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Gluten-Free Diet Phenomenon

A recent article in Medscape  discussed the dietary phenomenon  of gluten avoidance.  William Balistrei, MD., professor at Cincinnati Children’s Hospital Medical Center and author of the article stated that  eating gluten-free has become the “most popular dietary trend in the United States, with approximately 100 million Americans consuming gluten-free products last year.”  This also translates into an estimated $4 billion in retail sales in 2015.

He postulates that this phenomenon has been encouraged by the testimony of both celebrities and athletes who claim eating a  GF diet has been beneficial for their well-being and athletic successes.  Out of 910 world-class athletes and Olympic medalists, a survey found that 41%  followed a gluten-free diet, the majority did so based on perceived ergonomic or health benefits.  A study by Lis and Stellingwerff  looked at 13 competitive cyclists and reported that there was no overall benefit on performance, GI symptoms, well-being or inflammatory markers in nonceliac endurance athletes  eating a short-term (7 days) GF diet.  What about after eating GF long-term or a larger subject pool?

The downside of going GF includes the high cost of purchasing these foods, long-term safety of eating primarily pre packaged GF foods, the challenge of social restrictions when eating out or going to parties that may not offer GF options or potentially cross-contamination of GF options.

Many people have chosen to go GF  who have not been diagnosed with either celiac disease nor with a wheat allergy because they find that  when they avoid gluten there is a noticeable decrease in gastrointestinal symptoms such as abdominal pain, GI reflux, gas/bloating/ nausea, etc.  As well as, non-gastrointestinal such as headache, fatigue, anxiety, depression, muscle aches, “foggy brain”, and skin rashes.     

This has been termed Nonceliac Gluten Sensitivity (NCGS).  Dr Fasano and his colleagues have proposed a working definition for this disorder as:  “a clinical entity induced by ingestion of gluten leading to intestinal and/or extraintestinal symptoms that resolve once gluten is eliminated.”

Although Fasano said that there is a “fad component” to NCGS, there is increasing evidence for its existence as a true clinical entity.  So, should everyone go GF?  Probably not, but a raised awareness and self-advocacy of personal health is  important for maintaining or improving personal wellness.   Debate is healthy and further medical research is definitely welcome.  Until then, keep advocating for your health.  What we do know is that there is no “one diet fits all”, keep experiementing and find out what foods help you to obtain optimal health and well-being !

What’s your opinion?