The Gluten-Free Craze
http://thedianerehmshow.org/shows/2012-02-16/gluten-free-craze
The market for gluten-free food is booming. Products made without wheat were once just targeted to those with celiac disease – an auto-immune disorder of the small intestine. Most researchers believe celiac disease affects less than one percent of all Americans, yet as many as 25 percent of us seek out gluten-free foods. Many consumers believe eliminating wheat from their diet may improve their digestive health, help them lose weight, or relieve joint pain. Until now, it’s been difficult to diagnosis gluten-related disorders that aren’t celiac disease. That may be about to change. Diane and her guests discuss why gluten sensitivity is on the rise, how it differs from celiac disease, and what’s behind the latest food craze.
Guests
Dr. Alessio Fasano
professor of pediatrics, medicine and physiology and director of the University of Maryland Center for Celiac Research (CFCR) at the University of Maryland School of Medicine
Dr. Aline Charabaty
director of the Center for Inflammatory Bowel Diseases at Georgetown University Hospital
Melissa Abbot
director, Culinary Insights, The Hartman Group
Katherine Tallmadge
dietician, nutritionist and past spokesperson for the Academy of Nutrition and Dietetics.
Program Highlights
More Americans are seeking out gluten-free foods, but how does gluten sensitivity differ from celiac disease? Our guests discuss what's behind the gluten-free craze and how these new foods may be affecting our health.
What Is Celiac Disease?
Celiac disease affects up to 1 percent of all Americans. In people with the disease, gluten is actually toxic to the gut. "When patients with celiac ingest gluten, it destroys the lining of the small bowel so the small bowel is not able to do its proper function," Charabaty said. Celiac disease is a true auto-immune disorder. It can be difficutlt to diagnose, he said.
How Is Celiac Disease Different From Gluten Sensitivity?
Gluten sensitivity is a new diagnosis. There's no real test for it, but patients often end up trying a gluten-free diet to see how they feel. But Talmadge cautions that there's a "huge placebo affect" when it comes to gluten sensitivity. Before cutting out gluten entirely, she suggests trying an overall healthier diet and exercise program to see if a patient's health improves.
What's Behind The Gluten-Free Craze?
"What we've seen is that with gluten-free, a lot of the consumers are self-diagnosing," Abbot said. "What's really happening is that they're removing some of the processed foods from their diet, rather than actually just taking gluten out of their diet as the reason for feeling better,"
she said. Wheat is the number-one food containing gluten. Rye, barley, and spelt also contain it. Food retailers are taking advantage of the move away from gluten. In the long run, though, this might not be the best thing for companies because as Abbot puts it, gluten-free labels reduce "the healthy halo of the actual brand."
More Gluten-Free Junk Food
As the gluten-free trend has grown, Tallmade said, more food makers are producing gluten-free versions of junk food - cookies, pop tarts, donuts, and more. "They all contain highly refined starches that really contribute to problems with the digestive system," Abbot said. "More than anything
what we hear from consumers, the biggest complaint, the biggest condition that we hear beyond stress and inability to sleep at night is digestive issues,' Abbot said.
You can read the full transcript here.
Comments
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As the partner of someone with gluten sensitivity, I cannot imagine why anyone would voluntarily burden themselves with a gluten free diet. Eating GF is do-able, and getting easier, but still frustratingly limiting for those with the sensitivity.
Furthermore, many people still regard the gluten fee diet as strictly a matter of choice, and assume that those who request gluten free options are simply being finicky.
You are so right. I suffered for 2 years with extreme abdominal pain and other symptoms until my doctor suggested I tried a gluten free diet. Within a week, my symptoms were gone. Yes, the diet is restrictive but well worth it. I can't help but feel that it is the processing of our grains or the emergence of genetically modified foods.
A gluten free diet is indeed very difficult, but absolutely necessary for anyone with Celiac disease. While the estimates are 1 in 133 of the general population the numbers are far higher in people of northern and central European ancestry. The proliferation of gluten free foods shows that food manufacturers see a market for these items.
I would like to add that avoidance of baked goods and eating fresh food can result in a diet that is deficient in sodium. Yes *deficient*. It is easy to stay well below 2000mg of sodium on a strict gluten free diet. The RDA is 2400mg, and having too little sodium can land you in the hospital.
