American Society For Nutrition

The Gluten-Free Health Halo

The Gluten-Free Health Halo

Excellence in Nutrition Research and Practice
Posted on 04/05/2012 at 04:36:43 PM by Student Blogger
By 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?

References
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.

6 Comments
Posted Apr 06, 2012 9:57 AM by Steve

I've tried gluten-free pizza, just to taste it, and I wouldn't pay again to order it unless I did have a condition that required me to.


I avoid all gluten-free products because I don't have Celiac or a similar disease. Same goes for sugar-free products.

Honestly, I think most people are just overwhelmed by the choices at the grocery store. The average person probably realizes that most processed foods are not ideal, so seeing something "free" is bound to appeal to them.


Posted Apr 12, 2012 10:15 PM by Tom

I do have diagnosed celiac disease so I am following the diet in an effort to increase the absorption of certain deficiencies I know I have and of possible ones we don't even test for but are increasingly becoming aware of as important to long term health. I have thrown out hundreds of dollars worth of inedible gluten free foods in my attempt to find things that I can eat safely. While I have found some good products I cannot imagine eating 95% the packaged gluten free products instead of the original ones they are attempting to imitate if I did not have a need to do so and in most cases have just avoided them completely.

That's not to mention the problem of not being able to eat in normal restaurants or fast food places when I don't have the time or get tired of having to prepare almost everything from scratch.

What I would give for a fresh baked slice of rye bread or a croissant! Bottom line -- Why would anybody who does not need to follow this diet?


I've tried gluten-free pizza, just to taste it, and I wouldn't pay again to order it unless I did have a condition that required me to.


Thank you for making it clear what gluten is and gluten-free foods are for. I often see food products labeled as "gluten-free", and intuitively I was thinking that they were some kind of diet foods, but now I know, they are designed for people with specific health conditions.

But as you have written, such products are marketed as dietary and weight loss beneficial. It is obviously that if you avoid such rich in carbohydrates foods, you'll reduce your daily calorie intake significantly, which presumably will lead to weight loss, but not due to the absence of gluten. And if such products lack only for gluten, and remain their other nutritional value, I doubt they will contribute to weight loss. However, a well informed consumer can not be mislead easily.


This demonization of gluten will subside in a few years - people are always on the lookout to blame anything else but themselves for their unhealthy eating.

Removing gluten tends to remove items such as burgers and pizza, which are the real culprits (due to excessive calories), not the gluten itself.