Comments on: Gluten-free diets: who’s spreading the bulldust?

By: Jenny

Jenny — Fri, 20 Sep 2013 19:10:34 +0000

I was a participant in the second study you cite. While the researchers excluded FODMAPs, I hope they are able to repeat the study excluding food chemicals and gums (e.g. CMC) as well. Both these seem to cause gut irritation and may have skewed their results. See this article by Barrett which outlines this http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388522/ . It was also very interesting that they found that some people seemed to react to whey protein (I did) which may also have affected their results. I hope they investigate this further too. So I think you are a bit premature saying that non-coeliac gluten intolerance definitely does not exist. It may not but this has not yet been proved conclusively.

While only 1% of the population have coeliac disease, a far larger number, around 30% of the population are not able to absorb FODMAPs. They get bloating and other IBS symptoms. Fructans in wheat are a major source of FODMAPs. So people think that gluten is the culprit when actually they are reacting to the fructans in wheat. Symptoms from malabsorption of FODMAPs are dose related, so giving up wheat is often enough to greatly reduce symptoms for many people even when they are still eating other FODMAPs. Similarly, removing dairy from the diet removes lactose and whey protein and can also relieve symptoms.

Doctors and dietitians (some of whom have not kept up with their reading) would do a lot more for their cause if they clarified the mechanisms of FODMAP malabsorption instead of just telling people that gluten intolerance does not exist. People (including Gwyenth Paltrow) are not silly and can see the real difference in their symptoms when wheat is excluded. So when they are ridiculed and told that their real symptoms don’t exist they stop listening to conventional practitioners and move to the alternative sector. And who could blame them? My son and I malabsorb FODMAPs and for many years I was told it was all in my head – several doctors suggested I see counselling for my IBS and for my concerns for my son’s IBS. Now we are both on the low FODMAP diet and have no symptoms. I am a scientist (non medical) and I still use conventional doctors and dietitians – but with care! The medical profession really needs to be more humble, flexible, keep up with their reading and not dismiss patients so quickly. Or they will continue to loose them to Dr Google and fringe practitioners. Just because the causes of symptoms have not yet been fully clarified by research does not mean that they do not exist.

By: corina

corina — Sun, 01 Sep 2013 05:42:01 +0000

Bill, I recently discovered your site and I enjoy it more than I can say here. Being a public health nutritionist for 23 years (with a PhD in medical sciences), I am struggling all the time with misconceptions about nutrition. Nutrition became the science in which everyone is a specialist, as in football play (here, in Europe) or weather forecasting. I don`t know what`s more difficult: to keep up to date in nutrition science, or to teach my students and patients what`s true and what`s not from what they read on internet or hear in media. Congrats, I`ll follow you carefully from now on!

By: Tina

Tina — Tue, 27 Aug 2013 13:14:15 +0000

At last some common sense! Keep up the good work. And, thank you!

By: Bill Shrapnel

Bill Shrapnel — Sat, 17 Aug 2013 22:50:26 +0000

Hi Emma. I guess if someone follows a gluten free diet it will probably lower their glycaemic load. This may be a good thing for long term health but would it actually make you feel better?
You mentioned that people are ‘attributing’ benefits to a gluten free diet. I think this is a key point. The researchers in the first study appeared to have wrongly attributed benefits to the gluten free diet in their first study only to find that lowering FODMAPs was the likely source of the benefit in the second. For the lay person, commencing a particular diet in the BELIEF that it will provide benefit may become self-fulfilling – the placebo effect. Regards, Bill

By: Emma

Emma — Fri, 02 Aug 2013 12:49:30 +0000

Do you think perhaps the benefits people are attributing to their “gluten free” diets could in some cases arise from the avoidance of gluten also leading to a lower GI diet? When avoiding gluten, a lot of people might replace common high GI foods such as highly refined white bread, pasta and cake (which can make up a large proportion of our diets) with more protein and complex carbs, which could lead to feeling a lot better.

It’s just a thought because I know that I sometimes feel very bloated after eating refined white flour products, but it’s not a gluten thing as whole-grains or course ground products don’t seem to bother me in the same way.

