For many Americans, foods marked "free from" are always better in some way. Whether it's "fat-free," "GMO-free," "HFCS-free" or something else, consumers tend to believe that a health claim on the label is based on science showing it matters.
Of all of these claims, none are more curious than the desire among people with no medical reason to buy foods marked "gluten-free."
Gluten, a protein found in wheat, barley and rye, makes a small percentage of the population sick. For the 1 percent of persons with the inherited autoimmune illness known as celiac disease, gluten causes a response in which the body attacks the lining of the intestine, damaging your ability to absorb nutrients and digest. For another small percentage of the population, gluten causes marked discomfort. For almost everybody else, there is no need to avoid gluten.
But a lot of people do it anyway.
The rise of gluten-free products, poised to become a $4.7 billion industry by 2020, has been a godsend for the 3 million Americans with celiac disease. But research shows that people with celiac disease make up a minority of those eating gluten free. In an 8,000-person celiac prevalence study conducted by Mayo Clinic in 2012, when tested, most people who told researchers they followed a gluten-free diet did not in fact have celiac disease.
Market research has determined that 44% of the gluten-free market is made up of persons with no sensitivity to gluten, and that 65% of the public believe that gluten-free is healthier. In the hopes of learning whether skipping gluten has any benefit to the healthy, researchers in England recently launched the first study of its kind to feed healthy people either gluten or gluten-free food and see if they could tell the difference.
In the double blind, randomly controlled trial published in the journal Gastroenterology, Iain David Croall and colleagues randomly assigned 28 subjects known to not have gluten sensitivity into two groups, giving one of them regular flour and the other gluten-free flour. After the two groups baked at home and filled out questionnaires about their intestinal distress, the authors determined that "consumption of gluten-containing flour does not generate symptoms in healthy volunteers."
So yes, the sign suggesting that a GF scone is just somehow healthier than the others is most definitely full of it.
"The practice of people going gluten-free without a good reason doesn't make a whole lot of sense to me," says Joseph Murray, professor of medicine in gastroenterology at Mayo Clinic and co-author of the 2012 study. "There's nothing inherently bad about gluten. The idea that because gluten can cause celiac disease or non-celiac gluten sensitivity, that that means gluten is bad for everyone. It is like telling everyone not to eat peanuts because one person is allergic to peanuts."
Murray says the trend among hordes of the healthy to buy gluten-free and ask for same when dining out has created unintended consequences.
"It has led to a lack of appreciation of the seriousness for a patient with celiac disease of being exposed to gluten. I've had patients of mine who go to restaurants, and the wait staff ask them "Do you need to be gluten free, or are you just doing it?" Murray adds that the trend can diminish the ability of doctors to detect celiac disease in those who actually have it.
"I've seen more cases where patients are coming to me, people who might have had symptoms they didn't get tested. But they avoided gluten to see if they felt better. And then they felt better, so when they went to see their doctor for a diagnosis, the blood test can go negative very quickly." With false assurances of health, a gluten-free life-styler can easily fall off the wagon.
"It's hard to actually stick to as strict of a gluten-free diet as you need with celiac disease if you don't know you have the disease," he says. "In adults there's significant damage in the intestine that doesn't necessarily heal when you go gluten-free. So having an opportunity to identify the degree of damage might be quite important."
Gluten-free labeling may sell foods, it seems, but isn't a substitute for basic blood work.