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Gluten-Free: Friend, Fad, or Foe?

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Are we done yet talking about gluten? I say that tongue in cheek, because no, we probably are not. I think the “gluten vs. gluten-free, which is right, which is wrong, is it about health or weight or what, should I or shouldn’t I” circus is kind of fascinating. It’s also a great example of how once a discussion becomes a hot media item, and is perceived as trendy in any way in the health and food industries, the debate also becomes incredibly polarized and it’s really difficult to disentangle the threads of truth from the wails of emotion… and even harder to figure out what it means for you.

Of recent note has been a study done on gluten and something called FODMAPs [1,3] and non-celiac gluten sensitivity. I have read a number of articles in the last month or so that misinterpret the results of this study to draw definitive and emotionally-worded conclusions about gluten and gluten-free diets (more on this below). Most of these articles have been blog posts by authors who are either non-identified or have absolutely no indication of their qualification to be speaking about this topic, and yet they have been widely publicized, copied, and shared, and used by others (who may be unidentified as well) to support their own extreme opinion on the topic. For the record, any time you read an article about a study or health topic, it’s a great idea to consider if the author is qualified to be writing what they are writing, if they are benefiting monetarily from having an opinion, and even go and take a look at the original study, or references, yourself, before taking it in as gospel.

This article though, that you are reading right now, is not really about whether or not YOU should eat gluten. That decision would be up to you and your qualified health professional. This article is about the impact of the popularization of gluten-free foods on our health and our perspective on the issue. So without further ado:

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Friend: For anyone with celiac disease or who avoids gluten for other reasons, the rise in popularity and awareness of what ‘gluten-free’ means is fantastic. You may remember (or not, if this issue did not touch your life at that time), that just a few years ago it was difficult, if not impossible, for someone to completely avoid gluten while eating in public at all – while today there are so many substitutes that pretty much any food is an option at a meal, and the majority of restaurants at least know enough to know if they do NOT have gluten-free options. Many of them have complete gluten-free menus!

Friend: I can think of very few food items that have so much focus on them that they have stirred up a closer look, for many, at the overall state of the food industry and the Standard American Diet (S.A.D.). Wheat is up there with sugar, and meat, and probably eclipses dairy in this regard. Why do I think this is a good thing? In my world any time we take a step back and think about what is important to us in the food we eat and lives we live, it is a good thing. The increased awareness of what gluten is and the debate around it has increased awareness of the concept of food intolerance, allergy, and sensitivity, as well as inflammation, and the connection between nutrition and the way your body functions (yes! they are connected). Wheat is one of the more common food allergens, and wheat products are generally among the more inflammatory in the S.A.D., so greater awareness here is a good thing for the general health of the population.

Fad: The definition of a fad is a strong and widespread belief. Not necessary to a fad, but often there, is this belief not having a foundation in evidence. So here is where I’m going to get specific again and remind you, I’m talking here about gluten-free foods, not gluten. And, there is nothing inherent in a food product marked ‘gluten-free’ that makes it good for you. It simply lacks gluten. A lot of people now equate ‘gluten-free food product’ with ‘healthy’ and they are not synonymous.

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Fad: Back to that study I talked about above. What that study did, was take people who were sensitive to gluten but did not have celiac disease, put them on a diet low in FODMAPs (short-chain carbohydrates, a group that includes wheat), observe symptoms, then give them either gluten, whey (from dairy), or a placebo, and observe symptoms, then take them off again, and put them on something else. What was observed was (roughly) that people improved with no FODMAPs, then got worse when given gluten or whey. However, because of the pattern or worse and better, and given that the study was evaluating gluten response but included whey, the conclusion of the study was that they were unable to identify gluten-specific response (it was observed in 8% of the patients).

The article writers I referred to in the beginning, took that conclusion and ran with it to the effect of propagating the idea that ‘science confirms there is no such thing as non-celiac gluten intolerance’, when that is absolutely not what the study confirms, and other studies have confirmed the opposite [2]. What does this have to do with ‘fad’? If there were no fad-ishness around the idea of gluten-free, no one would bother making such claims. They would leave dietary choices to the people making them, and research interpretation and application to those qualified to do so. Instead we have widespread dissemination of sensationalized misinformation. I don’t know about you but I don’t want to have to defend my food choices to people half-crazed by something they ‘read somewhere’ and are shouting from the rooftops. As a practitioner I spend a lot of time re-educating people on these topics, and that annoys me as well (not the educating, but the uphill battle against misinformation. Don’t get me started on Vitamin E).

Foe: I know you were waiting for this. Waiting for me to bash gluten-free diets! Well, I won’t do that, because it can be a healthy choice, and necessary for some. What I will absolutely do is bash gluten-free food. The next time you are in the grocery store, find a freshly made gluten-containing product that you consider to be healthful, and look at the ingredients. Then find the gluten-free equivalent, and look at those. Notice any difference? In the majority of the ones I have seen, the gluten-free (packaged) foods contain many more ingredients, and many more additives. Many of the gluten-free flour substitutes are highly refined, and (back to FODMAPs again) quite likely to cause gastrointestinal upsets of their own. Well what about almond flour, you say, that’s paleo, so it’s good, right? Almond flour in large quantities also has it’s problems, in the form of phytic acid which blocks iron absorption. Consider the fact that it is possible to exclude gluten from your diet without buying anything labeled as gluten-free! There isn’t any gluten in a head of broccoli.

Foe: The last way in which the focus on gluten-free and popularization of a GF diet as a healthful one, is in what’s missing. There are a lot of components to a healthy diet, and fixating on one food item can obscure looking at one’s diet in totality, and with consideration for the needs of an individual. What’s more, if someone is on an incredibly limited diet, and has no indicators of inflammation, or adverse response to gluten, substituting gluten-free products for their gluten-containing equivalents is a big dietary modification that also can impact nutrient status for the individual. I’ll sneak this one in here too, the reasons to avoid gluten is that it causes problems for you for some reason. So gluten-free is a foe here too because the hype around gluten-free foods is that you will lose weight, live forever, and they will even do your laundry, and if those are the reasons for you to go GF, you may be disappointed.

Takeaway? Make dietary changes based on your own assessment of the research, and your own needs and symptoms – or lack thereof. If you need help, talk to someone who specializes in the topic. Remember that what happens in a study across a group of people can not necessarily be applied without consideration to the entire population or specific individuals without context. And any food or nutrition or health topic that has become a debate, and laden with emotion, should be evaluated with that in mind.

References:

[1] http://www.gastrojournal.org/article/S0016-5085(13)00702-6/abstract

[2] http://www.nature.com/ajg/journal/v106/n3/full/ajg2010487a.html

[3] http://en.wikipedia.org/wiki/FODMAP

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Jen Kahn is an integrative healthcare practitioner specializing in functional and behavioral nutrition, yoga therapy, and metaphysics with a focus on chronic health conditions and emotional eating. Through the blessings of modern technology she works with clients all over the world in private consultation and through online workshops. Her website is currently under construction, but you can find her latest event at http://freetastecall.weebly.com or contact her by email: jen@elementalhealthwellness.com. When she’s not working with clients, running events, or writing, she can be found biking, cooking, painting, snuggling with her cats or doing nothing at all in the Pacific Northwest.

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