Wednesday, March 21, 2012

Please Stop Dismissing the Gluten Free Diet

An Open Letter to Main Stream Media

Let me get this out of the way first. A gluten free diet for weight loss is probably no better than any other diet for weight loss. There are short term, quickly reversible results if it works at all. Let me repeat this part. No better than any other diet. More on this later.

We've been a gluten free manufacturer for over 20 years and as a family of celiacs, we are very familiar with the blank stare received when talking about gluten, gluten free, celiac disease & gluten intolerance. Hands up how many have said "I have a wheat allergy" because it's easier than explaining what being gluten free means.  In the last couple of years, we've seen exploding diagnosis rates for celiac disease from 0.9/100,000 in 1950 to 20 per 100,000 in 2003 *, a 400% increase in the actual rate of celiac disease since the 1950's.* , evidence that non-celiac gluten intolerance may affect as much as 6% of the population * and evidence that as many as 15% of people are gluten sensitive.  It's hardly any surprise that awareness of a gluten free diet is growing.

As a manufacturer of gluten free products, this has been a good thing. Our products are not only in health food and specialty stores where they were typically found for 15 of our 20 years, but in mainstream grocery chains. We've grown from selling products at a farmer's market in 1991 to 2 facilities with over 150,000 ft2. in production space.

Since our business -is- gluten free, we monitor trends in consumer awareness, retail and non-traditional and mainstream media. In the last year or so, I'm noticing a trend in mainstream media. Headlines like "Is a gluten-free diet a good idea?", "Is a gluten-free diet safe?, "Is a gluten-free diet bad for you?" and "Gluten-free diets may be overused". Now, on one hand celiacs have been clamouring for raised awareness for years and almost every article finally has the talking points around celiac correct and that's a very good thing. What I find disturbing is that every one of these headlines and in large part the articles that accompany them, are either dismissive of, or show outright hostility towards the diet for those who are not diagnosed with celiac. What's going on here?

 Major Themes

"A gluten-free diet isn’t necessarily a healthy one if you don’t need to be on it"  

OK. Hard to argue with this. Oh, but wait, a gluten free diet isn't necessarily NOT a healthy diet either. It's not as if the gluten containing diet of the majority of North Americans is a paragon of health. All one has to do is walk down the frozen foods, bakery section or cookie aisle of a major supermarket to see what I'm talking about. In fact,the gluten consumer has a 50 fold chance of picking an unhealthy choice because there are 50 times the amount unhealthy choices. Donuts everyday for breakfast are not a healthy choice whether or not they contain gluten. (and let's not even mention the gluten & sugar filled cereal aisle)


"People are going gluten free without a doctors diagnosis because it makes them feel better"

I want to be very clear here. If you think you have a problem with gluten you need talk to your doctor about it. Undiagnosed celiac disease can be life threatening. For a celiac, a gluten free diet is not a choice, it's a life long requirement. Let's however, speak to those who have been tested and are told that they do not show antibodies and do not have intestinal damage; those that do not have celiac. Should these people simply go back to consuming gluten in all it's sundry forms? Should they go back to bloating, headaches and some of the over 100 symptoms linked to gluten sensitivity? Should they stop eating gluten because it makes them feel better? Do we really even need to comment on this? Yet dozens of articles seem to imply this is inappropriate.

Medicine only knows what it knows.

50 years ago doctors told us that celiac disease was a children's issue to be grown out of, 20 years we were told it was rare, today it's classified as a growing public health issue *. When mainstream medicine says there's no evidence for what you're feeling. it may simply be that they haven't found the evidence yet. That's how science works. It doesn't mean that what you are feeling is in your head.


"Gluten free food lacks essential nutrients and often contains refined ingredients" 

Again this tars all gluten free products with the same brush and ignores that the exact thing can be said for gluten contain products. Pick up 20 gluten filled & gluten free products in any grocery store and compare the labels. You'll find a range of good, bad, and awful in terms of processed ingredients and nutritional value. I'd bet you'll find the gluten free products at least comparable. This idea that all gluten free foods are lacking in nutrients is plainly wrong. We've been adding vitamin and minerals, fibre & protein to our products for over 10 years. Our newest soft breads & buns were designed specifically to be the most nutritionally sound gluten free products on the market and they are at least as good or better for you than many of the mass produced "whole wheat" breads out there.

