Thursday, September 23, 2010

No gluten hoax

Steve Edwards wrote a blog “Gluten hoax” - gluten free for dummies.

This is my response.

Yes indeed, the gluten-free debate is raging hot. There are “believers”, and there are “non-believers”, and then fortunately there are the facts so we can be scientific about the problem. Whether gluten sensitivity exists or not is a matter of data, not belief.

Of course, with any food related diet, there will be a fringe /fad elements. This does not matter. This does not influence the facts. Our world is not simply black and white: there are many grey areas in our experience that require reasoned thought.

When it comes to gluten, undisputedly it does harm some people – however, the unanswered question is how big the problem might be. A survey this year shows that up to 25% of the USA population is either going gluten-free or substantially reducing their gluten intake. Interesting, and some of this food-behaviour will have a fad element. But, many of these people will genuinely have gluten-sensitivity.

Gluten sensitivity is only now being systematically investigated by the medical science community. The celiac-disease-doctors have now recognised that gluten does in fact severely affect many non-celiac sufferers. Most doctors dealing with gluten sensitivity estimate the problem to affect at least 10% of the population. Dr. Alessio Fasano, director of the Center for Celiac Research at the University of Maryland School of Medicine, figures that up to 7 or 8% of the U.S. population have some kind of sensitivity to gluten.

Eventually, the proportion of gluten-affected people is likely to be much higher. Currently, gluten-sensitivity can be tested for by AGA (Anti-Gliadin-Antibody) tests (also known as the IgG-gliadin test). However, this test is not widely available. More accurate and more sensitive tests for gluten sensitivity are currently being developed. When these are in use, the picture will become clearer.

Research evidence shows that gluten has a hand in triggering mental illness, autoimmune disease, skin problems and gut disease. As yet, the burden of gluten on the population has not been properly quantified.

Therefore, to launch a tirade about gluten-free being a fad and to ridicule people adopting a gluten-free life-style is, to my thinking, an uniformed approach. When you have had a chance to look at the data (for instance the work by Hadjivassiliou M , “Gluten sensitivity: from gut to brain”, Lancet Neurol. 2010 Mar;9(3):318-30) perhaps you will be in a position to write another more thoughtful piece.

Thank you for raising this controversy
Cheers, Dr Rodney Ford.

1 comment:

  1. Hi Dr Ford

    Nice response.

    I look at it this way with regard to the gluten-free movement. Most people claim that gluten-free foods do not taste as good as the regular foods they are used to eating. And in many instances, there is a price differential with GF food being more expensive. Yet, despite both financial and taste disincentives, the vast majority of people who go gluten free remain so (largely). Why? Why would an individual pay more for an inferior tasting food unless something else was of greater benefit to them.

    If GF is a fad, it is built on a house of cards and it will fall quickly. But it hasn't done and I doubt it will. And it is because people simply feel better eating that way.