Uncovering the gluten-free phenomenonSince the turn of the century, “gluten-free” has seen a tremendous rise in popularity.Research shows that 18,000,000 people in the United States allege they are bothered by products that contain&nbsp;<a target="_blank" rel="noopener noreferrer" href="https://en.wikipedia.org/wiki/Gluten">gluten</a>, the protein composite found in wheat and related grains.Gluten has been blamed for everything from acne to joint pain, migraines, depression, anemia and mouth sores.The style of eating gluten-free has become a way of life, a culture really– one that includes restaurant chef cards, similar to business cards, that help convey one's&nbsp;needs to the chef and kitchen staff as a way to help publicly&nbsp;deal with the “gluten sensitivity”.If you’re not gluten-free, chances are quite high that you know someone who is.Lots of people say they feel much better withholding gluten from their diets. But is it really gluten, or could it be something else entirely that causes so many people so much distress?Where is the&nbsp;substantial science behind gluten to support the mass gluten-free swear-off that millions of people claim?Let’s investigate.<h2 id="4017466d-f3de-475a-96ab-cddd75e08333" data-toc-id="4017466d-f3de-475a-96ab-cddd75e08333" style="text-align: left; font-size: 24px; line-height: 1.2;">Could the problem be new "wheat genes"?</h2><a target="_blank" rel="noopener noreferrer" href="https://www.amazon.co.uk/gp/product/B00HPN3K0M/ref=as_li_tl?ie=UTF8&amp;camp=1634&amp;creative=6738&amp;creativeASIN=B00HPN3K0M&amp;linkCode=as2&amp;tag=healdiva0f-21&amp;linkId=7CJEI7GUEB4BVZDK">"Wheat Belly"</a> author William Davis, M.D., argues that modern grains are now genetically different, possibly making gluten more abundant in them and therefore "more destructive".In the same camp we have David Perlmutter, M.D., author of <a target="_blank" rel="noopener noreferrer" href="https://www.amazon.co.uk/gp/product/B00H4EPCGW/ref=as_li_tl?ie=UTF8&amp;camp=1634&amp;creative=6738&amp;creativeASIN=B00H4EPCGW&amp;linkCode=as2&amp;tag=healdiva0f-21&amp;linkId=A5ZMKS6FM6FYDZAI">"Grain Brain"</a>, who speculates that wheat is hybridised to increase gluten content as much as possible.But is there any truth to these arguments?Unconvinced by such claims, Donald Kasarda, PhD in physical chemistry from Princeton University and expert in grain genetics at the the Agricultural Research Service (USDA), went onto research if there has been an actual increase in the gluten content of wheat as a consequence of wheat breeding. What Karsada found cast doubt on those allegations (i.e. that gluten content has been affected by genetics). His findings, published in the <a target="_blank" rel="noopener noreferrer" href="https://pubs.acs.org/doi/abs/10.1021/jf305122s">ACS Journal of Agricultural and Food Chemistry </a>last year, showed that gluten content in crops hasn't changed in the past 100 years. If anything, the new crops are <a target="_blank" rel="noopener noreferrer" href="https://www.sciencedaily.com/releases/2013/02/130206131129.htm">not to be blamed</a> for the rise in gluten sensitivities.Another <a target="_blank" rel="noopener noreferrer" href="https://www.producer.com/daily/frankenwheat-a-myth-says-new-u-of-s-research/">2015 study</a>, conducted by the University of Saskatchewan and published in Cereal Chemistry, arrived to the same conclusion: gluten composition in grains hasn't changed much since 1860.One of the study scientists, Professor Ravi Chibbar, explained that “It took us (nearly) three years to get to this stage to publish, even though the data was there. We (had) to be very thorough because we get it peer reviewed. Whereas (Davis’) book was never peer reviewed by scientists. That’s a big difference.”<h2 id="53db6f9e-6430-44f0-9b61-beb925559e82" data-toc-id="53db6f9e-6430-44f0-9b61-beb925559e82" style="text-align: left; font-size: 24px; line-height: 1.2;">So, what could it be?