Questions surround healthy perceptions of gluten-free diets

Data released by Mintel last December showed 37% of Americans who eat gluten-free foods said they think it’s better for their overall health and another 16% said they do so because “gluten is bad for you.” Yet their perceptions may not be based on any scientific reality.

“That is actually a myth,” said Jennifer North, vice-president of Beyond Celiac, Ambler, Pa., on a general link between gluten-free diets and better health. “If you compare the labels of gluten-free products to their gluten-containing counterparts, you’re going to find that gluten-free products must have ingredients that help the product mimic the properties — the taste and texture — of wheat.”

For example, Ms. North said high-glycemic ingredients like potato starch and white rice flour often are found in gluten-free items.

“They have to add gums and fillers and starches to that product to make it mimic the properties of wheat and to make it palatable to people,” she said.

People with celiac disease must avoid gluten because it causes an adverse reaction. Ms. North has known this well since 2008 when her daughter Molly, then 16, was diagnosed with celiac disease. Twenty-one million Americans require a gluten-free diet as the only treatment for celiac disease and non-celiac gluten sensitivity (“gluten sensitivity”), according to Beyond Celiac, formerly known as the National Foundation for Celiac Awareness.

Mintel’s data show 25% of Americans report they eat gluten-free foods. While 11% said they eat gluten-free foods because a health care professional suggested they eliminate gluten from their diet, another 19% do so because they want to lose weight.

“It’s become synonymous with the term ‘healthy’ in the same way that ‘natural’ has,” said Nicholas Fereday, executive director, food and consumer trends, for Rabobank, New York. Yet the 2015-2020 Dietary Guidelines for Americans made no mention of eating gluten-free foods as part of a healthy lifestyle, he said.

People should contact a health care provider if they believe they are non-celiac gluten sensitive, Ms. North said.

“Research on non-celiac gluten sensitivity is still in its infancy,” she said.

People first should be tested for celiac disease, she said. If that comes up false, then, under the direction of a health care provider, they should eliminate gluten and only gluten from their diet. If their symptoms are reduced, they should re-introduce gluten to the diet to see if symptoms return.

“A lot of times people stop multiple things at one time,” Ms. North said. “If they stop eating gluten and dairy and sugar, and they notice a difference in how they feel, that makes sense. Anyone who cuts back on how many carbs they are eating and starts eating more fruits and vegetables, they are probably going to feel better.”

Scientific studies have tackled the issue of gluten-free diets and health. One such study appeared in the August 2015 issue of the Journal of the American Academy of Physician Assistants.

“Our research confirms much of what we already knew,” said Glenn A. Gaesser, Ph.D., a co-author of the study and a scientific advisory board member for the Grain Foods Foundation, Washington. “While the gluten-free diet is a legitimate therapeutic tool for those affected by gluten-related disorders, there has been a corrosion of common sense from people needlessly jumping on the fad diet bandwagon. In fact, people who eliminate gluten may end up gaining weight because these foods often have more calories than their gluten-containing counterparts.”

Commentary appearing May 13 in The Journal of Pediatrics focused on gluten-free diets, too.

“Out of concern for their children’s health, parents sometimes place their children on a gluten-free diet in the belief that it relieves symptoms, can prevent C.D. (celiac disease) or is a healthy alternative without prior testing for C.D. or consultation with a dietitian.” said Norelle R. Reilly, M.D., from New York-Presbyterian/Columbia University Medical Center.

In people who do not have celiac disease or a wheat allergy, there are no proven health benefits, according to the commentary. A gluten-free diet potentially could increase fat and calorie intake, contribute to nutritional deficiencies and obscure an actual diagnosis of celiac disease.

Ms. North said Beyond Celiac emphasizes that people with celiac disease should eat inherently gluten-free products.

“If you shop the perimeter of the store and you eat naturally gluten-free foods, that is the healthiest diet,” Ms. North said.

She said some food companies have a better understanding of people with celiac disease. They will add ingredients like bean flour, seeds or ancient grains to increase the nutritional profile of gluten-free foods and “meet that desperate need that our community has,” she said.

Mr. Fereday said, “We can be thankful for the gluten-free trend in terms of opening people’s eyes to the whole world of grains beyond wheat. It’s just incredible now, the diversity of options out there, from quinoa to teff to even the ones I cannot even pronounce. I find that exciting and innovative and an indirect benefit of the gluten-free trend.”

Ms. North said the quality of gluten-free products has risen since her daughter was diagnosed with celiac disease eight years ago.

“Our goal (at Beyond Celiac) was to make sure the gluten-free food was affordable, accessible, safe, tasty and understood,” she said. “We’ve made great strides in so many of those areas, and we’re so thankful that it’s easier for people to eat inside the home.”