Gluten-free foods are everywhere.
It wasn’t always like this. I remember when the first gluten-free labeled products started appearing in the food / health trade shows around 2010, and thinking that they probably wouldn’t be commercially successful. But they grew, multiplied, and went mainstream. Today every multinational food company has a gluten-free range, and an astonishing 1 in 5 Americans (1) and 1 in 10 Australians (2) are now reducing or eliminating gluten from their diet.
It is based on shaky science (of which more later), but it is an excellent business model. The food industry designs and sells their processed gluten-free pap (3), with a label claim that enables them to increase their price points and margins, and of course market awareness.
A horde of consumers, rife with health problems and already deeply alienated from food and food production, then beats a path to their door demanding gluten-free, ‘clean’, organic, pure, natural, halal, kosher … It is both fashionable and deeply stupid, which explains why Hollywood ‘personalities’ like Gwyneth Paltrow have jumped on the bandwagon.
I am old enough to remember when vegetarianism was a fringe activity. Growing up in the post-war UK where some foods were still rationed, we ate whatever we could get our teeth into. Today’s plagues of food allergy, sensitivity and neurosis had not yet emerged, and from this perspective, the billion-dollar gluten-free landscape seems preposterous. And yet, the landscape is shifting.
A little history.
The Dutch physician Willem Karel-Dikke is credited with establishing the ground rules for celiac disease soon after World War 2, linking it to the ingestion of cereals such as wheat and rye and subsequently to the protein gluten (4-6). Australian researchers helped to determine that celiac disease was an autoimmune condition (7), and an Italian team discovered that celiac patients carried the gene HLA-DQ2, already linked to Type 1 diabetes (8). In 1980 the picture grew more complex when British researchers identified non-celiac gluten sensitivity (9). Shortly thereafter some clinicians (but not all) found that gluten-free diets had some positive effects in some cases (but not all) of Type 1 diabetes and multiple sclerosis (ie 10, 11). In 2003, the prevalence of celiac disease was established at around 1% (12), which made it interesting but not really a major public health concern. But then in 2009 a startling piece of research shook up the academic community, and set off the alarms.
In this study, a group of American scientists tested frozen sera obtained between 1948 and 1954 for antibodies to gluten, and compared the results with sera obtained from a matched sample from people living today (13). They identified a four-fold rise in the incidence of celiac disease in the newer cohort compared to the older one. They concluded that celiac disease may now affect as many as 5% of the population; and determined that undiagnosed celiac disease is associated with a 4-fold increased risk of death, mostly due to increased cancer risk.
As our genetic makeup has not changed in the last half century, this rapid increase in celiac disease could only mean that some aspect of the modern diet had become increasingly toxic.
This piece of research percolated into the public awareness, and the gluten-free food fad took off. Some say that the rising numbers of celiacs are due to the higher gluten content of modern strains of wheat, but while this would create more problems for existing celiacs, it is unlikely to have increased the number of celiac cases (14). There must be other factors at play too.
In the 60 years since the Dutch Doctor Dicke published his work on gluten, the progressive introduction of processed and then ultra-processed food products into our diets has created nutritional and clinical mayhem (15). Allergy and autoimmune disease has increased, together with obesity, type 2 diabetes, and all the other the chronic degenerative diseases. At the same time, their latency has decreased. As we grew sicker and fatter, so did the pharma companies; who could do nothing to prevent our falling health expectancy from leading, inevitably, to falling life expectancy (16,17). This is because drugs cannot alleviate the damage caused by modern processed foods, which pack the lethal combination of being calorie-dense and nutrient-light (18-20); and which are just as toxic for lab rats as they are for us (21).
At some level, most of us know this. We know that our diet isn’t right. We see the damage in our parents, in ourselves and in our children. But we don’t really know how to counter it.
Hectored by conflicting and ineffective government health recommendations (ineffective because our political ‘representatives’ are mostly whores for big business, and will not implement policies that might damage their paymasters’ profits), over-weight and ill, distanced from food production and distracted by fad diets and gastroporn, we have become deeply alienated from our food. A relationship that used to be pleasurable and health giving has become paranoid and toxic.
In this context the clamor for foods that contain zero fat, zero sugar, zero salt or zero gluten, and the panics about MSG, saccharin, sucralose, maltodextrin and the rest are all understandable. Our diet is somehow damaging us, and from there it is but a short hop to conclude that there is some damaging thing in our diet that must be removed.
Reality is rarely so simple. In all likelihood, multiple factors have contributed not only to the increasing numbers of celiac patients, but also to increased gastrointestinal disease in general.
