gluten free eating

Gluten-Free Eating

Movie stars and leading sports figures have lauded the health benefits of gluten-free eating but there is no scientific evidence of a benefit for most people.  Even so, the Consumer Reports National Research Center found that 63% of Americans surveyed thought that going gluten-free would help with weight loss or improve their physical or mental health.  Gluten is the major protein found in wheat, and related proteins are found in barley and rye.  Gluten phobia may be rational for the perhaps 6% percent of Americans who have gluten sensitivity that causes celiac disease symptoms without intestinal damage, or the fewer than 1% with a genetic predisposition to celiac disease. 

Celiac Disease
Celiac disease is an autoimmune condition in which gluten causes intestinal damage that interferes with the intestinal absorption of nutrients from food to the extent that it can be life-threatening by starvation.  Common symptoms in adults, infants and children are abdominal pain, bloating, constipation, diarrhea, vomiting and weight loss.  Other signs and symptoms that may occur in adults are anemia, arthritis, bone loss, depression, fatigue, infertility, joint pain, seizures and numbness in hands and feet.  Individuals who suspect they have a health problem related to gluten should see a medical specialist who can test for the disease.  Unfortunately it is difficult to diagnose many cases of celiac disease when symptoms are mild or atypical.

Less Nutritious
Rather than being a benefit to health, gluten-free foods are likely to be less nutritious than similar conventional foods because many gluten-free foods are not fortified with vitamins and ingredients such iron.  And, to restore taste, they are likely to be made with the high levels of the salt, fat and sugar often found in processed foods—unhealthy ingredients that contribute to weight gain.  Consumer Reports also found that half of the gluten-free foods they tested contained rice flour or rice in another form that contained measurable levels of the toxic inorganic chemical arsenic.  Consumer Reports noted that arsenic is a carcinogen, and concluded that unless rice-free foods are selected, eating a gluten-free diet might lead to the consumption of a significant amount of arsenic.

Whole Grains
For most of us, going gluten-free can be considered to be yet another unproven food fad that is probably not a good idea.  Eating a variety of minimally processed whole grain gluten containing foods is healthy.  Two recent studies have found that eating whole grains is associated with reduction in the risk of premature death.   A meta-analysis of 45 studies found that a 90 gm/day increase in whole grain intake (equivalent to three servings—for example, two slices of bread and one bowl of cereal) resulted in a 17% decrease in risk of mortality from all causes.  A high intake of whole grains was associated with reduced risk of coronary heart disease, cardiovascular disease, total cancer, and all cause mortality, as well as mortality from respiratory disease, infectious disease, diabetes, and all non- cardiovascular, non-cancer causes. Reductions in risk were observed up to an intake of 210-225 g/day (seven to seven and a half servings/day).[3]

A similar meta-analysis of 14 studies with 786,076 participants evaluated the associations between whole grain intake and mortality from all causes, cardiovascular disease (CVD), and cancer.  The study found that compared to those in the lowest category of whole grain consumption, those who were in the highest category of consumption had a 16% lower risk of all cause mortality and a 18% lower risk of CVD mortality.  The study authors recommend adherence to the current Dietary Guidelines for Americans, which calls for at least 3 servings per day of whole grain intake.[4]

Bottom Line
Here is the bottom line: gluten-free foods offer no health benefits for most of us, and they may replace healthier foods.  They cost about twice as much as their conventional counterparts, and were a $23.3 billion market in the U.S. in 2014.  Most of us would be well advised to skip the gluten-free fad and save our money.

Endnotes and Links

[1]The Truth About Gluten. Consumer Reports. January 2015.

[2] Arsenic in Your Rice: The Latest. Consumer Reports. January 2015.

[3] Dagfinn A, NaNa K, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, et al. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies BMJ 2016; 353 :i2716.

[4]Zong G, Gao A, Hu FB, Sun Q. Whole Grain Intake and Mortality From All Causes, Cardiovascular Disease, and Cancer A Meta-Analysis of Prospective Cohort Studies. Circulation. 2016;133:2370-2380 https://doi.org/10.1161/CIRCULATIONAHA.115.021101
Originally published June 13, 2016.

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