Philosophers have grappled with the concept of ‘true’ or ‘false’ or ‘maybe’ for eons. These questions are now being applied to gluten-free diets. Who has the right to be on a gluten-free diet?
It is a known fact that gluten causes some people to develop coeliac disease: this is damage to the gut which is reversible on a strict gluten-free diet (life-long). These people have a hereditary predisposition to getting coeliac disease, which is tested by the DQ2/DQ8 HLA gene. When coeliac disease was at first defined as intestinal damage (as proven by biopsy), 40 years ago, there were no blood tests to help with the diagnosis. Things have changed radically since then.
The gluten picture is now much more confused. The entity of gluten syndrome / intolerance has blurred the situation. There is now excellent data to show that gluten sensitive reactions are very common, with most estimates finding about 10% of the population to be adversely affected by gluten. Most of these gluten-sufferers do not have coeliac disease: they are negative to coeliac blood tests (tTG, EMA and DGP). However, they feel very much better on a gluten-free diet. So, now gluten syndrome / gluten intolerance has blurred the boundary between coeliac disease and non-coeliacs. There is now a grey zone between the black and white of true and false.
For the last 30 years I have been interested in people who have responded to a gluten-free but who do not have coeliac disease. This condition of gluten intolerance/sensitivity affects the bowel but also the skin and nerves. Because there is no specific test for this condition, the way to diagnose it is a trial of a gluten-free diet. And many people trying this feel so much better.
Recently, many celebrities including Madonna, have adopted a gluten-free diet … and have found it to their liking. They feel great. Being celebrities, their fans are very interested in what they are eating. This curiosity has helped spark great awareness about gluten-free diets. Lots more people have subsequently adopted a gluten-free lifestyle and are feeling the benefits of this.
Such wide-spread adoption of the gluten-free diet, without having any blood tests or endoscopies, has upset much of medical profession. Their claim is that going gluten-free without any blood tests is masking the possibility of diagnosing coeliac disease. In most medical establishments there are those who believe that coeliac disease should be the only reason (without exception) to be on a prescribed gluten-free diet. I disagree with such a stance, as do many others who have helped to define The Gluten Syndrome.
Gluten is an unnecessary protein. Nobody can digest gluten properly. Gluten is implicated in triggering many autoimmune diseases. Gluten is the cause of much disease and upset. Gluten is associated with depression and schizophrenia.
A gluten-free diet has been attributed to cure such problems as eczema, reflux disease, mental and behaviour problems, headaches ans migraines.
And now being gluten-free is becoming a celebrity status. In my opinion this is an excellent thing to be happening. It has allowed lots more people to hear about the idea of going gluten-free and feeling better from their chronic ills. Of course, there will be many people who adopt a gluten-free diet for whom it is not necessary, but his is okay. A gluten-free diet is a healthy diet, and there is no detriment of being gluten-free diet, as long as you adopt it by eating in a wholesome way (the majority of the population eat an unhealthy diet … most people eating gluten-free eat a lot better). Time will tell whether this celebrity status persists. My prediction is that it will. I also predict that in another decade, a third of the population will be on a gluten-free diet.
Adoption of the gluten-free diet by celebrities has just hastened the inevitable. The fact is that gluten-free will continue to regarded as both glamorous and a healthy food choice.
Dr Rodney Ford
Author of The Gluten Syndrome