Washington Post columnist Carolyn Butler examines gluten-free facts versus the latest health-fad hype. Butler interviews Gary Kaplan of the Kaplan Center for Integrative Medicine in McLean, VA who sees a growing number of people having problems digesting gluten. This number includes children with wheat allergies to an estimated 1% of Americans who have celiac disease. New research has also identified some with less serious gluten sensitivities who don’t test positive for a wheat allergy and who don’t meet the full criteria for having celiac disease. Kaplan generally recommends a full medical work-up for patients with any one of many associated conditions, including irritable bowel syndrome, Type 1 diabetes, thyroid disease, infertility and chronic fatigue syndrome, or a family history of celiac.
In Focus: Gluten-Free
In Focus: Gluten-Free:
It seems to be the latest rage, with many celebrities promoting the gluten-free lifestyle, a multitude of books being published, and countless numbers of articles appearing in the press about the supposed benefits of a gluten-free diet. Searching the Internet for information on “gluten-free diet and weight loss” returns over five million hits. Claims of the potential benefits of following a gluten-free diet include better sleep, increased energy, thinner thighs, faster weight loss, clearer skin, and improvement of medical conditions such as autism and rheumatoid arthritis. With this surge of media attention, the number of gluten-free products on the market is exploding. A recent report on gluten-free products in the United States (1) estimated the US market for gluten-free foods and beverages at 2.6 billion dollars in 2010, and by 2015 it is expected to exceed 5 billion dollars. In addition, the report reveals that the number one motivation for buying gluten-free food products is that they are considered healthier than their conventional counterparts. As a registered dietitian, chances are you are seeing more and more patients trying to follow a gluten-free diet. But where is the research to back these claims? That’s where it gets tricky. (Subscription Required)
When I meet people living a gluten-free lifestyle, I always ask them why they’ve given up wheat, bulgur, rye and barley. They tell me it’s “to feel healthier” or “to have more energy,” but when I ask if they’ve had a serologic test for high levels of IgA tissue transglutaminase antibodies, I get a blank stare… Going gluten-free is a disease management therapy, and it’s essential, if you’re among the 1% of Americans who have been diagnosed with the autoimmune disease called Celiac Sprue; however, if you’re not gluten-sensitive, going gluten-free can be harmful… so think before you give up whole grain bread and pasta. Better yet, go you your doctor, and get tested.
Gluten is a protein found in wheat, rye, barley and sometimes, through cross-contamination, oats that provide elasticity in bread products. Gluten flour is often mixed into flours that have less protein content in order to make better quality bread. Wheat gluten isn’t bad – in fact, it’s essential to making many of the great wheat products available today. However, an estimated 1 percent of the population has celiac disease, which is also known as gluten intolerance, and an additional 6 percent are thought to be gluten-sensitive. Gluten intolerance is different from an allergy and can be diagnosed by a doctor. Those who are gluten intolerant cannot eat gluten-containing products because the protein damages the lining of their small intestines. Everyone else – 93 percent of us – can consume gluten without concern.
Nearly three years past the 2008 deadline, the FDA is finally getting serious about defining what “gluten-free” means on food labels. Today, without a standard by the FDA, there is no legal requirement that needs to be met for a manufacturer to label food “gluten-free.” This has led to confusion for consumers and considerable angst for the 1 in 133 of them that suffer from celiac disease… With 10000 signatures on a petition that accompanied the building of the world’s largest gluten-free cake at a recent gluten-free labeling summit in Washington, the voices are now loud enough for Congress to take action. On August 3rd, the FDA re-opened the comment period for a proposed gluten-free labeling law.
Eating gluten doesn’t bother most consumers, but some people with celiac disease have health-threatening reactions, says Stefano Luccioli, M.D., a Food and Drug Administration (FDA) allergist and immunologist. They need to know whether a food contains gluten. FDA has been working to define “gluten-free” to: (1) eliminate uncertainty about how food producers may label their products and (2) assure consumers who must avoid gluten that foods labeled “gluten-free” meet a clear standard established and enforced by FDA. FDA’s actions on Aug. 2 bring the agency one step closer to a standard definition of “gluten-free.”



