Gluten is cast as the culprit de jour of the cyber-nutrition universe.  Health seekers crowd onto the gluten-free bandwagon, some follow the crowd – others follow nutrition thought leaders who vilify this grain protein with half-truths and exaggeration.

A 2014 food industry survey revealed a quarter of Americans believe gluten is not nutritious.

Nielsen’s and Consumer Reports found roughly the same statistics.

Detractors blame gluten for an array of digestive problems normally associated with IBS or IBD, skin problems, autoimmune disease, dizziness, hormone imbalances, infertility, migraines, chronic fatigue, fibromyalgia, and mood disorders.  In fact, “More than 55 diseases have been linked to gluten,” according to an oft-repeated claim.

Do you want to know what those 55 diseases are?  So do I.

Following the claims (same claim made at various sites), I uncovered a list of about 35 symptoms (not diseases) of celiac disease – a deadly autoimmune disease triggered by gluten.  Celiac disease causes intestinal damage which results in malnutrition (and increased cancer risk.)  The intestinal damage and malnutrition cause all the symptoms related to celiac disease.  Gluten alone does not cause the symptoms – and I have been unable to find that list of 55 diseases!

No wonder alarmed consumers rush to eradicate gluten from their diets!

But – if only about 1% of the population have celiac – why the widespread concern? Is it true that most people can benefit from a gluten-free diet?  Is gluten, in fact, toxic to humans?

I have been unable to discover any research to support the toxicity claims.  People sharing observations abound – which has some value – but navigating conflicting claims requires some concrete evidence.

 

“People need to know that gluten is not inherently bad. There’s nothing about it that results in poor health or disease. It’s something that our bodies can metabolize without any problems for the most part,” -Lisa Cimperman, M.S., R.D., L.D., spokesperson for the Academy of Nutrition and Dietetics.

Perhaps the very real rise in rates of celiac disease gives credence to the perceived gluten threat.  The reported rise may be due to increased awareness, but studies show an actual increase in rates of the disease over the past 50 years or so.

We are also experiencing a rise in wheat allergy, which can cause nausea, diarrhea, mouth/throat irritation, rash, congestion, eye problems, and even breathing problems.  This is another serious condition not caused specifically by gluten, but can be confused because wheat also contains gluten.

 

Also on the rise – and perhaps adding to the hyperbole – is gluten sensitivity or gluten intolerance.  Much skepticism surrounds non-celiac gluten sensitivity (NCGS), with some claiming it just does not exist.  Others conclude it may exist – but is not common.  While studies give minor credence to the condition, some believe it might be an early manifestation of celiac.  Many physicians now accept that patients suffering from digestive issues (gas, bloating, pain) and/or headache, fatigue, and “brain fog” may benefit by excluding gluten from their diets – even if only by placebo.

 

Celiac and wheat allergy are detected by a simple blood test.  Gluten sensitivity can only be determined by first ruling out these dangerous possibilities and then experimenting with eliminating and then re-introducing gluten.

Another consideration for the frequent digestive sufferer, maybe even more likely than NCGS, is food sensitivity to groups other than gluten.

Unlike the gluten poisoning claims, the FODMAP diet has been through several high-quality studies and found to be very effective at reducing irritable bowel symptoms. In a nutshell, a GI patient would cut out all potential problem foods from their diet for several weeks, until all symptoms subside, then begin introducing foods one at a time to observe sensitivities.  Broadly. FODMAP categories are:

F – fermentable carbohydrates (which are as follows)

O – oligo-saccharides (fructans and galacto-oligosaccharides in foods like wheat, onions, and legumes)

D – di-saccharides (lactose in dairy products)

M – mono-saccharides (fructose in excess of glucose in foods like honey, apples, and high fructose corn syrup)

P – polyols (sorbitol, mannitol, maltitol, xylitol in foods such as cherries, apricots, cauliflower and sweeteners added to “sugar-free” foods)

A full chart and more information can be found here, although working with a dietician through the elimination and food trial process would probably be the best route to a well-rounded, healthy diet.

I suspect more than a few “gluten sensitive” individuals would fare better by avoiding fructans rather than gluten, and probably a few foods from some of the other groups as well.

“ .. .there is a decidedly minority but still sizable — and apparently growing — population that can benefit from excluding gluten (entirely or mostly) from their diets. There is a population an order of magnitude smaller, also growing, for which it is vital to do so, and potentially even a matter of life and death.

For everyone else, going gluten-free is at best a fashion statement, and at worst an unnecessary dietary restriction that results in folly. It reflects a tendency to ingest the ever proliferating pop-culture perspectives on diet and health, without first separating the wheat from the chaff.” – Dr. David Katz