Gluten free Food : Fad, Friend or Foe ?

Authors(2) :-Jyoti Jwala, Dr. Bimla Kumari

The gluten-free diet, once confined to the treatment of celiac disease, has evolved into a widely adopted lifestyle choice, propelled by increasing awareness of gluten-related disorders, celebrity endorsements, and perceived health benefits. This diet eliminates gluten, a protein complex found in wheat, barley, rye, and sometimes oats, necessitating significant lifestyle adjustments for adherence. Originally a medical prescription for celiac disease—an autoimmune disorder where gluten ingestion damages the small intestine—the diet's application has expanded, driven by claims of improved health, weight management, and energy levels in the broader population. This paper delves into the historical context of the gluten-free diet, tracing its origins to the management of celiac disease and its transformation into a mainstream trend. It critically examines the health implications of adopting a gluten-free diet, emphasizing the necessity for those with celiac disease and gluten sensitivity and exploring the nutritional considerations, impact on weight management and chronic diseases, and psychological aspects of dietary adherence. Furthermore, the paper addresses the societal and economic impacts of the diet's popularity, including its perception as a health trend, the economic burden on consumers due to higher-priced gluten-free products, and its influence on food culture and industry innovation. The challenges of maintaining a gluten-free diet, such as cross-contamination risks and dining out difficulties, are highlighted alongside controversies surrounding its promotion for non-medical reasons and the debate over its purported health benefits for the general population. Looking forward, key areas for future research and development in gluten-free grains and alternative flours is identified, underscoring the importance of nuanced public health recommendations, and advocating for increased awareness and education about celiac disease, gluten sensitivity, and the proper implementation of gluten-free diets. In conclusion, while the gluten-free diet is indispensable for individuals with specific health conditions, its broader adoption warrants careful consideration. The distinction between medical necessity and lifestyle choice is crucial, underscoring the need for informed decision-making based on scientific evidence and health professionals' guidance to navigate the complexities of gluten-free living responsibly.

Authors and Affiliations

Jyoti Jwala
Research Scholar, University Department of Home Science, B.N.M.U., Madhepura, India
Dr. Bimla Kumari
Associate Professor & Head, University Department of Home Science, B.N.M.U., Madhepura, India

Gluten-free diet, Celiac disease, Nutritional considerations, Gluten sensitivity, Health implications, Food culture, Cross-contamination.

