By Jennifer Garrett
It makes bread light and fluffy. It helps pizza crust hold together when it's tossed. It is also the dietary scapegoat blamed for all sorts of health issues, from memory problems to gas and bloating to fatigue to depression to weight gain. We're talking about gluten. So how can it be so good and so bad at the same time?
There is one spot where things are quite clear: celiac disease. Individuals who suffer from this disorder cannot consume food that contains gluten because it damages their intestines and interferes with normal nutrient absorption. Symptoms vary but can include abdominal pain, diarrhea and constipation. Over time, fatigue, joint pain and even seizures could develop. There is no medical treatment; completely avoiding gluten is the only option.
Yet we all know that people with celiac disease are not the only ones avoiding gluten. The National Foundation for Celiac Awareness estimates that another eighteen million Americans do not consume gluten because of non-celiac gluten sensitivities. These sensitivities, commonly called intolerances, they can produce symptoms similar to those of celiac disease but without the intestinal damage.
Doctors can reliably diagnose celiac disease with a small-intestinal biopsy and blood test, but there is no similar test for gluten sensitivity. The best option for individuals who do not have celiac disease is an elimination diet, says Rebecca Georgia, a naturopathic doctor at the Family Clinic of Natural Medicine. "People often don't know that they're sensitive or intolerant to something until they take it away," she says. "I challenge patients to try a gluten-free diet, see if they can do it for a month, and see how they feel … I'm not saying this is the cure for everything, but it's worth a try."
Then there is the big reason that your friends and neighbors are eschewing gluten. "There are some people who feel you can lose weight on a gluten-free diet," says Shirley McCallum, a registered dietitian with the American Family Children's Hospital.
While McCallum acknowledges that some people lose weight by eliminating gluten, she cautions that the weight loss often has less to do with the eliminated gluten and more with the increased discipline and attention.
"The reality is that if you love bread and it's your favorite food and you eat a lot of it and you go on a gluten-free diet, the gluten-free bread doesn't taste very good so you eat less of it," she says. "It's more about the calories."
McCallum says many of us could achieve the same weight loss simply by cutting back on the amount of regular bread or grains that we eat instead of eliminating them or replacing them with gluten-free versions. She also adds that even some of the other positive health effects of going gluten-free might come more from the overall improved diet as gluten-containing processed foods—things like frozen pizza, Cheetos and Oreos—are eliminated.
"Overall, if people would shift to eating more fruits and vegetables and just in general reduce these huge loads of wheat that they're eating—but still eat wheat—they would probably feel better," McCallum says.
"Gluten-free has certainly been glamorized," agrees Donna Manring, past president of the Wisconsin Dietetic Association.
Manring notes that gluten-free alternatives to wheat-based food products such as bread or cake mixes can contain more calories and fat than their conventional counterparts. They are also more expensive.
Like McCallum, Manring is more inclined to credit health improvements to calorie reduction than gluten avoidance. "Perhaps people first want to look at the types of grains that they're eating or the amounts they're eating," Manring says.
But it's probably easier to blame gluten.
Jennifer Garrett is a Madison-based freelance writer. She blogs about healthy living in Health Kick.
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