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Gluten-free diet - for or against. Opinion nutritionist

'08.07.2022'

Source: Chicago Tribune

Kristi Brissett wrote a column on a gluten-free diet, which is published on the website Chicago Tribune. Christie is a famous blogger, nutritionist, Food Expert and president 80TwentyNutrition.com. In her Twitter many posts about how to eat right, as well as recipes and practical recommendations. Further - from the first person.

Photo: Shutterstock

As a nutritionist, I get asked all the time, "What's your opinion on a gluten-free diet?"

Let's look at what's bothering us in this thread. And not too much too much hype and misinformation.

A recently published study by Harvard scientists garnered a lot of attention with some very dramatic headlines. For example, the fact that the rejection of gluten can lead to the development of coronary heart disease. And although there was nothing innovative in the results of the studies, the headlines themselves looked even intimidating: “If you want to avoid heart problems, do not even think about giving up gluten” and “Gluten-free diet is contraindicated for those who do not suffer from celiac disease.” In fact, the authors of these articles are wrong, because each case must be approached carefully, and for some people who do not have concomitant diseases, such a diet may be suitable.

After reviewing the results of the study, I can't say with certainty whether there is a link between gluten and the development of heart disease. One of the stages of the study was filling out a questionnaire on the frequency of consumption of certain foods. More than 100 men and women took part in the survey: the percentage of those who experienced heart problems and at the same time adhered to a gluten-free diet was small.

The researchers then studied risk factors for heart disease using statistical models. For example, if someone was a smoker or someone who was overweight, they prioritized that very thing without considering the effect that gluten might have. The researchers then tried to compare the risk of developing the disease and the consumption of refined grains - that is, they really tried to find an association between the consumption of whole grains and the risk of heart disease. But all they found was a statistically significant trend towards lower risk of heart disease with increased gluten intake.

Whole grains have long been known to reduce the risk of heart disease. We also know that at least 8% of Americans get the recommended amount of whole grains per day, so excluding the influence of the main sources of gluten-containing foods (refined grains) from the statistical model is misleading. Claiming that total gluten intake is generally healthy for the heart skews these results.

Eating more whole grains instead of refined grains is a good move for your heart, and whether or not they contain gluten is up to you. I also argue that now that gluten-free whole grains (millet, quinoa, and buckwheat) are more widely available, claims that gluten-free diets low in whole grains are better are no longer true.

Do you know people who swear that they feel better after they eliminate gluten from their diets? In 2013, almost 30% of US adults tried to reduce or avoid gluten. And in 2012, celiac disease was diagnosed only in 0,7% of Americans.

So who makes up this large group of people who live without gluten but do not have celiac disease? Some people turn to a gluten-free lifestyle to lose weight, or because they think it is a healthier way to eat. But there is a constantly growing group of people who seem to have a so-called sensitivity to gluten, and the scientific community disagrees on how to identify, diagnose and treat it.

Symptoms of non-cellular gluten sensitivity can include digestive symptoms such as pain and bloating, diarrhea or constipation, or more general symptoms such as headaches, fatigue, depression, joint pain, and skin rashes. But since there is no biomarker that can identify gluten sensitivity, diagnosing it is difficult. Research papers estimate the prevalence of symptoms to be between 0,5% and 6%.

One way people can tell if they are gluten sensitive is through a selective diet. With the advice and supervision of a dietitian or physician, a person with suspected gluten sensitivity removes the appropriate foods from their diet and then slowly reintroduces them while making detailed notes about the symptoms they develop. This method requires patience and diligence, which explains why some people may skip this step. In my experience, some practitioners outright recommend a gluten-free diet in the hope that it will immediately solve all problems.

As a nutritionist, it bothers me. Allergies to wheat, irritable bowel syndrome (IBS), or other food sensitivities can be the cause of feeling unwell after consuming products containing gluten, which may indicate the presence of other components in the food, to which the human body reacts negatively.

For example, there is likely a significant overlap between gluten sensitivity and IBS, which the FODMAP diet can help. FODMAPs are fermentable sugar alcohols and sugars, including lactose (sugar in milk) and fructose (sugar in fruit). A survey of 147 adults who identified themselves as gluten sensitive found that 25% of respondents were able to control their symptoms despite avoiding gluten, suggesting that there are other causes that have not been identified.

There is also some research into whether gluten sensitivity is psychosomatic. A crossover study in which participants who are sensitive to gluten were given diets high in content, low in gluten and without gluten (placebo), and also with or without other food components associated with indigestion (FODMAP), found that people had similar symptoms even on a gluten-free diet. Participants seemed to feel better when they were on diets low in FODMAP, which suggests that gluten can be unfairly blamed.

I believe that the ideal diet is separate for each person. Some of my clients feel great on gluten-free diets, but with a high content of animal protein, healthy fats and vegetables, while others eat more plant foods, including whole grains and beans. Nutrigenetics, the science of the interaction between our genes and nutrition, is a new area that may soon give more answers.

One of the main culprits for weight gain and fatigue is a diet high in refined grains and junk food, and high in calories but low in nutrients. Many begin to see results when they cut their high-gluten, unhealthy diet and eat more gluten-free vegetables and whole grains. The key is a varied, nutrient-dense diet - whether it's gluten-free or not.

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