  1. National Institutes of Health (NIH), Celiac Disease Foundation.
  2. MarketsandMarkets research report.
  3. American Journal of Clinical Nutrition.
  4. Kent, Pamela S.. (2013). Is Going Gluten Free the Next Fad Diet?. Journal of Renal Nutrition, 23(2), e47–e50. doi:10.1053/j.jrn.2012.12.005
  5.  Rajpoot P, Makharia GK. Problems and challenges to adaptation of gluten free diet by Indian patients with celiac disease. Nutrients. 2013 Nov 27;5(12):4869-79. doi: 10.3390/nu5124869. PMID: 24288026; PMCID: PMC3875923.
  6. Sood A., Midha V., Sood N., Malhotra V. Adult celiac disease in northern India. Indian J. Gastroenterol. 2003;22:124–126.
  7. Arshad H., Ahmad Z. Histologic findings in biopsies/resection specimens from the small intestine with special emphasis on celiac disease: Experience from a developing country in South Asia. Ann. Diagn. Pathol. 2012;16:436–440. doi: 10.1016/j.anndiagpath.2012.03.003.
  8. Fasano, A.; Catassi, C. Clinical practice. Celiac disease. N. Engl. J. Med. 2012, 367, 2419–2426.
  9. Leonard, M.M.; Sapone, A.; Catassi, C.; Fasano, A. Celiac Disease and Nonceliac Gluten Sensitivity: A Review. JAMA 2017, 318, 647–656.
  10. Lionetti, E.; Gatti, S.; Pulvirenti, A.; Catassi, C. Celiac disease from a global perspective. Best Pract. Res. Clin. Gastroenterol. 2015, 29, 365–379.
  11. Freeman, H.J. Adult Celiac Disease and Its Malignant Complications. Gut Liver 2009, 3, 237–246.
  12. Halfdanarson, T.R.; Litzow, M.R.; Murray, J.A. Hematologic manifestations of celiac disease. Blood 2007, 109, 412–421.
  13. Panagiotou, S.; Kontogianni, M.D. The economic burden of gluten-free products and gluten-free diet: A cost estimation analysis in Greece. J. Hum. Nutr. Diet. 2017, 30, 746–752.
  14. Panagiotou, S.; Kontogianni, M. A cost comparison between gluten – free and conventional foods. Clin. Nutr. ESPEN 2016, 13, e56.
  15. Theethira, T.; Dennis, M.; Leffler, D. Nutritional consequences of celiac disease and the gluten-free diet. Expert Rev. Gastroenterol. Hepatol. 2014, 8, 123–129.
  16. Grace-Farfaglia, P. Bones of Contention: Bone Mineral Density Recovery in Celiac Disease—A Systematic Review. Nutrients 2015, 7, 3347–3369.
  17. Krupa-Kozak, U. Pathologic bone alterations in celiac disease: Etiology, epidemiology, and treatment. Nutrition 2014, 30, 16–24.
  18. Wierdsma, N.J.; van Bokhorst-de van der Schueren, M.A.E.; Berkenpas, M.; Mulder, C.J.J.; van Bodegraven, A.A. Vitamin and Mineral Deficiencies Are Highly Prevalent in Newly Diagnosed Celiac Disease Patients. Nutrients 2013, 5, 3975–3992.
  19. Gopalsamy, G.L.; Alpers, D.H.; Binder, H.J.; Tran, C.D.; Ramakrishna, B.S.; Brown, I.; Manary, M.; Mortimer, E.; Young, G.P. The Relevance of the Colon to Zinc Nutrition. Nutrients 2015, 7, 572–583.
  20. Shepherd, S.J.; Gibson, P.R. Nutritional inadequacies of the gluten-free diet in both recently-diagnosed and long-term patients with coeliac disease. J. Hum. Nutr. Diet. 2013, 26, 349–358.
  21. Sue, A.; Dehlsen, K.; Ooi, C.Y. Paediatric Patients with Coeliac Disease on a Gluten-Free Diet: Nutritional Adequacy and Macro- and Micronutrient Imbalances. Curr. Gastroenterol. Rep. 2018, 20, 2.
  22. Lis DM, Stellingwerff T, Shing CM, Ahuja KD, Fell JW. Exploring the popularity, experiences, and beliefs surrounding gluten-free diets in nonceliac athletes. Int J Sport NutrExercMetab. 2015;25(1):37–45.
  23. Aziz I, Dwivedi K, Sanders DS. From coeliac disease to noncoeliac gluten sensitivity; should everyone be gluten free? Curr Opin Gastroenterol. 2016;32(2):120–127.
  24. Peters SL, Biesiekierski JR, Yelland GW, Muir JG, Gibson PR. Randomised clinical trial: gluten may cause depression in subjects with non-coeliac gluten sensitivity—an exploratory clinical study. Aliment Pharmacol Ther. 2014;39(10):1104–1112.
  25. Cascella NG, Santora D, Gregory P, Kelly DL, Fasano A, Eaton WW. Increased prevalence of transglutaminase 6 antibodies in sera from schizophrenia patients. Schizophr Bull. 2013;39(4):867–871.
  26. Dohan FC, Grasberger JC, Lowell FM, Johnston HT, Jr, Arbegast AW. Relapsed schizophrenics: more rapid improvement on a milk- and cereal-free diet. Br J Psychiatry. 1969;115(522):595–596.
