Gwyneth Paltrow wrote an amazing gluten free cookbook, so you know that gluten free dieting is the real deal.
I mean if a Hollywood celebrity is cashing in on a diet trend to make a cool million by slapping her face on a cookbook written by someone else that screams “scientifically legit”, right?
Miley Cyrus also at one point declared herself gluten free and that it was responsible for her “weight loss”.
Let’s be real, if you aren’t modeling your diet based on someone who had a conscious separation or someone who literally rode a wrecking ball you are clearly doing your diet wrong.
Does that set the stage for you? Celebrities are often responsible for meteoric rises in dieting popularity and often make a pretty penny of selling ideas that are not well founded.
The gluten free diet was another one of those diets; there is an enormous amount of misunderstanding behind the gluten free diet so let’s set the record straight.
What the heck is gluten?
A ton of people have zero idea what gluten is, even people who follow a gluten free diet. Many people think gluten is a grain, but it is actually a mixture of proteins that is often found in wheat and other related grains like millet.
Speaking in nerd tongue, it is made up of several prolamins like giadin, glutenin, hordeins, secalins, and avenins.
The gluten we all are familiar with is a gliadin and glutenin based protein.
What is celiac disease?
Celiac disease is a medically diagnosable condition in which people have a very specific autoimmune response to consuming foods that contain gluten. This condition is often diagnosed based on a genetic marker and an antibody test (similar to most other autoimmune conditions like rheumatoid arthritis or systemic lupus erythematosus).
In the scope of “diseases”, celiac disease is actually quite common as it affects between 0.5% and 1.0% of the entire human population. In the United States, about 1 in 133 people suffer from overt celiac disease, similar to rates of rheumatoid arthritis.
While this is a fairly substantial number, this means that only about 2.4 million out of 318 million Americans may suffer from celiac disease. Additionally, the rate of celiac disease has not substantially increased over the last decade or so and both incidence and prevalence rates do not map onto the large amounts of people who have adopted a gluten free diet over the last decade.
What is non-celiac gluten sensitivity?
There have been large numbers of reports of people who report symptoms such as GI distress, mental fog, and joint aches and pains from consuming gluten but who do not test positive for celiac disease.
This is called, non-celiac gluten sensitivity.
In most research, the prevalence of people who report this phenomena of non-celiac gluten sensitivity falls between 5-8%, which if we fall around 8% or so means, roughly 24 million Americans may suffer from non-celiac gluten sensitivity.
What does the science say about gluten free diets?
Here is what we can be 100% certain of: If you have diagnosed celiac, stay away from gluten like it is the devil. This is not hyperbole. People with celiac disease have severe reactions to gluten that can leave them hospitalized and great care must be taken.
If you do not have celiac disease the story is much, much, much more complicated and research is a bit all over the map on this. One study took people with non-celiac gluten sensitivity and gave them straight gluten protein or placebo and showed that both placebo and gluten protein elicited the same effects, suggesting that gluten itself was not the issue1.
The compelling hypothesis here is that these “gluten related symptoms” were actually due to FODMAPS2 in their diet. So it appears that it may be gluten, or it may just be these silly FODMAPS.
On the flip side, other studies have shown that if you take a biopsy of human intestines and then expose it to gluten, gluten increases intestinal permeability in people without celiac disease, suggesting that gluten does directly impact your gut even if you are a normal person3.
However, this was not done in actual people and the findings haven’t been replicated so we can’t say this is a real phenomenon in normal people.
It turns out that a big piece to this story is probably your microbiome. Your gut bacteria can digest gluten and prevent it from being harmful4,5, suggesting that people with bacteria that break down gluten may be fine eating gluten while people who lack that may have issues. I wish it were that simple....
There is also evidence to suggest that people with celiac disease actually have higher amounts of bacteria that “feed on gluten” and that when they consume gluten these bacteria then interact with the stomach to cause the wide range of symptoms6.
Like I mentioned earlier, the story is just complicated and we don’t really know the full story about gluten in people without celiac disease.
What we can tell you about gluten free diets
That last section was kind of heavy and, to be honest, not super useful. It basically said, we don’t really know a lot about how exactly gluten causes or does not actually cause weird symptoms in a small subset of the population. That being said, there is a lot of things we do know about gluten-free diets.
- There is zero evidence that the gluten free aspect of gluten free diets is responsible for weight loss7. Gluten free diets are typically highly restrictive and people do not replace their gluten containing calories with other food sources equal in calories.
- There is ZERO evidence that gluten is responsible for neurodegenerative diseases like Alzheimer’s in people without celiac disease.
- There is no negative side effects from going gluten free. If you replace gluten containing foods with other nutrient and fiber dense foods you can have a very high quality gluten free diet.
The Wrap Up
Because a celebrity endorses or praises a diet does not make it a good diet to follow, but it also does not make it a bad diet to follow. On principle, just ignore any celebrity’s diet advice, except this tweet from Ryan Reynolds.
People in LA are deathly afraid of gluten. I swear to god, you could rob a liquor store in this city with a bagel.
— Ryan Reynolds (@VancityReynolds) January 7, 2017
People with diagnosed celiac disease should consume a gluten free diet and can manage their disease quite well on one. People without celiac disease but experience gluten sensitivity may have some benefit from avoiding gluten or FODMAPS in general as we aren’t 100% sure what underlies these symptoms in non-celiac gluten sensitivity.
For the rest of us who have no adverse response to gluten, there is no apparent benefit from going gluten free, but there also isn’t apparent harm.
It really just comes down to a lifestyle choice, just don’t be a crazy lunatic about it and tell everyone how cool you are because you went gluten free.
- No Effects of Gluten in Patients With Self-Reported Non-Celiac Gluten Sensitivity After Dietary Reduction of Fermentable, Poorly Absorbed, Short-Chain Carbohydrates.
- Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach.
- Effect of gliadin on permeability of intestinal biopsy explants from celiac disease patients and patients with non-celiac gluten sensitivity.
- Diversity of the cultivable human gut microbiome involved in gluten metabolism: isolation of microorganisms with potential interest for coeliac disease.
- Identification of Rothia bacteria as gluten-degrading natural colonizers of the upper gastro-intestinal tract.
- Is it true that coeliacs do not digest gliadin? Degradation pattern of gliadin in coeliac disease small intestinal mucosa.
- Is There Evidence to Support the Claim that a Gluten-Free Diet Should Be Used for Weight Loss?