Introduction
The recent years have seen the explosion of both fad and health-based diets in most contemporary societies as people become increasingly health-conscious. Among these diets is the gluten-free diet which has risen in popularity over the last two decades due to the surge in the prevalence of both celiac disease and gluten sensitivity disorders. A gluten-free diet is a type of diet that eliminates any foods that contain the protein gluten, which naturally occurs in wheat, rye, and barley (Cheezburger Incorporation). Other grains that contain gluten include Kamut, oat, spelt, and trificale. Traditionally, physicians recommended this diet for patients suffering from celiac disease – an autoimmune disorder exacerbated by eating foods containing gluten. A Greek doctor called Aretaeus of Cappadocia recorded the first known case of the illness in 2nd century A.D. and identified symptoms such as pallor, fatty diarrhea, and weight loss (Reho Travel Party Limited). The word ‘celiac’ comes from the Greek word ‘kailiakos’ which means ‘suffering in the bowels’ (Reho Travel Party Limited).
While several physicians made crucial observations over the years regarding the symptoms of the disease, it was not until the aftermath of WW2 that doctors made a fundamental discovery about its treatment, triggering the commencement of gluten-free diet. Between 1939 and 1946, a Dutch pediatrician, Professor Willem Dicke, proved how the health of children and infants with celiac disease improved dramatically when wheat, oat, and rye flours were eliminated from their diet and replaced with maize and rice flours (Reho Travel Party Limited). During the war period, there was a scarcity of wheat grain in Holland due to the obstruction of trading activities. After the war, however, trade resumed, and wheat became plentiful in the country, leading to its reintroduction in the diet. Consequently, Willem observed a rapid deterioration in the health of such children. In 1954, a UK physician, John W. Paulley, identified the abnormal lining of the small intestine associated with those suffering from the disorder, thereby unearthing a crucial feature of celiac diagnosis (Reho Travel Party Limited). He was the first person to link a gluten-free diet with the alleviation of celiac symptoms. Since then the diet became a health intervention strategy for celiac patients since no cure exists for the disease.
Today, however, most of the adherents to this diet are non-celiac individuals. Its prevalence in this population segment stems primarily from the landmark book, Wheat Belly, written by an American cardiologist, William R. Davis, in 2011 (Cheezburger Incorporation). In the book, the author claims that modern wheat is toxic due to its relatively high levels of gluten compared to and urges the readers to avoid all wheat products sold in the market if they want to prevent the accumulation of belly fat in their midsection. The book soon became a New York Times Bestseller within a month of its publication, causing widespread adoption of the diet among non-celiacs. Since then, the endorsement of gluten-free diets by celebrities such as Miley Cyrus, Oprah, and renowned online bloggers have accorded the diet fame status. The diet is an offshoot of the Paleo diet that advises its followers to exclude foods that humans did not consume before the advent of the Neolithic agricultural revolution such as legumes, dairy, processed oils, all grains, and refined sugars (Cheezburger Incorporation). The gluten-free diet is of particular interest because its adherents greatly outnumber celiac patients, stimulating the global consumption of gluten-free products and sales of about $2.5 billion annually in the United States (Tovoli et al.). Furthermore, wheat is one of the primary sources of food in the world, constituting about 50% of the caloric intake by individuals in both the industrialized and developing nations (Tovoli et al.). The massive sales and acute dependence on wheat, coupled with the rampant claims of rapid weight loss make the diet worthy of scrutiny and scientific evaluation.
