Gluten Hysteria

Americans have an insatiable compulsion to blame everything on a nutrient. Among the nutrients that have been blamed for everything are fat in general, saturated fat, carbohydrate in general, sugars in general and high fructose corn syrup. Now gluten is being blamed for everything. Suddenly the phrase “Gluten-Free” is printed on every third product package at the supermarket—or at least the whole foods market. Americans are now reportedly spending $2 billion on such products. What is gluten, anyway, and why is everyone afraid of it now? And how much of this fear is justified?

Gluten is essentially wheat protein. More exactly, it is a composite of two plant proteins and starch that is found in greatest abundance in wheat and is also present in smaller amounts in other grassy grains such as rye and barley. Gluten’s bad new reputation is based on the fact that between 0.5 and 1 percent of the population experiences an inappropriate immune response to the protein that causes diarrhea and other gastrointestinal complaints, weight loss, anemia and other symptoms. Celiac disease is genetic. Medical research has identified two gene polymorphisms—known as DQ2 and DQ8—affecting white blood cell behavior that create a genetic predisposition for the disease.

One percent is a small number—or, more bluntly stated, a small market. It cannot support the large number of gluten-free products now packing the shelves of health food markets. There is clearly a large demand for gluten-free foods among people who do not have celiac disease. Why? Because there is a spreading belief that many people who do not have celiac disease are nevertheless have a milder condition that is variously referred to as gluten intolerance, or gluten sensitivity and gluten sensitivity enteropathy. But does this “celiac disease lite” really exist, and if so, how widespread is it really?

This is one of those cases were the natural health community has gotten out ahead of the mainstream medical establishment. A PubMed search of the term “gluten intolerance” yields only research on celiac disease proper. A search on the term “gluten-sensitivity enteropathy” yields scores of studies, but a closer look reveals that this term is used synonymously with celiac disease within the mainstream medical establishment. For example, a recent Spanish screening study for gluten sensitivity enteropathy involving 1,868 subjects, only 15 were found to have the condition.

If gluten intolerance as a sort of subclinical celiac disease does exist, then, the mainstream medical establishment not only does not recognize it but is not even able to detect it. Which is pretty good evidence that gluten intolerance does not exist. Yet there is also plenty of anecdotal evidence that some form of non-celiac gluten sensitivity does exist. The typical gluten-free dieter is someone who discovered a pattern of suffering from gastrointestinal issues after eating gluten-containing foods and found relief upon switching to a gluten-free diet. Still, the current gluten-free diet trend is larger than the true prevalence of gluten sensitivity in the population. In other words, gluten is probably being scapegoated to some degree, probably because the preceding low-carb diet trend trained the public to think of grains as evil foods.

Lately many parents are blaming gluten for causing or exacerbating the symptoms of autism and attention deficit hyperactivity disorder in their children. Is there any scientific evidence of such a link? The short answer is no. In a recent Newsweek article on the gluten-free diet trend, Peter Green, director of the Celiac Disease Center at Columbia University is quoted as saying, “All this gluten intolerance, and using the diet to treat autism, ADHD … there's no documented scientific reason for that at all. However, patients without celiac disease often do notice an improvement in a whole spectrum of gastrointestinal or neurological symptoms when they start a gluten-free diet. But it's not defined by any medical diagnosis.” Experts like Green attribute the many anecdotal reports of improvement in autistic and ADHD kids placed on gluten-free diets to a placebo effect.

Where does this leave us? If you suffer from regular GI distress with no known cause, it can’t hurt to try a gluten-free diet. Remove all foods containing wheat, rye, and barley from your diet and replace them with alternatives made from corn, rice, millet, etc. But don’t be surprised if you don’t experience any relief, as the balance of evidence suggests that non-celiac gluten sensitivity is more hype than reality.

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