I’m sure you’ve noticed the increase of advertisement on products of any kind as gluten-free. How could you not. The global gluten-free products market has reached an incredible 5.6 billion US Dollars in 2020. ^[1]https://www.statista.com/topics/2067/gluten-free-foods-market/ Even many products which naturally do not contain any gluten, now display colorful badges 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. As always Sanity and Reason will guide us through the jungle of gluten-related claims and help us to make informed decisions, saving us money along the way 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).

non-celiac gluten sensitivity

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. ^[2]https://www.ncbi.nlm.nih.gov/pubmed/24533607/ link 

So, while NCGS might eventually exist as a real medical condition, other researchers ^[3]Carroccio et. al, 2012: Non-celiac wheat sensitivity diagnosed by double-blind placebo-controlled challenge: exploring a new clinical entity. Am J Gastroenterol. 2012 Dec;107(12):1898-906; quiz … Continue reading are not that sure, it seems, and referred to it as a non-celiac wheat sensitivity. This way the researchers are suggesting that the villain might not be the gluten, but some other substance contained in wheat.

For example, another suspect for possible allergic reactions are ATI or Amylase Trypsin Inhibitors, another kind of protein, with allergic potential (as most proteins!), which serves as a protector against bugs and helps during the germination of wheat. Another, often overlooked fact is, that the structure of gluten in soft wheat and spelt, for instance, is similar. How do we explain then, why many people with a wheat sensitivity report no adverse effects to the consumption of spelt products, suggesting that the cause could be another category of molecules. One suspect is 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 most probably we won’t have to wait very long before these become part of everybody’s daily supermarket experience.

And then there are the food faddists

The third category of gluten-sensitives are pure food faddists. These are the people who believe that eliminating gluten from their diets will have miraculous health benefits or weight loss powers. You can read what I think about food fads, here and here. Nowadays, this seems to be by far the biggest group of the gluten-avoiders and the biggest target for the industry of health gurus and food producers alike. Their numbers have multiplied, while the number of diagnosed cases of celiac disease is predictably stable, which makes sense as there is no reason to believe that a genetic mutation which causes celic disease will be more present in the general population in the range of a few decades.^[4]https://consumer.healthday.com/vitamins-and-nutrition-information-27/gluten-975/number-of-americans-on-gluten-free-diet-tripled-in-5-years-714551.html link

However, I want to admit that all this craze has one positive side-effect. These people choosing to spend more money on gluten-free products than needed plus extra time and effort to create gluten-free recipes for a medical condition they actually don’t have. This in turn helps to create more demand for gluten-free foods, which benefits the 2% of the population, who actually need to avoid gluten. I am truly happy for them, as it makes their lifes a lot more easier.

Should you exclude gluten from your diet?

Some people might  want to try out a gluten-free diet in order to narrow down the cause of their illness or conditions. Let me tell you that this is not advisable. If you or a loved one suspects to be affected by Celiac disease s/he should not start interventions like changing diet without consulting a doctor, because this could make the diagnosis more difficult. If you suspect to have a gastrointestinal or allergic reaction you should consult a professional in order to eliminate some food groups under supervision and narrow down the field of suspects while doing the appropriate tests. Don’t play with your health.

Many of the symptoms often invoked by anti-gluten food faddists as caused by Celiac Disease or Non-Celiac Gluten Sensitivity, like gastrointestinal problems but not limited to those, don’t have anything to do with gluten and a health professional can help you better understand which condition leads to your symptoms. And the earlier you identify the true culpable, the earlier you can remove him from your diet or lifestyle and get better.

Which are conditions claimed to be caused by gluten?

Gluten-free-advocates claim that gluten is the cause of innumerable conditions, more often than not without giving any plausible explanation of the mechanisms supposedly involved. I found innumerable references to obesity, high cholesterol and heart disease. They invent new diseases, for example the “gut and psychology syndrome”, which, according to it’s “creator”, Doctor Natasha ^[5]http://www.doctor-natasha.com/, could be the cause of a long list of  childhood conditions, including anything from simple colics or tummy aches all the way up to failure to thrive and autism. ^[6]http://www.gaps.me/ really, check this out, it’s crazy! Please, if your child suffers from anything, don’t trust a self-proclaimed internet guru: go see an accredited health professional, be it a MD or an ND or even a nutritionist with the right credentials. But don’t fall for the traps of self-proclaimed gurus that have a cure-all like going gluten-free. And always remember: anecdotes are no prove of anything!

Maybe the most worrisome is the claim that “going gluten-free” can cure cancer. “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]https://www.mesothelioma.com/blog/authors/jillian/eat-to-defeat-avoiding-gluten-to-fight-cancer.htm I don’t even want to analyze the alleged logic behind those claims. Assertions like these are unscientific and even dangerous:

I prefer to stick to the recommendation of the World Cancer Research Fund and the American Institute for Cancer Research ^[8]find the complete report on diet and cancer with 12.000 pages here. Many 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 of the todays top cancer researchers. What they recommend? Eat whole grains and/or legumes with every meal. Not every week or every day. Every! Single! Meal!

What else does the science say?

Just for fun, let’s look closer at one study on gluten, often cited by gluten-dispraisers.

In a large medical trial conducted in Ireland published under the title “Higher Cancer Deaths Overall in Gluten-Sensitive Individuals ^[9]https://www.verywellhealth.com/gluten-sensitivity-and-cancer-risks-562966 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”. This was defined by positive AGA-IgA or AGA-IgG blood tests, meaning their immune systems were reacting to gluten, but negative results on the EMA-IgA blood test, 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.

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. ^[10]Michael Greger, MD FACML: How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease, 2015 See on Amazon In short, the consumption of whole grains is linked to a lower risk of developing cancer. Whole grains are also linked to a lower risk of developing a whole set other modern diseases like obesity, type 2 diabetes, stroke and heart disease and consuming whole grains help in overcoming these conditions once they occurred. ^[11]https://academic.oup.com/ajcn/article/98/2/594/4577408

Conclusion

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 for the food industry to lay their hands on your hard earned money. In fact, this study ^[12]https://www.ncbi.nlm.nih.gov/pubmed/18783640 found that, on average, gluten-free products cost a whopping 242% more than their conventional counterparts!!! And while one might think this is because the market is relatively new and products will eventually be less expensive, when the market share rises, this doesn’t seem to be true, as greater market share does not translate into lower prices compared to similar “non-gluten-free” products. ^[13] https://www.ncbi.nlm.nih.gov/pubmed/26310267

Schär, from niche product in health stores to market leader of gluten-free products, increase in income over the last 10 years

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.” So please make sure to use sanity and reason in order to decide whether you need to forsake everything that has gluten in it, or spend more than necessary on a product, just because it displays a fancy label. Last but not least, gluten is bakers best friend. So, if you do not have Celiac Disease or Non-Celiacal Gluten Sensitivity, than you are part of the huge majority of lucky people that can enjoy gluten-containing products without any health consequences. Just make sure you consume whole plant-foods, no refined or highly processed foods, no added oils and sugars, and you’ll be fine.