Sunday, November 27, 2011

Gluten-Free: Fad or Requirement?

The exact cause of celiac disease, a genetic autoimmune disorder, is unknown. But the symptoms are - and this has become apparent due to the recent rise in gluten-free products lining the shelves of neighborhood grocery stores. Celiac disease causes damage to the lining of the small intestine along with an inability to absorb certain nutrients. However, this digestive condition is only triggered when people with this disease consume gluten, a protein found in foods containing wheat, barley, or rye. There is no treatment for this disease so the only way to effectively manage it is a change in diet. If no change in diet occurs then the immune system reacts to the consumption of gluten by damaging the villi in the small intestine. This leads to malnourishment no matter how much food the individual is actually consuming. Thus, a change in diet is necessary for a patient to lead a normal healthy life.

If the many gluten-free products that are becoming available to Americans now are due to this disease then why the sudden market increase? Where is this large consumer population coming from?

Gluten-free food products were practically impossible to find in the 1990s because doctors believed that celiac disease wasn’t a problem in this country. As Dr. Stefano Guandilini observed, a medical textbook published in 1999 labeled celiac disease as a mostly European disease and quoted a prevalence of 1 in 10,000 in the U.S. for having the disease. But neither Dr. Guandilini nor Dr. Alessio Fasano believed this, especially since the genes were somewhere present in America due to our large European ancestry. In Italy, Dr. Fasano regularly saw celiac disease and questioned its absence in the States. He later founded the University of Maryland Center for Celiac Research and set out to do a more comprehensive study in 2003 on the presence of the disease in America. His study had stunning results – 1 in every 133 people had celiac disease and since it’s a genetic disorder, among those related to celiac patients the rate was as high as 1 in 22. This caused people to finally give attention to the disease. As Dr.Fasano says “the history of celiac disease as a public health problem in the United States started in 2003.”

As awareness of celiac disease spread so too did the diagnoses increase. The requests for celiac blood tests jumped 25 percent since 2009. Not only have Americans become better at diagnosing it but the disease has also become more common. Young people today are five times as likely to have celiac disease for unknown reasons. The disease has been on the rise in other previously untouched countries as well, such as Mexico and India.

Because of this dramatic increase in the affected population gluten-free products are in high demand and so far they appear to be recession-proof as well. The industry is rapidly growing and major corporations have been moving into the market. General Mills is a prime example of this. Employees once made statements such as the following, ‘we love gluten’ and ‘we are the very best of gluten’. This once gluten-rich company is now making a complete roundabout by reformulating their Rice Chex along with other cake, brownie, and cookie recipes to be made without gluten.

Celiacs aren’t the only ones consuming these products. Among the consumers are professional athletes who claim that a gluten-free diet has enhanced their athletic performance, a statement which many doctors and scientists scoff at. Rather than being a sign of the benefits of a gluten-free diet this exemplifies that gluten-free has in reality become a fad. Despite these fad consumers more than 80 percent of the market is driven by those who are medically required to. The rising awareness is seen especially in the occurrence of events such as the Gluten Free Expo in Sandy, Utah, which drew nearly 6,000 by the end of the day. After all, everyone needs to eat.



References:

http://www.nytimes.com/2011/11/27/magazine/Should-We-All-Go-Gluten-Free.html?pagewanted=1&_r=1&ref=health

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001280/

http://www.ncbi.nlm.nih.gov/pubmed/22060243

3 comments:

  1. I have had problems with gluten since my junior year in High School. I felt noticeably sick every time I consumed a bread product or anything processed containing wheat. When I eliminated wheat from my diet completely, I no longer felt sick, bloated or unable to move after eating. As someone who had only had a slight reaction compared to the thousands of individuals who are inflicted with Celiac and can never introduce wheat back into their diet, I understand it negative effects.
    I believe that the increase in the diagnosis of Celiac disease in America is linked to the years of our overconsumption of genetically manipulated wheat. Modern age scientists have manipulated the genetics of wheat, actively using genetic selection to alter the makeup of few grains and little gluten to great harvests of wheat enriched with gluten. This alteration of the genes was implemented in order to improve bread making in high quantities in its industrial production. Wheat products dense in gluten are hard to digest. Studies conducted done at Stanford University show that the sequence of 33 amino acids of the gliadin gluten proteins in wheat are responsible for the toxicity in the small intestine that occurs in individuals with Celiac disease. In my own experiment with wheat products, I have found that wheat products less processed and dense with gluten, like spelt, has less of an effect on digestive system suggesting a link in the processing of wheat and its ability to be broken down within the body.

    http://grindstonebakery.com/healthbenefits2.htm

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  2. In our Biomedical Genetics class, we recently watched a video about the rise of allergies in different societies of the world. In many places, these allergies are becoming epidemics, particularly within small populations. In light of seeing this video, I believe there is somewhat of a genetic component to this increase in allergies, as one of the doctors in the article mentioned.
    However, I also agree with the previous comment that we can probably blame such a drastic rise in allergies of all kinds to the modern age we live in. For example, dramatic increases in asthma can be traced to an increase of certain African groups of people moving from rural areas to the modern housing and air pollution of the city. Before our modern advancements, there was no need for such hyper-reactivity to certain chemicals or irritants. This probably includes the case of celiac disease - many affected people do not even consciously consider gluten to be the cause of their sickness, and thus are not falling back on a fad simply to follow the trend. Eating more processed foods, both gluten-containing and others, has probably dramatically increased our sensitivity to certain substances in foods.
    Additionally, another component to the rise in celiac disease is simply the increase in knowledge about the disease and consequently more frequent diagnoses. This doesn't mean the disease didn't exist before, but maybe physicians didn't always include it in possible diagnoses.

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  3. I agree with both of the previous posts. I watched the same video as Ashley did in my Immunology class. The filmakers believed that there is a strong link between allergies and rapid modernization. They seemed to think that everything from pollution, dust mites, and overly processed foods could be increasing allergic reactions. They believe this because there is a higher population of people with severe allergies in modernized cities than there are in rural unmodernized cities. In addition, individuals that are unafflicted with severe allergies that move into more modernized societies develop allergies.
    When it comes to going gluten-free by choice I don't think it is a good idea. Although I don't have a lot of knowledge about the advantages and disadvantages of gluten-free diets, I do know that once your body adjusts to being completely gluten-free it is a difficult process to reintroduce gluten to your body. Ultimately, unless you are serious about going gluten-free I don't think it is the best thing to do.

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