{"id":33535,"date":"2015-03-05T16:54:01","date_gmt":"2015-03-05T15:54:01","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=33535"},"modified":"2015-03-05T17:50:01","modified_gmt":"2015-03-05T16:50:01","slug":"alvin-chan-chances-are-youre-not-sensitive-to-gluten","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2015\/03\/05\/alvin-chan-chances-are-youre-not-sensitive-to-gluten\/","title":{"rendered":"Alvin Chan: Chances are, you\u2019re not sensitive to gluten"},"content":{"rendered":"

\"alvin_chan\"<\/a>In the medical community, there are certain conditions that fall under the fuzzy category\u00a0of medically unexplained syndromes (MUS). These syndromes, like fibromyalgia, chronic\u00a0fatigue syndrome, and somatoform disorder, present with odd constellations of symptoms that\u00a0neither physical examination nor diagnostic tests can explain. [1] To some members of the medical\u00a0community, these are not diseases in their own right, but rather, clinical manifestations of\u00a0underlying depression or some other biological or psychological condition. Given all the\u00a0attention gluten is getting these days, I\u2019m beginning to wonder if gluten sensitivity belongs in\u00a0this category of MUS or is simply a result of the gluten-free fad.<\/p>\n

From what I hear from my patients who claim to be gluten intolerant, the \u201cdisease\u201d\u00a0causes a hodge-podge of symptoms, including, but not limited to, stomach pain, diarrhoea, bloating, \u201cchicken skin,\u201d migraines, fatigue, mood swings, and weight gain. As a (medical\u00a0student) doctor, I often struggle with how seriously I should acknowledge my patients\u2019\u00a0concerns\u2014after all, there is no scientific proof that the \u201cdisease\u201d even exists. In a double-blind\u00a0randomized placebo controlled trial, Australian researchers looked to see whether gluten\u00a0ingestion could induce symptoms in people with irritable bowel syndrome but not coeliac\u00a0disease. [2] Within one week, the group that ate gluten reported more pain and bloating than the group\u00a0controlled on a gluten-free diet. The researchers concluded that \u201cnon-coeliac gluten intolerance\u00a0may exist.\u201d However, in a second, double blind crossover trial by the same Australian team, the\u00a0researchers found that symptoms in people with self-reported gluten sensitivity were comparable\u00a0on a gluten-free diet as on a high-gluten diet, conflicting with findings from their first trial. And\u00a0thus, the great gluten sensitivity debate continues. [3]<\/p>\n

Unlike gluten sensitivity, coeliac disease is real, and people with coeliac disease must be\u00a0gluten-free to avoid abdominal issues, anaemia, arthritis, bone loss, seizures, and other potentially\u00a0life-threatening conditions. [4-6] While gluten restriction is absolutely necessary for the 1% of the\u00a0population with coeliac disease, gluten preoccupation has taken over a much larger portion of the\u00a0population. According to the 2013 Dieting Monitor report from consumer market research firm\u00a0NDP Group, 30% of adults said they wanted to cut down or be free of gluten. [7] Why? The answer\u00a0is simple. It\u2019s the same tactic that food companies use to deceive children into eating sugary\u00a0cereals\u2014advertising. Since the inception of the FDA-approved gluten-free logo, food companies\u00a0have, once again, capitalized on the American public\u2019s ignorance by stamping the logo on their\u00a0newly reformulated gluten-free products, like their gluten-free cookies, gluten-free brownies, and\u00a0gluten-free sodas, which traditionally never had gluten anyway (there\u2019s also gluten-free\u00a0shampoos). Food companies have lifted gluten-free to health halo status, misleading many consumers to believe gluten-free anything is superior. [8] As a result, consumers, my patients, are\u00a0spending 242% more money on gluten-free products for health benefits that might not exist. [9]<\/p>\n

In fact, people who unnecessarily shun gluten from their diets may be jeopardizing their\u00a0health. Whole grains, which contain gluten, are rich in dietary fiber, and fiber has been shown to\u00a0lower risks of high cholesterol, heart disease, obesity, and type II diabetes. [10] Whole grains are\u00a0also packed with vitamins and minerals to build bones, prevent anaemia, protect against oxidation,\u00a0and bolster immune systems. In many cases, gluten-free packaged foods are actually unhealthier\u00a0than the original versions because they contain more\u00a0added fat and sugar to compensate for the loss\u00a0<\/span>in flavor and texture when gluten is removed. People are also wasting extra money that could be\u00a0<\/span>better spent on fruits and vegetables. Most importantly, the gluten-free fad may detract\u00a0<\/span>consumers from picking up or adhering to dietary recommendations that are scientifically proven\u00a0<\/span>to promote healthier lives. It is possible that doctor\u2019s advice to eat more vegetables or to reduce\u00a0<\/span>sodium may be disregarded at the expense of \u201calready being gluten-free\u201d\u2014because let\u2019s face it,\u00a0<\/span>it\u2019s easier to eat gluten-free cookies than kale.
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\nObviously, more research needs to be done to better understand non-coeliac gluten\u00a0sensitivity; but in the mean time, as a soon-to-be doctor, here are my recommendations. Don\u2019t\u00a0fall for the gluten-free marketing trend. Gluten free or not, packaged foods are not as healthy as\u00a0whole foods. Eat fruits and vegetables that are naturally gluten free. Make whole grains part of\u00a0your balanced diet. And please, consult your doctor before self-diagnosing yourself as gluten\u00a0sensitive, because chances are, either there\u2019s something else going on, or there\u2019s something\u00a0healthier you can do than to restrict yourself of gluten.<\/p>\n

See also:<\/p>\n