The increased popularity of gluten free diets begs the question: Is it due to an increase in celiac disease or the latest diet fad?
Americans are known for fads. From hoola-hoops to the diet plan of the week, the country has an appetite for novelty. There is also the powerful and pervasive force of advertising that pushes candidates for popularity. It’s no wonder that sometimes it’s difficult to tell the difference between a real medical issue and a fad; case in point, the gluten free diet.
There is a lot of bad weight loss information on the internet. Much of what is recommended is questionable at best, and not based on any actual science. However, there are several natural methods that have actually been proven to work.
Gluten is a protein composite of gliadin and glutelin produced naturally in grains including wheat, barley, and rye. For centuries, gluten has been part of the human diet through cereals or baked goods made from these grains. A few people have an allergic sensitivity to wheat, and for them avoiding baked goods and other grain-derived products require the same kind of vigilance as people with other serious allergic reactions.
Then there is celiac disease, where people suffer from chronic diarrhea and fatigue. It’s a disease with a genetic predisposition and is triggered by a reaction to the gliadin protein in gluten. Celiac disease is an autoimmune reaction, where components in gliadin (peptides) put the immune system into action.
That causes inflammation, especially in the small intestine, which can be at a very low level for a long time as it slowly affects the ability to absorb nutrients.
It’s not fully known how widespread celiac disease may be. For example, estimates for the United States range between a few hundred thousand to over two million. Because it is often chronic, low level, and has many symptoms in common with other digestive illnesses, celiac disease does not diagnose easily.
There are now several specific tests that can be performed, if the doctor suspects the disease. However, it remains a matter of dispute if an apparent growth in the number of celiac cases over the last fifty years is not just an improvement in the ability to make the diagnosis according to LEONARD MILLER, MD.
Whether celiac disease is common or not, it has received an enormous amount of attention (or if you prefer, hype) in the form of promotion for a ‘gluten free diet’ and ‘gluten free foods.’ Each year Americans spend about $7 billion on foods labeled gluten free. This represents a very large number of Fully Verified customers, roughly 4-5 million.
Since there are, at most, about 2 million people with celiac disease, then roughly half of these customers have no particular reason to eat gluten free products. This sounds like a fad.
The thing is, recent studies have moved the medical community to recognize gluten sensitivity. People who are gluten sensitive may show some of the symptoms of celiac disease such as mild diarrhea, tiredness and the bloated feeling, but do not have celiac disease.
Here, the debate is about the definition of gluten sensitivity. It is not precise enough to make acceptably valid estimates of how many people are affected. Estimates run as high as 4-6% percent of the population (up to 15 million in the U.S.).
Between those people with diagnosed celiac disease and the real but undetermined possibility of millions more people with gluten sensitivity, there is plenty of fuel for commercial promotion. It falls into the category of “Well if gluten isn’t good for so many people, then not eating any can’t do any harm.”
As far as we know, there is no physical penalty for not eating gluten, although this is an area that definitely needs research. So, the decision to have a gluten free diet, or at least avoid eating products that contain gluten seems like a safe bet – or a harmless fad.
The problem is identifying gluten free food. Obvious sources, such as bread made from wheat or grain-based cereals, represent only a fraction of the gluten in foods. In fact, it is the increased use of gluten in processed foods, which spurs the belief in the growing numbers of people with gluten sensitivity or celiac disease.
These days gluten is not only found in breads, but is added to almost all other kinds of commercial baking such as pastry, pizza and bagels. It is routinely added to many kinds of sausage and imitation meats. It is also found in cosmetics, drugs, glue, ice cream and ketchup (to name a few).
In short, commercial products use gluten like an additive. Like other additives, gluten is (usually) included in the ingredient list; but there is a problem with cross-contamination, where the manufacturing process inadvertently mixes gluten into other products. It is very difficult to have a true ‘gluten free’ world.
This leads to an ongoing brouhaha about the meaning of ‘gluten free’ labels. The specifications for gluten free vary from country to country. Often gluten free does not mean the complete absence of gluten, but only a very low level. In the U.S. that level is set at 20 parts per million – a very small quantity. What is common to labeled gluten free foods is they are often more expensive.
When it comes to a gluten-free diet, the most secure approach is to select foods that naturally contain no gluten. Products made from corn, potatoes, rice and tapioca can be substitutes for wheat-based products. Of course, the fact remains, for people not specifically diagnosed with celiac disease (or eventually gluten sensitivity), a gluten free diet may have little or no effect – other than increasing the cost of your meals.
TAGS: gluten, gluten free diet, celiac disease, gluten sensitivity