Some pro-inflammatory compounds have been added to our diets, such as the AGE and ALE compounds formed in many processed foods, and the LPS that grows in cut fruits, salads and other foods when stored for long periods in the refrigerator. To these insults we should probably add glyphosate, the poison pill Bayer swallowed when they foolishly bought the about-to-be exposed Monsanto.
The evidence linking glyphosate exposure to celiac disease (and a range of other pathologies) continues to accumulate. Much of this was presented in reviews by Anthony Samsel and Stephanie Seneff, respectively an independent scientist and an MIT-based artificial intelligence specialist. Samsel and Seneff assembled a persuasive set of arguments that detail glyphosate’s negative impact on probiotic species in the gut, trace elements (specifically manganese and sulphur), the aromatic amino acids and the Cytochrome P450 enzymes, in ways that could plausibly increase the risk of kidney damage, thyroid damage and celiac disease (22, 23).
Other scientists examined a possible link between glyphosate exposure, dysbiosis and autism and other behavioural problems (ie 24, 25). Preclinical studies are beginning to indicate that this link may well be real, and significant (26, 27).
To recap, the addition of pro-inflammatory and toxic compounds (AGE’s, ALE’s, LPS and glyphosate) to the modern diet is a likely cause of the rising numbers of celiac and other digestive diseases, including colon cancer in younger individuals (28). If this is the case, the damaging effects of these compounds has undoubtedly been exacerbated by the removal from our diet of four of the most protective and anti-inflammatory nutrients; including the long chain omega 3 fatty acids, the polyphenols and the 1-3, 1-6 beta glucans, which has lead to increased inflammation throughout the body and the body public, though not yet, sadly, the body political.
The available evidence, however, suggests to me that it is the removal of a fourth group of nutrients, the prebiotic fibers, which is the most critical. A diet depleted in prebiotic fibers leads directly to dysbiosis, gram-negative dominance in the large bowel, and chronic inflammation in the intestines.
This may also be the cause of mal-colonisation, where probiotic species invade the small bowel and FODMAP diets are indicated.
To sum up, I believe that the vast majority of self-reporting cases of gluten-sensitivity have little to do with gluten at all, but are indicative of dysbiosis and non-specific, diet-induced gastro-intestinal inflammation. I believe, also, that the gluten-free market is largely fraudulent. In fact, gluten-free foods may be doing more harm than good. Compared with gluten- containing counterparts, gluten-free packaged foods contain twice as much fat, particularly saturated fat, more sodium – and less fiber, including the prebiotic fibers (29-31).
With the exception of confirmed celiacs and FODMAP cases, we should not be removing gluten from our diet. Instead, we should be adding prebiotic fibers.
- Golley S, Carsini N, Topping D, Morell M, Mohr P. Motivations for avoiding wheat consumption in Australia: results from a population survey. Public Health Nutr 2014;18:490-499.
- Pap: something lacking solid value or substance. https://www.merriam-webster.com/dictionary/pap
- Dicke WK. Simple dietary treatment for the syndreom of Gee-Herter. Ned Tijdschr Geneeskd 1941;85:1715-1716
- Dicke WK. Coeliac disease. Investigation of the harmful effects of certain types of cereal on patients with coeliac disease. (Thesis). University of Utrecht, Nl.1950
- Van de Kamer JH, Weyers HA, Dicke KW. Coeliac disease IV. An investigation into the injurious constituents of wheat in conjunction with their action on patients with coeliac disease. Acta Paediatr. 1953;42:223-231
- Maclaurin BP, Matthews N, Kilpatrick JA. Coeliac disease associated with auto-immune thyroiditis, Sjogren’s syndrome, and a lymphocytotoxic serum factor. Aust N Z J Med. 1972 Nov;2(4):405-11.
- Barera G, Bianchi C, Calisti L, Cerutti F, Dammacco F, Frezza E, Illeni MT, Mistura L, Pocecco M, Prisco F. Screening of diabetic children for coeliac disease with antigliadin antibodies and HLA typing. Arch Dis Child. 1991 Apr;66(4):491-4.
- Cooper BT, Holmes GK, Ferguson R, Thompson RA, Allan RN, Cooke WT. Gluten-sensitive diarrhea without evidence of celiac disease. Gastroenterology. 1980 Nov; 79(5 Pt 1):801-6.
- Acerini CL, Ahmed ML, Ross KM, Sullivan PB, Bird G, Dunger DB. Coeliac disease in children and adolescents with IDDM: clinical characteristics and response to gluten-free diet. Diabet Med. 1998 Jan;15(1):38-44.
- Kaukinen K, Salmi J, Lahtela J, Siljamäki-Ojansuu U, Koivisto AM, Oksa H, Collin P. No effect of gluten-free diet on the metabolic control of type 1 diabetes in patients with diabetes and celiac disease. Retrospective and controlled prospective survey. Diabetes Care. 1999 Oct;22(10):1747-8.
