Gluten-free diets: separating fact from fiction

How did gluten suddenly become dietary enemy number one?  It is now a substance to avoid, even for those who have never adhered to any previous suggested dietary advice.  Gluten-free diets have become the cure for all that ails North Americans.  Along with the flood of gluten-free products in the supermarket, there has been a glut of misinformation about gluten. While for some, gluten is indeed responsible for a host of ills, others who shun it, may not have a clue about  what it really is.

Check out this Jimmy Kimmel segment and you’ll see what I mean.

At the recent Whole Grains: Breaking Barriers conference sponsored by Boston based think tank Oldways  and the Whole Grains Council,  world-renowned celiac disease expert,  pediatric gastroenterologist  Alessio Fasano, M.D.,   director of the Center for Celiac Research at Mass General Hospital for Children, was the keynote speaker.

Dr. Fasano, author of the recently published  book, Gluten Freedom (Wiley Health),  an invaluable resource containing the latest research on celiac disease (CD), gluten-related disorders, and the gluten-free diet, provided insight into the  current dietary frenzy.

Those with CD carry the genetic markers  which can now be commonly tested for and may be key, in the near future,  in the prevention of CD.

Testing for the actual disease, though,  initially involves looking for the presence of  specific markers in blood serum including serum IgA anti-tissue transglutaminase (tTG) antibodies which are produced when an individual with CD consumes gluten. It’s also wise to have your physician include testing for total IgA antibodies as some people with autoimmune disease may not produce these auto-antibodies at all which would result in a false negative when assessing tTG levels.

If CD affects this small percentage, you may be wondering why the market for gluten-free products has exploded.  According to recent surveys, as many as 100 million Americans will consume gluten-free products within a year.  The popularity of these products in Canada is no different. You know gluten-free is hot when pet food commercials on television now tout that their brands are gluten-free.

There are other segments of the population, beside those with CD, who may be required to limit or eliminate gluten from their diets.  The emerging science suggests three basic groups: those with CD,  wheat allergy sufferers and those with a newly recognized condition, non-celiac gluten sensitivity  (NCGS) which may affect about five per cent of the population.

Those with wheat allergies may need to avoid only wheat products (which includes gluten and other of wheat’s components) for a period of time, depending on their allergic status. Allergy testing, which includes different compounds in the blood than with CD,  may be helpful when this is suspected. But as wheat allergies are more common in children and  can change over time, steering clear of  wheat products is often not a lifelong requirement.

As for  NCGS,  while immune function can be tested with blood testing for both CD and wheat allergy, currently diagnosing NCGS is not simple.  It’s thought this sensitivity  may lead to inflammation that may affect people in a wide and somewhat surprising range of  ailments.

For example, there may be associations with gluten sensitivity and the development of autism and ADHD in some individuals but Dr. Fasano cautions that these conditions are due to many factors and simply blaming gluten as the offender is flawed reasoning. On the other hand, experimenting with a nutritionally balanced gluten-free diet in these cases may not be unreasonable.

This area is definitely a hotbed of research as scientists look for ways to determine the various types of gluten intolerance.

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Up next: six key facts about gluten to keep in mind.

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Categories: Nutrition News

Author:Rosie Schwartz

Rosie Schwartz is a Toronto-based consulting dietitian and writer.

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