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Gluten

Gluten?


by Joel Fuhrman, MD

Should everyone be concerned about consuming gluten?  Gluten-free, like fat-free and low-carb, is a dietary fad that claims to promote weight loss and enhance health. But are there real health benefits to going gluten-free?

What is Gluten?

Gluten is a generic name for the primary protein found in wheat and grains related to wheat. It comprises about 70 percent of the total protein content in wheat. Gluten is an important component in grains ground into flour and used for baking, because it provides elasticity and chewiness in breads and helps dough to rise by trapping the carbon dioxide that is produced by yeast.

Gluten is found in many grains like farro, freekah, bulgur, spelt, kamut, barley, rye, and triticale. Since processed foods like pasta, breads, baked goods and meat substitutes are typically made with wheat, gluten is ubiquitous in the American diet. According to the USDA, about 17 percent of calories in the American diet come from wheat flour -- a large proportion of the diet from a single food.1

When is it Necessary to Go Gluten-Free?

For years, wheat has been blamed in diet books as a cause of obesity, dementia, and poor health. But there are only three health conditions that are gluten-related: wheat allergy, the autoimmune condition known as Celiac disease, and non-Celiac gluten sensitivity.

In Celiac disease, eating gluten provokes the body to launch an autoimmune attack on the small intestine.  This can lead to chronic inflammation and serious health problems throughout the body, not just in the digestive tract. Estimates are that about 1 percent of the population has Celiac disease .2 Another 1 percent of the population has a wheat allergy.

People with non-Celiac gluten sensitivity do not have the intestinal damage related to Celiac disease and they do not have an allergy to wheat or gluten. A diagnosis of gluten sensitivity is usually made after Celiac disease is ruled out and removing gluten from the diet removes the symptoms. Individuals with gluten sensitivity can have joint pain, muscle aches and fatigue in addition to digestive symptoms. The disease is not well understood and the symptoms are not clearly defined.

Overall, it is estimated that three to six percent of the population are sensitive to gluten.  This includes  irritable bowel syndrome and some autoimmune diseases that are sometimes  aggravated by gluten consumption.

Does Gluten have negative effects on our health?

Wheat has been called the main cause of the nation’s obesity epidemic in diet books, and losing weight seems to be a motivator in the trend of those seeking a gluten-free diet. Yet, there have been no studies published that show removing gluten from the diet results in weight loss; furthermore, there is also no evidence that intact wheat berries (unground wheat kernels)  which contain gluten, yet are a whole unprocessed food has any negative effect on health in people who do not have a medical need to avoid gluten .3 What often happens in books and online is that the negatives of high-glycemic refined carbohydrates (like white flour products and very finely ground whole wheat flour) are attributed to gluten or wheat. It is the refining process and the increased glycemic effect upon eating refined flour products that is unhealthful and not the type of grain or even gluten in particular that contributes to the promotion of chronic disease.  What usually then happens is other refined carbohydrates without the gluten, such as white rice flour is used instead, which isn’t an improvement.

A gluten-free diet can be just as high in calories and low in nutritional value as the Standard American Diet. Refined white flour, in the form of gluten-free pasta, cookies and bread will not help you lose weight. These products  are just as harmful as refined wheat flour.

However, if you replace gluten-containing pastas and baked goods in your diet with vegetables, beans, fruit, nuts and seeds, which happen to be gluten-free, you would most likely lose weight, (and be healthier) because these foods are naturally low glycemic and high in fiber and nutrients.

What Role Should Grains Have In Our Diet?

It is clear that not everyone needs a gluten-free diet, unless there is some medical need to restrict or avoid gluten.

Of course, eating an abundance of refined flour products does promote weight gain and poor health, regardless of whether they are made with wheat or other grains. Beans and other legumes are the healthiest carbohydrate-rich foods, however intact whole grains can be a healthful part of a health-supporting diet too. . Although there is no scientific evidence that people without gluten sensitivity or Celiac disease would be harmed by gluten, there is also no nutritional requirement for grains, either.

If you have a medical need to avoid gluten in your diet  and you do want to include grains, there are plenty of  gluten-free options like , wild rice, quinoa,  buckwheat, millet, amaranth and teff. Oats are often cross-contaminated with gluten-containing grains during processing, so choose the ones  labeled gluten-free.

The Bottom Line on Gluten

The bottom line: for most people, gluten is not a problem. Eating healthful gluten-containing foods such as wheat berries cooked in water or some coarsely ground (or sprouted) whole wheat bread will not negatively affect your health.  Many advocates of gluten-free eating programs have supplied scientific references showing the link between wheat and disease, by using studies on white flour products, incorrectly blaming the health problems resulting from white flour products on the gluten they contain, and that was not scientifically accurate. 

A diet should relies heavily on beans as a starch source, and includes a variety of starchy vegetables like peas, root vegetables and squash.  When grains are used, they are best intact whole grains cooked in water. Water-cooked whole grains are healthier than whole wheat breads or other flour products, because more nutrient are retained, the glycemic load is favorable and water cooking does not form toxic compounds that are generated when food is browned.  And of course, always remember the foods  I want you to eat regularly for optimal health and longevity are G-BOMBS: Greens, Beans, Onions, Mushrooms, Berries and Seeds.

References

1.              United States Department of Agriculture Economic Research Service. Food Availability (Per Capita) Data System. [http://www.ers.usda.gov/data-products/food-availability-(per-capita)-data-system.aspx]

2.              Fasano A, Berti I, Gerarduzzi T, et al. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med 2003, 163:286-292.

3.              Brouns F, Van Buul VJ, Shewry PR. Does wheat make us fat and sick? . J Cereal Sci 2013, 58:209-215.

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