Science of the diet
The science behind the weight loss claims arises from the documented effects of gluten in the human body. Until recently, William’s book was widely disregarded within scientific circles due to the absence of evidence to back his claims regarding gluten and his selective bias when identifying studies to support his theory. However, recent research published at the onset of 2013 by Brazilian scientists found a positive correlation between prolonged gluten intake and weight gain (Louis). The study aimed at examining the differences in certain biochemical and genetic markers such as metabolic syndrome and obesity that existed between rats fed with gluten and rats fed with gluten-free diets. While both groups of rats received high-fat diets, the second group consumed foods with 4.5% gluten. According to the findings, the control group (rats fed gluten free diet) displayed significant weight loss without any trace of fat in their excretion. Hence, the researchers concluded that the major risk factor for obesity is gluten and not calories or fat, since gluten disrupts the normal endocrine and exocrine processes responsible for controlling the concentration of lipids in the body, and modulates the nuclear gene expression to alter metabolism in favor of weight gain (Louis). The findings also attribute the increased prevalence of celiac disease and gluten sensitivity disorders to the development of agricultural hybrids of wheat and other grains, heightening their gluten levels from 5% in traditional species to 50% in modern grain varieties.
The continued consumption of gluten eventually causes an autoimmune response that prompts an attack on the body muscles by the immune system, leading to inflammation. In response, the body releases higher than normal amounts of insulin and cortisol (anti-inflammation hormone) to remedy the metabolic dysfunction. The side-effect of high cortisol concentration in the bloodstream is the increased storage of visceral (belly) fat, leading to weight gain (Gluten Free Society). The result is a decline in muscle mass since to fat ratio, energy reduction, and increased risk for diseases such as arthritis and muscle atrophy, which restrict mobility and, therefore, hinder the engagement in exercises. Less physical activity as well as stronger food cravings to compensate for the depleted energy leads to higher intake of gluten products, thus reinforcing the muscle wasting and weight gain cycle. In contrast, a gluten free diet implies normal metabolic functions due to the absence of gluten and less storage of visceral fat. For already overweight or obese individuals, gluten free diets reduce their insulin and cortisol levels, causing their fat storage process to decelerate while triggering the rapid digestion of existing fat stored in the belly area. The outcome is weight loss. This diet is different from other existing weight-loss diets because it causes changes in the metabolic processes associated with weight gain. Besides, the others emphasize the elimination of fats from the diet, yet scientific evidence proves the non-association between fat intake and weight gain.
Limits of the diet
Gluten free diets recommend the avoidance of several foods. Prohibited grains and starches include wheat, oat, rye, barley, and their products such as pasta, bread, cake, macaroni, muffins, pastries, waffles, pretzels, spaghetti, rolls, and pancakes among others (Massachusetts General Hospital). For beverages, the list includes instant tea and coffee, flavored milk, lagers, beer, ales, malted wine, and malted milk. Proscribed soups and casseroles include creamed soups, dishes sieved with gravy, bouillon-based broths, and casseroles thickened with flour. Other foods include wheat germ oil, marinades, malt vinegar, margarine, and spreads made with prohibited stabilizers, canned products with preservatives, emulsifiers, and candy.
Good points about diet
Among the benefits of the diet, include weight loss, energy boost, and alleviation of celiac symptoms. Apart from the normalization of metabolic processes mentioned above, weight loss also results from other behavioral changes that accompany the adoption of gluten-free diets. First, the diet recommends the replacement of gluten-containing foods with other high fiber, gluten-free grains such as quinoa. Generally, grains contain high dietary fiber content linked to a reduction in the body weight in adults. The reason for this relationship is that soluble fiber modulates the concentration of insulin and postprandial plasma glucose in the body, causing a reduction in serum and lipid amounts that result in decreased fat storage and weight loss (Rubin). Second, the diet eliminates most processed foods such as pastries, bread, and sweets that typically contribute to weight gain. Instead, it advocates the consumption of vegetables and fruits to strengthen the immune system and other metabolic processes. Moreover, the exclusion of highly processed foods reduces the risk factors for other health disorders such as diabetes and hypertension. Third, the adoption of gluten-free diet prompts individuals to pay close attention to food labels and thus make healthier nutrition decisions than before. When purchasing food products, individuals must look for labels indicating that the foods they purchase are free of gluten. In the absence of such labels, they may have to call the manufacturers directly to confirm the ingredients of their products before purchasing them. The intensified scrutiny of foods enables people to identify harmful synthetic chemicals and ingredients (apart from gluten) in some products that they may have ignored before. Some may also take up exercise to supplement the diet so as to attain their ideal weight faster.
