NUTRITION SERIES: Is Gluten-Free for Me?

Hi everyone! I can't believe it's spring, it has been both the longest and shortest winter I've ever experienced. I know that sometimes spring can bring some attention to personal health and diet questions, and this is one that is consistently coming up so I wanted to address it. 

Why are people eating gluten-free, and is it actually a healthier option? 

I think that to answer this question I should define what gluten actually is. 

The way the food industry presents it makes it seem like gluten is a rabid dog. Truly, gluten is just the general name for proteins that you find in wheat, rye, barley, and triticale (a cross between wheat and rye) (Celiac Disease Foundation [CDF], 2021). It helps foods maintain their shape and holds them together (CDF, 2021). 

Turns out, it's less of a rabid dog, and more of a protein. Kind of like the opposite of a rabid dog, if that makes sense. 

If you're not interested in details and just want a quick answer, here it is.

Is gluten free for me?

If you have celiac disease or a wheat allergy: Yes. 

If you do not have celiac disease or a wheat allergy: No. 

When someone has celiac disease, they have a serious autoimmune disease where if they eat gluten, their body sets off an immune response that attacks their small intestine, an organ that would be best not to attack (CDF, 2021). 

If someone does not have celiac disease or a wheat allergy, cutting out gluten or wheat will not bring any benefit (Harrison C., 2019). There is just no good evidence that there is any benefit for a patient that does not have a gluten/wheat allergy to be on a gluten-free diet, including those who have IBS or non-celiac gluten sensitivity (Niland et al., 2018). Simply put again, gluten is a protein, not rabies. 

Not only does it lack any remote health benefit, there are actually negative consequences derived from following gluten free diets unnecessarily.

We often dismiss psychological and psychosocial aspects of health as irrelevant or not as important, because subconsciously, we tell ourselves we're strong enough to get over them - but if you think about it… our world is shaped by our psychological health, and social factors. All of this impacts our overall health. 

Pleasurable and communal aspects of food and eating are potent and deeply rooted factors in our lives, and eating gluten free calls for a persistent dedication to restricting diet and lifestyle which can lead to social isolation, a negative psychosocial impact, or even just being present physically without feeling like you are participating in the group (Niland et al., 2018). It's not easy to consistently comply to such a restrictive type of diet, and the difficulty can also cause negative feelings, emotions, and lower self esteem especially if you can't remain compliant at times and follow it "perfectly" (Niland et al., 2018). 

You'll be surprised that I bring this up (haha just kidding) but actually going gluten free for people who are trying to fix their gut discomfort can mask… drum roll please… disordered eating, which is a significantly more likely cause of digestive troubles, especially considering that as many as 98% of people with eating disorders have gasterointestinal (GI) disorders, and that up to 44% of general patients seeking help for GI problems have disordered eating behaviors. (Harrison, 2019). 

A person will begin a gluten free diet with the intention of improving health and well being, but for some patients it ultimately just leads to pathologically obsessive diet behaviors and thoughts (Niland et al., 2018). 

On top of that, it's not nutritionally beneficial, and can actually be harmful to our nutritional health.

You can end up with deficiencies when not consuming whole grain foods, because we often rely on them for their enrichment. Whole grains give you substantial amounts of fiber, vitamins and minerals (Novella, 2017). Whole grains also significantly lower the risk of heart disease, and decreasing intake of them increases the risk (Heart Foundation, 2022).

I would prefer to eat food that I like, get all the nutritional benefits, and not engage in psychological warfare, if I can help myself. I'm also very blessed to not have to worry about a gluten free diet because I do not have celiac disease. Those who do have to work hard to maintain the lifestyle, and also have to work through some of these challenges. 

Unfortunately, most individuals who are on a gluten free diet do not have the physiological requirement of an allergy (Niland et al., 2018). 

In the United States from 2009-2014, it was found that even though the amount of people who had celiac disease remained the same, and the amount of people who had undiagnosed celiac disease was cut in half, the prevalence of people who avoided gluten more than tripled, and 72% of those who were on a gluten free diet did not have celiac disease, the majority of people were just eating gluten free (Niland et al., 2018).

This is really important, because it does impact our health and well being to be following a way of eating that does not only not benefit us but can hurt us. The food industry and media are making an incredible amount of money off of the trend, as well. 

The US market for gluten free foods grew from $580 million in 2004 to $1.85 billion in 2018 (Harrison, 2019). 

One study did a cost-comparison analysis of gluten-free vs. gluten containing foods in 2 large-chain grocery stores, where all 56 gluten free products were more expensive with an average unit price of $1.71 vs. $0.61 for products with gluten… making, on average, gluten free products 242% more expensive than regular products (Stevens et al., 2008). Now, this is very unfortunate for those who live on gluten free diets due to their disease, and it's also completely unnecessary to be spending money on, if you do not have the disease.

Before I close out, I wanted to address another point that can lead people to go on certain avoidant diets (such as gluten free). Sometimes we are desperate to figure out a problem and we will do anything for an answer. I want to caution people to be weary of some tests that health practitioners can use to diagnose "gluten sensitivity," (as we discussed allergy is the only reason to be cutting out gluten as there is no evidence otherwise) and other "food intolerances," such as hair analysis, applied kinesiology, and blood tests from labs that provide long color coded lists of food to avoid, because they lack scientific validity  (Kelso, 2018; Harrison, 2019). Results from these tests lack any correlation with disease, and are as likely as chance to predict food sensitivity/allergies, except they cost a lot more money than flipping a coin does (Kelso, 2018; Harrison, 2019). Always, always, always know your sources of information when it regards your health. 

Anyway, by now you're sick of hearing me debunk another diet. So I'll end with this:

Telling someone it's healthier to eat gluten free is about as arbitrary as telling someone not to sniff flowers. If you're allergic to flowers, do not sniff them. If you aren't allergic to flowers, go ahead, sniff them. 

They're too beautiful not to. Spring has sprung! 

If you have questions, comments or concerns please reach out. If you are concerned you have an allergy or autoimmune disease, please set up an appointment with your doctor as soon as possible. 

References

Celiac Disease Foundation. (2021). What is Celiac Disease? https://celiac.org/about-celiac-disease/what-is-celiac-disease/

Celiac Disease Foundation. (2021). What is Gluten? https://celiac.org/gluten-free-living/what-is-gluten/

Harrison, C. (2019). Anti-Diet: Reclaim Your Time, Money, Well-Being, and Happiness Through Intuitive Eating. Little, Brown Spark.

Heart Foundation. (2022). Are Whole Grains Good for You? https://www.heartfoundation.org.nz/

Kelso, J.M. (2018, March 1). Unproven Diagnostic Tests for Adverse Reactions to Foods. The Journal of Allergy and Clinical Immunology: In Practice, 6(2), 362-365. https://doi.org/10.1016/j.jaip.2017.08.021

Niland, B., Cash, B.D. (2018, February). Health Benefits and Adverse Effects of a Gluten-Free Diet in Non-Celiac Disease Patients. Gastroenterology and Hepatology, 14(2), 82-91. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866307/

Novella, S. (2017, November 8). Risks of a Gluten-Free Diet. Science-Based Medicine. https://sciencebasedmedicine.org/risks-of-a-gluten-free-diet/

Stevens, L., Rashid, M. (2008, August 22). Gluten-Free and Regular Foods: A Cost Comparison. Canadian Journal of Dietetic Practice and Research, 69(3). https://doi.org/10.3148/69.3.2008.147

Me (in back) and Gluten (in front) circa 2013