I’m sure you’ve noticed the increase of advertisement on products of any kind as gluten free. How could you not. Even many products which naturally do not contain any gluten, now display colourful signs indicating it’s safe to use for people who want to avoid gluten. Well then, can you explain what gluten is? No? You’re not alone. 100% of people in my life I interviewed about this was aware of something called gluten and 0% could explain what it actually is. As always Sanity and Reason will be our friends in guiding us through the jungle of health claims and make informed decisions, saving us money and letting us enjoy our life without complicating it unnecessarily.
First of all: What is gluten?
Gluten is a protein contained in wheat and some other grains. Without gluten, bread could not raise into a light, yet consistent dough. In the old days, bread was kneaded several times in order to develop the gluten and make it stronger. The longer protein chains, aka gluten, then trapped the CO2 which forms during fermentation in bubbles, and gluten plus CO2-bubbles together make for a perfect dough. Gluten is actually the bread makers best friend, and I don’t know any good reason why anybody would want to avoid, let’s say a real Pizza or Baguette, if not absolutely necessary (so, I am not talking about people really effected by celiac disease here).
Celiac disease. Gluten intolerance. Psychic gluten sensitivity. Let’s shed some light on these.
First of all there are People with celiac disease (CD), which is a real, serious genetical disorder. The prevalence may vary from population to population, but we are talking about 1 percent of the population. Sufferers of celiac disease have strong digestive distress when they eat food containing gluten, and can even react to trace amounts. When they eat gluten, their immune systems attacks the lining of the small intestine. Celiac disease is diagnosed through blood and genetic tests, or even biopsy of the small intestine, but can not be diagnosed just by its symptoms (which could be caused by many factors).
Then there are people who are affected by non-celiac gluten sensitivity (NCGS). This condition was first reported in England in 1980. Patients have digestive trouble, chronic diarrhoea or other problems when they eat food containing gluten, but they don’t meet the diagnostic criteria for celiac disease. This is a controversial category, even among gastroenterologists. Often people who report a NCGS are referred to psychiatrist to treat their underlying mental problems.1
So, while NCGS might eventually exist as a real medical condition, other researchers (Carroccio et. al, 2012) are not that sure, it seems, and referred to it as a non-celiac wheat sensitivity2 suggesting, that the villain is not the gluten but some other substance contained in wheat. Another suspect for allergic reactions are the ATI or Amylase Trypsin Inhibitors, another protein, with allergic potential as most proteins, which serves as a protector against bugs and helps in germination of wheat. Another, often overlooked fact is that the structure of gluten in soft wheat and spelt, for instance, is similar, not explaining while many people with a wheat sensitivity report no adverse effects after consuming spelt products, suggesting that the cause could be another category of molecules, namely a group of carbohydrates called fermentable oligo-saccharides, di-saccharides, mono-saccharides and polyols, or FODMAPs. Wheat does contain FODMAPs, but so do other foods like cow’s milk, onions, and blueberries. Food labels that say “FODMAP-free” are not yet popular, but, following the trend of the last years I’m sure we won’t have to wait for long until these become part of everybody’s daily supermarket experience.
The third category are pure food faddists, or people who think that eliminating gluten from their diets has miraculous health benefits or weight loss powers. You can read what I think about these guys, here and here. Today, this seems to be by far the biggest group of the gluten-avoiders. Their numbers have multiplied, while the number of diagnosed cases of celiac disease is actually stable.3
Choosing to spend more money on gluten-free products and time in creating gluten-free recipes for a medical condition they actually don’t have, those people help create more demand for gluten-free foods which help the 2% of the population who really need to avoid gluten.
Some people also might try out a gluten-free diet while trying to narrow down the cause of their illness, even though this is not advisable. If one suspects to be affected by Celiac disease she/he should not start interventions like changing diet without consulting a doctor, because this could make the diagnosis more difficult.