Some followers of the diet claim that it boosts their energy. Vegetables and fruits are not high-calories foods. Thus, the body digests them using very little energy. Furthermore, the diet advises its followers to consume high fat-process foods because their digestion involves the release of energy that boosts the existing energy reserves. Lastly, gluten-free diet alleviates the symptoms of celiac disease and other gluten sensitivity disorders such as gluten ataxia, wheat allergy, and dermatitis herpetiformis (Tovoli et al.). Since no known cure for such illnesses exists, a gluten-free diet is the next best solution to providing pain relief and discomfort to such patients.
Bad points about the diet
Despite its benefits, the gluten free diet poses numerous health and economic risks. Firstly, the exclusion of wheat from the diet means that individuals only have limited varieties of nutrient-enriched food products to choose from, leading to deficiencies in certain minerals such as calcium, iron, folate, riboflavin, niacin, and thiamine (UW Health). These minerals are essential in the development of bones. Their deficit in the body may eventually cause bone deformities such as osteoporosis. Secondly, wheat abstinence without replacement with an adequate source of dietary fiber could cause gastrointestinal disorders that may range from mild cases of constipation to severe instances of duodenal ulcer and hemorrhoids (Anderson et al.). Thirdly, the reduction grain intake (dietary fiber) could potentially hamper the production of beneficial bacteria in the gut such as Lactobacillus and Bifidobacterium that are vital for strengthening the immune system (UW Health). If this happens, the immunity of individuals may be compromised.
Thirdly, a gluten free diet imposes additional costs on its followers. Since gluten free products require careful handling to prevent cross-contamination and are relatively fewer compared to gluten products, their prices may be higher than gluten foods (UW Health). Thus, some people may not be able to afford them and may eventually drop the diet before achieving any success in weight loss. Being a relatively new diet, gluten free products may lack in variety and accessibility. Some stores may not stock the products, forcing individuals to go from shop to shop searching for the foods they want. This search is time-consuming and incurs high transport costs. Fourthly, it is tough to avoid gluten-containing products in the market due to the incorporation of gluten-grains in many other commodities apart from foods. They include medicines, cosmetics, shampoos, and lotions. Most of these goods display their ingredients in their chemical name, which is unrecognizable to lay audiences. Lastly, a gluten-free diet is highly restrictive. Wheat products such as pastries and confectionaries are usually very popular and are a staple food ingredient in some quarters. Their exclusion from the diet eliminates almost three-quarters of the food variety available in the market. This regimen may, therefore, be hard to follow, especially for those with a sweet tooth.
Rating diet
Based on the rating scale provided in the appendix, gluten free diet falls within the 120 mark out of 160 points. Its effectiveness stems from its superior weight loss capability over other diets, and adequate caloric levels of proteins, vitamins, and carbohydrates despite the elimination of numerous foods. However, some points, 10 for each, was subtracted for the diet being boring for those addicted to wheat products such as parties and candy. Other shortcomings include the lack of permanent behavioral changes such as exercise, health risks related to decreased mineral bioavailability, and misrepresentation of facts related to the diet by salespersons or celebrities lacking the necessary medical qualifications.
Conclusion
Overall, the gluten-free diet is effective in controlling celiac disease, gluten sensitivity disorders, and weight gain, while boosting the energy levels in the body. Although much controversy still surrounds the assumptions behind its efficacy, the little scientific literature that exists appear to demonstrate a positive correlation between the diet and weight loss. However, its followers, particularly non-celiac individuals, must take precautions to avoid some of the risks posed by the diet, including mineral deficiency, constipation, and additional costs. Nonetheless, successful weight loss and better health await those who adhere to the diet guidelines. Hence, I would be willing to try it out and even recommend it to my friends.
