Gluten Free 101: Experts say diet can help, but claims are overblown | by Lisa Marshall


Posted on Thu, Jan 16, 2014

If you’re not on a gluten-free diet already, chances are it has crossed your mind. In the past decade, the number of people consciously avoiding the maligned protein prevalent in breads and baked goods has soared, with athletes, celebrities, and savvy food marketers touting a “gluten-free lifestyle” for everything from quelling joint pain and depression to dropping a dress size and playing a better tennis game.

Even Dunkin’ Donuts and Girl Scouts of America have chimed in with new “GF” offerings, contributing to a food-and-beverage category expected to hit $10.5 billion in 2013, up 44 percent in the past year. And many GF consumers don’t even have a diagnosed sensitivity: 65 percent eat that way because they assume the food is healthier, and 27 percent do it for weight loss, according to the market research firm Mintel. Such numbers concern Jessica Crandall, a registered dietitian with Denver Wellness and Nutrition.

“Everyone thinks gluten-free means ‘healthy,’ but that isn’t necessarily true,” Crandall says. She and others warn that while going gluten-free can be life-changing for someone with diagnosed celiac disease or gluten sensitivity, those looking for a miracle cure for other issues might end up disappointed or even in worse shape.

Here’s the straight scoop on this latest diet craze:

What’s gluten?

Gluten is a protein naturally present in wheat, barley and rye that brings a soft and stretchy texture to pizza dough, bread and other baked goods. “It’s the binder that holds your grains together,” explains Crandall. But simply cutting out bread won’t do. Gluten also thickens sauces, soups, and condiments and prevails in processed foods, so cutting it out can be tricky.

What’s celiac disease?Eating For Health

According to a recent study in the Archives of Internal Medicine, an estimated 1 in 133 Americans are believed to have celiac disease – a genetic autoimmune disorder in which exposure to even minute traces of gluten prompts antibodies to attack the intestinal wall, damaging the fingerlike villi critical for nutrient absorption. As recently as the late 1990s, scientists believed the condition affected only about 1 in 10,000 people. But due to better screening tools, the diagnosis has skyrocketed, Crandall says. Classic symptoms include gas, bloating, diarrhea, weight loss, nutritional deficiencies, and sometimes joint pain, rashes, and migraines. If left unchecked, it can lead to anemia, osteoporosis and increased cancer risk. A blood test is available, but the most definitive test is a colon biopsy. The good news: Once people go off gluten, their villi heal, and their health typically improves, says Crandall. “If you have this diagnosis, you should be 100-percent gluten free all the time.”

What’s gluten sensitivity?

Just how many people have gluten sensitivity, and whether it exists at all, has been a matter of some debate in the medical community, but doctors seem to be warming to the idea that you can be gluten sensitive without having celiac disease. According to the Center for Celiac Research at Massachusetts General Hospital, as many as 7 percent of the population, or 18 million people, fall into this vague category, as a result of a far less understood immune response (distinct from the one that causes celiac disease). They suffer similar symptoms, but theirs tend to be less intense, with no lasting damage to the intestine. “It is absolutely a real thing,” says Diane Mueller, a naturopathic doctor with Progressive Health at Swedish Medical Center. There is no gold standard test yet for gluten sensitivity, but she offers blood and stool testing to look for certain antibodies (IGA and IGG) that can signal a sensitivity. And every time she takes a patient off of gluten? “I see a huge improvement in symptoms,” Mueller says.

Can gluten-free help me lose weight?

Simply ditching the gluten in a diet probably won’t induce weight loss, says obesity medicine specialist Dr. Ethan Lazarus, director of the Clinical Nutrition Center in Denver. “I think there is excellent evidence that low-carb, high-protein diets are effective for weight loss, but I do not think it is specific to gluten.” In some cases, a gluten-free diet can prompt people to put on weight, especially if they opt for junky gluten-free options that are high in fat, calories and other sugars. One recent review in the Journal of the Academy of Nutrition and Dietetics noted that there are no published reports showing that a gluten-free diet produces weight loss in persons without celiac disease or gluten sensitivity and pointed to three large studies showing that when overweight people with celiac disease cut out gluten and started digesting nutrients properly, they actually gained weight. “When it comes to weight loss, the reality is actually the opposite of what most people think,” says Crandall.

