A couple of posts back I talked about the parable of stone soup, which describes a village solving a problem but misidentifying the true source of the solution. Could the gluten restriction benefit us for some reason besides the gluten itself? Could gluten-free diets be the stone in a stone soup, a lie that nevertheless motivates something positive?
Despite the accumulation of more and more data, many questions in nutritional science still lack general agreement, and there are seldom simple explanations even where consensus exists. Multiple theories often fit the same data set, and after a theory has been adopted selection bias filters out any new data that doesn't fit.
If you intentionally adopt a gluten-free diet and notice improvements in health, you're likely to conclude that gluten is harmful for you, ignoring evidence that suggests otherwise and even inventing explanations for any setbacks, such as contaminated food or unlabeled gluten. The fact is, a person may feel better on a gluten-free diet and have absolutely no intolerance to gluten, and the setbacks so many people on this diet report may be evidence that gluten is scapegoating for the real cause of one's weight or health problems.
Here are a list of some reasons why a gluten-free diet might make you feel better.
Calorie Restriction
For the overweight and obese, eliminating a common food like wheat from their diet may make it easier to restrict calorie consumption, which naturally leads to weight loss. A healthy weight is associated with a reduced risk of several diseases and tends to make people feel better physically and psychologically. Moreover, many people believe that moderate calorie restriction even in normal weight individuals may prolong life.
In other words, some people lose weight on a gluten-free diet because they don't know what to replace their pasta, bread, and cookies with, and the resulting weight loss makes them feel good.
Gluten Intolerance (Celiac Disease)
If you have celiac disease, then the only solution is a strict gluten-free diet. In this case gluten is not a scapegoat but the actual problem. However, less than 1% of the American population suffer from this autoimmune disorder, which means most people who restrict gluten probably don't have it.
Gliadorphin Intolerance
Many parents of autistic children believe that a gluten-free and casein-free diet improves their children's psychological well being. Some experts have theorized that autistics react to the opiate effect of gliadorphin (in gluten) and casomorphin (in casein, a dairy protein). Support for this theory is speculative and controversial, however, and the claims of its proponents, such as that wheat and dairy may even cause autism, are unscientific.
Wheat Allergy
It is possible that a person might have a true immune-mediated allergy to wheat, in which case it would be necessary to give up wheat but not other gluten-containing grains such as rye and barely. However, wheat allergy is uncommon, occurs mainly in children, and generally resolves with age.
Insulin Resistance/Diabetes
The gluten-free diet is often low in carbohydrates because wheat is the chief source of starch in the American diet. If you have insulin resistance or type II diabetes, lower carbohydrate intake might make you feel better over the short term because of lower blood sugar levels. However, a low carb diet will eventually make your blood sugar problems worse because high fat diets are a cause of insulin resistance. If you are intolerant to carbohydrates (insulin resistant), you will probably feel better temporarily on a low-carb, gluten-free diet, but your health will deteriorate over time. Insulin resistance might not be a big deal if you eat a low carb diet your entire life, but carbohydrates are important for human health and should not be eliminated except in extreme situations.
Fructose Malabsorption
Fructose malabsorption is an impairment of the digestive system that leaves some dietary fructose undigested and available for bacterial fermentation in the gut. This impairment can lead to digestive complaints, bad breath, and nutritional deficiencies, notably in tryptophan, zinc, and folic acid, which have broad-ranging effects on mood, sleep, energy, and hormone levels. Some people with fructose malabsorption may also be sensitive to the fructans in foods such as onions, brown rice, artichoke, and wheat. Therefore, a gluten-free diet could benefit people with fructose intolerance because of the fructans in wheat, though it would not cure them if they continue eating fructose and fructans from other sources besides wheat.
Furthermore, eliminating all fructose and fructan-containing foods is not a cure to fructose malabsorption, which may be caused by digestive impairment that develops over time in response to stress and poor diet. Improving your digestion may allow you to eat wheat again without problems.
Iron Fortification
In order to ensure the population meets its daily dietary iron requirements, the USDA mandates that bakers and millers fortify their flour with high levels of unbound iron. While enrichment is effective in preventing anemia, it may also cause digestive upset and excess iron absorption, which has been implicated in several diseases, including malaria, rheumatism, and cardiovascular disease, as well as many other chronic conditions.
A person may even suffer from hemochromatosis, a genetic disorder that allows the intestine to absorb too much iron. Gradually, accumulated iron becomes so concentrated that it begins to disrupt the body's organs, causing fatigue, skin pigmentation and eventually more serious problems such as liver cancer, diabetes, and arthritis. The usual treatment for hemochromatosis is phlebotomy (bloodletting) but giving up gluten may also help lower iron levels because so many wheat products are heavily fortified with iron. The benefit would be lost, of course, if the flour was replaced mainly with red meat or other iron rich foods.
True iron deficiency anemia is rare in the United States because our diets are so rich in the mineral already. Mandatory iron enrichment, when deficiency is so rare and overload so common, amounts to a public policy catastrophe.
Starch Intolerance
Giving up gluten may be beneficial for people who have difficulty digesting starches. There isn't much research on the effectiveness of starch-free diets on people with digestive problems, but there is a popular diet called the Specific Carbohydrate Diet that makes broad claims about the health value of replacing starch with animal products and simple sugars. Elaine Gottschall, author of Breaking the Vicious Cycle, claims that a starch-free diet is "natural" for the human species and that many people have solved their digestive ailments adopting her way of eating.
However, in my experience, restrictive diets like the SCD may be beneficial short-term, but only end up making sensitivities worse. If you have difficulty digesting all starches, it is unlikely that starch is the root cause of the problem since starches have been the mainstay of human diets for thousands of years.
Junk Food
A gluten-free diet often requires fewer restaurant visits, fast food binges, and convenience meals. Even people without any real food sensitivities may become healthier eliminating gluten if the diet forces them to give up low-nutrient foods and replace them with healthful alternatives. The wider availability of GF alternatives is reducing this side effect of the gluten-free diet, however, as it now easier than ever to eat as much gluten-free junk food as you like.
Eliminating junk food (sugary, fatty, fried foods) from one's diet is likely to be more beneficial for most people than eliminating gluten.
In Summary
In all of the cases above except true celiac disease, a gluten-free diet may be temporarily beneficial even if gluten itself is completely harmless. However, even if you feel successful, it is still important to diagnose the true cause of the problem. If the cause of your impaired digestion and undesired weight gain were eating too much junk food, for example, then it would be overly restrictive to stop eating wheat products, while at the same time you might allow yourself to continue eating the foods actually responsible for your illness.
A useful lie may be useful, but it is still a lie and may ultimately lead to poor decision-making and unsatisfactory outcomes. Gluten is unlikely to be the problem that the current popularity of gluten-free diets would suggest. It would be a shame to eliminate a perfectly wholesome food from your diet because of fear or misdiagnosis. In the best case, gluten restriction might be a stone soup that leads to positive changes in your life; in the worst case, the diet creates a scapegoat that conceals the real culprit in your declining health and weight gain.
