal pain, fatigue, headaches, confusion or tingling of hands and feet are present, but blood tests and endoscopy find no evidence of celiac disease.(1) Those with gluten sensitivity are often advised to follow a gluten-free diet or at the very least, decrease consumption of the protein. Celiac disease and gluten sensitivity effect individuals of all ages and can occur at any time in life. One theory for the increased incidence of these conditions is that new agricultural practices have changed the gluten content in wheat.
While “gluten-free” foods are a great addition to the market for those dealing with these conditions on a daily basis, it’s important as future practitioners for us to examine a client’s diet carefully, even if they come in reporting that they are gluten intolerant, before recommending gluten-free foods. The increase in popularity of these foods is due to the many reports that a gluten-free diet can increase energy, reduce various health problems, and even help people lose weight. However, there is little scientific evidence to back this up. In fact, some research suggests that healthy individuals who follow a gluten-free diet may be damaging their gut’s beneficial microbe environment. A small study found that having healthy adults follow a gluten-free diet for one month decreased their healthy gut bacteria and increased unhealthy gut bacteria.(6) Another study compared the nutrient intake of subjects on gluten-free diets to the recommended intakes for Americans and found that all individuals on the gluten-free diet had significantly less niacin and carbohydrate intakes and that females had less thiamine and iron intakes and males had lower fiber intake while on a gluten-free diet.(3) Associating gluten-free products with healthy is unfounded. In fact, many gluten-free products on the market have been found to have more calories and TK compared with regular versions.(5)
Following a gluten-free diet is extremely difficult. Gluten is found not only in baked goods, but also used as a thickening agent in everything from ketchup to lip gloss. In addition, those with celiac disease and gluten sensitivity face the extra difficulty of being at an increased risk for nutritional deficiencies. Adopting a gluten-free diet is a serious decision that should be discussed with a medical professional and dietitian.
References
(1) Beck, Melinda. “Clues to gluten sensitivity” Wall Street Journal, August, 2011
(2) Beck, Melinda. “Gluten-free diet TK” Wall Street Journal, August 24, 2011
(3) C.N. Stanley, et al., “Nutrient Intakes of Individuals Consuming a Gluten-Free Diet Compared to Intakes of the General American Population and Healthy Eating Guidelines”
Journal of the American Dietetic Association, 110(9), Supplement 1, September 2010, Page A13
(4) Clark, Melissa. “Gluten-Free: Flavor-Free No More” New York Times. Retrieved on August, 2011 from http://www.nytimes.com/2011/06/01/dining/gluten-free-flavor-free-no-more.html?pagewanted=all
(5) Hill, Michael. “How has gluten-free become so popular? Retrieved on August, 2011 from http://www.salon.com/news/feature/2010/09/16/us_fea_food_gluten_free_boom
6) Biesiekierski B, et al., “Gluten Causes Gastrointestinal Symptoms in Subjects Without Celiac Disease: A Double-Blind Randomized Placebo-Controlled Trial” American Journal of Gastroenterology, advanced online publication, January 11, 2011