The Gluten-Free Diet – When It’s Not a Fad

8 Jun

Written By: Emily Farrell

 

Gluten Free

Picture courtesy of Emily Farrell

 

The gluten-free diet (GFD) has quickly become one of the most popular self-implemented diets in North America, leading to a proportionate increase in the gluten-free food industry (Reilly, 2016). A GFD is defined as a diet devoid of all food products containing gluten, namely, gluten-containing cereals – rye, barley, wheat, and triticale – gluten-containing food additives and foods contaminated with products containing gluten. Many people believe that a GFD is a healthy lifestyle choice, with perceived health benefits of eating gluten-free.

The general population’s recent devotion to a GFD has caused a perception among individuals that the GFD is nothing but a “fad diet”. The GFD, however, is considered a clinical nutrition therapy for several conditions relating to gluten sensitivity (Pietzak, 2012). Celiac disease, a genetic immune-mediated disorder causing the body’s immune system to attack normal tissue in response to gluten, requires individuals to follow a strict lifelong GFD. It occurs in 0.5-1% of the population, and the diagnosis is increasing in prevalence due to the growing awareness within the scientific community (Pietzak, 2012). Individuals with celiac disease have an increased risk of gastrointestinal cancers and, if gluten makes its way into their diet it can significantly increase their risk of nutritional deficiencies due to malabsorption (Pietzak, 2012). Other gluten-related conditions include, but are not limited to, wheat allergy, gluten ataxia, dermatitis herpetiformis – celiac disease of the skin – and non-celiac gluten sensitivity (El-Chammas and Danner, 2011). Non-celiac gluten sensitivity is a condition where individuals negatively react to gluten-containing products, in the absence of celiac disease. It is, however, recently hypothesized that individuals with non-celiac gluten sensitivity are reacting to a specific component in wheat other than gluten, and, as such, these individuals still benefit from a GFD as it eliminates wheat entirely (Escudero-Hernández et al., 2016).

Despite the various clinical conditions, it seems that many individuals in the general population are following a GFD due to reasons unknown to them, potentially wanting to join the “fad”. A large proportion of individuals believe that gluten-free products are healthier than their gluten-containing counterparts, viewing them as “healthier options”. The gluten-free food industry is increasing exponentially and is now almost a billion dollar business. This is not due to the increasing awareness of gluten-related sensitivities, but instead due to the increasing popularity of the GFD as a “fad diet” (Reilly, 2016). A survey conducted in 2015 involving more than 1500 American adults observed that the most common reason for consuming gluten-free products was for “no reason” (35% of individuals) (The Hartman Group I, 2015). This response was followed by “a healthier option” (26%), “digestive health” (19%), and “weight loss” (13%), with the least common reason being “I have a gluten sensitivity” (8%) (The Hartman Group I, 2015). Therefore, the question is, does the general population actually benefit from following a GFD?

That is a question some researchers have sought to answer. A literature review conducted in 2016 evaluated the nutritional quality of the GFD focusing on nutritional deficiencies and over-consumption of unhealthy food components (Vici et al., 2016). A GFD is often devoid of vital vitamins and minerals including vitamin B12, vitamin D, folate, calcium, zinc, magnesium, and iron (Vici et al., 2016). Moreover, a GFD is often low in dietary fiber which is important for gastrointestinal health and for the prevention of diabetes and cancer (Vici et al., 2016). Gluten-free products often contain a greater fat content than their gluten-containing counterparts and this can lead to higher consumption of lipids, including saturated fats (Vici et al., 2016). The nutritional inadequacies experienced while following a GFD may be attributed to the poor nutritional quality of gluten-free products and the avoidance of foods naturally rich in nutrients, such as whole grains. Therefore, individuals who are not required to follow a GFD often do not benefit from eating gluten-free.

While the general population may not benefit from a GFD, many individuals do. In fact, they need a GFD to maintain a reasonable level of health and quality of life. However, because this diet is now stigmatized as a “fad” diet, individuals requesting that their food is prepared “gluten-free” now experience a diminished presence of care. This introduces health hazards to individuals who must strictly follow a GFD. It is now often assumed that individuals are following a GFD due to the “fad” and limited caution may be used in preparing meals to ensure zero contamination.

It remains to be seen how long the GFD fad will remain. Nonetheless, for those who choose to eat gluten-free, regardless if they are following a GFD due to necessity or personal preference, should do so following the guidance of a registered dietitian to ensure that they are getting adequate nutrition.

References

El-Chammas, K., and Danner, E. (2011). Gluten-free diet in nonceliac disease. Nutrition In Clinical Practice, 26(3): 294-299.

Escudero-Hernández, C., Peña, A.S., and Bernardo, D. (2016). Immunogenetic pathogenesis of celiac disease and non-celiac gluten sensitivity. Current Gastroenterology Reports, 18(7): 1-11.

Pietzak, M. (2012). Celiac disease, wheat allergy, and gluten sensitivity. Journal of Parenteral and Enteral Nutrition, 36(supplement 1): 68S-75S.

Reilly, N. (2016). The gluten-free diet: recognizing fact, fiction, and fad. The Journal of Pediatrics, 175: 206-210.

The Hartman Group I. “The Hartman Group’s Health & Wellness 2015 and Organic & Natural 2014 reports.” http://www.hartman-group.com/acumenPdfs/gluten-free-2015-09-03.pdf. Accessed February 2017.

Vici, G., Belli, L., Biondi, M., and Polzonetti, V. (2016). Gluten free diet and nutrient deficiencies: A review. Clinical Nutrition, 35(6): 1236-1241.

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