Are gluten-free diets a passing fad?

ERIK JENSEN
Last updated 10:39 28/01/2012
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FORBIDDEN: Many people claim to feel better after cutting out gluten from their diets - but are they really gluten intolerant?

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Novak Djokovic called him ''the great doctor'' - a Sarajevo-trained GP with expertise in Chinese medicine and acupuncture, a graduate of the Indian Institute of Magnetotherapy in New Delhi, lately specialising in the use of a Budapest-designed biofeedback machine.

More than anyone else, Igor Cetojevic is the man credited with revolutionising the world No 1's tennis game. He is the man who told Djokovic he was gluten intolerant.

''He's done a great job in changing my diet after we established I am allergic to some food ingredients, like gluten,'' Djokovic said of the diagnosis that turned around his career two years ago.

''It means I can't eat stuff like pizza, pasta and bread. I have lost some weight but it's only helped me because my movement is much sharper now and I feel great physically.''

The improvements to Djokovic's form are not in contention. But the explanation for the Serbian's success is based on one of the most vexed areas of dietary science.

''There are a whole lot of people who believe they are gluten intolerant, who don't have coeliac disease,'' says Professor Peter Gibson, professor of gastroenterology at the Alfred Hospital in Melbourne.

''This is very controversial because there is a quite big percentage - even up to 10 per cent - of people who are avoiding gluten because they think gluten is their problem.

"Naturopaths have put them on a diet, or they have done it themselves after reading the internet or speaking to a friend.''

As yet unpublished research from Monash University, co-written by Professor Gibson, found only 14 per cent of people on gluten-free diets were put on the regime by a doctor.

Almost half had simply decided to cut wheat and grains from their diet because they assumed they were intolerant. More than 60 per cent had not been tested conclusively for coeliac disease.

''It's a very emotive area,'' Gibson said. ''Fortunately, now there is a lot of work going on around the world trying to define this and how we can identify people who are truly gluten intolerant.''

The issue is a question of medical distinction: coeliac disease is an immunological complaint in which gluten interferes with the body's ability to absorb nutrients, identifiable by a blood test; gluten intolerance has no diagnostic test or biological mechanism by which to explain it.

Improvements to a person's health without gluten can be explained several ways, by placebo effect or by the fact a gluten-free diet removes other agents from the body - most importantly the poorly absorbed carbohydrates known as fructans, which may cause illness or discomfit.

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An Australian study published last year in the American Journal of Gastroenterology showed for the first time that gluten could trigger symptoms of fatigue in people without coeliac disease - making the argument for what doctors call non-coeliac gluten intolerance. But the mechanism remained unexplained.

''Gluten intolerance in individuals without coeliac disease is a controversial issue and has recently been described as the 'no man's land of gluten sensitivity','' the authors wrote.

''The evidence base for such claims is unfortunately very thin, with no randomised controlled trials demonstrating that the entity does actually exist.''

Finland has done more than any other nation to identify its coeliacs. It has the most reliable data on increased prevalence: a doubling, from 1 per cent to 2 per cent between 1979 and 2000. Fins have been eating gluten-free burgers at McDonald's for two decades.

Some academics argue perceived increases in coeliac disease are heightened by increased testing, but it is generally agreed that prevalence has increased.

The increase in people identifying with non-coeliac gluten intolerance is more conflicted. An editorial in the Medical Journal of Australia last year noted the distinction: ''The popularity of the 'fad' gluten-free diet might be peaking, but the medical need for gluten-free diets continues to rise.''

Penny Dellsperger, a dietitian at Coeliac NSW, said there were significant medical risks to people adopting gluten free diets without first ascertaining whether they suffered coeliac disease. She said the symptoms could easily relate to other illnesses.

''Obviously there are a lot of people on gluten free diets who don't need to be and who haven't had the proper tests. We have to be careful gluten doesn't get a bad wrap,'' she said.

''I don't understand why you would [maintain a gluten free diet] if you didn't need to. It's been marketed a lot and gluten has been promoted as an evil thing when it's actually not.''

-Sydney Morning Herald

125 comments
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Gluten Free 9 yearrs   #125   07:06 am Feb 02 2012

I think a lot of things about the gluten free diet are BS . I have Celiac Disease I was diagnosed in 2003 . I have many blood tests to check my levels and an extra biopsy to check my villi etc. I am 1000 times worse on the gluten free diet for 2 years I was not too bad just stomach pains evet now and than .

But since I have had years and years of back problems , stomach problems , tiredness , Vitamin levels very very low.

I read how it can help tiredness , sleeping problems , stomach problems , joint pain pretty much everything . Yet 9 years on the diet and I still have stomach , back problems , vitamin deficiencies.

The media never reserach people who are on the GF diet and still struggle with health problems , the amount of people on Celiac problems who have double the amount of problems as me is very high .

I have always hated when non Celiac's go gluten free without having an allergy or intolrence because they bring the seriousness down of the disease.

Some people have lists of 10 + problems and claim after a day or 2 they are 100 % better it's BS. Celiac Disease is linked too many other health problems and complications , it's not as simple as go gluten free and you will be 100 % healthy :(

Hanz   #124   10:26 pm Feb 01 2012

My coeliac disease was picked up because i had low iron and my aunty already had it... she unfortunately had to get skeletal before they accepted she actually had a disease. This subject is a pretty emotional one, looking at all the comments! Thankfully there are more food options now which is great but a fair bit of gluten free food is also processed and full of fat and sugar, that seems to be the way to make it taste good! The only thing i ask is that waitstaff get taught about the main allergies. My friend is allergic to dairy and people say to him "so you can't have eggs?" and people say to me "so gluten free means having pasta instead of rice?" However, at least it's a disease that appears to be fixed simply by a (annoying) diet!

