A Dublin caf茅 owner sparked internet outrage this week when they said . They later admitted it was just a joke, but the commotion reflects the rise of what might be called 鈥済luten intolerance intolerance鈥�.
Many people see going gluten-free as just another fad diet, but researchers are still trying to figure out what science might underlie it. Now a US study has found that while the number of people with coeliac disease has dipped slightly in the past five years, staying at just under 1 per cent of the population, those who , to 1.7 per cent.
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Coeliac disease is supposed to be the main medical reason for avoiding gluten 鈥� it arises when the immune system reacts to gluten in wheat and damages the lining of the gut as a result. The finding that it鈥檚 not on the rise is being taken by some as proof that those annoying people who say they can only eat gluten-free food are really just fussy eaters.
To me, the only real surprise was that the number of people saying they eat gluten-free is so low. Other surveys have suggested that the proportion of people in the US who try to at least reduce their gluten intake is .
But the latest findings do not mean that all those people are acting irrationally. In fact, most of those who avoid gluten do not claim to have coeliac disease, but a less severe condition sometimes called gluten intolerance. They say that after eating wheat they get stomach pains and bloating. We may or may not believe them, but statistics about coeliac disease tell us nothing.
Should you eat wheat? The great gluten debate
There are reputable nutrition researchers who believe that gluten intolerance exists in some people. Some think that , called FODMAPs (short for fermentable oligosaccharides, disaccharides, monosaccharides and polyols).
The incidence of a genuine gluten problem is probably low. Various studies have tried to measure this by eliminating gluten from people鈥檚 diet and then reintroducing it in a way that meant people didn鈥檛 know if they were getting it or not. They conclude that . So at least some of those who claim to be suffering from 鈥渨heat belly鈥� are right.
The popularity of going gluten-free may also be explained by its overlap with another controversial food trend, of avoiding not just bread but all starchy food as part of a low-carb diet. This is diametrically opposed to most official guidelines on healthy eating 鈥� and yet studies suggest it can help people lose weight and even help people with type 2 diabetes reduce their blood sugar level.
To be fair, there are also studies that support the mainstream dietary advice, of eating food that is high in carbs and low in fat. It is a sad fact that the entire field of nutritional research is riddled with inconsistencies. As an epidemiologist from outside the field wrote in the BMJ: 鈥�.鈥�
You can understand some people thinking that if the experts can鈥檛 agree among themselves, why shouldn鈥檛 they take dietary advice from celebrities 鈥� or just go with their own gut instinct?
And some people with coeliac disease report that the gluten-avoiding craze has a major benefit: it is now much easier to get their hands on gluten-free processed foods, from pasta to birthday cake.
Conversely, they also say that other people may not take their gluten avoidance as seriously as before, lumping them in with those fussy eaters. Maybe those doctor鈥檚 notes aren鈥檛 such a crazy idea after all.