Additionally since you have a picture of Whole Foods GF products, I would like to say these are generally horrible. Not only are they gluten free they are mostly low sodium and low sugar. Celiacs are not diabetics, nor as stated above do they tend to get too much sodium in their diets.
My son is autistic and acts very mean in his behavior when he eats anything gluten-filled. He tested not positive for gluten or dairy allergies but it obviously an intollerance. I also gave up wheat 3 years ago along with him and can tell immediately upon eating it. I have even opened my own bakery (also without dyes) for just that reason and that he can have a job here some day as most disabled can't have regular jobs. These intollerances are often discounted and misunderstood. Gluten free helps people with many, many disabilities, such as fibromalgia and many more. People also call it "the gluten free diet" which is a misnomer for those removing carbs.
I stopped eating gluten a year and a half ago. Before I stopped I barely went out of the house. I knew where all the restrooms and rarely went out for dinner with my husband. I would have diarrhea within an hour or so after eating. I have always been a very healthy eater. I rarely eat meat, but I was a big bread and carb eater. My husband , who is a pediatrician, suggested I stop eating gluten. Within 24 hours I was feeling better. My entire household does not eat gluten now. I refuse to put it back into my diet after feeling this much better. I don't understand why the guest on your show think that you have to be diagnosed? If I am better why not just go with what works. It isn't like I am taking a drug to feel better I just took gluten out of my diet and haven't had a problem since.
Thank you,
Karen
Cary, NC
I have 3 friends who have been diagnosed with Celiac disease, all having received the diagnoses in their 40's. The percentage of people diagnosed with celiac in the last 10 years or so seems to be a recent phenomenon. I think it's the way our wheat/starch food products are processed which results in an increase in the gluten content of flours already containing natural gluten, and possibly gmo foods...
After living in China for three years (with a primary diet of rice & rice noodles), my return to America resulted in a very difficult gastrointestinal transition. After considerable testing (thyroid, Celiac, IBS etc.) and three relatives being diagnosed with Celiac, I gave up all gluten (after eating a very healthy, balanced diet for those two years) three weeks ago and have felt better than ever before. Life-changing despite the lack of a diagnosis by my primary care physician, specialists and many tests. I'm only 26 and share very different symptoms than my three diagnosed relatives...
My gastroenterologist confirmed gluten sensitivity after more than a year by trying a new higher-level blood test. I do not have celiac disease but I do have a "very high" genetic probability towards this disease. based on that a nutrionist worked with me to move towards a gluten free diet and my fibromyalgia, irritable bowel syndrome, peripheral neurophathy and some other medical problems have vastly improved. It is amazing. But my whole life (i am 69) has been based on wheat-based food and it is very very difficult to have a good alternative on a sustained bases. Especially difficult are snacks.
My husband became dehydrated after a severe bout of diarrhea to the point that he looked like he had just walked out of a concentration camp and his blood was so think that the er doctors said that he would had a stroke in very short order. He was in the hospital for several days and had a biopsy was done on his colon and he also had a blood test done by the Mayo Clinic which confirmed that he does have celiac disease. Since that time he has been very conscience of labels but I am sure he does have some contamination from eating out but not enough to put him in the hospital again. It's a very hard lifestyle as far as eating at home since I am Indian and we indulge in a lot of bread. Help! Could it have been something else.
What about Hasimoto's Thyroid Disease wherein gluten masks the thyroid condition?
I am a physician who did not have time to go through gluten challenge (not enough time to be sick), so I used Celiac HLA genetic testing which confirmed that I have a DQ2 genotype. What does the panel think about using the easily obtained genetic testing as a guide to gluten sensitivity?
Dr. Emily
Gluten causes inflammation. How do your guests feel about avoiding gluten to reduce inflammation?
I am 67 and started having stomach aches and no other symtoms, about 28 years ago, after clearing up an ulcer. I tried giving up certain foods, until I hit on wheat and oats being the problem. I do not have Celiac Disease, just an allergy to wheat and oats. Thank goodness there are now gluten free substitutes on the market, including rice and corn pasta and baked goods.
I wonder if anyone has considered that, rather than gluten, there is a more general inflammatory response to a high carbohydrate diet in general. A low carb diet has done me a lot of good both with blood lipid profile as well as acne and asthma.
Fats and amino acids are essential to human health, but there is no such thing as an essential carbohydrate!
Since more and more research is showing gluten to be problematic to more anymore people, why are dietitians like your guest suggesting people continue to eat them?
