2013-09-04

This is a comment I’m starting to see more and more often. Go to any news article about gluten and the comment section will be littered with angry outbursts and outright vitriol for people who go gluten-free. Skeptical blogs love to trot out posts lambasting and ridiculing the “gluten-free fad.” And from what I can tell, nothing inspires a contemptible eye-roll like a person asking a waiter in a restaurant if they have gluten-free options. By some stretch of the known laws of cause-and-effect, the removal of gluten from someone’s diet apparently causes irreparable harm to people with knowledge of the decision and deserves unequivocal reprobation. Otherwise, why else would they care so much?

Well, gluten-free is clearly more popular than ever. More and more people are becoming aware of it. Google searches for “gluten” have been trending higher month over month for years, while the number of searches for “celiac” has plateaued. 30% of American adults are actively trying to reduce or eliminate gluten from their diets, according to a recent poll. Gluten-free dating sites are popping up to help gluten-free dieters match up with people who share their situation. The FDA’s just weighed in with some official standards for gluten-labeling. It’s everywhere, in other words. It’s arrived. It’s popular. And whenever anything gets popular, people immediately begin hating it. I’m not sure why that is, really, but it’s a known human phenomenon. Couple that with your already annoying co-worker droning endlessly on about this new diet she’s on, and I can see how someone might get a bit annoyed at all the gluten-free talk.

But is the vitriol really necessary? Does its popularity invalidate it as a legitimate therapeutic option for people with a sensitivity or downright intolerance to gluten? Should incurious cynics masquerading as skeptics be so quick to dismiss it?

Okay, maybe sometimes people can be a bit evangelical about avoiding gluten, and that’s unpleasant. And sometimes, people can’t give you a straight answer when you grill them on exactly why they’re avoiding gluten. I’d wonder why you felt it was your place to “grill them” in the first place, of course, but there is that subset of the population who takes umbrage at people making health decisions without conducting randomized controlled trials, being able to cite research by memory, and consulting the authorities.

I’ll also admit that the prospect of marketers taking over and appropriating the movement for their own benefit concerns me. For many people, a “gluten-free” label unfortunately bestows a cachet of health onto whatever processed food it graces. Potato chips? They’re gluten-free! Triple-chocolate brownie mud slide fudge-topped soy flour locust bean gum explosion? Gluten-free! Eat without guilt! Gluten-free bread that makes up for the lack of gluten’s texturizing power with a half cup of soybean oil? Go for it! Even foods that never contained gluten in the first place, like Cheetos, and hummus, are getting the gluten-free label to capitalize on the trend.

On one hand, it’s like the fat-free labeling craze, where you had fat-free cookies with twice the sugar, fat-free yogurt with thrice the sugar, fat-free salad dressing with whatever sorcery they incorporated to make that possible. And people ate those things with willful abandon, confident that “fat-free” was a synonym for “healthy” – and obesity rates continued to rise. Heck, the fat-free movement most likely exacerbated America’s obesity problem. I can understand why people who mistrust food marketing would be skeptical of gluten-free in general.

Of course, there is an important difference that distinguishes gluten-free from other faddish, market-driven diets: you don’t actually need gluten-free products to go gluten-free. The fat-free movement turned people off of legitimately healthy nutrient-dense foods like beef, eggs, butter, nuts, avocados, and olive oil just because they contained fat, whereas going gluten-free doesn’t remove a vital, essential nutrient or food. In fact, it can even increase your intake of nutrients, assuming you replace the gluten-containing foods with naturally gluten-free meat, fish, fruits, vegetables, and nuts rather than gluten-free junk food. In my experience, gluten-free consumers are more informed about health in general and do the former.

Amidst all the marketing speak, the gluten-free water, the gnashing of teeth upon discovering that the person you’re talking to avoids gluten, real science is being done, and any honest, literate person who looks at the available evidence on the health effects of gluten will admit that there’s something to this “fad.” And yet, I’m increasingly struck by the unwillingness of intelligent people to acknowledge the reams of research coming out every week exploring the effects of gluten on non-celiacs.