Lizzy   #123   07:53 pm Feb 01 2012

I find it very interesting that those that have issue with Gluten cut wheat from there diet, why do I?? simple really, gluten is not only found in wheat..so when they cut wheat from their diet to "avoid" gluten and feel just so much better...., yep I am sure they do because they could be eating less wheat based products and more than likely more fruit & vege, however, if you have Coeliac Diease as do I, you have to avoid "all gluten containing grains, traces of and diriviative of..." and that includes things like not just the obvious, but things such as skin creams, prescription drugs, tootpastes, sports drinks, alchol and the list goes on....not to mention cross contamination...i.e own toaster, marge, jams etc.. I was diagnosed when I was 44yrs, and I can tell you that I eat very healthy and always did. My work mates always comment on my "healthy lunch box" but how I would give for the opportunity to swap...as a suffer you do not have choice, and I can tell you I cannot understand why you would choose it...I also wonder how many people that "choose" would fly from Auckland to London eating apples as the airline forgot to put your food on board...(and I couldnt even eat the nuts as they had a coating containing gluten)

Leigh   #122   02:15 pm Feb 01 2012

It turns out that we're all intolerant of gluten, grains and dairy. Diseases like coeliac and other symptoms are the more extreme end of the scale. Grains damage us in ways that unfortunately society deems normal. We think bloatedness, weight-gain and even heart disease are inevitable with age when they are largely symptoms of a grain based diet.

Yes, people have been eating grains and bread for a few thousand years but this amount of time is a drop in our evolution's bucket. Physiologically we are no different from our so called "caveman" ancestors. These people had no agriculture and survived on meat that they hunted and killed with the occasional bit of fruits and veges they could forage. There is plenty of research showing that these people lived longer, healthier, less-diseased lives than the agrarian societies who followed.

Put simply, our bodies (and even the bodies of the livestock we eat) are not designed to digest grains and dairy (past infancy). They break down slowly with all manner of diseases and become overweight. There is good information about this by biochemist turned author, Robb Wolf and Dr Robert Lustig. Lustig's videos can be found on YouTube.

Jodi   #121   03:40 pm Jan 31 2012

Articles like these annoy me!?! I am not Coeliac, however i did some free blood tests at my doctors after suffering from CHRONIC hayfever like symptoms and rashes. My hayfever was so bad i couldn't breathe, was on about 10x different anti histamines a day etc etc. Turns out i am NOT coeliac, however, i Am HIGHLY intolerant to WHEAT!! Have cut out ALL wheat from diet (and like most of you have commented this is bloody hard!! especially living in a tiny town with 1 small not well stocked supermarket) and have no symptoms now. If i eat anything with Wheat of any kind in it i get horrible stomach cramps, diarrhea, rashes, sneezing etc. SO...even though people may not be coeliacs, there are still many valid reasons to go gluten free - i mean, seriously, why would people want to fad gluten free diet with the limited range of choice and bloody cost??

Eva   #120   12:51 pm Jan 31 2012

Coeliacs should be glad that there are a lot of people that eat gluten free even though they do not 'have to'. They make it so much easier to find gluten free options and to eat in restaurants. My mum was diagnosed as a coeliac acouple of years ago at age 64. In hindsight she has probably suffered from it for 10-15 years before it was diagnosed and ended up with osteoporosis as well. In the Netherlands where she lives it is hard to find products and virtually impossible to go out for a meal, so she loves coming to NZ.

Robin Mc   #119   11:52 pm Jan 30 2012

more and more genes are appearing. those hla dq type genes just happen to be the one the sars virus attaches too as well. funny how a weapon system can be built around .but not better testing

the below was taken of an iranian website doing gluten awareness

Newly identified genetic risk variants for celiac disease Six regions harbor genes controlling immune responses, including CCR3, IL12A, IL18RAP, RGS1, SH2B3 (nsSNP rs3184504) and TAGAP. Whole-blood IL18RAP mRNA expression correlated with IL18RAP genotype. Type 1 diabetes and celiac disease share HLA-DQ, IL2–IL21, CCR3 and SH2B3 risk regions.

b   #118   09:27 pm Jan 30 2012

there are blood tests and biopsies that diagnose coeliacs disease, but for gluten intolerance: the test costs hundreds of dollars and is not covered by our government. i couldn't afford it. and so, i just decided to do without... lo and behold: after 3 weeks without gluten my skin improved, my energy levels improved, my digestion improved. placebo? who cares!

Larissa   #117   08:03 pm Jan 30 2012

Gluten free diet as a 'fad' annoys me. If it improves peoples health why should it be mocked? My sister was diagnosed with CD (after suffering for life from stomach and bowel problems) and as a result, immediate family had to get tested as its genetic. Turned out I also had it, despite having no symptoms other than low iron. I explained my eating habits to dietitian and she said I probably did not have symptoms as it sounded like I replaced a lot of foods automatically ie I enjoyed the taste of foods like macaroni, pizza, pies, but could never stomach very much of them. Now eating gluten free versions I can eat until i am full. This is no fad!

Geoff   #116   03:17 pm Jan 30 2012

If you actually have it you know why you follow the diet; if you haven't and you're doing it then that's your choice. It's an education thing really.

If you're a Gluten free by choice, will you're lucky but don't belittle those that do it because they have too, it just shows your ignorance. I love the comment in the "comments section"; "They are just looking for attention"! Anyone with this attitude to a Ceoliac - Tip - You're totally transparent and interestingly it reveals you as not "Gluten Intolerant" but "Different Intolerant" and that's a really nice box to live in!


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