Against The Grain: What’s All the Fuss about Gluten?
By Naomi Stapleton
People suddenly seem to have lots of opinions of gluten. There are the people avoiding gluten, and there are the ones aggressively avoiding those people at all costs. Gluten is feeling a lot of hostility lately, and it’s not yet completely clear if there is any scientific basis for it.
What we know for sure is that gluten is a protein found in wheat, barley, and rye. In and of itself, gluten is not unhealthy. It is a binding agent infamous for its role in helping bread rise and keeping pasta together. Gluten can also be found in more surprising (and not necessarily unhealthy) places like salad dressings, food colorings, and soups. Trace amounts are often found in food products made in facilities that also process wheat. In general, gluten is not the thing that makes these foods unhealthy or fattening.
Gluten-free alternatives are not necessarily any healthier. Making foods like cookies, muffins, and bread without gluten often makes it more difficult to reproduce their preferred texture, so many manufacturers compensate by adding even more sugar and salt. These alternatives often lack nutrients like folic acid and iron that wheat flour does provide. Thus, an uninformed gluten-free diet can actually be more fattening and nutrient-deficient. Gluten-free diets filled with fresh, unprocessed foods and a safe nutritional balance can be healthy, but it is by no means a given.
For some though, gluten is very dangerous. People with celiac disease — a hereditary autoimmune disorder — suffer from symptoms like diarrhea, bloating, fatigue, and “brain fog” after consuming even the smallest amount of gluten. After encountering even the smallest amount of gluten, the immune system attacks the small intestine, damaging the intestinal lining, or villi. These small fingerlike projections support nutrient absorption, so continual gluten consumption in somebody with celiac can eventually cause severe long-term health problems. There is no cure for this disorder; the only option is to completely avoid gluten in any products, including certain cosmetics. Untreated celiac can lead to conditions like iron deficiency anemia, infertility, osteoporosis, gall bladder malfunction, and epileptic seizures.
Similarly, some suffer from a wheat allergy, which is an immune system overreaction to wheat, rather than gluten. People with this allergy are still often able to eat the other grains associated with gluten. A wheat allergy is not a digestive disease like celiac; instead, eating wheat products triggers a typical allergic reaction, ranging from mild symptoms, like hives and swelling, to severe symptoms like trouble breathing and loss of consciousness.
A majority of children with a wheat allergy grow out of it by age three. Additionally, people with celiac only account for 0.5 to 1 percent of the world’s population, whereas a Gallup poll in 2015 showed that 17 percent of Americans actively avoid gluten in their diet. Sales of gluten-free foods increased by 63 percent between 2012 and 2014 according to a Mintel Research study, even though celiac disease diagnoses did not increase. The newly gluten-free cite several reasons for attempting this often restrictive diet: some do it for weight loss, while others claim that avoiding gluten relieves their celiac-like symptoms, such as foggy mind and gastrointestinal distress. Many doctors now categorize this as non-celiac gluten sensitivity (NCDS) or intolerance, but there is great scientific debate over the validity of this diagnosis.
The science has yet to catch up and find a convincing link between gluten and symptom relief in NCDS patients. Some early studies suggest that removing gluten from the diet of irritable bowel syndrome (a similar disorder) patients improved their symptoms. Other studies even suggest that a gluten-free diet relieved symptoms of neurologic and neuropsychiatric disorders, like autism and schizophrenia.
However, there have been very few rigorously designed studies with a large enough sample size. The closest to this was conducted by Peter Gibson, Ph.D., in 2014. Gibson highlights a psychological factor, saying that the participants who thought they were eating gluten showed increased symptoms. These results have yet to be confirmed in larger samples by other research groups. In general, Gibson suggests that a majority of people are cutting out gluten unnecessarily. He raised the possibility that NCDS patients are actually reacting to a food group called FODMAPs (“Fermentable Oligo-, Di-, Monosaccharides And Polyols) which are carbohydrates that often have gluten in them.
There are still questions of whether it is gluten, the grain, or something else entirely causing (or not causing) problems. Professionals are calling for much-needed large, well-designed clinical studies to finally begin answering this question. While the gluten-free diet has certainly become fad that is not necessarily benefiting all of its believers, we cannot know gluten’s intestinal impact for sure until sound studies are conducted.