  27. Brietzke E, Cerqueira RO, Mansur RB, McIntyre RS. Gluten related illnesses and severe mental disorders: a comprehensive review. NeurosciBiobehavl Rev. published online August 19, 2017. doi:10.1016/j.neubiorev.2017.08.009.
  28. Tanpowpong P, Broder-Fingert S, Katz AJ, Camargo CA., Jr Predictors of gluten avoidance and implementation of a gluten-free diet in children and adolescents without confirmed celiac disease. J Pediatr. 2012;161(3):471–475.
  29.  Slim M, Calandre EP, Garcia-Leiva JM, et al. The effects of a gluten-free diet versus a hypocaloric diet among patients with fibromyalgia experiencing gluten sensitivity-like symptoms: a pilot, open-label randomized clinical trial. J Clin Gastroenterol. 2017;51(6):500–507.
  30. Marziali M, Venza M, Lazzaro S, Lazzaro A, Micossi C, Stolfi VM. Gluten-free diet: a new strategy for management of painful endometriosis related symptoms? Minerva Chir. 2012;67(6):499–504.
  31.  Emilsson L, Semrad CE. Obesity, metabolic syndrome, and cardiac risk factors: going gluten-free, for better or worse? Dig Dis Sci. 2017;62(9):2215–2216.
  32. Thompson T. Folate, iron, and dietary fiber contents of the gluten-free diet. J Am Diet Assoc. 2000;100(11):1389–1396.
  33. Thompson T. Thiamin, riboflavin, and niacin contents of the gluten-free diet: is there cause for concern? J Am Diet Assoc. 1999;99(7):858–862.
  34.  Umberto Volta U, Bardella MT, Calabrò A, Troncone R, Corazza GR and The Study Group for Non-Celiac Gluten Sensitivity. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Med. (2014) 12:85. doi: 10.1186/1741-7015-12-85
  35. Taetzsch A, Das SK, Brown C, Krauss A, Silver RE, Roberts SB. Are gluten-free diets more nutritious? An evaluation of self-selected and recommended gluten-free and gluten-containing dietary patterns. Nutrients. (2018) 10:E1881. doi: 10.3390/nu10121881
  36. Shewry PR, Tatham AS Improving wheat to remove coeliac epitopes but retain functionality. J Cereal Sci. (2016) 67:12–21. doi: 10.1016/j.jcs.2015.06.005
  37.  Melini V, Melini F. Gluten-free diet: gaps and needs for a healthier diet. Nutrients. (2019) 11:E170. doi: 10.3390/nu11010170
  38. Lerner A, Jeremias P, Matthias T. The world incidence and prevalence of autoimmune diseases is increasing: a review. Int J Celiac Dis. (2015) 3:151–5. doi: 10.12691/ijcd-3-4-8
  39.  Sapone A, Bai JC, Ciacci C, Dolinsek J, Green PH, Hadjivassiliou M, et al. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Med. (2012) 10:13. doi: 10.1186/1741-7015-10-13
  40. Lerner A. The enigma of oats in nutritional therapy for celiac disease. Int J Celiac Dis. (2014) 2:110–4. doi: 10.12691/ijcd-2-3-1
  41. Lerner A, Jeremias P, Matthias T. The world incidence of celiac disease is increasing: a review. Int J Recent Sci Res. (2015) 6:5491–6.
  42. Newberry C, McKnight L, Sarav M, Pickett-Blakely O. Going gluten free: the history and nutritional implications of today's most popular diet. Curr Gastroenterol Rep. (2017) 19:54. doi: 10.1007/s11894-017-0597-2
  43. Pearlman M, Casey L. Who should be gluten-free? A review for the general practitioner. Med Clin North Am. (2019) 103:89–99. doi: 10.1016/j.mcna.2018.08.011
  44. Silvester JA, Weiten D, Graff LA, Walker JR, Duerksen DR. Is it gluten-free? Relationship between self-reported gluten-free diet adherence and knowledge of gluten content of foods. Nutrition. (2016) 32:777–83. doi: 10.1016/j.nut.2016.01.021
  45. Paganizza S, Zanotti R, D'Odorico A, Scapolo P, Canova C. Is adherence to a gluten-free diet by adult patients with celiac disease influenced by their knowledge of the gluten content of foods? Gastroenterol Nurs. (2019) 42:55–64. doi: 10.1097/SGA.0000000000000368
  46. Freeman HJ. Dietary compliance in celiac disease. World J Gastroenterol. (2017) 23:2635–9. doi: 10.3748/wjg.v23.i15.2635
  47. Buchman AL. Celiac disease, gluten-free, and today's fashionista. Gastroenterol Clin North Am. (2019) 48:xiii–xiv. doi: 10.1016/j.gtc.2018.10.002