Will gluten-free make me a better athlete? Gluten Free Diet

Digestive issues often plague endurance athletes, such as runners and cyclists, but Crandall doesn’t suggest joining the gluten-free trend for relief. “I have seen absolutely no science to back that up,” says Crandall, a runner and fitness trainer. She says a high-carb diet (which is often higher in fiber too) is more likely to blame for athletes’ digestive distress. Instead of focusing on gluten, she recommends adding a little protein to a pre-workout meal to slow digestion.

Can gluten-free help me with other health problems?

Mueller says anecdotally she has seen patients go off gluten and see symptoms of depression, migraines, arthritis and other conditions subside. And some studies suggest that a gluten-free diet can help people with rheumatoid arthritis and psoriasis. But Crandall isn’t convinced yet: “Unless they have a diagnosis of celiac disease or gluten sensitivity, I do not recommend it. Eliminating entire food groups in your diet can cause a whole host of other nutritional concerns.”

Are there downsides to going gluten-free?

Crandall notes that gluten-free products tend to lack calcium, iron, fiber, and B vitamins, leaving people deficient. And Lazarus warns that people who suspect they might have celiac disease should wait until after they have been tested to eliminate gluten. “If you have someone who thinks they have celiac disease, but they are eating gluten-free, they can have the test, and it will show they don’t have it,” he says. Comforted by the results, they may end up reintroducing gluten into their diet, harming their intestines even more.

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  1. (Here is an insightful email I received from Dr. Guillory of The Care Group. Thank you for allowing me to share Dr.! I welcome the dialogue.)

    I enjoyed reading your latest edition of health and wellness. I wanted to comment on the article regarding gluten. This is an area I have been studying for over 25 years having written the first book for patients with irritable bowel syndrome back in 1989. I have been suggesting people go off gluten on a trial basis since the early 1990s so this is nothing new for me. “Health experts” who claim that going gluten-free is just a fad are wrong. I agree with the naturopath Diane Mueller, who stated in your article “it is absolutely a real thing”. She also suggests that although there is no gold standard for gluten sensitivity, IgA and IgG antibody testing may be helpful-I also agree with her on this point as well, although many conventional allergists do not agree.

    Here is where a lot of the confusion arises. There are 3 different ways you can reacted gluten. The first is celiac disease which is an autoimmune disorder, in which her body makes antibodies which attack the lining of the small intestine. The incidence has gone up over 400% in the past couple decades. If cancer or heart disease had gone up over 400% during this time everybody would be alarmed-as they should be. Coincident with this dramatic increase in the incidence of celiac disease there has been an increase in other autoimmune disorders such as lupus, psoriasis, and rheumatoid arthritis. There is a connection. The second way people react to gluten is this new subset called non-celiac gluten sensitivity (NCS). How many people does this effect? No one knows for certain because there is no accepted biomarker or blood test. There are specialty labs that are offering cutting edge testing to help define these patients and I do find these tests helpful. We encourage all of our patients to try and go gluten-free as this is the only real way to see if you might have NCS. It is not easy but it is a lot easier now than it was 20 years ago and in my experience just about everyone feels better. The third way you might react to gluten is “wheat sensitivity” where your body makes IgE antibodies to gluten. This is relatively rare.

    This is going to be one of the biggest stories of the decade. We are going to find that gluten is the tobacco of this century once we truly understand the many ways it can harm our bodies.


    Gerard Guillory, MD
    The Care Group
    750 Potomac Street Suite 111
    Aurora, Colorado

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