Posted on 04/05/2012 at 08:36:43 PM by Student BloggerBy Sarah Gold
The gluten-free aisle of the grocery store is growing exponentially. While this explosion benefits many individuals, it also contributes to a growing number of misconceptions about gluten and it's role in weight, energy, and other health concerns.
Gluten is a protein found in wheat, barley, and rye products. Celiac disease, an autoimmune disorder in which the affected person cannot tolerate gluten, affects about 0.75% of the United States population (1). Gluten triggers an immune response that damages the mucosal lining of the small intestine, which can lead to malabsorption of many nutrients and gastrointestinal symptoms including gas, bloating, vomiting, and diarrhea (2). It can be diagnosed with a simple blood test, and confirmed with an intestinal biopsy, if necessary. Currently, the only treatment for celiac disease is avoiding foods with gluten.
Gluten sensitivity, a condition affecting between 6-10% of the U.S. population, often leads to similar but less severe symptoms and tolerance varies among individuals; however, it is not accompanied by the development of antibodies and damage to the mucosal lining. Research is limited in this area, though a recent study did find that gluten sensitivity does exist and is clinically different than celiac disease (3).
Until recently, following a gluten-free diet meant avoiding foods such as bread, pasta, cookies, crackers, cakes, pizza, and beer. For a long time, the gluten-free version of these products was extremely limited, and lacked the flavor and texture of its gluten-containing counterparts, leaving taste buds unsatisfied. As we've come to understand more about gluten intolerance, the demand for these products has grown, food technology has caught up, and there are now many palatable, and even tasty choices for people who need to avoid gluten. What started as a niche market, the gluten-free food industry now includes products from some of the country's largest food companies, and represents an estimated $2.54 billion in sales, expected to double by 2015 (4).
Like other food trends, the food industry, the media, and celebrities like Oprah Winfrey, Gwyneth Paltrow, and Jenny McCarthy have created a health halo around gluten-free foods. Claims of the benefits include improved energy, better sleep, weight loss, clearer skin, and reduced risk of autism. Consumers continue to turn to the latest weight management or health trend in hopes of a quick fix, and the gluten-free diet is no different.
Removing gluten-containing products from one's diet could result in weight loss and greater energy if all gluten-containing foods like cookies, cakes, and crackers are replaced with foods that are naturally gluten-free like fruits, vegetables, legumes, low-fat dairy, and some naturally gluten free grains like quinoa, amaranth, and oats. But, if weight loss occurs, it would be from reducing calorie intake, not avoiding gluten. Research has yet to show any weight-loss benefits directly related to removing gluten from one's diet. In fact, it's common for people with celiac disease to gain weight when starting a gluten-free diet because nutrient absorption in the intestines is restored (5).
An important factor to consider when choosing to go gluten-free is that replacing gluten-containing items with gluten-free foods could actually negatively affect a person's nutrition status because gluten-free foods are often not fortified like refined grains. Interestingly, adherence to a gluten-free diet pattern has been associated with reduced intake of iron, folate, niacin, zinc, and fiber (6).
In spite of the lack of scientific support for a gluten-free diet, consumers continue to pay a premium for gluten-free foods, even in the midst of a recession. While the increase in gluten-free foods has led to improved health and quality of life for individuals with celiac disease and gluten sensitivity, if you don't have one of these conditions, I'd save your pennies. What is your experience and would you pay more for such foods?
1. Fasano A, Berti I, Gerarduzzi T, et al. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States. Archives of Internal Medicine. 2003;163(3):268–292.
2. Thompson, T. National Institutes of Health consensus statement on celiac disease. Journal of the American Dietetic Association 2005; February: 194-195.
3. Sapone, A., Lammers, K., et al. Divergence of gut permeability and mucosal immune gene expression in two gluten associated conditions: BMC Medicine 2011; 9(23): 1-11.
4. MarketResearch.com Gluten-free foods and beverages in the U.A., 3rd edition. February 2011. Web. 25 February 2012.
5. Barton, S. Murray, J. Celiac disease and autoimmunity in the gut and elsewhere. Gastroenterology Clinics of North America 2008; 37: 411-428.
6. American Dietetic Association (ADA). “Evidence based nutrition practice guidelines on Celiac Disease.” ADA Evidence Analysis Library. ADA. May 2009. Web. 25 February 2012.