Is “gluten sensitivity” the chronic fatigue syndrome of the 21st Century?  An article I saw today in Annals of Internal Medicine hints at the answer.  The writers note that while a very tiny percentage of people have true documented and officially diagnosed celiac disease (gluten intolerance), a growing number of people claim to have “nonceliac gluten sensitivity“, which isn’t even a real diagnosis, and could easily be mistaken for a clever marketing scam, designed to sell gluten free foods.  

Nevertheless some people claim to feel better when they avoid gluten.  And there’s the catch.  Going off gluten isn’t just going off gluten.  When you give up gluten, you end up radically re-configuring your food choices and your nutritional intake by default.  You have no other option.  There are no chemically and nutritionally equivalent foods to substitute for all the foods you are now avoiding.   Here are just a few of the dozens of other changes that result when you avoid gluten:

1. No more fast food burger meat or hot dogs, as well as the cheese that goes with them, because you’re avoiding buns.  You’re also avoiding fillers, flavors, added MSG or salt, conditioners, preservatives, nitrites in the hot dogs and soy that’s used in some processed cheese.
2. No more pizza: processed cheese (soy – see above), pepperoni and sausage (nitrites, flavorings, preservatives, MSG, salt, colorings)
3. No more sandwiches and subs: cured meats (filler, nitrites, flavorings, preservatives, MSG, salt, colorings), mayonnaise and dressings (MSG, salt, flavorings, colorings)
4. Fewer cold cereals: added sugar, dozens of added vitamins and minerals (NOTE: calcium carbonate, frequently used for calcium fortification has known adverse effects on digestion for some people).  You also may end up consuming less milk.
5. No more pastries, doughnuts, cakes, quick breads, giant muffins, pancakes and waffles: lower sugar intake, less fat and vegetable shortening, especially from frosting.  Also less of the preservatives, colorings, flavorings and other additives common to commercial bakery products.  If you typically ate sugary doughnut, super-sized muffin or waffle breakfasts, what did you substitute?  Maybe your entire breakfast improved.
6. No more cookies — less sugar, vegetable shortening and inexpensive chocolate flavoring used in some products.
7. Far less of the nutrients that are added to all wheat flour, by law.  This includes a few B vitamins, most recently folic acid.  Iron must be added to wheat flour, and certain iron salts are known to cause adverse digestive effects for some people.  So giving up gluten means less consumption of added iron.
8. No more bread: yeast, dough conditioners, shortenings and all the other things added to commercial bread.  Plus, if you typically ate toast or bread with jelly, jam, peanut butter and the like, you are now eating less of those items as well.
9. No more bagels: no more cream cheese, low fat cream cheese (with various additives to make it seem more like the real thing) or cream cheese flavorings.
10. No more crackers: did you just mindlessly chow down on crackers right out of the box?  Did you eat cheese or some other dip along with them?  Then you’re eating less of those things, too.
11. No more pretzels and snack mixes, along with sugary “yoghurt” covering on the pretzels and seasonings on the snack mixes (salt, flavorings, sugar, colorings, MSG).
12. Cheese: unless you’re in the habit of eating cheese with cut up fruit slices, you may be eating much less cheese by default when you give up gluten, since cheese goes with pizza, sandwiches, cheeseburgers, burritos and crackers.
13. Pasta: you’re also eating less pasta sauce, such as creamy al Fredo sauce, tomato sauce, sausage (see above) and tomato, as well as any flavorings, preservatives or additives (MSG) added to your bottled sauce.
14. Burritos: no cheese, no refried beans, no salsa, no chorizo (MSG, flavorings, colorings, preservatives, fat)
15. French fries: if you typically ate french fries along with your burger, now you have no other reason to eat them.

These are just a few of the default avoidances associated with a gluten free diet.  Any or all of them could contribute to the complaints common to people who consider themselves gluten sensitive.  

Then there’s the other side of the gluten avoidance effect: what are you eating now that you weren’t eating before?  After all, when you cut out all those foods, you need to find something else to eat.  Many people lose weight when they give up gluten.  No surprise there – if they’re now avoiding all those foods listed above, you’re probably eating less calories and will lose weight by default.  It’s not the gluten; it’s the calories.

Other reasons you may feel better eating less gluten:

1. More fruits and vegetables?  You should have been doing that anyway, but now you have to fill in your diet with something.  So more fiber, potassium, minerals, vitamins and antioxidants.
2. More salad?  Then you may be eating more olive oil as dressing.
3. More nuts?  Nuts are full of key minerals and vitamins not found in pizza and cheeseburgers.
4. Better breakfasts?  If you can’t eat sugary cereals or pastries, or heavy bagel sandwiches, you may be starting the day with more fresh fruit, yoghurt or eggs.  More yoghurt means more probiotics, good for digestion.  You should have been eating that anyway.
5. Less mindless eating?  If your typical snack foods are now off limits, you may end up cutting out snacks or sticking to fruit or vegetables, giving your digestive system a needed rest for a few hours between meals.  Constantly grazing on low fiber highly processed junk food is not a good plan to keep your digestion humming.

So when you describe your diet to your friends, it would be more truthful to describe it as the “higher fiber, lower fat gluten-frenchfry-cheese-addedsugar-sausage-hotdog-flavoring-MSG-nitrite-mineralsalt-vegetablefat-fastfood-bagel-pizza-bread-yeast-pasta-coloring-doughconditioner free diet.”  Have I left anything out?

Until next time…
look good, feel good, do good
Sara B.