By Dr Adam Simon

Gluten-free diets: Why ditching the grain could be a pain

Going gluten-free is all the rage, but is this dietary trend a dead-end for those who don't suffer from reasonably rare medical conditions?

Going gluten-free is all the rage, but is this dietary trend a dead-end for those who don't suffer from reasonably rare medical conditions?

In this guide, we'll trawl through the science so you don't have to and get to the bottom of this controversial issue.

What is Gluten?

Gluten is a type of protein found in cereal grains like wheat, barley and rye and used in many processed foods.

Diets that promote going gluten-free have seen a meteoric rise in recent years, spurred on by celebrity endorsements from the likes of Gwyneth Paltrow and Novak Djokovic. And in the UK, sales of gluten-free products have boomed to £184 million up 15 per cent from 2013.

But what's prompted this surge in popularity? Let's look at the background.

Gluten Sensitivity and Coeliac Disease

It's long been known that sufferers of coeliac disease, a rare autoimmune disorder, or wheat allergies, can encounter a range of problems when it comes to gluten. These include unpleasant symptoms like diarrhoea and bloating, as well as a wide range of non-digestive issues that can vary wildly from case to case.

However, it's only fairly recently that investigations into gluten (and wheat) sensitivity for those who don't suffer from coeliac disease have made any headway and the results can be somewhat confusing.

For a long time, it was thought that gluten could only cause negative effects in people with these types of conditions. But research to the contrary gradually built up and in 2012, a thorough analysis by experts concluded that reactions to gluten were not limited those with allergies or coeliac disease.

Non-coeliac Gluten Sensitivity

The study's authors conceded that non-coeliac gluten sensitivity (NCGS) could exist and suggested that the rise in the number of conditions that caused negative reactions to the protein could be due to genetic modification in wheat crops and a lack of adaptation in humans.

One possible explanation is that the selection of wheat varieties with higher gluten content has been a continuous process during the last 10,000 years, with changes dictated more by technological rather than nutritional reasons, they said.

It's still fairly rare to suffer from any condition that affects your reaction to gluten, however. Coeliac disease affects around one in 100 people in the UK, wheat allergy affects less than one per cent of the entire population and it's not known how common NGCS is, since there's no tests to identify it.

In the opinion of many gastroenterologists, however, the number of sufferers is negligible. Indeed, in the view of Dr Stefano Guandalini, founder and medical director of the University of Chicago's Celiac Disease Centre, this is a small, tiny, tiny, tiny number.

And the existence of NGCS was thrown into fresh doubt last year. An intense study took 37 self-reported gluten sensitive patients and quarantined them, providing them with every meal for the duration and cycling them through high-gluten, low-gluten and a placebo diet containing no gluten, without them being aware of which they were on.

Researchers discovered absolutely no specific response to gluten and a further study, published a few months later backed up these findings. However, it's worth noting that symptoms did seem to improve when participants went on low-FODMAP diets, which could indicate a more conventional gastrointestinal disorder like IBS may be responsible.

To summarise, if NGCS does exist, which is still far from certain, it's exceptionally rare to have it.

Is Going Gluten-free Bad For You?

Even if you don't suffer from one of these rare conditions, going gluten-free can't do any harm, right? Wrong. All available evidence suggests that you should think twice before ditching gluten, since the whole grains that contain it can do wonders in terms of promoting good health.

indicates that gluten protein can boost the performance of your body's natural killer cells, which are responsible for fighting off viral infections and even cancer.

Similarly, whole grains have been found to have a protective effect against the likes of obesity, diabetes, cancer and heart issues.

Another study found that gluten could help protect from cardiovascular disease and further research discovered that going gluten-free could have a detrimental effect on the bacteria that live in your gut, which can have a knock-on impact on not only digestive issues, but also the strength of your immune system.

Going gluten-free without a diagnosis of coeliac disease or wheat allergy can also increase the chances of these issues going undiagnosed, since doctors will look for the tell-tale inflammation response to gluten when testing for these conditions.

Choosing a gluten-free diet of your own accord can further frustrate the chances of a successful diagnosis in cases of coeliac disease, since the food you eat may not be as free from gluten as you think. One US study that looked at 100 people with coeliac disease discovered that 45 per cent weren't adhering to a strict gluten free diet, with 24 found to be inadvertently ingesting gluten.

Gut Feeling

In summary, if you suspect you might have a condition like coeliac disease or a wheat allergy the best step is to get the tests that can confirm or rule out these disorders.

Deciding to go gluten-free to try and combat digestive issues, or even just because it's in vogue, could have serious consequences for your long-term health.

And You?

If you've had any experiences with going gluten-free that you'd like to share, or have any questions to ask be sure to leave us a comment below or get in touch via Facebook or Twitter.