</h2>If wheat genes aren't the cause of a mass increase of "self-diagnosed" gluten sensitivities, where should we look at?Despite these findings, people still perceive the term "gluten-free" as being a healthier choice. Doesn't matter if it's bread, soups, gravies, lip balm, or hot chocolate!The food industry has capitalised on that perception and thus the market for gluten-free is flourishing. As a matter of fact, <a target="_blank" rel="noopener noreferrer" href="https://www.mintel.com/blog/mintel-market-news/mintel-in-the-media-this-weeks-highlights-6">market researchers in the US estimate the gluten-free category will produce more than $15 billion in sales by 2016.</a>This is a complex subject indeed.Gluten is damned for nearly every sickness. Sensitivity around it is a real issue for some people, like those with coeliac disease.But could this sensitivity be something more serious, like true coeliac disease, or might it be caused by the person's overall diet rather than gluten on its own?We may not be able to fully uncover the absolute specifics; however, as you read on, you'll be clearer on what the actual culprits could be rather than blaming gluten for everything.<h2 id="09abe127-54d9-43c1-9b3e-455d60e49758" data-toc-id="09abe127-54d9-43c1-9b3e-455d60e49758" style="text-align: left; font-size: 24px; line-height: 1.2;">Defining&nbsp;coeliac disease</h2><a target="_blank" rel="noopener noreferrer" href="https://en.wikipedia.org/wiki/Coeliac_disease">Coeliac disease</a> is an autoimmune disorder that damages the insides of the small intestine, thereby diminishing its ability&nbsp;to absorb nutrients from food. Gluten is the offender in this disease because it triggers that immune response.<blockquote>Curiously, only 1% of the population has coeliac disease; more precisely, <a target="_blank" rel="noopener noreferrer" href="https://www.coeliac.org.uk/coeliac-disease/myths-about-coeliac-disease/">1 in every 100 Brits</a>, <a target="_blank" rel="noopener noreferrer" href="http://www.beyondceliac.org/celiac-disease/facts-and-figures/">1 in every 133 Americans</a>, and <a target="_blank" rel="noopener noreferrer" href="https://www.coeliac.org.au/coeliac-disease/">1 in every 70 Australians</a>.</blockquote>Here's where the possible harm comes in when you completely abolish gluten from your diet without that sensitivity confirmation: if you do not have coeliac disease, you could be doing yourself more harm than good in avoiding gluten.Peter Green, M.D., director of the Celiac Disease Center at Columbia University, says that unless the previous condition applies <a target="_blank" rel="noopener noreferrer" href="http://www.webmd.com/diet/healthy-kitchen-11/truth-about-gluten">“a gluten-free diet can lack vitamins, minerals, and fiber.”</a>But what if you’re not coeliac?Can you still have a gluten sensitivity, without being coeliac? Does that even exist, or is it just in our heads because we hear so much about it?<h2 id="80e86efc-f08e-45ae-8e3e-4cd1d1e8b8fc" data-toc-id="80e86efc-f08e-45ae-8e3e-4cd1d1e8b8fc" style="text-align: left; font-size: 24px; line-height: 1.2;">The study that proved that (non-coeliac) gluten sensitivity exists</h2>Until very recently, medical doctors thought that gluten&nbsp;sensitivity&nbsp;was a "fad" popularised by book authors and gluten-free manufacturers. As far as the medical community was concerned, only coeliac gluten sensitivity was a valid diagnosis.But a <a target="_blank" rel="noopener noreferrer" href="http://www.nature.com/ajg/journal/v106/n3/abs/ajg2010487a.html">2011 study led by Peter Gibson</a>, professor of gastroenterology at Monash University and director of the G.I. unit at the Alfred Hospital in Melbourne, Australia, showed that gluten can cause gastrointestinal symptoms in people without coeliac disease.The news came as a shock to most doctors!His research, published in the American Journal of Gastroenterology, showed you can have a gluten sensitivity without being coeliac and that gluten can cause gastrointestinal symptoms even if you're not coeliac.This confirmed that non-coeliac gluten sensitivity exists and that gluten may be responsible for symptoms such as pain, bloating, and tiredness.But it gets more interesting with the second study led by Gibson&nbsp;in 2013, which points the finger to other foods as accomplices to the gluten scene.