Adopting a gluten-free diet deserves careful consideration

On the list of current dietary villains, many now add gluten. But not everyone should consider it an enemy.

First came fat, then carbs. Now gluten is the latest dietary villain to be on the chopping block. Claims that going gluten-free can increase energy and help with weight loss have Hollywood A-listers and health-conscious consumers jumping on the bandwagon.
Gluten, a type of protein, is naturally found in wheat, barley and rye, and is what gives baked goods their soft, chewy texture. Many packaged and processed foods contain some form of wheat, barley or rye. Obvious sources of gluten include most bread, pasta, cakes, cookies, muffins and crackers. Not so obvious offenders that may contain gluten-derived ingredients include soy sauce, salad dressing, frozen yogurt, French fries, canned soup, processed meat products, vitamin supplements and cosmetics.
For some, cutting out gluten is not a choice or a fad diet. For people who have been diagnosed with coeliac disease, an autoimmune condition where the body has a severe reaction to gluten, causing damage to the small intestine and reduced absorption of vitamins and minerals, avoiding it is a necessity. According to Coeliac UK, symptoms of the disease, which is estimated to affect about one percent of the population, include weight loss, abdominal pain, diarrhea, anaemia, migraines, joint pain and fatigue. Despite the common misconception that coeliac disease is often diagnosed in early childhood, a recent Canadian study found the average age for diagnosis in adults to be 46. Unfortunately, statistics show that many people with coeliac disease don't know they have it, and as few as one in eight people with the disease have been properly diagnosed. According to the Canadian Celiac Association, strict adherence to a gluten-free diet is the only treatment for coeliac disease and is essential to reduce the risk of further health complications associated with the disease, including osteoporosis, depression, infertility and certain cancers.
But gluten-free diets are gaining far wider popularity. According to Packaged Facts, a publisher of market research, the global gluten-free market has grown at an annual rate of 28 per cent since 2004, with sales expected to top $2.6 billion (Dh9.5b) by 2012.
Many health-conscious consumers cite its reported health benefits, including weight loss, improved digestion, reduced bloating and clearer skin. But as with any diet craze, unnecessarily adopting a gluten-free diet isn't without its risks.
The fact is that for most people, gluten isn't a dietary villain. Unlike saturated and trans fats, which have been shown to increase the risk of heart disease and certain cancers, gluten is not intrinsically unhealthy and most people can tolerate gluten as part of a balanced diet. Unless someone has been diagnosed with coeliac disease or gluten sensitivity, cutting gluten from the diet isn't a decision that should be taken lightly.
If the reason for eliminating gluten stems from a suspected intolerance or sensitivity, it's imperative that a proper diagnosis be made before changing the diet. Prematurely eliminating gluten from the diet can cause a misdiagnosis of coeliac disease, which is detected through a blood test and a small bowel biopsy. Gluten must be present in the diet in order for these tests to be accurate.
Nixing gluten also means eliminating many nutrient-dense foods from the diet. Not only are wheat, barley and rye excellent sources of fibre, iron and antioxidants, but many foods that contain these grains, such as bread and breakfast cereal, are also fortified with a host of nutrients that aren't usually present in their gluten-free counterparts. As a result, gluten-free diets tend to be low in vitamins and minerals. One study conducted by Swedish researchers found that half of adults on a gluten-free diet showed signs of poor vitamin status, including low levels of folate and vitamin B12. Another study released earlier this year found children on a gluten-free diet lacked fibre, vitamin D, riboflavin, niacin, thiamine, magnesium and selenium.
Whole grains such as wheat, barley and rye are actually nutrient powerhouses that can help prevent chronic disease. Studies consistently show that whole grains can help lower the risk of heart disease by decreasing cholesterol and blood pressure. Their intake has been shown to help prevent and manage diabetes, as well as reduce the risk of certain types of cancer. As a result, most healthy eating recommendations suggest that whole grains be the cornerstone of a healthy diet, and that adults get half of their grain servings from whole grains.
As for weight loss claims, a gluten-free diet may actually cause weight gain, not loss. That's because many gluten-free foods have added fat and sugar to make them taste good, and as a result they tend to be higher in calories than similar products that contain gluten. A gluten-free diet has not been proven to be an effective weight-loss diet, and in fact, studies show that people who consume the most whole grains, including wheat, barley and rye, tend to weigh less than those who miss out on whole grains.
What's more, a study released last year by Spanish researchers found that following a gluten-free diet may be detrimental to gut health. Researchers found populations of beneficial gut bacteria such as lactobacillus decreased on a gluten-free diet, while potentially harmful bacteria including E. coli increased.
Finally, unlike some other diet trends, a gluten-free diet is extremely restrictive and requires extraordinary patience and a financial commitment. Reading food labels and grilling waiters in search of hidden sources of gluten becomes routine; as does seeking out expensive gluten-free products made from alternative grains and flours, such as quinoa, rice and corn, which tend to cost substantially more than their gluten-containing counterparts. For people who are genuinely intolerant to gluten, however, increased consumer demand is contributing to more widely available products.
Here in the UAE, gluten-free products can be found at both major grocery stores and specialty food stores. LuLu, Spinneys and Carrefour all carry a small range of gluten-free products from brands such as Glutino, Schar, Mrs Crimble's and Basco, including gluten-free cookies, cake mix and pasta. Organic Foods and Café in Dubai offers one of the best selections of gluten-free products in the country, including pasta, cereal, crackers, pizza and cookies, as well as fresh baked gluten-free bread every Tuesday.
The bottom line is that while a gluten-free diet makes sense for some people, including those diagnosed with coeliac disease, it may offer more health risks than benefits for the rest of us. Anyone considering a gluten-free diet should consult with a registered dietitian who can provide guidance on healthy gluten-free alternatives to help meet the daily requirements for vitamin, minerals, fibre and other nutrients.