Works Cited
Anderson, J. W., P. Baird, R. H. Davis, S. Ferreri, M. Knudtson, C. L. Williams. "Health benefits of dietary fiber." Nutrition Reviews 67.4 (2009): 188-205. Web. 21 Mar. 2016. <doi:10.1111/j.1753-4887.2009.00189.x>.
Cheezburger Incorporation. "Gluten Free Diet." Know Your Meme. N.p., n.d. Web. 21 Mar. 2016. <http://knowyourmeme.com/memes/gluten-free-diet>.
Gluten Free Society. "Eating Gluten Causes Weight Gain & Muscle Pain." N.p., Web. 21 Mar. 2016. <https://www.glutenfreesociety.org/eating-gluten-a-quick-way-to-muscle-pain-and-weight-gain/>.
Louis, P. F. "Gluten Confirmed To Cause Weight Gain." Hungry for Change. N.p., n.d. Web. 21 Mar. 2016. <http://www.hungryforchange.tv/article/gluten-confirmed-to-cause-weight-gain>.
Massachusetts General Hospital. Gluten Free Diet. N.p., 2008. Web. 21 Mar. 2016. <http://www.massgeneral.org/digestive/assets/pdf/gluten_free_diet.pdf>.
Reho Travel Party Limited. "History of Coeliac Disease." Glutenfree Travel. N.p., n.d. Web. 21 Mar. 2016. <http://www.glutenfreetravel.com.au/history-of-coeliac-disease>.
Rubin, R. C. "Dietary Fiber — New Insights on Health Benefits." Today's Dietitian 13.2 (2011): 42. Web. 21 Mar. 2016. <http://www.todaysdietitian.com/newarchives/020911p42.shtml>.
Tovoli, Francesco, Chiara Masi, Elena Guidetti, Giulia Negrini, Paola Paterini, and Luigi Bolondo. "Clinical and diagnostic aspects of gluten related disorders." World Journal of Clinical Cases 3.3 (2015): 275. Web. 21 Mar. 2016. <http://www.wjgnet.com/2307-8960/full/v3/i3/275.htm>.
UW Health. "The Reality Behind Gluten-Free Diets, Nutrition and Health Library | Madison, WI." UW Health. N.p., 8 Dec. 2012. Web. 21 Mar. 2016. <http://www.uwhealth.org/nutrition-diet/the-reality-behind-gluten-free-diets/31084>.
Appendix
Start by giving your diet an initial score of 160 points. Subtract points as instructed whenever the diet falls short.
Provides a reasonable number of calories (1200 or more). If not, subtract 10 points.
Provides enough protein, but not more than twice the required. If no, subtract 10.
Provides enough fat at approximately 30% of calories taken in. if no, minus 10 points.
Provides enough carbohydrates. Approximately 10 grams of carbohydrates for an average sized person, if not, minus 10.
Offers a balanced assortment of vitamins and minerals. This can be indicated by the addition of fruits and vegetables in the diet plan. If no, minus 10 points.
Offers a variety of different foods. If you think it a boring diet, subtract 10 points. (Answer: - 10)
Consists of ordinary foods that are available at local grocery stores or eating establishments. If not, minus 10 points.
Promises rapid weight loss (more than 1% of total body weight per week). If YES, minus 10.
Encourages permanent realistic lifestyle changes, including regular exercise and behavioral changes for maintaining weight loss. If no, minus 10 points. (Answer: -10)
Misrepresent salespeople as counsellors supposedly qualified to give nutritional advice or collect large sums of money for expensive long term plans. If YES, minus 10 points. (Answer: -10)
Fails to inform clients of risks. If YES, minus 10 points. (Answer: -10)
Promotes unproven weight loss aids, such as starch blockers, diuretics, appetite suppressants and other unique ingredients. If YES, minus 10 points.
Final score 120 points.
