Gluten, a Red Herring?
By Samantha E. Williams, student, SUNY Empire State College
January 16, 2015
Health shows discuss it often, it is in the news and it even met parody criteria for the creators of South Park recently. To be gluten-free or not to be…that, seemingly, is the question of all questions concerning diets today. What is gluten? If you do not have celiac disease, an autoimmune response to gluten, should you consider going gluten-free at all?
In the June 2009 Harvard Health Letter, titled “Getting out the Gluten,” Harvard mentions gluten-free food becoming “more popular” due to increased celiac disease diagnosis. Celiac disease may have forced the market to package more gluten-free alternatives, but celiac patients are not the only consumers. The Health Letter explains that “a growing number of people dodging gluten fall into a gray area: they don’t have celiac disease but seem unable to digest gluten properly.”
A post from Harvard’s Health Blog in February 2013 by Holly Strawbridge further investigates the non-celiac gluten-free dieters. Strawbridge asserts: “Based on little or no evidence other than testimonials in the media, people have been switching to gluten-free diets to lose weight, boost energy, treat autism, or generally feel healthier.” Celiac disease can be tested through a blood test, whereas, what Strawbridge and others call “Non-Celiac Gluten Sensitivity” (NCGS) cannot be verified through any test available today. NCGS refers to people who experience “symptoms similar to celiac…without the intestinal damage” faced by those with celiac disease, Strawbridge explains.
Gluten, both the Harvard Health Letter and Strawbridge clarify, is a protein found in grains such as wheat, barley and rye. “Other grains,” says the Health Letter, “also contain protein, but [these] varieties…aren’t broken down by digestive enzymes.” Instead, to go gluten-free, one would need to consume things such as quinoa, millet, and buck wheat, to maintain fiber and vitamins found in a balanced diet. Both the Harvard Health Letter and Strawbridge hint at gluten being a red herring, but neither outright describes how.
Linda Geddes, however, explains gluten as a possible red herring in “The Blame Grain.” She muses: “Wheat is not a squeaky-clean superhero, but neither it is [sic] the supervillain some claim.” Geddes further describes how gluten is being blamed for such health issues as bloat and lethargy. To defend gluten, Geddes uses a trial held by Peter Gibson in Australia. He “recruited 34 non-coeliacs [sic] with gut symptoms that largely disappeared when they went gluten-free.” The study appeared to support NCGS, but Gibson felt there was more to the issue and held a second study. His study results can be found online, published May 2013.
Gibson conducted “a randomized, double-blind, cross-over controlled feeding trial of 3 diets differing in gluten content” using IBS patients. None of the patients tested positive for celiac, but did identify as NCGS. Gibson wanted to see if gluten was the problem or if FODMAPs (fermentable, oligo-, di-, monosaccharides and polyols) were causing digestive symptoms in patients identifying as NCGS. FODMAPs are sugars found in the same grains containing gluten and therefore a possible symptom cause in non-celiac patients.
The study is one of few having been conducted in a respected, scientific fashion, even after decades since celiac was first diagnosed and NCGS was first conceived. Gibson found that the removal of gluten did not improve symptoms in his second study. Instead, the reduction of FODMAPs in a diet improved symptoms. Geddes summarizes: “people who think they are gluten-sensitive might instead be reacting to the FODMAPs found in wheat. FODMAPs are poorly absorbed in the small intestine and so instead tend to be eaten by bacteria living further down the digestive tract, producing an abundance of gas. They also attract water, leading to bloat” and other symptoms.
Since the market is slow to label “FODMAP-free” foods, each individual needs to make their own choice about whether to go “gluten-free” or not. If tests show one is not celiac, but one continues to have digestive symptoms with no diagnosis or relief, a change in diet may be a way to fix the problem. But, as pointed out in all the sources mentioned here, going gluten-free can set a person up for vitamin deficiencies, so checking with your medical provider before starting any diet is advisable.
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