Gluten-free – good, bad or indifferent?

Gluten-free eating has become somewhat of a parody; comedians using it as an opportunity to joke about the middle classes and their tendency to opt for restrictive diets considered by some to be unnecessary. So is gluten bad or not? 

You cannot help but notice the vast array of gluten-free products now available in the supermarkets.

We’re also told to eat clean, which apparently means to avoid processed and refined foods, which includes many foods containing wheat, such as bread and pasta (1).

What is gluten?

Gluten is a protein found naturally in 3 grains: rye, wheat and barley. However, other grains may also be contaminated with gluten, depending on farming practices – this most notably affects oats (2).

Buying oat-based products would therefore have to have a guarantee that they’re gluten-free.

Gluten derives from the Latin word for glue. It’s a protein that gives bread dough its elasticity, helping it to rise and giving it its distinctive texture.

In Asian culture, gluten is often extracted to make fake meat known as seitan, and is frequently the dominant ingredient in fake duck, chicken and beef.

They don’t do this because of any welfare toward animal concerns, but because seitan is cheap and meat is not. And it’s a source of protein they might not otherwise get.

Who should not eat gluten?

The current medical literature suggests that only coeliac disease is gluten-sensitive (3), although there are other grain-based allergies not specific to gluten.

It is potentially dangerous for people with coeliac disease to eat foods with gluten, although it is recognised that this disease is highly under-diagnosed, and so many people won’t even know they have the disease (3).

Coeliac disease is a condition that causes the small intestine to become damaged by the gluten in our foods, and can cause serious consequences for the sufferer including malnutrition.

A relatively new condition has come to light known as non-coeliac gluten sensitivity (NCGS), where patients who test negative to coeliac disease respond to a gluten-free diet.

However, it is still to be recognised by the British Society of Gastroenterology as a disease state (4).

Patients with NCGS complain of bloating, stomach cramps, diarrhoea, constipation and other symptoms typically associated with irritable bowel syndrome (IBS) – yet these symptoms disappear when they stop eating gluten.

Coeliac UK suggest that it is possible that it isn’t gluten that’s at fault, but the carbohydrates found in grains known as FODMAPs – but research into this area is by no means extensive and so very little is known about this condition.

So what is the deal with gluten and should we avoid it?

Gluten-free diets are favourites among many celebrities such as Miley Cyrus, Gwyneth Paltrow and Novak Djokovic (5), and is a key component in the Wheat Belly diet derived by cardiologist, Dr William Davis and the Paleo diet designed by Dr Loren Cordain.

A recent story in the Daily Mail suggested that a prominent gastroenterologist feels that there is some weight behind following a gluten-free diet, because it might be an early form of coeliac disease – or, at least, a disease caused by an immune response similar to the way coeliac occurs.

One of the forefront speakers on gluten avoidance is Dr Alessio Fasano who found a connection between gluten consumption and a condition known as leaky gut syndrome.

He believes that a component of gluten, called gliadin, releases a protein called zonulin, that damages the lining of the gut allowing particles (including bacteria) to pass through the gut wall (6).

However, Dr Fasano does not advocate a gluten-free diet in healthy people.

Arsenic exposure

Recent evidence shows that people who follow a gluten-free diet are consuming more products that are marketed as gluten-free, yet these often substitute wheat flour with rice flour (7) .

Rice naturally contains more inorganic arsenic than other grains (8, 9, 10), which is a strong cancer-causing metalloid (11).

Maria Argos, a professor of epidemiology in the UIC School of Public Health, USA, looked at data from the National Health and Nutrition Examination Survey and found that those who were following a gluten-free diet had higher concentrations of arsenic in their urine (12).

She continues that this could be more of an issue for the US population, because Europe has strict guidelines on arsenic levels in food, whereas the US do not.

However, these guidelines cannot guarantee that the consumer is not exposed to toxic levels of arsenic due to higher than average consumption, particularly in children (13).

Gluten-free products

Gluten-free products may look like a good healthy alternative, and they certainly appear to be marketed that way.

There is no doubt that gluten-free has grown hugely in popularity; the UK market alone has grown 19% in just one year, with 27% of Brits regularly shopping in the free-from aisle (14). This is also expected to grow by around 6% between 2015 and 2019 (15).

Gluten is sometimes seen as a toxin, and this is certainly the case for coeliac sufferers. But for the rest of the population, there is no evidence that gluten causes reported symptoms.

But are gluten-free products healthier than regular products?

Not so according to the Consumer Reports November 2014 edition. They cite the following less healthy factors associated with gluten-free products:

• Wheat flours are often fortified with vitamins and minerals where gluten-free are not.
• Gluten-free products are often higher in fat and sugar to compensate for the flavour loss.
• Gluten products may contain more dietary fibre, which is actually better for the gut.
• If gluten-free products use more rice flour, there is the potential for more toxin exposure such as mercury and arsenic.
• Gluten-free products appear to be higher in calories, and therefore you are more likely to gain weight.
• Gluten-free products are significantly more expensive, so for the extra fat, sugars, salt, calories, possible toxins, less nutrients – you’ll be paying more.

My opinion

Following a gluten-free diet can be fairly restrictive and often involves removing a whole food group (grains) from your diet. Whole wheat, oats and bran can form part of a healthy diet – providing dietary fibre, B vitamins and minerals.

Moreover, grains are fairly traditional part of a typical British breakfast whether you eat toast in the morning or a bowl of cereal.

Removing grains often means finding substitutes, and substitutes (such as gluten-free products) may seem more appealing as a healthy alternative, but very often they are not.

Like all things in life, don’t exclude anything from you diet unless there’s a really good reason to do so.

If you do have IBS-like symptoms and test negative for coeliac disease, then trying a gluten-free diet to see if the symptoms disappear might be a good idea.

But give it some time and try and re-introduce them back into your diet slowly – preferably under the guidance of a nutritionist.

Never reintroduce gluten products if you have coeliac disease.

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