Over the past few years consumers have seen the gluten-free section in their local grocery store grow from a few measly boxes of mostly unappealing products to whole aisles of gluten-free food. Online communities of folks touting the benefits of being gluten-free have sprung up, and marketers have seized the opportunity to let us know their products are gluten-free, even products you never would have thought might contain wheat. (If you see “Gluten-Free!” olive oil in the aisle at your supermarket, walk on by; olive oil is made from, well, olives — which don’t contain gluten, anyway.)
The American College of Gastroenterology reports that “there has been a substantial increase in the prevalence of celiac disease over the past 50 years and an increase in the rate of diagnosis in the past 10 years.” But even taking this into consideration, it fails to account for the tremendous increase in popularity of gluten-free foods and the numbers of people who are “going gluten-free.”
Gluten is what gives yeast doughs their structure and firmness. Its sticky, stretchy properties are activated by moisture and agitation, as in kneading. Its presence is why working a pie crust too much will make it tough.
Gluten is a generic name for proteins that are found in many grains. The gluten in wheat, barley, rye, and triticale — a cross between wheat and rye — contains amino acid sequences (proteins) that are harmful to people with celiac disease. Research is ongoing, but it seems there may also be a subgroup of people with celiac who are also sensitive to oats. People with celiac disease who are not part of this subgroup may still be oat-sensitive because these grains are often grown together and may be processed in the same facilities, contaminating the oats.
Celiac disease is a hereditary autoimmune disease that causes inflammation in the small intestine that, if left untreated, damages the lining, disrupting the intestine’s ability to absorb some nutrients. Symptoms are wide ranging — stomach pain, bloating, diarrhea, fatigue, and weight loss are classic — and can be severe or mild. Some people have no symptoms at all, but that doesn’t mean intestinal damage isn’t occurring. There is no cure. The only treatment is a lifelong gluten-free diet.
An additional condition, known as non-celiac gluten hypersensitivity (gluten sensitivity, gluten intolerance), has been identified as “a potentially common disease on the basis of studies of patients with claimed reactivity to gluten but without the characteristics of celiac disease.” This diagnosis remains controversial. Research is ongoing, but at least one study has confirmed the existence of non-celiac wheat sensitivity as a distinct clinical condition. Within this population it appears there are two subgroups — one with characteristics similar to CD and the other with characteristics that indicate a food allergy.
In addition to the conditions above, some researchers believe that there is a spectrum of gluten-related disorders that are on the rise. There are several reasons speculated for this increase. Humans have been consuming wheat and other grains for thousands of years, but the wheat we eat today is completely different from what we consumed fewer than 100 years ago. Sophisticated hybridization techniques have been used to develop high-yielding, drought- and disease-resistant varieties. These varieties have been shown to contain a higher concentration of gluten than older varieties. One experiment with Khorasan wheat (Kamut), an ancient grain acclaimed for its beneficial health effects, showed “. . . that a replacement diet with Kamut products could be effective in reducing metabolic risk factors, markers of both oxidative stress and inflammatory status.”
Further, before the development of modern food processing techniques, wheat was ground whole, preserving the nutritious bran and germ. The grain was often sprouted, further adding to its nutritious quality. Today, most wheat is highly refined, reducing its nutritional value and delivering it in a form that is rapidly digested, causing spikes in blood sugar.
Another factor may be our level of exposure. Since the last half of the 20th century the food industry has started adding wheat protein to many products. Gluten can be separated from wheat (vital wheat gluten) and used as a binder, thickener, or emulsifier. Gluten can also be modified (isolated wheat proteins) for specific uses. Today, not only is gluten added to baked goods — in addition to the flour that’s already in them — but it can also be found in breakfast cereal, meat, vegetarian “meat” options, soy sauce and other sauces and dressings, canned and dried soups, candies, ice cream, vinegar, jam, and baby food. It’s also widely used in pet food. It’s even used in lotions, hair-care products, and cosmetics.
So is the gluten-free diet just another fad? For people with celiac disease, wheat allergy, and likely some other folks, no. But for the rest of us, the truth is it’s too soon to tell.
One of the objections to going gluten-free without a clear diagnosis of a health condition is the fact that it eliminates a good source of protein, vitamins, minerals, and other nutrients like fiber. Wheat is a legitimate source of nutritious dietary calories and supplies approximately 20 percent of the world’s dietary protein. Furthermore, many of the foods that are heralded as “healthy” because they are gluten-free are little more than their own class of junk food. Gluten-free cookies and crackers are still just cookies and crackers, and the starches that are used to replace highly-refined flour are also, often, highly refined.
On the other hand, if you eliminate gluten you will obviously cut out of your diet things like bread, crackers, cookies, and many of the other empty-calorie foods that have become staples of the Standard American Diet.
If you do not have health concerns, it’s probably of little use to go gluten-free. However, it is important to eat a healthy, well-balanced diet that includes a wide variety of minimally processed foods — and maybe try your hand at baking your own bread.
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October 16, 2015
Janet O’Dell, RN