Ten years ago no one in the United States had a problem with eating gluten in breads and other foods. Today gluten-free products are quickly going out the doors of grocery stores. Restaurants offer gluten-free dishes. Churches are even offering gluten-free Communion wafers. Americans will spend about $7 billion this year on gluten-free foods. I asked Jody Victor to tell us more about it.
Jody Victor: For a very small number of people gluten is a big health risk. For a few more people gluten can be an annoyance. For the majority of people who have jumped on the gluten-free bandwagon it appears to be a fad; a fad that researchers are studying in trying to determine whether there is a biological basis for it, or not.
Gluten is a protein compound made of gliadin and glutelin, which are bound together by starch (a carbohydrate). In nature, gliadin is found mostly in the seeds of grasses. Edible seeds of grasses are known as grains. Grains are made up of three parts: the bran or hull, the germ, and the endosperm. Whole grains contain all three. Gluten is found in the endosperm, the part of the grain that is retained when grains are refined. And so gluten is present in grains such as wheat, rye, and barley whether they are whole or not. Genetic modifications have increased the gluten content of wheat and other grains. Modern food processing has also added more gluten to our foods. Everything from candy, to deli meats, to potato chips contain gluten, which is used as a texturizer.
Grasses are not native human food. People can’t digest the stalks and the seeds of most grasses are too small to offer any nutritional benefits. Grains entered the human diet with the advent of agriculture in the Fertile Crescent over 12,000 years ago. Domestication led to increased seed size. The large seeds of wheat and other edible grains are the product of the careful growing by humans of the grasses nature provided. One reason some people have problems consuming gluten is that it is a recently introduced nutrient. Gluten is foreign to the Stone Age diet that shaped humans’ biological adaptations. Twelve thousand years may be long enough for human selection to change grains, but it’s not enough time for natural selection to change humans.
The big health problem associated with gluten is commonly called celiac disease (or celiac sprue or non-tropical sprue). Celiac disease is diagnosed with blood testing, genetic testing, or biopsies of the small intestine. If you have celiac disease your immune system responds to gluten as if it were a dangerous invader. The inflammation from the response damages your intestinal lining and leads to malabsorption of nutrients, including vitamins and minerals. Symptoms from celiac disease can be severe starting with abdominal discomfort, bloating, and intermittent diarrhea to manifestations of nutrient deficiencies to an itchy rash to, eventually, increased risk of intestinal cancer. Unaddressed, the condition can be lethal. Celiac disease was once considered extremely rare in the U.S. But about 20 years ago a few scientists began to explore the disease and concluded that it was not that rare, just underdiagnosed. Recently a research team at the Mayo Clinic determined that celiac disease is actually increasing. Their research confirmed estimates that about 1 percent of U.S. adults have it today, four times more common than it was 50 years ago. Scientists believe there is more celiac disease today because people eat more processed wheat products like pastas and baked goods than before. Those processed items use wheat that has high gluten content. Gluten helps dough rise and gives baked goods structure and texture. Mayo Clinic’s Dr. Joseph Murray, head of the research, also believes it could be the changes made to the wheat itself. In the 1950s, scientists began cross-breeding wheat to make it hardier, shorter, and better-growing.
The changes made to wheat in the 1950s may have contributed to the annoying condition now known as “gluten sensitivity”. Gluten sensitivity patients suffer bloating and other celiac symptoms but don’t actually have the disease. They seem to be helped by avoiding gluten. A study in Australia asked for volunteers who had gluten sensitivity symptoms. Half were put on a gluten-free diet and half on a regular diet for six weeks. The people who did not eat gluten had fewer problems with bloating, tiredness, and irregular bowel movements. Gluten sensitivity is estimated to affect 6 percent of the U.S. population. Celiac disease can be diagnosed by tests whereas gluten sensitivity has no test. The only reliable test for gluten sensitivity is a trial elimination of gluten to determine if symptoms come and go with its intake.
The adverse health effects of gluten in people with celiac disease and gluten sensitivity have caused a preoccupation in the public discourse with gluten. People are getting the impression that gluten is a bona fide toxin and is harmful to all. This is a false assumption. Gluten is not bad for people who can tolerate it any more than peanuts are bad for people who are not allergic to peanuts. For the vast majority of the people in the U.S., a gluten-free diet appears to be much ado about nothing. The argument supporting the fad is that going gluten-free may lead to weight loss because avoiding gluten means avoiding a lot of processed foods, lowering calorie intake. The theory that lowering calories leads to weight loss is not some new-fangled idea.
People who suffer from celiac disease and gluten sensitivity are grateful for the gluten-free fad. Until a few years ago they found it hard to find gluten-free choices at grocery stores and restaurants. Gluten-free foods used to taste like cardboard. Now the shelves are filled with tasty gluten-free options.
All the Best,