If you haven't had a friend, relative, or acquaintance recommend that you go gluten-free as an all-encompassing cure for headaches, stress, asthma, and/or ingrown toenails, consider yourself lucky. "Gluten-free" has become the watchword for a long-running dietary fad--but what is this gluten stuff, anyway, and why do people think we should avoid it? Here's the who, what, where, when, and why that you should know about gluten if you're considering cutting it out of your diet once and for all (or if you just want to know what all the fuss is about).
Where do you find gluten? Gluten is a protein found in certain grains: mainly wheat, but also barley and rye. But because gluten has some useful properties as a stabilizing agent and binder, you'll find it in a lot of places at the grocery store besides just the bread aisle. Of course the beer aisle is a glut of gluten too, but gluten also turns up in vegetarian meat-replacement products, sausages, sauces and gravy, and even medications and vitamins.
Why do some people really need to avoid gluten? The main reason is a condition called celiac disease. In this disorder, the mere presence of gluten hanging out in the small intestine sends an "ATTACK!" signal to the body's immune system--and leads it to attack the intestine itself. Over time, the intestinal lining becomes damaged, and damaged intestines are intestines that aren't very good at absorbing nutrition. The only treatment for celiac disease is to go completely gluten-free; there's no "cure" and unlike, say, lactose intolerance, there's no pill you can pop in order to safely binge on bread.
Other people have a wheat allergy that requires them to steer away from all the sorts of foods that would contain gluten. Wheat allergies can be mild enough not to deter a person from eating wheat at all, or they can be bad enough to send you into anaphylactic shock after eating a Saltine.
The number of people who have celiac disease and wheat allergies is a very small one--in the USA, it's somewhere around 1% of the population. But the percentage of Americans who want to reduce the amount of gluten in their diet is 30%. Some of them have just cut it out of their diet out of a generalized (and not well-supported) sense that gluten=evil; while others are said to suffer from something called "non-celiac gluten sensitivity", which, well, may or may not exist.
What is the case against gluten? The science behind non-celiac gluten sensitivity is a very mixed bag. Some small studies have suggested a role for gluten in tummy troubles of a dietary variety, but follow-ups have raised the very real possibility that something called the "nocebo effect" is at play. Know how a placebo pill doesn't actually do anything physiologically but still somehow convinces a patient that they're feeling better? The nocebo is the same thing, but makes the patient feel worse. In experiments, patients who claimed non-gluten sensitivity were subjected to a series of different diets, including some periods of only gluten-free food. Researchers found that patients reported feeling worse every time the diet changed--possibly because they simply expected to feel worse with the new test diet!
The scientific basis for non-celiac gluten sensitivity is still shaky, and it certainly isn't something that affects a third of the population. But if you're willing to look outside the purview of science, you'll find plenty of people willing to claim gluten (and other substances) cause something called a "leaky gut". Gluten is purported to cause tiny holes in the intestines that cause bacteria, waste, and of course the omnipresent "toxins" to leak out into the rest of the body. Believers say that leaky gut syndrome is responsible for everything from seasonal allergies to hormonal imbalances to--you guessed it--autism. Leaky gut syndrome is not, however, recognized by doctors who didn't find their diploma in the bottom of a cereal box.
Who is telling you gluten is dangerous? When there's a lot of bad information out there in the ether, it's a good idea to question where it's coming from. And unsurprisingly, the people flogging the all-gluten-free, all-the-time diet are some of the usual suspects.
The "beginner nutrition plan" from the Mercola website begins, of course, with eliminating all gluten from the diet. Gwyneth Paltrow's cookbook is gluten-free, of course, but I prefer to take nutritional advice from my doctor and not from actresses, even ones who have won an Academy award. And of course there's the whole Paleo diet thing which has put gluten on the no-no list--that's probably a whole other column entirely, but suffice it to say for now that yes, people 10,000 years ago were totally eating wheat.
Hucksters selling diet plans and cookbooks, naturopaths selling "alternative health" regimes to those who want a simple answer like "buy gluten-free granola bars" to their difficult and complex health questions ... these are not the people you should be trusting your bodily well-being with.
Why is it going to bite you in the ass if you forgo all gluten? For those who don't have a real medical reason to avoid the stuff, completely cutting gluten out of your diet can cause more problems than it prevents. Going gluten-free can make it harder for friendly bacteria to survive in your gut, which makes it easier for the nasty stuff to thrive. Bread and cereal, which are Gluten Central, are also important dietary sources of thiamine, iron, and vitamins, so the gluten-avoidant need to find another way to make sure they're getting these nutrients into their mouths. (Folate is another nutrient packed into wheat products, so a gluten-free pregnancy may not be a great plan.)
Plus, a diet lacking in wheat products also tends to be lacking in fiber (which means it is sadly not lacking in constipation). And finally, a non-medical but still very real consideration is that gluten-free food options tend to cost a lot more than the regular variety. Going gluten-free can be a kick in the wallet as well as the colon.
Of course, the upshot of the gluten-free craze is that finding alternative gluten-free foods has gotten a lot easier for those with genuine allergies or celiac. So in conclusion? If you want to give up gluten for nebulous reasons, go for it. Just do it knowing that it's not going to keep you healthy ... and maybe spare the rest of your yoga class from hearing about your new diet every week.
(Image: itVega / Shutterstock)