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Consumer Reports weighs in on gluten.

Gluten-free food advertising is everywhere. There is, after all, an extremely robust market for these Products. According to a survey conducted by the nonprofit, independently-funded consumer watchdog group Consumer Reports, a majority of Americans now believe a gluten-free diet would improve their health. A subset of this group consists of still millions of Americans who believe they must desist all gluten consumption--the survey found 33% of its respondents buy gluten-free products and actively try to avoid gluten. These are not Celiac disease patients or, the numbers show, even those diagnosed with gluten sensitivity. The number of people estimated to have genuine gluten sensitivity is far, far lower--less than 7% of all Americans. All this might be harmless, but it turns out for non-gluten sensitive people, cutting out gluten is decidedly less nutritious than leaving it in the diet.

A quarter of the people Consumer Reports surveyed thought gluten-free foods have more vitamins and minerals than other foods. But the organization's detailed review of 81 products free of gluten across 12 categories revealed they are too often not enriched or fortified with nutrients such as folie acid and iron, as many products that contain wheat flours are.

In an article from the Harvard Health Letter dating back to 2009, concerns over gluten-free products containing a lot of empty calories and fewer nutrients were raised:

"The gluten-free diet has traditionally depended on starch from rice, corn, and potatoes. Food makers have also learned how to use xanthan and guar gums to replace gluten's elasticity: a common complaint about gluten-free baked goods is that they are powdery. But these formulations can also leave diets short of fiber and B vitamins."

Gluten is a protein found in wheat, barley and rye, and for years now it has been blamed for problems as diverse as forgetfulness, joint pain and weight gain. This last one seems to be a major reason people go gluten-free. According to the recent survey, that same third of people who restrict gluten do so because they think that going gluten-free will help them slim down. Unfortunately, there's very little evidence that doing so is a good weight-loss strategy; in fact, the opposite is often true. Eliminating gluten often means adding sugar, fat and sodium, which are commonly used to compensate for flavor and texture in these foods, like the empty calories of xanthan and guar gums only worse: sugar and fat also add more calories that could cause some people to actually gain weight on these "diets."

Apart from weight loss, among the top benefits of going gluten-free that respondents cited were better digestion and gastrointestinal function, increased energy, lower cholesterol and a stronger immune system.

But the reality is, worldwide, gluten is a source of protein, both in foods prepared directly from sources containing it, and as an additive to foods otherwise low in protein. People who exercise heavily need protein. Many others get too much. But even if you're following the sensible 60% carb--22% fat--18% protein recommendations of many sports-related nutritionists, avoiding gluten will mean avoiding not just protein--but also a good deal of healthy carbohydrate. This is because gluten is a good source of fiber.

"While people may feel better on a gluten-free diet, there is little evidence to support that their improved health is related to the elimination of gluten from their diet," said Trisha Calvo, deputy content editor for health and food, in a statement issued by Consumer Reports. A gluten-free diet means avoiding all products that contain wheat, rye, and barley, as well as their derivatives. The list ineludes types of wheat like durum, farina, graham flour, and semolina. Also prohibited are bulgur, kamut, kasha, matzo meal, spelt and triticale. Swearing off whole grains such as these is not a good idea if you don't have Celiac disease; for athletes it's an even worse idea. (And if you're consuming gluten-free versions of these foods rather than eliminating them altogether, you are stripping away much of the fiber anyway.)

Celiac disease is a rare autoimmune condition in which gluten causes potentially life-threatening intestinal damage. In the case of going gluten-free, it's starting to look like if for you it feels like a choice at all, it is not one worth making. But for those who must cut out gluten:

1. Eat grains. Consuming a variety of whole grains is healthy regardless of whether you're gluten-free, so don't cut them entirely out. Replace wheat with amaranth, corn, buckwheat, quinoa, millet and sorghum, which aren't related to wheat and have high vitamin and fiber content. Also supplement these with an occasional serving of rice.

2. Shop the grocery store perimeter. Stick with naturally gluten-free whole foods: fruits, vegetables, lean meat and poultry, fish, most dairy, legumes, grains and nuts.

3. Read the label. Minimize the intake of packaged foods made with refined rice or potato flours; choose non-rice whole grains instead. When buying processed foods, keep an eye on the sugar, fat and sodium content of the product, as well as the presence of nutritionless fillers like xanthan gum.

At the intersection of "good advice" and "plausible explanation" (for why so many people perceive health improvements after losing gluten), lies the fact that eating lean protein plus plenty of vegetables, fruits, nuts, and seeds is a great way to avoid gluten. It is also a very healthy way to eat. This therefore could contribute to the reason some people in fact feel better cutting out gluten--they are simply eating much better, and the lack of gluten is taking the credit for the reason they feel better. But this outcome requires sticking to whole vs. processed gluten-free foods. So far, research shows that removing gluten from the diet just isn't medically necessary for the vast majority of people.

Consumer Reports, November 2014, "The Truth About Gluten," consumerreports.org

Harvard Health Letter, June 2009, "Getting Out the Gluten," http://www.health.harvard.edu/newsletters/Harvard_Health_Letter/2009/June/Getting-out-the-gluten

Celiac Disease Gluten-free Diet Support Center, "Celiac Disease From Medical Authorities" and "Celiac Disease Statistics," by Jefferson Adams, with additional material by Scott Adams, www.celiac.com/index.html
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Date:Nov 1, 2014
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