What is the incentive for keeping gluten in one's diet, when so many healthier options are available?
Gluten-free is not a "craze" as you have referred to it. I want to stress the need for much more research regarding the "gut-brain connection" for many disorders. My young son started having seizures at 9 months old and prior to that had severe GI problems that doctors kept diagnosing as reflux. After 4 years of daily seizures, 15 different medications, and neurologists telling us there wasn't much left they could do we turned to a Gluten and Casein free diet for my son (100% organic as well). After 2 months on a strict diet, he stopped having seizures altogether and has not had a single one since (the past 2 years). He continues to be Gluten-free and he is now a thriving happy 6 year old. By the way, we now know he does have 2 of the 3 markers for celiac but he does not have the "celiac" label. Our fear of the seizures returning keep us from ever considering introducing gluten again...
Thank you also for having on Dr. Fasano - his research has been invaluable to us.
Many thanks from Dallas, TX
Gluten-free is not a "craze" as you have referred to it. I want to stress the need for much more research regarding the "gut-brain connection" for many disorders. My young son started having seizures at 9 months old and prior to that had severe GI problems that doctors kept diagnosing as reflux. After 4 years of daily seizures, 15 different medications, and neurologists telling us there wasn't much left they could do we turned to a Gluten and Casein free diet for my son (100% organic as well). After 2 months on a strict diet, he stopped having seizures altogether and has not had a single one since (the past 2 years). He continues to be Gluten-free and he is now a thriving happy 6 year old. By the way, we now know he does have 2 of the 3 markers for celiac but he does not have the "celiac" label. Our fear of the seizures returning keep us from ever considering introducing gluten again...
Thank you also for having on Dr. Fasano - his research has been invaluable to us.
Many thanks from Dallas, TX
Please emphasize that it's important not to self-diagnose the cause of bloating, fatigue and digestive changes like diarrhea and constipation.
My mother, a nurse, decided that she had celiac disease when those symptoms appeared. In fact, she had ovarian cancer, which can present with similar symptoms. By the time she went to a doctor, her cancer was very far advanced.
Moral of the story: take the symptoms seriously. Don't just change your diet. See a doctor.
Gluten is a protein, not a carbohydrate. But I agree with your observation that carbohydrates aren't essential in the human diet.
KATHERINE TALLMADGE has given the public a lot of misinformation. THERE ARE TESTS TO DETERMINE IF A PERSON HAS THE GLUTEN GENE. It is genetic. It is the HLA-DQ gene that determines if a person has a gluten intolerance. This is stated in the American Medical Journal. There is a saliva test and stool test which is the most accurate and less invasive than an intestinal biopsy. That is an extreme test to order, and can be inaccurate. If the area of the intestine that is biopsied does not contain the gluten antibodies, then the results will show that there is no gluten intolerance. However, there are approximately 30 feet of intestines. You cannot possibly biopsy the entire large and small intestines. Also, the gold standard with any food intolerance/sensitivity is the Elimination-Provocation diet. You eliminate the food for a month, then you reintroduce the food by eating it once a day for three days. Then you observe your symptoms. If any of your symptoms are exacerbated, then you are sensitive to that common food. Most people experience symptoms after the first reintroduction, and can stop after that.
By the way, many of the gluten-free foods, such as breads, are low in fiber, so that would not explain why people would lose weight and feel better by eating gluten-free foods.
I was recently at a dinner party where 7 of 10 people present claimed Gluten intolerance. It strikes me as highly improbable that such a large percentage of the population would have a sensitivity to a food substance that our species has been eating and cultivating for at least 13,000 years.
Isn't this just another example of American society's dysfunctional approach to food? I recall in the midst of the Atkins diet craze describing it to some French friends who looked incredulous and asked us, "Why would anyone eat like that?" What are the rates of gluten sensitivity in other countries?
First - thank you very message for this topic. Improved education and awareness of celiac disease is essential for coping with the disease.
I was diagnosed with celiac ten years ago. The hightened awareness of the gluten free diet in the restaurant world is bitter sweet. While dining at a restaurant in Atlanta recently, the server asked about my level of sensitivity, citing some folks can tolerate some menu items. This is not a good message for celiac patients . The gluten sensitivity "trend" is
#2 - Is there a connection between alcoholism and celiac disease?
#3 - When going to the doctor for an annual physical or check up, what are there particular concerns for the maintence of overall good health for the celiec patient? I have difficulty finding a general doctor that understands the overall affects of celiac disease.
thank you!