<h2 id="cdd26d10-6d0d-4541-86dd-3f327aa43d3b" data-toc-id="cdd26d10-6d0d-4541-86dd-3f327aa43d3b" style="text-align: left; font-size: 24px; line-height: 1.2;">Is it gluten to fully blame, or is it something else?</h2>The <a target="_blank" rel="noopener noreferrer" href="https://www.gastrojournal.org/article/S0016-5085%2813%2900702-6/abstract">second study led by Peter Gibson</a> in 2013, investigated the specific effects of gluten after a reduction of FODMAPs.That strange acronym stands for Fermentable Oligosaccharides (fructans), Disaccharides (lactose), Monosaccharides (fructose) And Polyols (e.g. xylitol) –&nbsp;<a target="_blank" rel="noopener noreferrer" href="https://en.wikipedia.org/wiki/FODMAP">FODMAPs</a>.A rather large number of people are sensitive to these short-chain carbohydrates, which are incompletely absorbed in the gastrointestinal tract. Because they are easily fermented by bacteria in the gut, they can cause symptoms such as gas, pain, and diarrhea.This second study included&nbsp;people with non-coeliac gluten sensitivity and people with IBS (irritable bowel syndrome).The subjects were put on a low FODMAP diet and when gluten was reintroduced&nbsp;only 8% of them showed negative gluten symptoms.These findings show that perhaps FODMAPs may be the cause of the symptoms&nbsp;together&nbsp;with gluten.How interesting!<a target="_blank" rel="noopener noreferrer" href="https://www.celiaccentral.org/non-celiac-gluten-sensitivity/">It's important to note</a> that wheat, barley and rye (gluten-containing grains) are all high in FODMAPs too.<h2 id="20913ea9-eff9-47e2-b46f-147f523f8a07" data-toc-id="20913ea9-eff9-47e2-b46f-147f523f8a07" style="text-align: left; font-size: 24px; line-height: 1.2;">Uncovering your own sensitivities</h2>As you can see, this can be a complex issue in terms of the direction you are heading or helping to steer when advising a client.In our <a target="" href="https://www.thehealthsciencesacademy.org/en/advanced-food-allergies-and-intolerances-nutritional-advisor-level-5-diploma">Food Allergies and Intolerances certification</a>, we teach our students how to uncover and alleviate food sensitivity risks in a methodical manner. And that's really important, because you might be sensitive to just one single FODMAP food, and not all of those in the FODMAP list. It would be a crime to stop eating&nbsp;fruits, vegetables, legumes and dairy, all of which are high in FODMAPs! These are very healthy and not a problem for most of us.Sensitivity to a FODMAP item tends to happen when you eat a FODMAP ingredient in ultra-concentrated amounts – think high-fructose corn syrup and added sugars in processed foods like pastries, pies, biscuits and cakes, which by the way also contain gluten (as well as gluten-based additives to improve texture).Unsurprisingly, these types of foods can be quite addictive and easy to overeat.<h2 id="7cf9f4a0-f71c-452e-a480-ceb99db7744d" data-toc-id="7cf9f4a0-f71c-452e-a480-ceb99db7744d" style="text-align: left; font-size: 24px; line-height: 1.2;">What do you think?</h2>Have you ever self-diagnosed a reason to go gluten-free? Do you think gluten is to blame - or might it be your overall diet?Join the conversation and share with us below your comment or story so we all can benefit from each other.And pass this along to those who might enjoy discovering some misconceptions about gluten!

Since the turn of the century, “gluten-free” has seen a tremendous rise in popularity.

Is There Any Science Behind the Gluten-Free Phenomenon?

The study that proved that (non-coeliac) gluten sensitivity exists

Is it gluten to fully blame, or is it something else?

Explore science-based articles on nutrition, health, wellness, behaviour change, clinical practice, dietary supplements, gut health, sports nutrition, menopause, and professional development.

Nutrition Blogs | Evidence-Based Health and Nutrition Articles | THSA

Discover science-based nutrition articles, research insights, clinical practice tips, and professional development resources from THSA.

Is There Any Science Behind the Gluten-Free Phenomenon?

Is There Any Science Behind the Gluten-Free Phenomenon?

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