  48. David L, Maurice C, Carmody R, Gootenberg D, Button J, Wolfe B, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature. (2014) 505:559–63. doi: 10.1038/nature12820
  49. Di Cagno R, De Angelis M, De Pasquale I, Ndagijimana M, Vernocchi P, Ricciuti P, et al. Duodenal and faecal microbiota of celiac children: molecular, phenotype and metabolome characterization. BMC Microbiol. (2011) 11:219. doi: 10.1186/1471-2180-11-219
  50. Sanz Y. Effects of a gluten-free diet on gut microbiota and immune function in healthy adult humans. Gut Microbes. (2010) 1:135–7. doi: 10.4161/gmic.1.3.11868
  51. Moshfegh AJ, Friday JE, Goldman JP, Ahuja JK. Presence of inulin and oligofructose in the diets of Americans. J Nutr. (1999) 129:1407S−1S. doi: 10.1093/jn/129.7.1407S
  52. Jackson FW Effects of a gluten-free diet on gut microbiota and immune function in healthy adult human subjects - comment by Jackson. Br J Nutr. (2010) 104:773. doi: 10.1017/S0007114510001960
  53.  Ascher S, Reinhardt C. The gut microbiota: an emerging risk factor for cardiovascular and cerebrovascular disease. Eur J Immunol. (2018) 48:564–75. doi: 10.1002/eji.201646879
  54. Wang Z, Klipfell E, Bennett BJ, Koeth R, Levison BS, Dugar B, et al. Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease. Nature. (2011) 472:57–63. doi: 10.1038/nature09922
  55.  Zhu W, Gregory JC, Org E, Buffa JA, Gupta N, Wang Z, et al. Gut microbial metabolite TMAO enhances platelet hyperreactivity and thrombosis risk. Cell. (2016) 165:111–24. doi: 10.1016/j.cell.2016.02.011
  56. Hosseini SM, Soltanizadeh N, Mirmoghtadaee P, Banavand P, Mirmoghtadaie L, Shojaee-Aliabadi S. Gluten-free products in celiac disease: nutritional and technological challenges and solutions. J Res Med Sci. (2018) 23:109. doi: 10.4103/jrms.JRMS_666_18
  57. Lerner A, Matthias T. Possible association between celiac disease and bacterial transglutaminase in food processing: a hypothesis. Nutr Rev. (2015) 73:544–52. doi: 10.1093/nutrit/nuv011
  58. Hager A-S, Wolter A, Jacob F, Zannini E, Arendt EK. Nutritional properties and ultra-structure of commercial gluten free flours from different botanical sources compared to wheat flours. J Cereal Sci. (2012) 56:239–47. doi: 10.1016/j.jcs.2012.06.005
  59. Lerner A, Matthias T. Editorial: Celiac disease: intestinal, heart and skin inter-connections. Int J Celiac Dis. (2015) 3:28–30. doi: 10.12691/ijcd-3-1-6
  60.  Patel NK, Lacy BE. Another reason to avoid the gluten-free fad? Clin Gastroenterol Hepatol. (2018) 16:184–5. doi: 10.1016/j.cgh.2017.10.002
  61. Dernini S, Berry EM. Mediterranean diet: from a healthy diet to a sustainable dietary pattern. Front Nutr. (2015) 2:15. doi: 10.3389/fnut.2015.00015
  62.  Basso MS, Luciano R, Ferretti F, Muraca M, Panetta F, Bracci F, et al. Association between celiac disease and primary lactase deficiency. Eur J Clin Nutr. (2012) 66:1364–5. doi: 10.1038/ejcn.2012.153
  63.  Lerner A, Wusterhausen P, Ramesh A, Matthias T. Celiac disease and lactose intolerance. Int J Celiac Dis. (2018) 6:68–70. doi: 10.12691/ijcd-6-3-8
  64.  Morreale F, Agnoli C, Roncoroni L, Sieri S, Lombardo V, Mazzeo T, et al. Are the dietary habits of treated individuals with celiac disease adherent to a Mediterranean diet? NutrMetab Cardiovasc Dis. (2018) 28:1148–54. doi: 10.1016/j.numecd.2018.06.021
  65. Pellegrini, Nicoletta; Agostoni, Carlo . (2015). Nutritional aspects of gluten-free products. Journal of the Science of Food and Agriculture, 95(12), 2380–2385. doi:10.1002/jsfa.710

Publication Details

Published in : Volume 7 | Issue 1 | January-February 2024
Date of Publication : 2024-02-15
License:  This work is licensed under a Creative Commons Attribution 4.0 International License.
Page(s) : 62-72
Manuscript Number : SHISRRJ24718
Publisher : Shauryam Research Institute

ISSN : 2581-6306

Cite This Article :

Jyoti Jwala, Dr. Bimla Kumari , "Gluten free Food : Fad, Friend or Foe ?", Shodhshauryam, International Scientific Refereed Research Journal (SHISRRJ), ISSN : 2581-6306, Volume 7, Issue 1, pp.62-72, January-February.2024
URL : https://shisrrj.com/SHISRRJ24718

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