Science still can’t agree on the whole gluten-free thing
The great gluten debate continues to upset the tummies of a lot of people…
According to new research published in JAMA Internal Medicine, there has been a huge surge in the number of people adopting a gluten-free diet despite the fact that instances of coeliac disease have remained stable.
Looking at data compiled by the National Health and Nutrition Examination Surveys (NHANES) between 2009 to 2014, researchers at the Rutgers New Jersey Medical School found that of the 22,278 people who had been tested for coeliac disease and followed a gluten-free diet only 0.69 per cent (106 people) actually tested positive.
Not surprisingly, this has seen a number of professionals quickly point out that the gluten free movement is a crock.
Anthony Frew, Professor of Allergy and Respiratory Medicine at Royal Sussex County Hospital, said of the study that it “fits with our feeling within the allergy community that many people have put themselves on gluten-free diets without any clinical evidence of gluten sensitivity”.
And there’s the rub — the suggestion that people are automatically lying because they haven’t submitted themselves to some form of medical testing.
A grain of truth
I get it — I’ve even been guilty of these thoughts myself and I’m clearly no doctor, just a judgmental journalist. Get a group of friends together for lunch and invariably someone pipes up at the last minute to mention that they can’t eat something because it contains gluten. And more often than not, they haven’t been tested. But that doesn’t mean that people don’t know their own bodies.
Coeliac expert Dr Rob Loblay from Sydney’s Royal Prince Alfred Hospital says that, despite the some suggestions they’re a fad, there’s no denying people do respond positively when they take on gluten-free diets.
“There is no doubt that coeliac and gluten sensitivity are two different things and both are mostly found in people who have IBS,” he tells Fairfax.
“When they decrease their intake of wheat and gluten, they undoubtedly begin to feel better. It’s quite a common condition.”
Loblay also stresses that, quite often, it isn’t just gluten that is the problem but a mix of other compounds and dietary habits contributing to the issue.
So if people are aware that gluten could be a problem, why would they avoid getting “official” documentation to prove it?
Maybe because the the testing required for coeliac disease and gluten sensitivity is, if you do suffer from either of these (and gluten sensitivity is a thing despite Frew’s assertions), a small form of torture.
Patients who suspect they suffer from either condition are told they have to eat gluten-based products every day for six weeks before undergoing blood tests and a bowel biopsy.
This might not sound too hard for the rest of us but for someone with non-coeliac related gluten sensitivity — that’s six weeks of constipation, nausea, potential vomiting, cramping, a constant feeling of bloating while battling through fatigue and lethargy.
“There is only one method we have to determine coeliac disease and that’s the gluten challenge,” explains Dr Loblay.
“These reactions people have are not like allergies, and there is no real alternative testing for it. But in saying that the gluten challenge also has its flaws where people aren’t eating pure gluten and quite often their baseline diet can impact the results. But it is still the only truly reliable test.”
Despite this, there’s no guarantee the test will come back with any clear result.
So is it any wonder people would rather not get diagnosed and instead get proactive about their condition? Bonus points if it works.
This doesn’t automatically let every Tom, Dick and Harry off the gluten-hook, mind you. There are undoubtedly some individuals who have jumped on the bandwagon with little knowledge of what gluten actually is or does. (Seriously, I once had a personal trainer tell me that I needed to stop eating gluten because it was preventing me from losing weight… nothing at all to do with the big bowls of ice cream I’d eat as a snack.)
And, as Loblay points out, there are any number of variables that can contribute to the symptoms people attribute to gluten sensitivity such as FODMAPs.
“Even FODMAPs are still just a tiny component of a much larger, complicated number of variables that include preservatives and additives,” explains Loblay.
“Gluten just became the compound that the public fixated on. What studies such as Gibson’s has found is that quite often people were mistaken in their triggers and it was other substances they were responding badly to.”
But nor should we automatically assume that someone is trying to ruin your chance at a giant pizza for lunch.
“When it comes to breaking down what it is that is causing these symptoms it gets incredibly complicated and the science still has a long way to go pinpointing the issue. But if you do feel that it is something that could be affecting you, I would suggest seeing a qualified dietitian to get nutritional help.”
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