In “Unraveling the Gluten-Free Trend,” online today with media partner EatingWell, FERN Editor-in-Chief Sam Fromartz investigates the science and controversy behind the “gluten-free” craze. Fromartz draws on the latest medical research to explain what we really know about gluten’s health impact and what might be hype. The story focuses on the emerging research around “gluten sensitivity,” which, as Fromartz shows, isn’t well understood, and thus prone to conjecture.
While writing his acclaimed book In Search of the Perfect Loaf: A Home Baker’s Odyssey (2014), Fromartz traveled the globe studying bread baking and the history of our relationship with this most ancient staple food. It’s a relationship that has become more complicated, though, he notes, as a growing number of people see gluten in bread and other products as the source of a wide variety of health problems.
“Wheat—and the main protein it contains, gluten— has been cited as a cause of weight gain, ‘brain fog,’ skin rashes, joint pain, headaches, tiredness, allergies, gas, intestinal distress, irritable bowel syndrome, depression and, in the case of celiac disease—where the immune system goes haywire and attacks the body—even death,” writes Fromartz. “Yet wheat, which is found not only in bread and pasta, but also in beer and numerous processed foods, makes up one-fifth of all food eaten worldwide and is the number-one source of protein in developing countries.”
The origins of wheat trace back to the beginning of agriculture, when humans first domesticated wild grasses in the Near East. Yet today, many Americans are wary of the food their ancestors relied on for roughly 10,000 years.
“Consumer data are pretty clear: around 22 percent of adults are trying to avoid gluten, creating an estimated $8.8 billion market that grew 63 percent between 2012 and 2014, according to market research firm Mintel,” reports Fromartz. “As many as 20 million Americans think gluten-free diets are healthier and around 13 million are giving up gluten to lose weight.”
Yet, just 1 percent of the population has celiac disease, a severe auto-immune reaction brought on by gluten, and an even smaller fraction, 0.4 percent, experiences an allergic reaction when they eat wheat or breathe flour dust. Many others claim to be “gluten-sensitive,” a term that still has no official definition in the medical community. Essentially, gluten-sensitivity refers to people who exhibit a range of symptoms when they eat gluten, but who don’t have celiac disease or a gluten allergy.
Here’s how Fromartz explains the difference: “Researchers think gluten sensitivity involves a misfiring of the innate immune system, a first line of defense against a foreign substance, like carpet-bombing the enemy with general inflammation. In celiac disease, gluten triggers a more precise response in genetically susceptible people: elite squads that are part of the adaptive immune system are marshaled for attack, but they end up targeting the cells of the intestinal wall, preventing the body from absorbing nutrients. With gluten sensitivity, people may suffer from gut or joint pain, headaches or other symptoms, but not exhibit any similar intestinal damage.”
But gluten sensitivity remains a nebulous diagnosis, because there is no blood test or biomarker that can confirm the disease. Some scientists aren’t even sure whether gluten is the culprit. As Fromartz reports, a widely cited Australian study found that the real issue may be a group of carbohydrates called FODMAPs. Other studies continue to point to gluten.
But if gluten is the issue, then why has the incidence of disease gone up? Fromartz highlights some of the most popular explanations, from claims that modern wheat varieties have more gluten to the belief that genetically modified wheat is to blame (despite the fact that GMO-wheat is not sold anywhere in the world). Ultimately none of the explanations has the weight of evidence behind it.
Until the science catches up, Fromartz notes that doctors have little choice except to trust their patients when they say they feel better avoiding gluten. People might not be able to pinpoint what makes them feel unwell after a bowl of pasta or a slice of bread, but for now the onus is on individuals and physicians to interpret their symptoms and make the best decision.