Gluten Is Not The Enemy
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If you have been a follower of the diet and health space for some time, chances are you’ve heard prominent voices and many commercial entities tell you gluten is enemy #1 in our diet. A publication in 2013 convinced a large and still increasing number of people to believe that many aspects of their health – from headaches, brain fog, digestive issues, IBS, fibromyalgia and many others would improve if they eliminated this victimized protein. The demonizing of gluten in our diet has not only been extremely lucrative, with the global market for gluten-free food expected to continue to expand between 2020 and 2025, from 5.6 billion U.S. dollars to 8.3 billion U.S. dollars, but this trend has also created an epidemic of food-related fears, pushed a diet which deprives your body of gluten (among much more – keep reading), with very little evidence it plays a negative role in non-celiac individuals. Obviously, If you have celiac disease, this is a different story, but for those who haven’t, you should be outraged.
Gluten is a protein which is present in wheat, barley, and rye. In celiac disease, gluten can trigger severe immune responses which have been linked to cognitive impairment, depression, and anxiety. A longitudinal study of 11 patients, aged 22-39 years with celiac disease, showed that following a gluten-free diet in this patient population for 52-weeks resulted in modest improvement in cognitive performance.
However, there is no consistent evidence that this is the case in those without celiac disease. A common statement you hear from people who decide to cut out gluten from their diet is that they have their “brain fog” lifted. I’ve read many articles which claim that for those without celiac disease, this is simply a placebo effect, and after doing some more research into this question, it seems more and more likely that this is the case. There is also the possibility that if you are benefiting from cutting gluten out of your diet you may have a condition called “wheat allergy”, an allergic reaction to foods containing wheat as a result of antibodies produced by your immune system against non-gluten proteins contained in wheat. However, one thing that seems likely for why a gluten-free diet lifts “brain fog” could be that you are cutting out many ultra-processed food items such as white bread, non-whole grain pastas, cereals, muffins, etc. The elimination of such food items with high glycemic index, reduces the number of insulin spikes and postprandial hypoglycemia in some individuals.
In January, our contributor, Juliette Frank, wrote a post titled, “Does a Gluten-Free Diet Help with IBS Symptoms?”. She found that an increasing number of people without Celiac Disease are adopting a gluten-free diet, thinking it is healthier and will improve their overall health and physical appearance. In a 2017 survey of 1,000 consumers of gluten-free products in North America, 46% of people reported buying gluten-free products for reasons other than an allergy or medical condition, e.g. celiac disease.
An interesting claim I found in the same article is that because gluten-free products tend to be lower in protein and fiber, cutting gluten out of your diet can increase the risk for nutritional deficiencies. Furthermore, because gluten-free products lack the cohesive, stretchy texture of gluten, they also generally contain more saturated lipids and sodium than non-gluten-free products.
As we’ve also mentioned in an earlier post, gluten plays an important beneficial role in the microarchitecture of pasta, slowing the absorption of carbohydrates and reducing the resulting insulin spike. This does not sound like it is beneficial to those who are able to process gluten.
After reading Juliette’s article, I decided to do some more digging and came across a May 2021 article in JAMA from a group of investigators with senior author Andrew Chan from Harvard Medical School titled, “Long-term Intake of Gluten and Cognitive Function Among US Women”. Looking at the question, “Is dietary gluten intake associated with cognitive function in the general population?”, these researchers found some interesting data.
This study used the Nurses’ Health Study II (NHS II), a nationwide prospective cohort of female nurses aged 25 to 42 years when enrolled in 1989. Lifestyle and health information was collected using questionnaires every other year, while dietary information was collected every 4 years since 1991 using a validated food frequency questionnaire (FFQ). In order to assess cognitive function, the nurses used a validated, self-administered, online Cogstate Brief Battery which consists of 4 tasks (the test battery has been shown to be a reliable assessment for mild cognitive impairment).
It is worth noting that the authors of this study give credit to previous work looking at the benefits of a gluten-free diet in patients with celiac disease, implying there isn’t a one-sided agenda here. However, when looking at their cohort of 13,494 women, with a mean age of 60.6 years and without celiac disease, the researchers found there was no statistical evidence of any association of long- or short-term gluten intake with cognitive function. Obviously, such epidemiological studies don’t prove any causality or lack of causality between diet and impaired health, but they certainly seem to contradict the mantra of the multimillion dollar business that has been built on the gluten myth.
It is amazing that despite the lack of solid scientific evidence to support their claims, the gluten lobby has pushed their demonization of this protein – and the associated health promoting food items like whole grain bread and pasta with no restraint. There is now even gluten-free bottled water, milk, and seafood expanding the gluten related fears to food items which cannot have any gluten molecules in it, like water!
I know this has become a sensitive topic to many and by no means am I saying this applies to everyone who doesn’t have celiac disease! If cutting out gluten is working for you, by all means do what makes you feel your best. However, by looking at the evidence, it seems likely that the health benefits you are experiencing are more than likely due to a placebo and a reduction of your food related fears than on avoiding gluten itself.
E. Dylan Mayer is a graduate from the University of Colorado at Boulder with both a major in Neuroscience and minor in Business. He is fascinated by the interactions of brain, gut and microbiome, and the role of nutrition in influencing the health of our microbiome, as well as our own well-being.