Over the last several years, gluten has become the latest health buzzword that is seemingly everywhere. And there are a lot of us – up to 30% of Americans – who believe they should be eating less gluten, a protein found in some grains such as wheat, barley and rye. Let’s learn if the gluten-free way of life is really necessary.
BY: MASCHA DAVIS, MPH, RDN
What’s the deal with gluten, and should we really fear it?
Celiac disease, an allergy to gluten, is a very real condition, and affects less than 1% of the US population. Gluten sensitivity, on the other hand, is a relatively new topic, and there has been a huge surge of interest in Non-Celiac gluten/Wheat Sensitivity (NCWS).
Scientists estimate that between 0.5% – 6% of the US population may have some degree of gluten sensitivity. Some of these individuals may be pre-celiac whereas others may be allergic to wheat (which is different from being allergic or sensitive to gluten). Still, other individuals may be sensitive to other compounds called FODMAPs, which are a class of carbohydrates that some people have difficulty digesting.
Whatever the real number, the bottom line is that it’s nowhere near the 30% of Americans who think they are sensitive to gluten.
Have there been any important studies that question the number of people who are actually gluten-sensitive?
Professor and scientist Peter Gibson carried out a study in 2011 that gave some credit to the belief in gluten sensitivity. However, in 2013 he revisited the same topic to take a closer look at its credibility, discrediting his own initial study in the process. The study parameters were as follows:
Subjects were given every single meal for the duration of the study. Any other potential causes of symptoms were removed from the diet (lactose from milk, etc).
To test whether gluten was having any negative effects (stomach pain, bloating, brain fog, joint pain, etc.), Gibson put them on one of three diets: gluten-free, low-gluten, and high-gluten. Each diet consisted of the same foods; the only difference was the amount.
Each subject spent a week eating meals from each category, while undergoing tests and keeping a daily symptom diary. It turned out that gluten seemed to have zero measurable harmful effects. The second study was more rigorous than the first, and showed that it’s very unlikely that gluten is the culprit.
But how is it possible that people experience real health improvements when they go gluten-free?
Some people who cut out gluten-containing foods and claim to feel better may actually have sensitivities to other compounds (like FODMAPs) or wheat. Other studies show a placebo-like effect. It’s also possible that eating fewer processed foods (i.e. many grain products) is behind the reason they are feeling better.
In other words, it is not the gluten itself, but the reduction of simple carbs in general. These are much more likely to be one of the alternative explanations than gluten. But don’t ask the food companies. They are on track to make $16B USD in profit from gluten-free products in 2016.
Do you see any potential dangers for someone who decides to go gluten-free without clearing it with a medical professional?
Simply eliminating gluten can actually end up doing more harm than good. People who unnecessarily eliminate it end up cutting out many healthy sources of carbs. They replace them with far less healthy foods, or poorer sources of energy which do not taste nearly as delicious!
Are there ways that people can find out whether they are sensitive to gluten?
With a lot of research underway, the existing limited data shows that people don’t need to avoid gluten. That is why it’s important to see a doctor and dietitian if you suspect you have celiac or gluten sensitivity. They’ll recommend the right tests and help you with proper elimination diets to figure out the right treatment for you.
A number of screening blood tests for celiac disease exist, as well as tests for HLA DQ2 and DQ8 genes. These genes help determine if someone is potentially at risk for celiac disease.
These genetic tests, however, are not definitive; – 40% of all people carry these genetic variants with only 1% who actually have celiac disease. Emerging research also indicate that there may be potential new ways to identify NCWS.
Any words of wisdom for folks who are on the fence about going gluten-free?
For the vast majority of individuals (about 98% of the population), gluten is OK to eat! It may sound crazy amidst the latest trends, but it’s what all of the current research points to.
For the small number of truly sensitive individuals who will benefit from restrictive gluten diets, it’s definitely worth it to consult medical professionals. A physician or dietitian will make sure they are properly diagnosed and treated.
At the end of the day, how a person chooses to define healthy is up to them…so if this is the lifestyle that makes you feel great, go for it! There are definitely ways to reduce or eliminate gluten and still be healthy. But ensure yourself the diet stays balanced and key nutrients (like fiber and the right amount of energy dense carbs) are not cut out along with it.
Consulting a nutrition expert such as a Registered Dietitian is one of the best ways to ensure that you are meeting all of your nutrient needs, whether you are eating gluten or not.
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Mascha Davis, MPH, RDN is a Los Angeles-based private practice dietitian who shares her love of health and wellness through a unique global perspective. From world-class U.S. medical centers to rural villages in Africa, Mascha has dedicated herself to traveling the world, spreading her love of healthy living through both her humanitarian work and private practice. Learn more about Mascha at Nomadista Nutrition.