THE DETAILS: Celiac disease is a digestive disorder that causes affected individuals to have an immune-system reaction to the protein gluten, which is found in wheat (all types, including semolina, durum, spelt, kamut, and faro), rye, and barley. The reaction triggered by the gluten damages the small intestine and prevents it from absorbing nutrients, which can lead to vitamin deficiencies that harm the brain, nervous system, bones, liver, and other organs, as well as stunt the growth of children with the disorder. Symptoms of celiac disease make it difficult to diagnose, as they can be vague and hard to pinpoint, for instance, diarrhea, bloating, abdominal pain, fatigue, unexplained weight loss or gain, and unexplained anemia.
According to the Celiac Disease Foundation, one in 133 people are afflicted with the disorder, but nearly 97 percent of them go undiagnosed. And that can actually shorten people’s life spans, based on the results of the study published in Gastroenterology. The authors followed 9,133 Air Force personnel for 45 years and found that members with undiagnosed celiac were four times more likely to die within those 45 years than people who’d been diagnosed with the disease.
WHAT IT MEANS: Thanks to improved testing, the disease is getting easier to diagnose, says Dee Sandquist, MS, RD, spokesperson for the American Dietetic Association, and as a result, the number of people with positive diagnoses has gone up. Whether the rise in diagnoses is due to better testing or to a greater incidence of the disease is difficult to tell, says Sandquist. If incidence is on the rise, it could be because that our food system is exposing more people to gluten than in the past. “Wheat is used in a lot of products in which it doesn’t occur naturally,” she says, such as soy sauce. “Wheat is in so many things. Our bodies could just be getting overwhelmed by it.”
Whatever the cause, all these new seekers of gluten-free foods have driven the gluten-free food category to grow by 28 percent from 2004 to 2008, according to the market research group Packaged Facts. And at least some of that market is people buying those foods not because they’re afflicted with celiac disease, but because they believe those foods are healthier for them. “Definitely in some circles, it’s a trendy diet,” says Sandquist. However, she notes, there isn’t any evidence that people who aren’t celiac sufferers benefit from eating gluten-free food. “There’s no research to support that it’s healthier,” she says. In fact, going completely gluten-free if it’s not medically necessary and could deprive you of nutrients like vitamin B and iron, which are often added to fortified wheat gluten.
If you’re considering going without gluten, here are a few things to keep in mind:
• Don’t do it blindly. Sandquist recommends getting a blood test rather than jumping headfirst into a gluten-free diet simply because you think you have a gluten problem.
• Don’t assume it’s healthier. If you’re shelling out extra dough to get gluten-free processed foods without a diagnosis of celiac disease, you might be wasting your money. They are more expensive than standard foods, and as Sandquist says, there isn’t any scientific proof that they’re healthier for the general population. Gluten-free diets tend to contain more fruits and vegetables than the average American diet does, says Sandquist, so that may be why some people report feeling better after cutting back on gluten-containing foods.
• “Gluten-free” is still pretty vague. The Food and Drug Administration is currently proposing guidelines for “gluten-free” labeling, but currently the agency hasn’t set any standards on the use of the term. The fact that it’s unregulated means that unscrupulous marketers can use it to sell products that could contain small amounts of gluten. Stick to reading labels and avoiding wheat, rye, or barley, or products made in plants that produce those ingredients.
• Know where to eat out. The nonprofit Gluten Intolerance Group of North America has compiled a list of restaurants that serve gluten-free foods at a partner website, www.glutenfreerestaurants.org.