GLUTEN BE GONE

Just a decade ago, the word “gluten” was foreign to many Canadians. Now it’s become nearly as ubiquitous as “low fat” on food labels,and eliminating the substance — a mix of two proteins, gliadin and glutenin, found in wheat, barley and rye — from daily diets is a runaway trend. But is going gluten-free really the healthiest course for everyone?

Before gluten-free diets became the rage, it was mostly people diagnosed with celiac disease, a dietary sensitivity first linked to gluten in the 1950s, who were advised to stay away from wheat. Celiac disease affects only one in every 100 to 200 Canadians and is diagnosed through a combination of a blood test that detects antibodies and an intestinal biopsy that looks for damage to the small intestine.

In the 1980s, doctors began to notice that some of their patients who didn’t meet the criteria for celiac disease nonetheless thrived without wheat.

In 2011, doctors with expertise in celiac disease from seven countries met in Oslo, Norway, to define standards for diagnosing and treating gluten-related disorders, and formalized the term “non-celiac gluten sensitivity.” That same year, a small, randomized study by Monash University in Australia of 34 patients with irritable bowel syndrome (IBS) found those who ate bread that contained gluten were more likely to report digestive pain, bloating, constipation, diarrhea and fatigue. And the trend began to grow.

With so few studies investigating how gluten affects us, we still don’t have enough information to determine whether it’s truly a digestive irritant in people who don’t have celiac disease.

However, last August, the same Monash University researchers published a study in Gastroenterology in which they amended their original methodology and discovered gluten may be the wrong target. In the study, 37 participants with IBS who thought they had a gluten sensitivity thrived on a low-FODMAP diet.

FODMAP stands for “fermentable oligo-, di- and monosaccharides and polyols,” all of which are short-chain sugars that are poorly absorbed by the body, including fructose, lactose, fructans, galactans (found in beans) and polyols (found in artificial sweeteners and pitted fruits). And when the researchers secretly added gluten (but not wheat) to the low-FODMAP diet, participants didn’t have a problem. The study hypothesized that fructan, a short-chain sugar found in wheat, could be the culprit, not gluten. And it’s possible those who do well without wheat might need to eliminate other foods, such as ones that contain polyols, or artificial sweeteners, for example.

Regardless of what science suggests, books like Wheat Belly have captured the public’s imagination and encouraged an overwhelming perception that gluten consumption leads to a slew of health problems. With society’s fascination with food fads, especially quick fixes, the gluten-free industry is booming.

A 2013 report by market research firm Packaged Facts estimates the gluten-free market in Canada exceeds $450 million; and the Gluten-Free Expo, where around 100 vendors hawk their cookies and crackers, will hit five major Canadian cities this year. But there’s a danger to seeing gluten as the culprit for all of one’s health woes. “I think people far too quickly ascribe their medical problems to gluten,” says Dr. Yoni Freedhoff, an obesity expert and medical director of the Bariatric Medical Institute in Ottawa. Symptoms could be related to stress, a problem with the digestive tract like IBS or another food trigger, such as lactose. Before making the switch to a gluten-free life, keep a food diary and record the timing of your symptoms. Then make an appointment with a doctor or nutritionist.

By Wendy Glauser in "Reader's Digest Canada Edition", April, 2004. Adapted and illustrated to be posted by Leopoldo Costa.

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