Gluten-free diets are good for people with coeliac disease but nobody else, yet going gluten-free has become a major international food trend driven along by celebrity endorsement. Hocus-pocus like this doesn’t just happen; it’s sophisticated food marketing on a global scale.
All dietitians and nutritionists are familiar with coeliac disease – the gastrointestinal disorder suffered by about one percent of the population. It’s due to an inflammatory response to gluten, a protein found in wheat, rye and barley, which damages the gut wall resulting in malabsorption of nutrients leading to gas, distension, diarrhoea and weight loss. Adopting a gluten-free diet provides great benefits to those with coeliac disease but it has long been thought that such a diet offers no benefit to people without the condition.
What about gluten sensitivity?
More recently, a hypothesis has emerged that there is a spectrum of reactions to gluten with full-blown coeliac disease at one end and mildly irritable bowel at the other. The term gluten sensitivity has been coined to describe the “no man’s land” in the middle. If it’s true, millions of people could be affected. But gluten sensitivity is almost impossible to diagnose as the gut wall is not damaged and there is no diagnostic biomarker. So, if you have tummy troubles and they seem improve when you go on a gluten free diet, well, maybe, perhaps you have gluten sensitivity.
However, there is hardly any scientific evidence that gluten sensitivity actually exists. The scant scientific literature uses terms such as ‘emerging concept’ or ‘evolving paradigm’ or ‘hypothesis’.
Two recent trials
Just a handful of randomised controlled trials have been conducted to assess whether gluten sensitivity is real, two of them by the same research group in Melbourne. In the first trial subjects thought to have gluten sensitivity ate bread and muffins containing gluten or similar control foods without gluten. Their bowel symptoms got worse on the gluten-containing foods so it appeared that gluten sensitivity could be real.
However, in the second study the same researchers were careful to limit confounding dietary factors. Importantly, the 2-week run-in diet was low in FODMAPS – fermentable, oligo-, di- and monosaccharides and polyols known to produce gas and distension. Although subjects for the trial were presumed to have gluten sensitivity, their symptoms improved on the run-in diet low in FODMAPs. But when they were challenged with gluten no adverse effect was observed. The researchers concluded:
These … studies showed no evidence of specific or dose-dependent effects of gluten in patients with [non-coeliac gluten sensitivity] placed on a low FODMAP diet… These data suggest that [non-coeliac gluten sensitivity] … might not be a discrete entity or that this entity might be confounded by FODMAP restriction, and that … gluten might be not be a specific trigger of functional gut symptoms once dietary FODMAPs are reduced.
The current diet craze
That’s the science but let’s face it, all the scientific facts in the world are never going to get in the way of a good diet craze like the current gluten-free mania. TIME labelled the gluten-free movement as Number 2 on its top 10 list of food trends for 2012. Gluten-free options are popping up on menus all over the United States. Earlier this year the NDP Group, a leading information company, reported that one in every three American adults claimed to be cutting down on gluten or avoiding it altogether… and it’s growing. According to NDP “This is the health issue of the day”.
Health issue? What’s the health issue exactly?
To get a deep understanding of the benefits of going gluten-free one has to rely on insights from a long line of celebrities. Gwyneth Paltrow apparently found that going gluten free has made her feel lighter and more relaxed. Prior to going gluten-free, Gwynnie says she had “a lot of unexpressed anger. I made everyone else’s feelings more important than my own. I’d suck it up and then be alone in my car yelling at traffic or fighting with hangers in my closet when they got stuck together.”
Miley Cyrus told her fans that “Everyone should try no gluten for a week. The change in your skin, physical and mental health is amazing.” Elisabeth Hasselbeck has apparently discovered myriad benefits of a gluten-free diet, including the alleviation of autism. Victoria Beckham, Miranda Kerr and the appropriately named Lady Gaga have reportedly embraced a gluten-free diet as a means of losing weight.
Who’s spreading all this bulldust?
OK, it’s time to put your Sceptical Nutritionist hat on. Given that there is negligible evidence that a gluten-free diet will provide any health benefit to 99% of the population, what’s driving this diet craze? How do celebrities in the United States, Britain and Australia simultaneously come to a collective belief that a gluten-free diet is amazingly good for you? Why are two of them – Paltrow and Hasselbeck – so convinced of the benefits that they have written books on the topic? Coincidence?
Celebrities earn a living from being famous which provides opportunities for endorsements. But why the sudden collective endorsement of the gluten-free diet? This has got ‘public relations campaign’ written all over it.
But who is writing the cheques? Who stands to benefit from a jihad against wheat and other grains?
Brave new world
Welcome to the brave new world of global food marketing. If conventional nutrition science gets in the way of business the way forward for your industry is clear: Firstly, concoct a baseless health campaign. Then recruit a gaggle of celebrities to carry the message directly to the general public. It’s important to bypass nutrition experts altogether. After all, who needs an informed voice of reason when you have testimonials from celebrities? And then you roll the campaign out globally.
The idea is not to promote your own food category but to damage a competitor category, changing the paradigm of what comprises a healthy diet in the process, at least in the minds of the star-struck public.
It’s issues management on a global scale. Very cynical but very effective.