Many of the symptoms often invoked by anti-gluten food faddists as cause by CD or NCGS, mostly related to gastrointestinal problems but not limited to, don’t have anything to do with the clinically recognised condition. Which are conditions claimed by gluten-free-advocates as caused by bad, bad gluten, you ask? Let’s see.
I found innumerable references to obesity, high cholesterol and heart disease. But some go as far as gut and psychology syndrome, which, according to it’s creator, Doctor Natasha4, could be the cause of a long list of conditions children could be affected with, including anything from colics or tummy aches to failure to thrive and autism5 (really, check this out, it’s crazy!) or even cancer6 are caused by consumption of gluten and can be cured or alleviated by reducing the gluten in your life. Claims like these are unscientific and even dangerous: “Even for people with uncompromised immune systems, gluten has been found to have many negative effects on health, digestion and nutrient absorption. Inside the digestive system, gluten forms a thick, paste-like substance that smothers the lining of the intestines. It is believed that this can significantly hinder the availability of nutrients from food. This one fact alone makes a strong case for avoiding gluten during and after cancer.”7
I think I prefer to stick to the recommendation of the World Cancer Research Fund and the American Institute for Cancer Research (find the complete report on diet and cancer with 12.000 pages here). Nine (!) independent research teams from around the globe went through data of some half a million studies and created a “landmark scientific consensus report” which was then reviewed by more then twenty top cancer researchers we have today. So what is theiration recommend? Eat whole grains and/or legumes with every meal. Not every week or every day. Every! Single! Meal!
Just for fun, let’s look closer at one study on gluten, often cited by gluten-dispraisers.
Study: Higher Cancer Deaths Overall in Gluten-Sensitive Individuals 9 “In a large medical trial conducted in Ireland, researchers found more deaths from cancer – plus more deaths from all causes – in people they defined as sensitive to gluten. The researchers looked at cancer rates in people deemed “gluten sensitive,” which they defined as someone who had a positive AGA-IgA or AGA-IgG blood (meaning their immune systems were reacting to gluten), but negative results on the EMA-IgA blood , which is specific to the type of intestinal damage found in celiac disease. (The AGA-IgA and AGA-IgG blood tests indicate the presence of antibodies against the gluten protein, but cannot determine if there’s intestinal damage.) 10
In fact, there are markers in our blood that react on the consumption of grains. But instead of causing inflammation the opposite seem to be true. The inflammation markers ALT, GGT, IL-6, IL-8, IL-10, IL-18, PAI-1, TNF-alpha TNF-R2, as well as whole blood viscosity and erythrocyte filtration all seem to be improved after the consumption of whole grains (Greger, 2015).
The consumption of whole grains also lower the risk of encountering modern diseases like obesity, type 2 diabetes, stroke and heart disease and helping in overcoming these conditions once they occurred.11
There is no good reason why a juice or liquor, coffee, a package of mashed potatoes or vinegar should contain gluten. And even though people affected with real celiac disease have to pay extra attention in order to avoid any cross-contamination, let’s say in a production side that also uses wheat for some of their products, or additives, that might contain gluten, it seems that gluten-free labels and advertisements are just another way to ask for some extra money from costumers (This study found that, on average, gluten-free products cost a whopping 242% more than their conventional counterparts!!! 12 also with greater market share the prices keep being higher than average 13) and to add to the vast amount of diet crazinesses around.
Schär, from niche product in health stores to market leader of gluten-free products, increase in income over the last 10 years
Furthermore, while any reasonable health advice should be for eating more whole grains, many internet resources and self-proclaimed health gurus claim the opposite causing more harm than good, even if without bad intentions. Or, as Dr. Greger put it in his book “How not to die”: “a few especially persistent memes directly contradict the available science. When I see books, websites, articles, and blogs parroting claims like “grains are inflammatory – even whole grains” I can’t help but wonder what alternate dimension the authors call home.” Nothing to add here.