4 Reasons the Gluten-Free Diet Has Staying Power

Sure, They Call It A Fad. But It Actually Makes People Feel Better

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Gluten-free is here to stay. Grady Coppell/Getty Images

Plenty of people are predicting the imminent demise of the gluten-free diet.

It’s a fad, they say, a silly trend, and people will soon get tired of the difficulties it causes when dining out and food shopping. They'll return to their old gluten-eating ways, a little lighter in the wallet and a little less picky in the grocery aisle. Bread sales will jump back up, and pizza orders (conventional, of course) will skyrocket.

Really?

Sure, there are some who will try the diet and, failing to see any benefit, will ditch it in fairly short order (possibly when their friends have ordered regular pizza and they just can’t resist a slice).

But the gluten-free diet truly has staying power. I believe many of those who have tried it in the past couple of years will stick with it, and many more will join in, for four specific reasons.

Please note that some of these reasons are not backed up by current medical science, and they may never be. They are reasons why people already are following the gluten-free diet, not reasons why they should be following it (that's for medical research to work out over the next few years).

But these reasons for the gluten-free diet's staying power mean that those readers who contact me, worried that their gluten-free food options at restaurants and in the grocery store will disappear because the gluten-free diet "trend" is fading, most likely don't need to worry after all.

Here are the four reasons I believe the gluten-free diet is here to stay:

1) People with celiac disease need to be gluten-free.

Sure, those with diagnosed celiac disease represent a small percentage of those who are currently following the gluten-free diet. But studies show nearly 1% of all Americans (one in 133, to be exact) has the condition, and the vast majority – more than four out of five at this point – remain undiagnosed ...

meaning they don't even know yet that they should be gluten-free.

Since celiac disease awareness continues to grow (in part because of better physician education, and in part due to the trendiness of the gluten-free diet), more and more people are getting diagnosed and are going gluten-free. This will only increase once new celiac disease drugs – currently in development – are approved and come on the market.

Ultimately, we could see nearly one in every 100 people (again, one in every 133) diagnosed with celiac disease, an accepted medical condition that requires them to eat gluten-free. This alone would be enough to keep the gluten-free diet “trend” alive.

2) People with non-celiac gluten sensitivity (probably) need to be gluten-free.

Now, there’s much less research on gluten sensitivity than there is on celiac disease. It does appear to be a separate condition from celiac disease. But it’s not clear whether it’s what’s called a “functional” condition, where the gluten just upsets your system without causing permanent damage, or whether there are potential health risks associated with having gluten sensitivity.

In fact, studies have conflicted on whether those who believe they have “gluten” sensitivity actually are reacting to the gluten protein or to something else in the wheat grain (possibly some forms of carbohydrates called FODMAPs). Some studies say it's gluten, while others say it's FODMAPs (even studies originating from the same research team differ in their conclusions on this point).

Ultimately, we have a lot more to learn about non-celiac gluten sensitivity and its effects on your health. We may need to rename it “non-celiac wheat sensitivity,” or something else.

But until that research is conducted (and depending on what it determines), many people who find their symptoms are improved or eliminated by dropping gluten from their diet are going to continue to eat gluten-free, keeping the trend alive. And some estimates indicate there may be a lot of people with gluten sensitivity – far more than those who have celiac disease, in fact.

3) People with a variety of other serious health conditions are finding that the gluten-free diet seems to help them.

I’ve seen a smattering of studies and multiple anecdotal reports that the gluten-free diet seems to alleviate symptoms in a variety of different health conditions, including thyroid disease, fibromyalgia, autism, rheumatoid arthritis and even multiple sclerosis. It’s not a cure for any of these conditions, of course, but some people say they feel better ... sometimes, much better.

There’s even research backing some of this – for example, in the case of rheumatoid arthritis, two small studies have shown that a gluten-free vegan diet appears to improve symptoms.

In other areas, there's medical research ongoing. For example, a few parents are testing whether eating gluten-free can help protect their high-risk children from developing type 1 diabetes or put the disease into remission, even if those children haven't been diagnosed with celiac disease; some early medical case studies indicate it might.

And then there are people — many times with the support of their physicians — who go gluten-free because it helps other health conditions they have.

For example, I spoke with a woman in a popular gluten-free restaurant who said she twice tested negative for celiac disease, but she needed to be strictly gluten-free because her autoimmune thyroid disease worsened instantly and significantly when she deviated from the diet. I can't vouch for the veracity of what she was telling me about her thyroid, but I can say she was absolutely determined to stay gluten-free at all costs.

These folks are motivated to stay gluten-free because they believe the diet is helping them manage their serious health conditions. They certainly aren’t chasing the diet trend-du-jour, and they are unlikely to go back to a gluten-containing diet without strong medical evidence pointing them in that direction.

4) Some people who go gluten-free without any diagnosis simply find that it makes them feel better.

Yes, some people may have adopted the diet because it sounds “healthier,” or because they know people who recommended it (even if they didn't really understand the science behind it). And sure, most of them will fall off the gluten-free wagon pretty quickly if they don’t see any difference in their health (or not enough of a difference to make the diet worth the trouble).

But some of them will discover they feel better gluten-free … maybe even lots better. Perhaps they have undiagnosed celiac disease (here’s why doctors warn not to go gluten-free without ruling out celiac disease) or non-celiac gluten sensitivity. Perhaps they have another health condition that – surprisingly – seems to improve with the gluten-free diet. Maybe it's just a placebo effect.

Regardless of the reasons people may have for eating gluten-free, there are enough people who believe the diet has a positive impact on their health to keep this “trend” going. And that’s really the reason the gluten-free diet has staying power: It just makes people feel better.

Sources:

Biesiekierski JR et al. Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial. American Journal of Gastroenterology. 2011 Mar;106(3):508-14.

Biesiekierski JR et al. No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Gastroenterology. 2013 Aug;145(2):320-8.

Hafström I. et al. A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology (Oxford). 2001 Oct;40(10):1175-9.

Hafström I. et al. Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: a randomized study. Rheumatology (Oxford). 2008;10(2):R34. doi: 10.1186/ar2388. Epub 2008 Mar 18.

Sildorf SM et al. Remission without insulin therapy on gluten-free diet in a 6-year old boy with type 1 diabetes mellitus. BMJ Case Reports. 2012 Jun 21;2012.

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