In general, there has been a shift in the Western diet towards an increase in the consumption of gluten, which is the pain protein in wheat products. Subsequently, recently, there has been a call for gluten-free diets or an overall decrease in gluten intake. Many of those who endorse a gluten-free diet often cite health benefits from cutting out gluten from their diet. In general, most of the studies surrounding gluten-free diets have revolved around celiac disease, which is an immune reaction that causes inflammation in the lining of the small intestine and malabsorption due to consumption of gluten. Increased incidence of celiac disease has been linked to the increase in glucose consumption and a small number of other studies suggests that gluten consumption might also be linked to other autoimmune disorders because the increase in autoimmune disorders coincides with a societal increase in gluten consumption. Recently, reports have shown that gluten consumption might have detrimental effects on health in general, with possible symptoms such as inflammation, increased apoptosis in the cells of the small intestine, a decrease in DNA and glycoprotein synthesis, and many more (all of which can be summarized in figure 1 below). However, as mentioned before, most of the research about the effects of gluten has surrounded those with celiac disease and is not representative of the population as a whole. Moreover, there is a lack of research on the effects of gluten in controlled human studies; most of the evidence of the detrimental effects of gluten is limited to several in vitro studies in model organisms. Thus, further clinical trials are required before people can begin to claim that cutting out gluten can be advantageous. In light of the current debate about gluten and the possible benefits of a gluten-free diet, I would argue that there simply isn’t enough research supporting the supposed benefits of a gluten-free diet (excluding those with celiac disease). Thus, popular opinions surrounding gluten should be taken with some skepticism!
Source:
Lerner, Aaron, et al. “Adverse Effects of Gluten Ingestion and Advantages of Gluten Withdrawal
in Nonceliac Autoimmune Disease.” Nutrition Reviews, vol. 75, no. 12, 2017, pp.
1046–1058., doi:10.1093/nutrit/nux054.
Angela, super interesting post. The gluten debate has been particularly interesting to me since I worked closely with a doctor for a few years who all of sudden changed his entire practice after reading a book called “Wheat Belly”, I’m sure you’ve heard of it. Perhaps I am exaggerating a little but subjectively, it seemed that after he read this book he began recommending to all his patients that they decrease, if not, cut gluten out of their diet altogether. I have great admiration and respect for him so initially, I thought “Yes! I should try to eliminate gluten too!” I even bought the book (but only made it halfway through it) and personally it was too hard for me to just give it up. Anyway, I started to think about what he was asking of his patients. Yes, understandably, there is some evidence showing the health benefits of a gluten-free diet, particularly in patients with Celiac disease as you mentioned. However, what about the rest of us? Also, how costly is it for someone to make this change? Is it really going to help with their severe heart failure? I am not certain. I do believe that there is a great benefit to a reduction in processed foods (I would argue undeniable) but like you, I agree (and found an article showing) that there is still plenty of room for studies investigating the benefit of a gluten free diet in the general population.
ReplyDeleteReference : Kim, HS., Demyen, M. F., Mathew, J., Kothari, N., Feurdean, M. Ahlawat, S. K. (2017). Obesity, Metabolic Syndrome, and Cardiovascular Risk in Gluten-Free Followers Without Celiac Disease in the United States: Results from the National Health and Nutrition Examination Survey 2009–2014. Digestive Diseases and Sciences, 62(9), 2440-2448. doi: 10.1007/s10620-017-4583-1
This was a very insightful post! As someone who was recently diagnosed with celiacs disease, let me tell you cutting out gluten was HARD! Gluten can be found in things such as soy sauce and even some toothpastes, which are things that never even crossed my mind when it came to cutting out gluten from my diet. After being diagnosed I read almost everything I could find on the topic and something that caught my attention about going on a gluten-free diet was weight loss. For an individual suffering from celiacs a common symptom is weight loss, since thier body is not able to absorb the necessary nutrients due to the damage in their small intestine. In comparison, those following the gluten-free diet trend would experience weight loss primarily from cutting out desserts (high in sugar) and fried foods (high in fat), which commonly contain gluten. Of course weight loss would be a visible indicator that the gluten-free diet is working, but is that actually the case? As you mentioned going on a gluten-free diet has become some what of a trend, which is scary considering there is not a lot of research about the long-term affects of going on gluten-free diet when you don't really need to. My GI recommended going to see a nutritionist to make sure I was eating foods that could supplement the minerals and vitamins found in wheat. I fear that malnutrition is a possibly outcome for those following the gluten-free trend, if they aren't conscious of supplementing the nutrients they are cutting out!
ReplyDelete