Giving Up Gluten

Darshak Sanghavi senses a fad:

According to USA Today, up to one-quarter of all consumers now want gluten-free food, even though only one person in 100 has celiac disease, the autoimmune disorder worsened by gluten ingestion. Going gluten-free seems somewhat faddish. The roster of celebrities who’ve gone temporarily or permanently off it includes Chelsea Clinton, Lady Gaga, Miley Cyrus, Drew Brees, and Oprah Winfrey, among many others.

Celiac disease can be diagnosed with a blood test, but people with wheat allergies or gluten intolerance are harder to pin down:

There’s not even a mediocre blood test for gluten intolerance. The diagnosis simply relies on someone’s subjective feelings of bloating, bowel changes, or mental fogginess after eating gluten. This is a set-up for all manner of pseudo-scientific self-diagnoses, especially when you consider that 2 percent of people believe they have illnesses caused by magnetic fields. And yet, a randomized, blinded trial in Italy just showed that one-third of patients with gluten intolerance clearly felt better with gluten-free diets, which confirmed “a distinct clinical condition.” …

This is the most frustrating part of gluten intolerance. There are certainly people who have a problem with gluten that’s not autoimmune or allergic. And yet, the data suggest that almost two-thirds of people who think they are gluten-intolerant really aren’t.

The NYT recently polled some “celiac experts” critical of dieting without a diagnosis. Seth Roberts sighs:

As someone put it in an email to me, “Don’t follow the example of the person who improved her health without expensive, invasive, inconclusive testing. If you think gluten may be a problem in your diet, you should keep eating it and pay someone to test your blood for unreliable markers and scope your gut for evidence of damage. It’s a much better idea than tracking your symptoms and trying a month without gluten, a month back on, then another month without to see if your health improves.”

Thoughts on my own gluten-free diet here and here.