GASTRO
September 12, 2016

A Gluten-Free Hoax?

The number of people who've decided to go gluten-free without a diagnosis of celiac disease has tripled. Are they foolish?

Going gluten-free is one of the most popular diet trends right now. While the prevalence of celiac disease has remained steady, the number of people following a gluten-free diet, without a diagnosis of celiac, has tripled.

Gluten is the protein found in wheat, barley and rye. People diagnosed with celiac disease, a hereditary autoimmune disorder in which the consumption of gluten causes damage to the small intestine, must avoid ingesting gluten. Eliminating gluten from one's diet has become popular, touted for weight loss, the treatment of various gastrointestinal symptoms and overall well being.

An increasing number of people have diagnosed themselves with gluten sensitivity and claim improved gastrointestinal health after giving up gluten. Many believe it helps with nonspecific gastrointestinal symptoms and aids in weight loss.

Using data from the National Health and Nutrition Examination Surveys 2009-2014, Rutgers University researchers looked at the current trends in the prevalence of celiac disease and how many people said they ate a gluten-free diet, whether they had celiac disease or not. Though the number of people with celiac disease remained stable during the five-year period, those who reported following a gluten-free diet increased — by a lot.

It is possible that these two trends could be related. The decrease in gluten intake could be a contributing factor to the stable prevalence of celiac disease, according to the study, published in JAMA Internal Medicine. Since gluten consumption has been recognized as a risk factor for celiac disease, a decreased intake — or even a stable intake — may be behind the leveling off in the number of new diagnoses of the disease.

The popularity of the gluten-free diet may be the result of the public perception that gluten-free is a healthier way to eat. An increasing number of people have diagnosed themselves with gluten sensitivity and claim improved gastrointestinal health after giving up gluten. Many believe it helps with nonspecific gastrointestinal symptoms and aids in weight loss. As a result, gluten-free foods are more widely available now than ever before. This makes it easier for those interested in exploring the possibility that the diet may help their digestive problems to avoid gluten.

An invited commentary in the same journal issue suggests it is possible that the avoidance of the grains themselves could be responsible for the reported benefits of a gluten-free diet. The fermentable sugars and insoluble fiber found in grains that contain gluten can cause gas and bloating, so not eating these grains could reduce digestive symptoms in people who do not have celiac disease.

It's also possible that people who eliminate gluten incorporate other dietary measures that help to improve gastrointestinal symptoms and that the elimination of highly processed foods, including those that contain gluten, might make people feel better overall and help with weight loss.

Many people who do not possess the typical features of celiac disease say they have experienced improved health after giving up gluten. It certainly can't hurt to reduce one's consumption of carbohydrates. To get to the final verdict, more research will need to be focused on the benefits of the gluten-free diet for those without celiac disease.

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