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Gluten-Free Diets: Fad or Necessity?

You may have heard the phrase “gluten-free” floating around recently, whether in restaurants, nutrition books, or your local grocery store. For those with celiac disease, a condition where the small intestine cannot process gluten correctly, it’s important to avoid gluten as much as possible. However, those who have non-celiac gluten sensitivity, or NCGS, have recently been informed that their knowledge surrounding gluten and how it affects their bodies is incorrect. In fact, Peter Gibson, who originally discovered that gluten can cause allergic reactions to happen in the body, has all but denounced his original theories.

So what’s so terrible about gluten?

David Kohn wrote an impressive article for The New Yorker about Gibson and the gluten-free phenomena. In 2011, Gibson published a study that claimed gluten proteins can cause allergies in the digestive system that lead to abdominal pain and bloating (amongst other symptoms). He further stated that these tendencies can occur even in people that don’t have celiac disease. Due to his findings, many chose to abandon gluten products and gluten-free products began to flourish in the food industry.

In 2013, sales of gluten-free products totaled more than ten billion dollars and are even estimated to rise another five billion in the next two years. Two popular books that serve as proponents of a gluten-free diet include Wheat Belly by William Davis, M.D., and Grain Brain: The surprising truth about wheat, carbs, and sugar; your brain’s silent killers by David Perlmutter. Each suggest giving up gluten altogether for a much healthier diet. Some doctors have suggested that an estimated six percent of the American population has some form of NCGS. Those who show similar symptoms are commonly diagnosed, but as cases less severe than those with celiac disease.

Gibson looked back over his research, and in 2013, he performed another study. He studied subjects who ate low-gluten foods and compared them to people who ate high-gluten foods. Both groups were fed a baseline diet. He found they both had similar gastrointestinal problems. Another study he performed consisted of feeding his subjects what they believed to be “treated” food, when in actuality they were not. The subjects still reported gastrointestinal problems. Gibson called this the “nocebo effect”, or a negative placebo effect. He believed that the test subjects reported negative reactions when they thought they were given a treatment, when the treatment was actually harmless.

What Gibson discovered, however, was that a carbohydrate called FODMAPs (Fermentable, Oligo-, Di-, Mono-saccharides, and Polyols) might have been causing the gastrointestinal issues instead. In his studies, the gluten had no harmful effect, while the FODMAPs, when eaten in high regularity, caused more problems.

After this second set of studies came out, other scientists came out to argue against Gibson, saying that NCGS was still a thing. Alessio Fasano, a gastroenterologist at Massachusetts General Hospital, strongly believes that NCGS is still an arguable condition and that Gibson’s study was skewed because he only looked at people with irritable bowel syndrome (IBS).

Gibson continued his research. He looked at the same patients with IBS and found that after eating gluten products for three days, it had no effect on the digestive system. It did, however, show an increase of symptoms for depression.

Davis’ Wheat Belly and Perlmutter’s Grain Brain, while they both followed the gluten-free fad closely, are said to have provided some incorrect information. James Hamblin wrote an article for The Atlantic about Perlmutter’s book and viewpoint on carbohydrates. He suggests that carbohydrates, even the ones that society has accepted as good (such as whole wheat or quinoa), can cause many neurological problems, such as dementia, ADHD, anxiety, and several others. He believes we should live closer to the Paleo diet, which is a diet based on our Paleolithic ancestors (think hunter-gatherer) and what they would have eaten and avoided. In this diet, wheat and many other grains are not an option.

However, this theory looked at by Chris Kresser, an integrative medicine practitioner. Kresser noticed the positives of a low-carb diet, but he also understood that the carbs may not have been the original cause of the various disorders. Kresser asked us to draw our attention to cultures that are doing just fine with a carb-based diet. He stated: “the Hadza of north-central Tanzania and the Kuna of Panama obtain a high percentage of their total calories from foods that are high in natural sugars, such as fruit, starchy tubers and honey, yet they are remarkably lean, fit and free of modern disease.” How much, then, can we trust Perlmutter’s word when other civilizations have been doing just fine on a carb-heavy diet, and why, Kresser asks, should we take on the diet of an era where the human life expectancy was 30 years?

It would appear, then, that William Davis may have gotten his figures confused — at least in Kresser’s opinion. Andrew Weil, M.D. wrote a quick review of Davis’ book. To summarize, he states that the quality of the carbs we choose is the first step towards a healthier life. Turning to refined sugar and white bread instead of brown sugar and whole wheat bread, for example, is not the way to go. He further states that the obesity problem in America (amongst other health issues) is due to the fact that the average American is eating more “empty” calories as a whole than people in the recent past did.

Despite the varying arguments among scientists, it has been proven that gluten is in fact harder for your body to break down than other proteins. Its link to depression also warrants further study. However, the current frame of thinking is that gluten does not need to be treated with such disdain. Gluten-free diets don’t appear to do any harm, at the very least, but do be wary of diet trends in general; they can mess with your system in ways that are not visible right away. If anything sounds too good to be true, don’t be afraid to do some research of your own and/or consult a doctor, because chances are it is. In the meantime, we advise everyone to use good common sense when making basic food choices.

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