More people than ever are buying, cooking and eating gluten-free foods — not that they all require the diet. Gluten-free living appeals to about 30 percent of American adults — but seems to still be widely misunderstood.
There are many hypotheses about the sudden increase in interest in the gluten-free way of life, as well as the rise of patients raising gluten-related concerns with their doctors, says Dr. Sheila Crowe, M.D., a spokesperson for the American Gastroenterological Association and a professor in the division of gastroenterology at the UC San Diego School of Medicine. “We don’t have proof to say if some are right or others wrong.”
Despite the lack of scientific clarity, gluten-free eating appears here to stay, whether it’s trendy for some or necessary for others. In the meantime, some of the confusion can certainly be cleared up.
Here are nine things you should know before going gluten-free.
1. Some people need to ditch gluten, others just want to. But for most people, it’s not necessary.
About 1 in 133 people — about .75 percent — have celiac disease, an inherited autoimmune disease that causes damage to the small intestine when gluten is ingested.
About .4 percent of people have a doctor-diagnosed wheat allergy, according to a 2006 study. In those people, a true allergic response to wheat (which contains gluten) can include skin, respiratory and gastrointestinal symptoms.
A larger group of people is estimated to have what’s called “non-celiac gluten sensitivity,” which may also produce similar symptoms but is not very well understood by experts. “We don’t really know the mechanism by which this arises,” says Crowe. According to the National Foundation for Celiac Awareness, as many as 18 million Americans have some non-celiac sensitivity to gluten.
People without symptoms may consider avoiding gluten for health reasons, says Crowe. “There’s more of a modern concern that gluten is somehow not good for us,” she says, possibly linked to our transition from hunter-gatherers to cultivators and farmers and the simultaneous increase of grains in our diet. But there’s little evidence proving going gluten-free means good health, she says.
2. If you think you have celiac, you must talk to your doctor first.
Before taking treatment — i.e. gluten-free eating — into your own hands, “you want to nail down that diagnosis,” says Crowe. If you’re losing weight, deficient in iron, anemic or you have a family history of celiac disease, talk to a doctor before simply giving up gluten to see how you feel.