The Rise of Gluten-Free Products
The consumption of gluten-free products has increased significantly over the last 30 years. In 2016 alone, people spent over $15.5 billion on gluten-free foods [1]Gluten-related diseases such as coeliac disease and gluten ataxia are rare conditions that affect less than 1% of the population, yet the avoidance of wheat and gluten is a worldwide phenomenon [1]. A gluten-free diet is recognised as the standard for patients with gluten-related diseases. For example, the treatment option for people with coeliac disease is a lifelong avoidance of gluten to alleviate symptoms. However, the avoidance of gluten has extended to healthy individuals as they believe a gluten-free diet is healthier and can provide health benefits[2]. This begs the question, “Is gluten really as harmful as some make it out to be?”
What is gluten?
Gluten refers to a family of proteins that are commonly found in a multitude of grains such as wheat, barley, rye, and oats. Each type of grain contains differing amounts of gluten. Gluten helps foods maintain their shape, acting as a glue that binds food together [3]. Gluten-containing grains such as wheat makes up a large portion of the modern Western diet because of the ease of farming, procession into a wide variety of foods, and how appetizing it is [1]. Wheat-containing foods include bread, cereals, and pasta– to name a few.
Who does it affect?
Coeliac Disease
Coeliac disease is a gastrointestinal autoimmune condition that causes damage to the inner lining of the small intestine. To date, it affects approximately 1% of the population [2]. For those who have coeliac disease, gliadin (a grain protein in gluten) triggers an immune response which leads to the damage of the lining of the small intestine. When this happens, the body is unable to absorb nutrients properly [4]. Symptoms of coeliac disease include iron deficiency anaemia, diarrhoea, weight loss, fatigue, cramps, bloating, and skin problems. The diagnosis of coeliac disease can be difficult as symptoms can begin to occur anytime from childhood through to late adulthood and the intensity varies from person to person. As mentioned before the only approved treatment is lifelong avoidance of gluten.
Wheat allergy
Wheat allergy is a reaction to the gliadin proteins found in wheat. Symptoms include itching and swelling in the mouth, nose, eyes, and throat, skin rash and wheezing, and anaphylaxis. They can develop within minutes to hours after gluten ingestion [5]
Non-coeliac gluten and/or wheat sensitivity (NCGS)
NCGS is thought to be an immune reaction to gluten or other components of wheat with intestinal symptoms which improve once gluten and/or wheat is eliminated from the diet and after appropriate testing for coeliac disease and wheat allergy has been ruled out. Symptoms include abdominal pain, bloating, constipation, and diarrhoea, joint and muscle pains, fatigue, and “foggy mind”. Diagnosis of NCGS is very difficult due to the lack of validated criteria for testing. At present, studies testing for NCGS have found that a high proportion of patients suspected to have an NCGS did not have symptoms in response to consuming gluten when they were not able to distinguish between foods with or without gluten [6]. The researchers believed that this could be in part due to the “nocebo effect”, or from another wheat molecule. The Nocebo effect is when people’s beliefs about a substance can be enough to trigger a psychosomatic response to it. This does not make the symptoms any less real however it does show the power of how fear of foods can manifest itself negatively.
So, are gluten-free products healthier?
Thanks to the rise in popularity of a gluten-free diet, the market for gluten-free foods is booming, which is great for people who suffer from coeliac disease, a wheat allergy, or non-coeliac gluten sensitivity. However, going for a gluten-free product doesn’t automatically make it healthier — nor does it need to be. Gluten-free products provide an alternative for those who cannot ingest gluten. It allows those with coeliac disease to enjoy a bag of chips or baked goods without gastrointestinal problems. At the moment, gluten-free products are often higher on the glycaemic index, and gluten-free baked goods often contain more fat and sugar to improve the taste and texture when gluten is removed. These products also tend to be low in fibre and lacking other nutrients such as folic acid and calcium [7]. These gluten-free products also come with a financial cost as they are more expensive than foods containing gluten [1].
The Bottom Line
At the end of the day, nobody knows your body better than yourself. If opting for a gluten-free diet reduces gastrointestinal symptoms and makes you feel better — go for it. Gluten is not something you need to be afraid of, as, despite the claims in the media, it only impacts a small percentage of the population. To date, there is no evidence that shows opting for a gluten-free diet in a healthy population is better for you.
If you experience ongoing gastrointestinal issues, consult a health care practitioner as you may be cutting out food groups unnecessarily while still not getting to the bottom of what is causing your symptoms.
Information this week by: Kirstyn Church, an Associate Nutritionist with Nutrition Consulting Services. Tru Valu Supermarket is one of the leading grocery chains in Trinidad and Tobago with five stores and the best customers. Have a question? Email us truvalusupermarkets@gmail.com.
Always consult your GP or health practioner before making dietary changes. This information is for knowledge purposes and does not constitute medical advice.
References
[1] B. Niland and B. D. Cash, “Health benefits and adverse effects of a gluten-free diet in non-celiac disease patients,” Gastroenterology and Hepatology, 2018.
[2] A. Diez-Sampedro, M. Olenick, T. Maltseva, and M. Flowers, “A Gluten-Free Diet, Not an Appropriate Choice without a Medical Diagnosis,” Journal of Nutrition and Metabolism. 2019, doi: 10.1155/2019/2438934.
[3] J. R. Biesiekierski, “What is gluten?,” Journal of Gastroenterology and Hepatology (Australia). 2017, doi: 10.1111/jgh.13703.
[4] A. di Sabatino and G. R. Corazza, “Coeliac disease,” The Lancet. 2009, doi: 10.1016/S0140–6736(09)60254–3.
[5] J. R. Biesiekierski and J. Iven, “Non-coeliac gluten sensitivity: Piecing the Puzzle together,” United European Gastroenterology Journal. 2015, doi: 10.1177/2050640615578388.
[6] E. Lionetti et al., “Re-challenge studies in non-celiac gluten sensitivity: A systematic review and meta-analysis,” Frontiers in Physiology, 2017, doi: 10.3389/fphys.2017.00621.
[7] C. Cross, “Gluten-free industry is healthy, but is the food?,” CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne. 2013, doi: 10.1503/cmaj.109–4555.