I have been tested for Celiac disease which came back negative, but even the smallest amount of gluten can cause abdominal pain and explosive diahrea for days. I am a healthy, active, 58 year old woman. I have always eaten healthy foods, primarily a vegetarian. I have had a gluten issues for the past two years. I believe I am a celiac. I choose and prepare foods as if I am. As a result, I feel better. The only reason I would like to pursue an accurate diagnosis is for my daughters. I understand celiac is genetic. I do not however, want to undergo a surgical procedure to prove what I already know. Karen in St. Louis
I was diagnosed with celiac as a baby. in fact, first birthday cake was a carton of cottage cheese with a candle in it.
Am I destined to get celiac again?
Did you say celiac can affect fertility?
I was never able to get pregnant with no known physical problems.
What can I expect from my future.
Brad, 13000 years is a drop in the bucket as far as genetic adaptation. I'd assert that not only are we not adapted to gluten, we are not adapted to eating grains and a high carb diet.
My wife is on a gluten free diet and we have had difficulty securing drugs that can be verified as gluten free. Can your guests speak to this issue? It is one of the hidden sources of gluten when a person starts to go gluten free.
I was diagnosed with celiac as a baby but was over it before I was three. Can I expect for this to recur?
Trust me, it was a nightmare for my mom. She'd get me all straightened out and they'd feed me a cookie in the nursery at church.
I'm 53 now and wondering about my future. Do Ineed to worry?
Your experience is very similar to my own, Karen. I have always adhered to a much healthier diet than others in my life (requisite serving of vegetables, protein and fruits each day) and have been suffering from intense gastrointestinal distress on and off throughout my life. Colonoscopy and endoscopies came out clean, as well as biopsies and blood tests for celiacs, so of course I just assumed that it was just something that I had to deal with. I decided to try a gluten free diet (after trying everything else -- bentyl, probiotics, peptic enzymes, etc.) as a last recourse. While it was hardest to keep up with for the first month, I eventually stopped having any sort of stomach pain/distress, diarrhea, gas and stomach distention after and between meals. I have not had a recurrence in 10 months since I started the gluten free diet -- and this has been a lifelong problem.
I hardly think that this could be due to me eating a "healthier" diet -- I eat the same amount of carbs (in the form of root vegetables and non-wheat flours), fruit, and protein as I have throughout my life. If anything, my diet is less healthy due to the increased calories in the types of substitute non-wheat flours and increased consumption of prepackaged gluten free meals -- gluten free products such as waffles are NOT healthier than wheat based products!! They have a significant increase in calories compared to wheat based products. As an aside, I always ate whole grain based products throughout my life.
For your guests that keep mentioning "healthier diets":
Please do not assume that the alleviation of these symptoms is simply due to eating a more balanced diet. That was certainly not the case with me, and I doubt is the case for many others that have similar experiences.
I have been following a gluten free diet as a result of saliva testing. I became interested when I read something about the relationship between gluten and peripheral neuropathy which my father suffered from and which I believe is beginning to affect me. Neither of us are/were diabetic.
As a result of the testing, I was told that my gut had been damaged by gluten and that going gluten free would repair the damage and improve digestion. I have never felt I suffered from bad digestion or stomach problems of any sort. I have suffered from constipation since childhood.
The gluten-free diet has taken care of the constipation. I have not experienced any dramatic improvement in numbness of toes on either foot. I wear good fitting shoes, we do not eat processed foods, I have been cooking very carefully for many years using only "food" as Michael Pollen defines it. The argument that wheat has increased in gluten content as a result of "improved" varieties would suggest that some of us have systems which do not digest higher gluten content now present in breads, baked goods and pastas. Ironically, my father was a flour miller all his life and insisted on bread at every meal and was constantly exposed to flour dust in his work place. He was also involved in convincing farmers to grow the new varieties with higher gulten content.
My husband has had a positive endoscopy, has the genetic
markers, and positive antibodies. He is consider exquisitely
sensitive. Unfortunately, he is not only sensitive to when it is ingested
but inhaled. His reaction begins in 10-15 mins and last from 1-3 days.
Specialists don't have an explanation for the high sensitive unless research hasn't
discovered this yet. He spends his time in rural America and does fine (until harvest) until travel to areas where one can identify where wheat may be. Do you have any information you can help or we can read on this?