- Fasano A, Berti I, Gerarduzzi T, Not T, Colletti RB, Drago S, Elitsur Y, Green PH, Guandalini S, Hill ID, Pietzak M, Ventura A, Thorpe M, Kryszak D, Fornaroli F, Wasserman SS, Murray JA, Horvath K. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med. 2003 Feb 10;163(3):286-92.
- Rubio-Tapia A, Kyle RA, Kaplan EL, Johnson DR, Page W, Erdtmann F, Brantner TL, Kim WR, Phelps TK, Lahr BD, Zinsmeister AR, Melton LJ, 3rd, Murray JA. Increased prevalence and mortality in undiagnosed celiac disease. Gastroenterology. 2009;137(1):88–93.
- Croall ID, Aziz I, Trott N, et al. Gluten does not induce gastrointestinal symptoms in healthy volunteers: a double-blind randomized placebo trial. Gastroenterology 2019;157:881-883.
- ‘Global, regional, & national comparative risk assessment of 79 behavioural, environmental, occupational & metabolic risks or clusters of risks in 188 countries, 1990–2013: systematic analysis for Global Burden of Disease Study ’13’. US Institute Health Metrics & Evaluation (IMHE), Lancet Sept 2015
- Hiam et al. why is life expectancy in England and Wales stalling? J Epidemiol Comm Health 2018 (May)72(5): 404-408
- Association between Ultra-Processed Food Consumption and Risk of Mortality Among Middle-Aged Adults in France. Schnabel et al, JAMA Intern Med 2018.7289
- Consumption of ultra-processed foods & cancer risk: results from NutriNet-Sante prospective cohort. Fiolet et al, BMJ 2018 Feb 14, 101136/bmj.k322
- Rico-Campa et al. Association between consumption of ultra-processed food and all-cause mortality. SUN prospective cohort study. BMJ ’19; 365:l1949
- Napier BA, Andres-Terre M, Massis LM, Hryckowian AJ, Higginbottom SK, Cumnock K, Casey KM, Haileselassie B, Lugo KA, Schneider DS, Sonnenburg JL, Monack DM. Western diet regulates immune status and the response to LPS-driven sepsis independent of diet-associated microbiome. Proc Natl Acad Sci USA published ahead of print February 11, 2019. https://doi.org/10.1073/pnas.1814273116
- Samsel A, Seneff S. Glyphosate, pathways to modern diseases II: Celiac sprue and gluten intolerance. Interdiscip Toxicol. 2013 Dec;6(4):159-84.
- SamselA, Seneff S. Glyphosate, pathways to modern diseases III: Manganese, neurological diseases, and associated pathologies. Surg Neurol Int. 2015; 6: 45.
- Rueda-Ruzafa L, Cruz F, Roman P, Cardona D. Gut microbiota and neurological effects of glyphosate. Neurotoxicology. 2019 Aug 20;75:1-8.
- Argou-Cardozo I, Zeidán-Chuliá F. Clostridium Bacteria and Autism Spectrum Conditions: A Systematic Review and Hypothetical Contribution of Environmental Glyphosate Levels. Med Sci (Basel). 2018 Apr 4;6(2). pii: E29.
- Aitbali Y, Ba-M’hamed S , Elhidar N, Nafis A, Soraa N, Bennis M. Glyphosate based- herbicide exposure affects gut microbiota, anxiety and depression-like behaviors in mice. Neurotoxicol Teratol. 2018 May – Jun;67:44-49.
- Dechartres J, Pawluski JL, Gueguen MM, Jablaoui A, Maguin E, Rhimi M, Charlier TD. Glyphosate and glyphosate-based herbicide exposure during the peripartum period affects maternal brain plasticity, maternal behaviour and microbiome. J Neuroendocrinol. 2019 May 7:e12731.
- Siegel RL, Fedewa SA, Anderson WF, Miller KD, Ma J, Rosenberg PS, Jemal A. Colorectal Cancer Incidence Patterns in the United States, 1974–2013. J Natl Cancer Inst. 2017 Aug; 109(8): djw322.
- Fry L, Madden AM, Fallaize R. An investigation into the nutritional composition and cost of gluten-free versus regular food products in the UK. J Hum Nutr Diet 2018; 31:108-120.
- Miranda J, Lasa A, Bustamante MA, et al. Nutritional differences between a gluten-free diet and a diet containing equivalent products with gluten. Plant Foods Hum Nutr 2014;69:182-187.
- Golley S, Baird D, Hendrie GA, Mohr P. Thinking about going wheat-free? Evidence of nutritional inadequacies in the dietary practices of wheat avoiders. Nutr Diet 2019;76:305-312.