Flavour of the Week

Gluten-Free for Me?


Gluten-free has been all the rage lately (well, at least one of the recent fads) but is it really a healthier choice than a diet containing gluten? Obviously if you have Celiac disease flavour-of-the-week-logo3the answer is yes, but what about for the rest of us? I often hear people claim that a food is healthy solely because it does not contain gluten. The food in question maybe healthy but it may not.

Gluten free does not automatically mean the food is low in sugar, salt, fat, calories, and is rich in fibre, minerals, and vitamins. Here we expose the possible less-than-healthy consequences of going gluten-free to help you decide if this is the diet for you.First off, absolutely, there are a people who should not consume gluten-containing products for health reasons; this debate is not for them, they have no choice! BUT the prevalence of gluten allergy and intolerance cannot possibly explain the booming sales of gluten-free products.

Approximately 35,000 people in Canada have been diagnosed with Celiac Disease and an additional 300,000 are thought to remain undiagnosed (1). Conversely, the Canadian Celiac Association estimates that 1 in 133 people are “affected” by the disease; however, admit that they do not have the actual statistics and this is an estimate. For a laugh and a rather facetious take on the issue, you can check out Brian Donovan’s rantings on Thought Catalog:

5 Signs Your Gluten Allergy is Fake – Are you really allergic to gluten or are you just doing it to seem cool? Here’s how you know, from a genuine Celiac sufferer……

For the rest of us… are there actual health-related reasons to opt for gluten-free? Maclean’s magazine recently published an article about the concerns with the popularity of the gluten-free diet. You can check out the full article on-line, but here are a few of the highlights. We encourage you to consider the following before sending wheat by the wayside…

1. Gluten-Free Grab ($ money $).
The gluten-free market generated $90 million dollars in Canada and is continuing the grow at a predicted 10% per year. In the U.S., gluten-free is worth an astounding $4.2 billion (1). Not only are the number of gluten-free products increasing, but you pay a high premium for a gluten-free product. Turns out gluten-free products are on average 242% more expensive than the equivalent gluten-containing version, and up to 455% more expensive in some cases.

Furthermore, of the 56 products compared, none of the gluten-free versions were less expensive than the “regular” product (2). Another study reported that not only are gluten-free products more expensive, but also offer limited choices with only 41% of regular products being available in gluten-free form (3); although this is changing rapidly, thanks to consumer demand!

2. Incorrect Self-Diagnosis.
The catch with Celiac Disease is that symptomatically it it displays as generalized “gut problems”, which could be a variety of different diseases. In order, to actually diagnose Celiac Disease you need to undergo the gold standard diagnostic test of intestinal biopsy AND be consuming gluten-containing products regularly for at least a couple of months. With the mainstream villainizing of gluten, many people simply cut it out of their diet pre-diagnosis and then receive a falsely negative diagnosis for Celiac Disease.

There are also those who cite “non-Celiac Disease gluten intolerance” or “gluten sensitivity”; however, although this may be the case, the existence of such a disorder is still controversial with little scientific evidence (4,5). What is our biggest concern with self-diagnosis? It is an increasingly popular scapegoat, but if you falsely blame gluten for gut issues you might miss the *actual* culprit and the appropriate treatment.

3. A Worsening of Eating Habits.
Following a gluten-free diet is often assumed to mean preparing more meals at home, eliminating processed foods, and eating more vegetables and fruits. If this is the case, we would all likely benefit from gluten-free! Unfortunately, this is a misconception and medical professionals often report a worsening of diets and weight gain when people switch to gluten-free. The tendency is to rely on processed gluten-free foods and these are often low in vitamins, minerals and particularly fibre.

A common switch in gluten-free products is rice and tapioca flour to replace whole grains; but these GF flours are high on the glycemic index and relatively weak nutritionally (1). Case in point, check out the nutritional labels for Italpasta Gluten Free Pasta vs. their Whole Wheat Pasta. Can you guess which is the gluten-free option?

NI_IP_GlutenFreePastaNFT

NI_MisuraWholeWheatPastaNFT


Even when portion size is standardized, the whole wheat option (pictured right) provides seven times the fibre of the GF pasta (pictured left), not to mention nearly four times more protein (and more minerals too).

People often think that they are following a gluten-free diet by omitting pasta and bread, but the reality is that gluten is in so many more products than most of us realize…

No Baloney’s advice? Unless you put a lot of time and effort into gluten-free diets, there’s a good chance they mean higher cost, less variety, and lower nutritional quality. We say keep the gluten if you can! Otherwise tread carefully by reading labels and avoiding heavily processed gluten-free products as much as possible. Don’t allow the gluten-free “health halo” to mask the sugar, calories, sodium, and low fibre content of foods!