It couldn’t be that non-celiac gluten sensitivity is real and we don’t know how many people actually have it as the epidemiology is too new and underdeveloped. It can’t possibly be that gluten-free diets might reduce adiposity/inflammation via epigenetic effects (potentially reaching across generational lines). There’s no way that gluten free diets help non-celiac IBS patients who had no preconceived notions of gluten-free dieting (and thus no risk of being influence by the hype). And that case study of the child with type 1 diabetes going into remission with a gluten free diet? Let’s just sweep that under the rug and completely forget about it. Oh, what about the link between autism and non-celiac gluten sensitivity? Doesn’t exist. PubMed is a liar. Those autistic kids with GI symptoms who do respond positively to a gluten-free diet? They don’t, and the study you just thought you read is a figment of your imagination. All that hubbub about modern dwarf wheat being more allergenic than ever is also nonsense. Besides needing a stool to reach the top shelf, modern wheat is totally identical to older wheat and is no more allergenic.

Another popular canard is the “celiac is too rare for most people to worry about” one. Well, about that: the latest research out of Australia (a remarkably gluten-conscious country) shows that celiac is far more prevalent than previously thought and about 50 percent of the population carries the genetic markers associated with gluten sensitivity. Scientists used a combination of traditional antibody testing (which measures the immune response to gluten) with analysis of genetic risk factors for celiac to reach their conclusions. Not everyone with risk factors actually displayed gluten intolerance or celiac disease, of course, but the presumption is that some combination of environmental factors – inflammatory diet, damaged gut microbiome, etc. – could trigger its expression. (Epigenetics rears its head yet again.) Most people skeptical of gluten-free diets take an “either you are or you aren’t” stance on gluten sensitivity or celiac disease, while the results of the Australian research would suggest that it’s far more dynamic and that a large portion of the population can develop issues with gluten given the right (or wrong) environmental context.

Nope, forget all that research: it’s just people latching onto a fad. It’s just nearly a third of Americans going gluten-free because Miley Cyrus did it (I eagerly await widespread adoption of twerking by millions of soccer moms). It’s millions of people sticking with a dietary regimen that offers no tangible benefits and actually makes them actively unhealthier. And if there is a benefit, it’s all in their heads.

I guess it’s easier to pick on the easy targets and ignore the people with evidence. It’s easy to dismiss the entire movement because of a few misinformed trend-followers, but it’s dishonest. Look – I’m all for the denunciation of health fads and trends that don’t make sense and are based on spurious claims, but not everything that’s popular is bad.

My favorite thing is when “concerned health experts” caution against starting a gluten-free diet without talking to your doctor, paying for a test to determine a gluten allergy, and consulting with a registered dietitian. As if giving up bread, pasta, and cake for more animals and plants is a dangerous undertaking that requires professional assistance. As if removing gluten and feeling loads better only to feel terrible upon a chance reintroduction is an unreliable way to determine if you should go gluten-free.

Here’s why I welcome the explosion in gluten-free awareness, even if it all amounts to a whole lot of nothing for some people: it leads to an overall more healthy diet. Even if you can eat gluten without incident, even if your gut flora is able to cleave gluten in twain for easy digestion, you will still get more nutrients by replacing your grain products with more meat, seafood, vegetables, roots, and fruit. Sure, you’ve got the folks who go gluten-free by swapping in gluten-free versions of all their favorite foods and end up eating nutrient bereft diets full of refined alternative flours, but I think they’re in the minority for a few reasons.

First, gluten-free junk food tastes worse than the originals, although that’s changing as the market grows and food producers improve their methods.

Second, gluten-free products are generally more expensive than the regular products.

Third, in my experience, people who go gluten-free usually stumble into a Primal way of eating. The way I see it playing out is you have sweet potatoes or rice instead of rolls at dinner. You go with a real corn tortilla or lettuce wrap tacos instead of burritos. Instead of buying all that gluten-free bread that turns into dust at the slightest touch, you spend the money on meat and vegetables. You go out to eat at a burger joint and maybe they don’t have the gluten-free bun that day, so you have the patty on a salad and realize it’s not such a bad way to eat – and you stick with it.

I’ve read the studies. I’ve consulted the experts (who are actually studying this stuff). I’ve witnessed the incredibly positive changes in thousands of readers, friends, family members, and clients who gave up gluten (and most grains for that matter). Heck, I’ve felt it myself. Is there something to this whole gluten-free thing?

I’d say so, yeah.

What about you?

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