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Gluten Free Diet: When trend confuses the population

We currently live in a world where: the media, influencers, social networks, or the internet, have a great influence on what people think. For the month of April 2018, it was recorded that the words “gluten free” were searched on the internet on the Amazon platform 545,800 times on average. While, for the year 2014, the market value of gluten-free products in the United States was 4.21 trillion dollars, and it is forecast that by 2020 it will be 7.59 trillion dollars. The media can influence these numbers, such as one of the New York Times best-selling books, Wheat Belly, draws a lot of attention with statements like the following:

“A complex range of diseases results from the consumption of wheat, from Celiac Disease – the devastating intestinal disease that develops due to exposure to wheat gluten – to a variety of neurological disorders, diabetes, heart disease, arthritis, rashes in the skin, and the delusions of schizophrenia. ”- Wheat Belly Book

The Gluten Free Diet has become a fad and many people have welcomed it as the healthiest. However, it is only scientifically evidenced that the Gluten Free Diet is beneficial in people with Celiac Disease (CD) and gluten sensitivity. But now … what is Celiac Disease? and then what is gluten?

Gluten is the main protein storage for wheat grains. It is a mixture of hundreds of proteins, mainly gliadin and glutenin. Gluten acts as a “glue” helping food maintain its shape. It is found naturally mostly in wheat, barley, rye, “triticale” and oats.

On the other hand, Celiac Disease is an autoimmune disorder caused by a permanent intolerance to gluten proteins in genetically susceptible individuals. This disease is very rare, with a prevalence of 0.02%, although some studies in several countries suggest that it can vary between 0.33% and 1.06% in children and 0.18% to 1.20% in adults.

When a person with Celiac Disease consumes gluten, their immune system produces substances that damage the intestine. Due to this reaction, the person with this condition does not adequately absorb nutrients and may be malnourished. Some of the most common symptoms are abdominal pain, bloating, gas or indigestion, diarrhea, lactose intolerance, nausea, vomiting, abnormal stool and / or unexplained weight loss. Diagnosis of Celiac Disease requires a doctor to evaluate symptoms, medical history, and perform a physical exam. Some people may be sensitive or intolerant to gluten, but do not necessarily have CD.

The Gluten Free Diet is the primary medical-nutritional treatment for Celiac Disease and gluten sensitivity. Some foods that contain gluten and that are restricted in this diet are: pasta, bread, pastry desserts, cookies, baked desserts (biscuits, brownies, etc.), cereals, granola, pancakes, waffles, French toast, crepes, biscuits, croutons, panko, some sauces (such as the traditional soy sauce), tortillas, beers, malts and any other food that indicates that it contains “wheat flour”. However, for those who suffer from Celiac Disease there are options of the mentioned foods that do not contain gluten.

It is possible that people without Celiac Disease who carry out the Gluten Free Diet report that they lose weight, feel more active, sleep better, among other aspects. However, it is not scientifically evidenced that it is a direct relationship with the Gluten Free Diet. Furthermore, several studies indicate that overweight or obese people with Celiac Disease who follow a Gluten Free Diet tend to gain weight, possibly related to improving the absorption of nutrients in the body. It is important to mention that the fact that a food is gluten-free does not necessarily mean that it is low in calories, rather, many gluten-free products have more calories than those that do contain gluten. For example, a regular pretzel service provides 108 calories and 1 gram of fat, while a gluten-free service provides 140 calories and 6 grams of fat.

On the other hand, there is research that shows possible benefits of wheat and / or gluten. For example, some studies indicate that starches that exist in wheat can help the healthy composition of the gastrointestinal flora, which can protect the intestine against certain types of cancer, inflammatory conditions, and / or cardiovascular diseases. Also, gluten can be beneficial for people who have altered triglyceride levels in the body. Research has shown that a high intake of gluten (in conjunction with a maintenance diet) can further lower triglycerides in the body compared to dietary fiber.

In conclusion, it is important to recognize that the Gluten Free Diet is recommended only for patients with Celiac Disease and / or gluten sensitivity. For people who do not suffer from these conditions, there is no scientific evidence that the Gluten Free Diet is healthier or helps to lose weight. It is important to clarify that gluten is not harmful to our health if there is no Celiac Disease or gluten sensitivity. It is imperative to orient and educate yourself with trained health professionals to recommend a diet or eating pattern, since any diet can negatively or positively affect our health.

References:

Academy of Nutrition and Dietetics. Gluten. Recuperad en mayo de 2018 de  https://www.eatrightpro.org/news-center/nutrition-trends/weight-management/gluten-free-diet-and-weight-loss

Angadi, S.S., Gaesser, G.A., Gluten-Free Diet: Imprudent Dietary Advice for the General Population? Journal of the Academy of Nutrition and Dietetics. (2012). DOI: 10.1016/j.jand.2012.06.009

Baum, J., Fung, T., Herbold, N., Priven, M., Vieira, E., The Influence of a Factitious Free-From Food Product Label on Consumer Perceptions of Healthfulness. Journal of the Academy of Nutrition and Dietetics. (2015). DOI: 10.1016/j.jand.2015.03.013

Celiac Disease Foundation. (s.f.) Sources of Gluten. Recuperad en mayo de 2018 de  https://celiac.org/live-gluten-free/glutenfreediet/sources-of-gluten/

Celiac Disease Foundation. (s.f.) What is Gluten? Recuperado en mayo de 2018 de  https://celiac.org/live-gluten-free/glutenfreediet/what-is-gluten/

Shahbandeh, M. (noviembre). Gluten-free food market value worldwide. Recureado en mayo de 2018 de https://www.statista.com/statistics/248467/glabal-gluten-free-food-market-size

Saturni, L.; Ferretti, G. y Bacchettu, T. The gluten-Free Diet: Safety and Nutritional Quality. Recuperado en mayo de 2018 de  http://www.mdpi.com/2072-6643/2/1/16/htm

Klemm, S. (mayo, 2018) Celiac Disease: An introduction.  Recuperad en mayo de 2018 de  https://www.eatright.org/health/diseases-and-conditions/celiac-disease/celiac-disease-an-introductio

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