From apple pie to mac n' cheese to burgers on bakery buns, wheat has long been a quintessential component of the American diet. Our heartlands are filled with undulating wheat fields that supply the nation's daily bread. Yet, for an estimated three million Americans with celiac disease, the patriotic amber grain is not a source of sustenance and comfort but rather a poison to their bodies.
It's a Protein
Wheat, as well as other cereal grains including barley, rye, spelt, and kamut, contains a protein known as gluten. In celiac disease, the body misperceives this protein as an invader, touching off an autoimmune response that can damage the small intestine, impair the absorption of nutrients, and lead to gastrointestinal distress, anemia, premature bone loss, and increased cancer risk. Though drug therapies are being studied, currently the only known cure for celiac disease is complete avoidance of gluten. This is harder than one might think, as gluten is now ubiquitous not only in the usual suspects like baked goods but also in packaged foods like soup mixes, ice creams, salad dressings, and deli meats as well as medications and cosmetics.
On the Rise
Once thought to be exceedingly rare, new research shows that the disease is on the rise. It is four times more common today than it was in the 1950s. Celiac was previously thought to affect 1 in 3000 individuals; new studies put that estimate closer to 1 in 100. This increase may be due to changes in the way wheat is grown and processed or simply the high prevalence of the grain in our diets. In recent years, as awareness of celiac disease has increased, so too has the availability of gluten-free products from pastas to cake mixes. According to the market-research group Packaged Facts, sales of gluten-free products have grown an average of 28% over the past five years.
However, demand for these products is not limited to celiac patients. On the heels of the low-carb craze, "gluten-free" has become the newest buzzword in health-focused restrictive diets. Even though they may not meet the clinical diagnostic criteria for celiac disease, many Americans are finding that they feel better—and slimmer—by avoiding gluten. Others are convinced that a gluten-free diet can combat everything from autism to chronic fatigue, multiple sclerosis, ADD, arthritis, migraine, schizophrenia, and fertility problems.
For those with celiac disease, a gluten-free diet is a clear necessity. Research shows that even celiac patients who do not exhibit symptoms in response to eating gluten still do damage to their intestines when they eat it. But what about for those without a celiac diagnosis? Is a gluten-free diet health promoting, potentially damaging, or simply an innocuous fad?
No matter what your health profile, there's no question that wheat is difficult to digest. The human body is incapable of fully processing gluten; undigested protein fragments pass through the digestive tract with varying degrees of irritation, with celiac being the most extreme response. An estimated 10-15% of Americans have what's known as "gluten sensitivity," a milder response ranging from gas and bloating to headaches and achy joints. Such individuals may indeed find benefit in cutting gluten from their diets. In addition, eliminating such carbohydrate-laden foods as bread, pasta, and pastries can help shed unwanted pounds.
Not Always Beneficial
However, there are several things to consider before jumping on the gluten-free bandwagon. First, trying to self-diagnose celiac disease is a problematic prospect. If you suspect you may have celiac, see your doctor before going on a gluten-free diet, because celiac is hard to detect when someone has not ingested gluten for a long period of time. If you're approaching the diet for holistic health or as a weight-loss tactic but don't experience particular gluten sensitivity, you may want to think twice. A study in the British Journal of Nutrition found that gluten-free diets could hamper the growth of beneficial gut bacteria. Gluten-free products may also provide less fiber, nutrients, and B vitamins like folic acid than their non-gluten-free counterparts.
Overall, the jury is still out on the broader benefits of going gluten-free for those without celiac disease. More research is needed on the role gluten sensitivity may play in diseases like autism and chronic fatigue. In the meantime, the increased attention to gluten is good news for celiac sufferers, who for decades found themselves eating outside the mainstream. One sign that the gluten-free movement has arrived is the opening of a gluten-free concession stand this past summer at Coors Field in Denver, which offers gluten-free hot dogs, hamburgers, brownies, and even beer at the ball game. What could be more all-American?