By: Bill Shrapnel

Bill Shrapnel — Mon, 22 Jul 2013 23:34:38 +0000

Hi Rochelle. It sounds like you are in safe hands and I suggest that you take the advice of your dietitian. Given your family history you may be down the coeliac end of the spectrum. Coeliac disease in adults can be sub-clinical, with relatively mild symptoms which do respond to the withdrawal of gluten. Best wishes, Bill

By: Rochelle

Rochelle — Mon, 22 Jul 2013 05:40:00 +0000

Hi Bill,
I appreciate your take on the GF fad… I am interested on your opinion in regards to my gluten problems and confusions.
I am within a family of six.
Four out of my six family members have been diagnosed with Coeliac Disease – myself and my Dad were the only ones who came back negative for the disease. Prior to my family being diagnosed (slowly, one by one) I was seeing a Doctor for severe and long term irritable bowel syndrome. Straight after my sister found herself in hospital and diagnosed as Coeliac, we were informed that Coeliac can be a hereditary disease and instantly figured “wow this could explain my symptoms and could be the answer to my problems!” and should get the whole family tested – results showed though that it was not and I was referred to a Dietician. The Dietician then started seeing myself (for IBS) and my Mother and 3 sisters for Coeliac Disease. She eventually recommended that I try a gluten-free diet as well as it may be the answer to my problems – nothing else seemed to be working. Within a month my irritable-bowel symptoms ceased, I had more energy, no longer felt fatigued bloated and sick after certain foods – it was liberating! The Dietician explained I was gluten-intolerant.
Is gluten-intolerance possible for some individuals? Particularly given that they may (like myself) have an obvious family genetic disease? Is it possible I may be diagnosed with Coeliac Disease in the future? Is it true it can become activated later in life?
Looking forward to your thoughts and advice

By: Bill Shrapnel

Bill Shrapnel — Mon, 22 Jul 2013 05:38:26 +0000

Hi Joey. It’s good to see that George Weston Foods is supporting nutrition research. Without food companies’ support very little nutrition research would be conducted in Australia. Who else would fund it?

I suspect that you are assuming that because the study is industry-funded you can’t believe the results. In my experience all researchers conducting industry-funded work demand the right to publish the work, irrespective of the results. This is written into the contract.

Why would GWF want to scuttle the gluten-free concept? There is a huge market opening up that they could capitalise on. Maybe they we just seeking the truth. Regards, Bill

By: Joey

Joey — Tue, 16 Jul 2013 23:04:51 +0000

I’m not certain if anyone else has pointed this out, but the study you cited as providing proof that the gluten-free lifestyle by non-celiacs is ‘bulldust’ was bought and paid for by George Weston Foods. A quick view of their homepage on their website pretty much explains what’s going on, here, so I feel no need to continue commenting. http://www.gwf.com.au/

By: Deanna

Deanna — Tue, 09 Jul 2013 00:18:35 +0000

Hi Bill,
I understand your point of view, and I agree whole-heartedly. But does it really matter? Coeliac Disease is real, and regardless of gluten sensitivity being real or not, it means that labelling and products that are gluten free need to be available. The personal choice to refute gluten is an individual decision that, as you say doesn’t necessarily result in miraculous health benefits, but actually often results in more expense, higher fat, lower fibre and more often than not, inferior taste and texture. The placebo effect, or the feeling of control over food cannot be ignored, often people feel better because they are in control of their food (because they often can’t feel this for other aspects in life) can be more satisfying and stomach settling in itself. Stress, anxiety and many other mental illnesses can cause gluten-sensitive-like symptoms themselves, so this is another avenue that can produce results – As you say, few studies have clearly shown a definitive positive relationship between gluten and alleviating symptoms, and it is hard to distinguish such generic symptoms when there are other intolerances like fructose malabsorption/FODMAPS to look at too.
So why not claim you are gluten sensitive? I’d imagine they feel important requesting their meal to be special, and isn’t the point of healthy eating to enjoy your food? The main harm you are doing is confusing consumers about gluten intolerance and ‘sensitivity’ (if there is such a thing); who wouldn’t be confused as a chef/waiter when some people come asking for GF bread cooked on a different toaster to regular bread to avoid contamination, while other people don’t mind a little bit of gluten. This confusion or mis-communication can make it much harder for the Coeliacs out there. But at least our food labelling laws (which I understand have limitations in themselves) do not take celebrity endorsement seriously. And why not write a book about how miraculous cutting out gluten was from their life? Such celebrity divorces are the hottest topic in town and the joke is on you if you buy into that stuff really! Doesn’t this automatically make you fail the life skills test if you believe it?
Thanks for your point of view. I do wonder how long it will last, and what will be next. But on a positive note, eating out as a Coeliac (or, to be fair, as a gluten-sensitive person) is now much easier with restaurants understanding what ‘gluten’ is, the labelling of menus, food safety teams trained in the area and general awareness of it. I’m sure many long-diagnosed Coeliacs are enjoying less conversations about what they can and can’t eat now, making the dining out experience much less of a hassle (I’m aware some will refute this, with, as my point above points out there is still some confusion, however I’d imagine it’s easier now than 10, 20years ago regardless). The best study would be to invent some sort of new diet (albeit not an ethical study) and see how long it takes to circulate globally. My thought is that you’d have to choose your celebrity wisely and also the social media you will flood with endorsements, recipes, etc etc etc……