The Benefits of a Gluten Free Diet

Is gluten really Public Enemy #1?  Many seem to regard it as a toxic agent that causes a variety of symptoms.  Restaurants and supermarkets offer a wide variety of gluten-free foods.  Years ago, physicians advised a gluten-free diet only for individuals who had celiac disease (CD), which is an autoimmune disease that largely affects the small intestine.  If a celiac patient wades back into gluten territory, then his or her intestine will revolt.  I care for a few of these folks, but they are but a slim fraction of my patients who are shunning gluten.  

Gluten are proteins contained in wheat and other grains.   Many adherents of a gluten-free diet believe that avoiding gluten is a more healthful dietary choice.   There is no actual test to confirm gluten intolerance, but many patients feel better on this diet. . Why should it matter if an individual chooses to avoid gluten?  After all, there’s no risk here?  In fact, avoiding gluten can lead to vitamin deficiencies and increased exposure to arsenic and mercury.  I’m not suggesting that glutenphobes are at risk of poisoning themselves, but they should make sure that they remain nutritionally sound.

Amber Waves of Grain

  

There are 3 conditions with scientific support for avoiding gluten.

Celiac Disease:  Without question, gluten is the enemy

Gluten Intolerance (GI): A murkier condition that likely exists but may be over-diagnosed.  The relationship between gluten and the symptoms attributed to GI, such as abdominal pain, brain fog, bloating, fatigue, headaches and bowel irregularity, is tenuous.   Many other medical conditions beyond gluten exposure might be responsible.  There is no accurate test for GI.

Wheat Allergy:  This is a food allergy.   True food allergies (not intolerances) are very rare, although many patients mistakenly believe they are suffering from them..  Allergic features include hives, wheezing, itching and difficulty breathing. 

Most gluten avoiders do not fall within the above categories.  They avoid gluten because they feel better on the diet or believe that it is serving their health interests.  We all do stuff that we believe benefits us, even if there is no scientific support.  If you feel better avoiding a food item, then of course you should do so.

We are a free country and we have the right to be gluten-free.   But, let’s make sure that we separate fact from myth, or put another way, separate the wheat from the chaff.