UPDATE: October 11/ 2013 I've added this table to illustrate my point. (Dempsters is one of the top selling mass produced wheat based bread lines in Canada)


Per Serving
(2 slices)
Kinnikinnick Multigrain
Gluten Free Bread
Dempsters Original
Whole Wheat Bread
Calories 150 170
Fat* 6 2
Saturated Fat 1 0.4
TransFat 0 0
Cholesterol 0 0
Sodium 180 350
Carbohydrates 20 32
Fibre 5 4
Sugars 1 2
Protein 3 7
Vitamin A 0 0
Vitamin C 0 0
Iron 10 10
Niacin 10 10
Riboflavin 8 4
Folate 8 15
Thiamine 10 15
Calcium 4 4

* > 2g grams of fat comes from "healthy sources" in flax oil, sunflower seeds, quinoa & teff

The Dempsters Bread also contains the following preservatives and dough enhancers: calcium propionate, sodium stearoyl-2-lactylate, monoglycerides, acetylated tartaric acid esters of mono and diglycerides, sorbic acid. May contain calcium iodate, calcium carbonate, calcium sulphate, ammonium chloride

The gluten free bread in this case wins the nutritional battle in Calories, Sodium, Carbs, Fibre, Sugar and has mostly equal values in the vitamin content (both are enriched). I think it’s very possible to make the case that in this example, the gluten free bread is the better choice than one of the top selling whole wheat breads in Canada.



The dietitian and the diet

The strange thing about these articles is that many of them are written by dietitians. Unfortunately, the viewpoints the seem to be expressed in the articles often come across as the Gluten Free Diet Versus The Ideal Diet. Don't get me wrong, dietitians are hugely important to the gluten free community. They are often the first people that a newly diagnosed celiac will see and can be a huge help to in those first traumatic days of "what do I eat now". Everyone's favourite gluten free dietitian, Shelley Case has been a major reason why we started enriching our breads over 10 years ago and is a major reason why we've created our new breads with such great nutritional values. She wasn't a consultant. She simply bugged us every time we saw her at trade shows, conferences and other events over the past 15 years. "Why aren't you enriching? Why aren't you adding fibre? Why aren't you using whole grains? There's no reason a gluten free product needs to be any less nutritious." And she was right.

That being said, not all dietitians appear to give gluten free the same consideration. Most of the time what these articles say is true; a gluten free diet can be unhealthy if you eat too many carbs, too much sugar, too much sodium, not enough fibre and on and on. But frankly that can be said about every manufactured food on the market today. At least the gluten free consumer reads every label every time and has a much better chance of knowing what they are eating. Whether they care is what the dietitians should be focusing on.

A gluten free diet for weight loss, celebrities on gluten free and the athlete connection

Here's where things get a bit murky. Does a gluten free diet work for weight loss? In and of itself, probably not. But there are plenty of anecdotal claims that it does. For some. Why? It's impossible to know. Certainly, switching out gluten free 1 for 1 in a diet that's unhealthy to start with isn't likely to make any difference. Perhaps it's because the drive through window and most fast foods are now off limits. Maybe there is a metabolic reason for some people (see note on what science knows above). My personal theory? Perhaps it's merely a case of reading every label and being aware of what they are eating.

Celebrities going gluten free may signal the pinnacle of the "gluten free fad". Or perhaps they are simply some of the most visible examples of people with gluten sensitivity. Just because they are famous doesn't mean they don't have health issues like the rest of us.

The latest trend seems to be athletes going gluten free. An article by 5 time Canadian Rowing champ Matt Jensen on our blog outlines some of his reasons for going gluten free. Since that article, there are now 5 rowers on the Canadian team that are on gluten reduced diets. Novak Djokovic's credits some of his recent tennis success to a gluten free diet. Other athletes are eliminating or reducing the amount of gluten they are consuming because they see tangible results. Do they have gluten sensitivity? Hard to say, but the traditional gluten filled carb loading of pasta before an event may start to become a thing of the past. Remember that pasta is made from "hard wheat" which has higher than "normal" gluten content. Perhaps a finely tuned body doesn't deal with that as well. Perhaps it makes no difference. Science doesn't know yet. The diet is not easy to follow especially when you travel like athletes do but I imagine the athletes know pretty well what makes them perform better. 

Today's gluten isn't the same as your grandmothers. (well it is, but there's a lot more of it) 

According to some estimates, wheat has been bred to have an increased gluten content of up to 50% compared to wheat from 100 years ago. Gluten is seen as "a good thing" by the conventional baking industry. It makes "better" bread. Not only that, but as anyone on a gluten free diet knows, it's in -everything-. But do we really have a good idea what all that hyper gluten consumption is doing to us. Could that be the reason the incidence of true celiac disease is up 400%? We're often told that humanity evolved eating wheat and are asked how could it be a problem for us. Yet no one mentions that humanity did not grow up eating -this wheat-. Have we reached a tipping point in terms of how much gluten a person can tolerate? Is it a real problem? Science can't say right now. All they can say is based on best evidence, today, wheat is ok for the majority of people; the majority being somewhere around 80-85%.

Let's focus on Healthy Eating, gluten filled or gluten free

The Gluten free diet is a fad for some, a necessity for celiacs, and a benefit for others. Don't belittle us by making broad generalizations on topics that can be just as easily applied to gluten containing products. Talk about proper, life long nutrition without a qualifier. Eat more fruits and vegetables.
 
So please. Can we stop with these articles. The other 15-20% of us will appreciate it.

Sincerely,

Jay Bigam
Executive Vice President
Research, Development & Innovation
Kinnikinnick Foods Inc.