The New York Times (May 8, 2007) includes an article by Kate Murphy entitled "Jury Is Still Out on Gluten, the Latest Dietary Villain." I've got mixed feelings about it.
First of all, I want to go over some basics. As the article states down in its 13th paragraph (out of 24), "The prevalence [of celiac disease] in North America was previously estimated at about 1 in 3,000, but several studies published in the last three years indicate that it is closer to 1 in 100--and 1 in 22 for those with risk factors like having an immediate relative with celiac disease." The article quotes Dr. Peter Green as saying that "Chances are now that people actually know someone who has it."
But the article does not say something else that is true: Among the 1 percent estimated to have celiac disease, only a very low percentage--perhaps 3 percent--has been correctly diagnosed. That, to me, remains the big story: Nearly 1 percent of the population--from infant to senior--remains unaware that it has celiac disease. That is what I call a national health crisis.
Instead, the article focuses on people who go on gluten-free diets because they feel better on the diet (or think they might feel better on the diet) despite testing negative for celiac disease or not even testing for it at all. There's nothing in the article that suggests that going on such a diet would, by itself, be harmful. So I suppose the article comes across as part health article, part trend piece, and part marketing report (as it discusses the increasing availability of gluten-free products).
I'm not sure why I feel a little disappointed by the article beyond its failure to hammer home the existence of a real and quantifiable health crisis. But it might have to do with some of its phraseology. Here's a paragraph that got under my skin:
Nevertheless, it has become a popular dietary villain. Gluten-free foods are popping up on grocery-store shelves and restaurant menus, including those of national chains like P. F. Chang’s and Outback Steakhouse. Warnings of gluten’s evils are common on alternative medicine Web sites and message boards.The use of the phrase "popular dietary villain" strikes me as inappropriate and not supported by the article. There's no statistic to show that the gluten-free foods are popular--and I don't think they are. Gluten-free labeling is actually increasing largely because people with celiac disease have fought long and hard for this reasonable practice. The sentence associating vague "warnings of gluten's evils" with alternative medicine could give readers the false impression that the warnings aren't also associated with mainstream medicine. And I think that the almost obligatory roll call of common substances that contain gluten--salad dressings, ice cream, peanut butter, adhesives on envelopes, and lipsticks and lotions--might've been better researched. Most if not all peanut butters are, to my knowledge, gluten-free, and I've been hearing that the warning against adhesives on envelopes might lack substance, too.
Another misleading sentence: "But with supermarkets brimming with gluten-free breads, cereals, cakes and cookies and restaurants serving gluten-free pastas, pizzas and beer, it has become far less difficult to stay on a gluten-free diet." I'd like to dare Ms. Murphy to show me supermarkets brimming with gluten-free baked goods. Not even Whole Foods qualifies. And as for restaurants serving gluten-free pastas, pizzas and beer? They're still very rare.
I do share the concern of quoted University of Texas gastroenterologist Dr. Don W. Powell that "A lot of alternative practitioners like chiropractors have picked up on it and are waving around magic silver balls, crystals and such, telling people they have gluten intolerance." A consultation with an informed gastroenterologist can be invaluable in diagnosing or ruling out celiac disease using a panel of blood tests possibly followed by an intestinal biopsy.