Gluten is a protein composite found in foods processed from wheat, barley and rye (and related grains). It is found in the endosperm of the grain kernel and consists of the proteins gliadin and gluterin. Gluten gives elasticity to dough, helping it rise and keeps its shape. You may have heard or read about the health benefits of gluten-free diets and seen numerous gluten-free products in the grocery store. Proponents of gluten-free diets claim that this dietary pattern promotes weight loss and may be beneficial in numerous other ways, such as helping those with osteoporosis, anemia and diabetes. Have you wondered if this is true? Have scientific studies been conducted to back up these claims? Let’s take a closer look at some the purported health benefits and also consider who may benefit most from a gluten-free diet.
There are indeed folks that have to avoid gluten at all costs, namely, those suffering from celiac disease (also frequently called celiac sprue). This autoimmune disorder occurs in genetically predisposed people from early life onwards. People with celiac disease experience pain and discomfort in the GI tract, chronic constipation, fatigue and other symptoms. The underlying cause is related to gluten exposure. In those with celiac disease, an enzyme in the epithelium of the GI tract reacts with gluten proteins and causes an immune reaction whereby the immune system attacks the small bowel tissue. This causes an inflammatory reaction and as a result, the villi of the epithelium are blunted and malabsorption of many nutrients occurs. The only treatment for celiac disease is life-long adherence to a gluten-free diet. Clearly the preponderance of gluten-free products now available in the grocery stores benefits those with the disease. But what about other individuals, can they also benefit from gluten-free foods?
How about going gluten-free for weight loss? Gluten-free diets tend to be similar in energy content to traditional diets, but more careful planning when going gluten-free may promote making healthier food choices. So from this perspective, gluten-free may promote weight loss, for reasons not directly related to gluten. Does avoiding gluten help those with the other disorders listed above? There are few properly controlled scientific studies to support many of the gluten-free claims, so it’s hard to know for sure. Another consideration is the foods that you might avoid by going gluten-free, such as breads, pastas and other grain products. Given that these foods are important dietary sources of B vitamins, fiber, iron and other nutrients in the American diet, avoidance of them may increase risk for various nutrient deficiencies.
Certainly, the incidence of celiac disease is increasing in the U.S. Current estimates are that 1:100 people may have celiac disease and some of them may be undiagnosed. For these individuals, going gluten-free is necessary and will often dramatically improve quality of life. From this perspective, the current popularity of going gluten-free is beneficial. The real question though is, how beneficial is gluten avoidance for the other 99/100 people in the U.S.?