Gluten: the villain of the century

For the last few decades, the number of people trying to eliminate gluten from their diet dramatically increased across the globe. Healthcare and lifestyle magazines and blogs are swamped with articles describing “evidence-based” research demonstrating that gluten is pure evil and everyone should keep a gluten-free diet (GFD).

Without a doubt, there are people who suffer from diseases that require a GFD, but is it healthy for everyone to switch into GF products?

Today, we will try to get to the bottom of the global GF obsession, but first things first: What is gluten?

Gluten

Gluten is an umbrella term for proteins that are found in starch and numerous cereal grains. From Latin, gluten is translated as a verb “to stick”. Gluten is widely used in the food and non-food industries for its adhesive properties. Thanks to gluten, dough obtains it's elastic chewy texture.

Diseases that require GFD

In a small proportion of people the consumption of gluten leads to severe inflammation and problems in the gastrointestinal tract. The diseases accompanied by severe inflammatory and allergic reactions to consuming gluten include celiac disease, gluten ataxia and dermatitis herpetiformis (1).

Celiac disease (CD) is an autoimmune disease that develops in individuals with a genetic predisposition and a high consumption of wheat, barley and other gluten-containing food components.

The symptoms of celiac disease can only be treated with a lifelong GFD. Currently, about 1.8% of the Western population is diagnosed by celiac disease (2). It is important to note that the global incidence of celiac disease coincides with the increase in “gluten-rich” diets, which is the most probable explanation in the villainization of gluten by the mass media and bestseller books on nutrition.

Things to consider before excluding gluten from your diet

As previously mentioned, GF products are portrayed as healthier options, which supposedly improve the quality of life in people without CD. To date, the scientific evidence supporting this claim is almost next to none. Instead, a growing amount of scientific studies have revealed adverse effects of the increasingly fashionable GFD. An extensive study published in 2019 highlighted the most important negative aspects of GFD for people that were not diagnosed with CD and other gluten dependant conditions (3):

1. Nutritional deficiencies. An extensive study of GFD nutritional profiles has revealed that it could lead to deficiencies in crucial components such as protein, iron, folate, zinc and potassium. Moreover, GFD products are full of fat, sodium and sugars (4). It is also worth mentioning that the overriding majority of GFD products are not fortified, in order to make them healthier.

2. Toxic effect of GFD. Typically people who maintain GFD consume larger amounts of rice and fish, which leads to a build up of heavy metals in the organism. It was reported that non-celiac disease people that maintain GFD had higher levels of arsenic in their urine and elevated levels of mercury, cadmium and lead in their blood (5). It also was speculated that there are harmful effects of artificial additives to GFD products including microbial transglutaminase (mTg).

3. Mental health and GFD. GFD is by far one of the most difficult diets to maintain. It requires a lot of lifestyle changes, which some people might find too hard to bear. It was reported that a certain proportion of CD patients suffer from a range of mental disorders including but not limited to depression, anxiety, learning disabilities, mood and sleep disorders (6). However, the direct link between GFD and mental health issues is yet to be determined.

Concluding today’s post I would like to stress that if you are indeed thinking of maintaining a GFD you should consult your GP, who would advise you on how to make your diet as healthy and balanced as possible. I guess we live in the era where almost every one of us has felt the need to be on some kind of diet at one point or another. But I think we should move away from the generalised “fit for all” diets to more personalised diets that would benefit the exact needs of our organism.

1) Elli L, Branchi F, Tomba C, Villalta D, Norsa L, Ferretti F, et al. . Diagnosis of gluten related disorders: celiac disease, wheat allergy and non-celiac gluten sensitivity. World J Gastroenterol. (2015) 21:7110–9. 10.3748/wjg.v21.i23.7110.

2) Lerner A, Jeremias P, Matthias T. The world incidence of celiac disease is increasing: a review. Int J Recent Sci Res. 2015 Jul;7:5491-6.

3) Lerner A, O'Bryan T, Matthias T. Navigating the Gluten-Free Boom: The Dark Side of Gluten Free Diet. Frontiers in pediatrics. 2019;7.

4)Melini V, Melini F. Gluten-free diet: gaps and needs for a healthier diet. Nutrients. 2019 Jan;11(1):170.

5) Raehsler SL, Marietta EV, Murray JA. Accumulation of heavy metals in people on a gluten-free diet. Clinical Gastroenterology and Hepatology. 2018 Feb 1;16(2):244-51.

6) Slim M, Rico-Villademoros F, Calandre EP. Psychiatric comorbidity in children and adults with gluten-related disorders: a narrative review. Nutrients. 2018 Jul;10(7):875.