Tuesday, February 05, 2008


Many recent articles about being gluten-free revolve around the diet being a medical necessity; other recent articles treat the diet as a fad. Today's Newsday picked up a Chicago Tribune article by Janet Helm entitled "The challenge of giving up gluten."—a well-sourced item that addresses both the medical issues and the possible trendiness related to the diet.

Some highlights:
Most definitely, people with celiac disease need to avoid gluten. Otherwise, this autoimmune disorder can damage the small intestine and interfere with the absorption of nutrients. For celiac sufferers, a gluten-free diet is far from a fad - it is the only treatment.

What appears less clear is whether gluten can be blamed for other problems such as autism. Carol Fenster has been gluten-free for 20 years even though she does not have celiac disease. She's part of a growing group who say they simply feel better avoiding gluten.

Experts say that the growing attention on gluten is a mixed blessing. On one hand, it may encourage more people to get tested for celiac - which still remains undiagnosed in about 97 percent of the people who have it in this country. A typical diagnosis often takes 10 years because the symptoms are mistaken for other conditions. But, ironically, the current fervor over gluten may be making a proper diagnosis even trickier.

Starting a gluten-free diet before being tested for celiac may cause the gut to heal temporarily and an accurate diagnosis will be missed, said Dr. Joseph A. Murray, a celiac disease specialist at the Mayo Clinic in Rochester, Minn.

"If you're concerned about celiac, you should be tested before treating yourself," he said.

Self-diagnosis is rampant, probably due to the increased awareness of the disease. People are more likely to know someone with celiac now, and they relate to the diverse and often vague symptoms associated with the disease, Murray said.

If celiac is ruled out, Murray said there is little or no evidence to support a connection between gluten and other ailments, including autism. Even so, he said there is nothing wrong with cutting out gluten as long as your diet is nutritionally complete.
Lately I've been wondering about a possible contributor to the trendiness of gluten-free diets that Helm's article doesn't mention. With the food industry's bullishness about gluten-free products, it seems that more and more products show up with "gluten-free" labels but no explanation that the labels are pertinent for people on medical diets. Consumers who see the labels possibly associate the labels as something generally positive (like "vitamin packed") rather than of most relevance to people with celiac disease and/or wheat allergies. Perhaps increased awareness of celiac disease causes people to go on the diet, but perhaps increased awareness of the "gluten-free" label—without increased awareness of celiac disease—might come into play, too.

Just musing, is all. I'd be interested in seeing studies of the phenomena discussed in the article. And I'm looking forward to seeing studies about possible relations between gluten and symptoms associated with autism. I think there are some coming.


ShannonCC said...

Well first of all, not all of us with gluten intolerance have celiacs, right? My mom even had an enterologist (however you spell that) look at her colon, tell her there wasn't any sign of celiacs but if her digestive symptoms cleared up going gluten free (they did - big time) then that was a diagnosis as far as he was concerned. No fancy tests there.

Also, the way doctors have treated my problems the past few years I now get a little angry at the ones who whine about their opinion of people who self treat. You don't want me to self diagnose myself? Then LISTEN to my symptoms and try to HELP instead of patting me on the head and sending me on my way as just another hysterical woman.

Um, none of that was aimed at this blog, which I enjoy LOL! Just sparked by the article.

ShannonCC said...

Sorry, I meant that was a diagnosis of gluten intolerance for my mom, not celiacs. The guy told her she didn't seem to have celiacs but there is more to gluten intolerance than celiacs - most doctors don't seem to know this though (like the guy who tested me for celiacs when I had been gluten free SEVEN MONTHS - I told him there was no point but he insisted on wasting the money).

crazyorangeturtle said...

In Canada there are very few 'regular' products (i.e. ones not in the special health food section of the grocery store) that have a label that says "Gluten-free". Many have a line after the ingredients that says something to the effect that the product was manufactered in a plant that also uses major allergens such as eggs, dairy, nuts or wheat, but only two that I know of specifially say gluten-free in big letters on the front.

Yet the trend towards gluten-free is still present in Canada. So labelling cannot possibly be only the fuel for the fire. Something else must have triggered this fad, although I'm not sure what.

Personally I think the trend benefits celiacs and those with intolerance. If more of the population wants to spend huge quantities of money on unnecesary gluten-free products, then the demand for the products will increase and additional gluten-free products will become avaialable. I'm all for a wider selection of grocery items. I'd feel bad about this selfishness, if being gluten-free compromised nutrition. But it doesn't. Those that feel they want to go gluten-free can still eat very nutritious and healthy foods. Nobody will suffer, unlike some of those nutritionally poor fad diets, the gluten-free "fad" shouldn't hurt a person's well being.

Plus the 'fad' gives celiacs and those with intolerances the opportunity to educate additional people about these disorders. Perhaps more undiagnosed celiacs will become aware of their condition and will seek medical help. I hope that the average 10 year diagnoses will soon be a thing of the past.

David Marc Fischer said...

Thanks for the feedback. Over the past ten years, I think I've seen a greater acceptance of the notion that people tested negative for celiac disease might still have a problem with gluten. Dr. Green's book (written with Rory Jones) has sections about gluten sensitivity and gluten intolerance (which used to be synonymous with celiac disease) as well as celiac disease.

I can see how there might be some sort of benefit to people going gluten-free as part of a fad, but I have serious misgivings about that, especially since the market can still be dramatically expanded through conventional diagnoses, which would clearly improve the health of multitudes of people. So I'd rather see the gluten-free diet understood as a genuine solution to diagnosable conditions rather than as the latest fad diet, and I'd rather see the diet adopted by the many people it could help than by people who might be helped by something else.

shannoncc said...

I don't undestand the "fad" part either but I also haven't really seen it in action. All the people I know who are not eating gluten actually had symptoms that cleared up from cutting it out. The ones who didn't find relief from their symptoms gave up the diet and looked elsewhere for help. I don't personally know anyone who is eating gluten free just because it's "in" or something.

Though I did make a gluten free cake for a party that gluten eating people loved so much they asked me for the recipe, does that count? ;)