Healthy Eating

Gluten-Free Zone

Is the diet du jour good health or great hype?

Gluten-Free Zone
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A decade ago, none of us had even heard the word “gluten.” Yet, here we are— countless cookbooks, celebrity testimonials and $2.6 billion in gluten-free sales later— wondering whether we, too, should eliminate gluten from our diets. Why is a protein found in wheat, rye and barley suddenly our sworn dietary enemy? Before jumping on the glutenfree bandwagon, here’s what you should know.

Gluten 101
Let’s start with the basics. Gluten is the protein component in wheat, rye, barley, spelt and triticale responsible for giving dough elasticity (think chewy bagels). You’re probably already aware that most breads, pastas, pizza, crackers, cereals, cookies, cakes and baked snacks contain gluten. But you may be surprised to learn that gluten is also used as a thickening agent in soups, candy, processed meats and seafood, marinades, gravies, soy sauce, tea, herbal supplements, medicines and even Communion wafers! Though food scientists aren’t altogether certain why, gluten can trigger a negative physical response in many people. The most extreme example is celiac disease, an autoimmune disorder that affects 3 million Americans. When someone with celiac eats even the tiniest bit of gluten, the immune system attacks the small intestine and prevents absorption of vital nutrients, which can lead to life-threatening malnutrition. A less serious reaction is gluten sensitivity (also called gluten intolerance), whose symptoms vary in each person but can include diarrhea, constipation, gas, bloating, vomiting, nausea, skin irritation, fatigue, muscle cramps, fog brain and depression.

Gluten’s rise to fame
One reason you’re hearing so much about gluten nowadays is that the rates of both celiac disease and gluten intolerance are steadily escalating. A recent study in Gastroenterology determined that celiac disease incidence has increased fourfold in the last 50 years. What’s more, 18 million Americans are now estimated to be gluten sensitive. There are a number of possible reasons for the rampant rise—one being increased exposure. “We used to only be exposed to gluten through wheat products,” says Eric Esrailian, M.D., M.P.H., vice chief of the division of digestive diseases and assistant clinical professor of medicine at the David Geffen School of Medicine at University of California, Los Angeles. “But now gluten is in so many different types of foods, it’s not surprising that more people are intolerant.” Digesting gluten may also be an ability we haven’t quite developed. In terms of evolution, gluten is a relatively new dietary staple. Before the advent of agriculture about 10,000 years ago, our ancestors ate fruits, nuts, herbs, tubers and, when the hunt was productive, meat. “Humans lack the enzymes to break down gluten completely,” says Robin Foroutan, M.S., R.D., H.H.C., communications chairwoman for Dietitians in Integrative and Functional Medicine (a specialty group of the Academy of Nutrition and Dietetics in Chicago). Yes, there were also grains in the diet, but not like those of today. “This is not the bread we ate in biblical times,” says Scot Lewey, D.O., an integrative gastroenterologist and spokesman for the American College of Gastroenterology in Colorado Springs, Colo. “Grain strains today have been biologically engineered to have a much higher gluten content.” Why? The additional gluten helps ward off insects (producing higher crop yields) and creates breads and cakes with more spring.