References:

  1. Gullie C. (2013) The dangers of going gluten-free. Maclean’s. September 10, 2013 retrieved September 30th from http://www2.macleans.ca/2013/09/10/gone-gluten-free/
  2. Stevens L & Rashid M. (2008) Gluten-free and regular foods: a cost comparison. Can J Deit Pract Res; 69(3):147-50.
  3. Singh J & Whelan K. (2011) Limited availability and higher cost of gluten-free foods. J Hum Nutr Diet; 24(5):479-86.
  4. Cadenhead K & Sweeny M (2013) Gluten elimination diets: Facts for patients on this food fad. BCMJ; 55(3):161.
  5. Hammond J (2013) Re: Gluten elimination diets. BCMJ 55(6):271-272.
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7 thoughts on “Gluten-Free for Me?

  1. As I’ve learned on my own journey, it may not be gluten as such that’s the problem for so many people, but rather, FODMAPs (http://www.todaysdietitian.com/newarchives/072710p30.shtml, http://www.todaysdietitian.com/newarchives/030612p36.shtml), the different types of sugars in the foods we eat. As soon as you cut out bread and other wheat products from your diet, you’ve removed one FODMAP (fructan) along with the gluten, so you can’t really tell which one is causing you problems, though odds are, it’s the fructan. I’ve been hemming and hawing over whether I have a sensitivity to gluten, but as you’ve noted, there really isn’t a whole lot known about “gluten sensitivity”, or if it even really exists (which accounts for the fuzziness of information on this subject!). Unfortunately, there are many people who have bought into a gluten-free diet as a healthier way of eating without really understanding what such a way of eating entails. Those who must be on a gluten-free diet because of celiac disease know only too well the challenge of eating healthy. It can be done, but it takes a lot of work and creative meal preparation.

    • Hi Gail,

      Thanks for the comment! It’s interesting you mention FODMAPs. A group that I belong to in Calgary presented on the evidence for FODMAP restriction in IBS and have a forthcoming letter to the editor. Some clinical observations and interesting preliminary research data, but just that – preliminary. Despite some very strong opinions out there in the ether, there are still only a handful of studies looking at the FODMAP-restricted diet and GI symptoms.

      Wheat is not the only source of fructans, and it has a relatively low concentration compared to some veggies. If you can tolerate artichokes, onions and garlic, it’s definitely not fructans. I always like to point out that fructo-oligosaccharides (short-chain fructans) have been shown in several studies to be beneficial for people with IBS and resulted in improved symptoms, not worsening. As with any GI issues, an individualized approach is key. Some people may experience bloating and gas with FOS, but may not need to restrict every FODMAP. The FODMAP-restricted diet is EXTREMELY restrictive – cutting out gluten is a piece of cake compared to limiting fermentable carbohydrates! Takes a lot of patience to sometimes narrow down what could be the culprit.

      • The gastro doc who suggested I try the FODMAP diet did point out that anyone would have to be crazy to eliminate all FODMAPs; he, too, said that a gluten-free diet compared to a FODMAP-restricted diet was easy! I’ve never tried artichokes (but they do look oh, so pretty in still-life pictures!); onions and garlic form a big part of my cooking and don’t seem to be obviously problematic. White flour seems to be a problem, but not a mixture of white and whole wheat! At least now that I am aware of the whole FODMAP issue, I understand why certain foods (and it’s just very few) cause me some discomfort, which becomes apparent fairly soon after they are consumed.

        I, too, do wonder about the gluten-free craze. There are certainly many foods that don’t contain gluten and that can form a healthy diet so it’s not especially necessary to always purchase gluten-free products, but we’re all so used to eating bread and other wheat-based foods that it takes some major rethinking of how and what we eat to try to work around gluten. (I realize that for someone who has celiac disease, the need for gluten-free everything, on the other hand, is very important.)

  2. Although gluten-free products are low in vitamins, minerals, and fibre, there are still so many fruits, vegetables, grains/seeds that can be eaten that do have the ingredients that are missing from gluten-free packaged foods. I think one of the hardest things about eating gluten-free is baking gluten-free; it is doable, but takes a lot of trial and error, and getting used to different textures for baked goods.

    • You are right – a gluten-free soufflé is probably never going to happen! In the interest of fibre, we tend to steer away from the school of white rice flour. We’ve had success with teff flour, millet flour and coconut flour, as well as brown rice and almond flour. It does take a lot of trial and error – hopefully delicious trial and error with not too many inedible mistakes along the way!

      • There was one gluten-free cookbook that I looked at that used only almond flour, trying to prove the point that you don’t have to have a multitude of gluten-free flours in your pantry! There’s another blog I follow that’s all about gluten-free cooking called The Gluten-free Goddess, http://glutenfreegoddess.blogspot.ca/.

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