What is gluten? What’s undesirable about it? What are the health benefits of a gluten-free diet? Is it advisable for everyone?
Gluten is a protein component of wheat, rye, barley, oats and crossbreeds of these grains. It is the protein that makes dough elastic and gives bread its chewy texture. For most people, gluten poses no problem, but for people who have celiac disease (about one percent of the population) or are gluten-sensitive, it is a health risk. In the Philippines, the reported incidence of celiac disease is lower than in developed countries. This is probably because Filipinos are rice eaters instead of bread eaters and/or the illness is underdiagnosed.
Celiac disease and gluten-sensitivity
Celiac disease (CD) is an autoimmune disorder that’s triggered by eating gluten-containing food such as bread products. Gluten-containing food damages the intestinal villi of people with CD, which results in impaired absorption of nutrients and its consequences, i.e., malnutrition, osteoporosis, and iron deficiency. Chronic injury to the villi also increases the risk of intestinal lymphomas (a type of cancer) in people with CD.
In children below two years old, the symptoms of CD include chronic diarrhea and abdominal distention, malabsorption, loss of appetite, and impaired growth.
In older children, adolescents, and adults, on the other hand, CD is characterized by milder or even absent gastrointestinal symptoms, but a wide spectrum of non-intestinal manifestations that can involve any organ of the body sometimes occur.
Non-celiac gluten sensitivity (NCGS), meanwhile, is a condition of multiple symptoms that improves when switching to a gluten-free diet. People with NCGS may develop gastrointestinal symptoms similar to those of CD but without damage to the villi, and/or a wide variety of non-gastrointestinal symptoms, such as headache, chronic fatigue, fibromyalgia, atopic diseases, allergies, neurological diseases, or psychiatric disorders, among others.
Other supposed benefits of gluten-free diet
There are some studies that suggest that a gluten-free diet may, in at least some cases, improve gastrointestinal and/or systemic symptoms in diseases like irritable bowel syndrome, rheumatoid arthritis, multiple sclerosis, and HIV enteropathy.
Some studies also hint on the possible association between gluten on the one hand and schizophrenia and autism on the other hand, but the current evidence for the efficacy of gluten-free diets in treating these conditions is limited and weak.
Gluten-free diet is also being promoted as an aid in weight reduction and in enhancing the proper utilization of energy by the body.
As a fad diet
Largely because of their purported health benefits and aided by the endorsement of American celebrities and some world-class athletes and promotion by manufacturers of gluten-free food products, gluten-free dieting has lately become a fad. A wide variety of gluten-free food items and beverages are now being marketed worldwide, including the Philippines.
Many people without CD and NCGS have shifted to a gluten-free diet because they believe it will help them lose weight, make them feel better, or because they mistakenly think they are gluten-sensitive.
Downside of a gluten-free diet
Shifting to gluten-free products adds a financial burden on people. Also, an unbalanced selection of food and an incorrect choice of gluten-free replacement products may lead to nutritional deficiencies, particularly iron and B vitamins.
Should you go gluten-free?
Experts say people with CD and NCGS should go gluten-free, but all others should be warned that gluten-free eating might do more harm than good. My personal take is that Filipinos who have no CD or NCGS need not shift to a gluten-free diet, in as much as our traditional diet, with rice as staple, is already practically gluten-free.
source: Manila Bulletin
Written by Eduardo Gonzales, MD
Created: 14 March 2017