A New Diet Villain/ Are Gluten-Free Diets Healthier, or Is It Hype?

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http://www.newsweek.com/id/171953/page/1

A New Diet Villain

Americans are spending about $2 billion a year on gluten-free

products, which advocates claim can help with everything from autism

to ADHD, but is the trend more about hype than health?

Springen

Newsweek Web Exclusive

About six years ago, Diane and Jim McConnell and their son, Jr.,

11, embarked on a dramatic diet change. They decided to give up foods

containing gluten, a protein found in wheat, rye and barley. Sticking

to the regimen is no easy feat†" gluten is ubiquitous in the American

diet, as well as in other nonfood products. Not only is it in almost

every kind of commercially baked good and pasta, it's even in

medications, lipsticks and Play-Doh.

Why take such a life-changing step? It all started when Jr.

began suffering from chronic constipation. " Sometimes I couldn't play

with my friends because I was hurting so bad, " he says. His condition

baffled doctors, who initially prescribed laxatives. He stopped

growing and started losing weight. Finally, doctors diagnosed his

condition as celiac disease, an autoimmune disorder of the small

intestine that's caused by a reaction to the gluten protein gliadin.

The only treatment is a gluten-free diet. Bye-bye, regular pizza and

birthday cake.

For McConnell and the estimated 3 million other Americans with

celiac disease, staying away from gluten is a fact of life if they

want to prevent long-term intestinal damage and the myriad digestive

discomforts that come with the disease. But they're not the only ones

avoiding this common protein. Gluten has become the new diet villain.

Over the past year, manufacturers in the United States have sold more

than $2 billion worth of products with " gluten-free " claims, according

to the Nielsen Co. Devotees of the diet include parents of children

with attention-deficit hyperactivity disorder (ADHD) and autism,

pregnant women, people with allergies and others who say they simply

feel better on a gluten-free diet. Some 15 million to 30 million

Americans are buying gluten-free products, says registered dietitian

Kupper, executive director of the Gluten Intolerance Group.

" It's a much bigger market than just the celiac population. "

High-profile abstainers are adding to the hype. During her 21-day

cleanse this summer, Oprah Winfrey avoided gluten. (She followed the

advice found in former model Kathy Freston's book " Quantum Wellness, "

which urges people to eliminate sources of toxins and allergens.) The

actress McCarthy put her autistic son on a diet free of the protein.

But is this trend more about hype than health? " To my knowledge,

celiac disease is the only indication for a gluten-free diet, " says

gastroenterologist Green, director of the Celiac Disease Center

at Columbia University and author of " Celiac Disease: A Hidden

Epidemic. " " All this gluten intolerance, and using the diet to treat

autism, ADHD … there's no documented scientific reason for that at

all. However, patients without celiac disease often do notice an

improvement in a whole spectrum of gastrointestinal or neurological

symptoms when they start a gluten-free diet. But it's not defined by

any medical diagnosis. "

Even without direct scientific support, many families of autistic kids

just say no to the protein anyway. The theory is that kids with autism

may have a " leaky gut, " which allows some toxins from

gluten-containing foods to get into their brains and cause problems,

says Bell, executive vice president of Autism Speaks. Bell's own

son was a " nonresponder " to the diet. But anecdotally, he says, " as

many as 20 to 40 percent of kids seem to respond favorably. "

Researchers are sympathetic to, if skeptical of, these claims. " If I

was a father of a kid with autism, I would do anything, " says Dr.

Alessio Fasano, a pediatric gastroenterologist at the University of

land. " However, these are the facts: celiac disease is present in

roughly 1 percent of the general population and maybe can affect twice

as much [of the population] among autistic kids. " That means perhaps 2

percent of autistic kids have it " at the most, " says Fasano. " I don't

think there's too much scientific basis to justify [the] broad

intervention of a gluten-free diet. " By contrast, 10 percent of people

with type 1 diabetes and 10 percent of people with Down syndrome have

celiac disease, he says.

Getting a celiac diagnosis in the first place can be complicated. Some

97 percent of those who have it are currently undiagnosed, says

Columbia's Green. Typically sufferers see specialists and physicians

for 11 years before their condition is recognized and treated.

Patients are often misdiagnosed with other problems, such as irritable

bowel syndrome, he says. They may come in complaining of fatigue,

muscle cramps, missed menstrual periods and depression. Kids with

undiagnosed celiac disease may have discolored teeth. The average age

of diagnosis is in midlife, when people are 40 to 50 years old. " It

was once thought to be a disease of childhood. Actually, it can be

triggered at any age, by anything from a surgery to a pregnancy to a

cold, " says the Gluten Intolerance Group's Kupper. " It's like turning

on a light switch. "

People who think they might have celiac disease can experiment with

not eating gluten, but Green says it's better to be tested. After all,

why avoid wheat for a lifetime if it's not necessary? The gold

standard of diagnosis requires a biopsy of the small intestine. That

way doctors can check for the inflammation that occurs when people

with celiac disease eat the protein, which their bodies see as a

foreign object. But first, patients typically take a blood test that

looks for the antibodies the body creates in response to things that

irritate the small intestine and damage the villi that are crucial to

absorbing nutrients.

When patients lay off gluten, their intestine should heal and symptoms

should go away, says Kupper. But following a gluten-free diet is a

challenge, especially for kids. In the McConnell family, it requires

planning. " At birthday parties, either I eat a giant dinner before it,

or my mom buys a gluten-free donut for me to bring, " says Jr. It

helps that his mom and dad are also on the diet. The disease often

runs in families, so doctors tested 's mom, who had been

misdiagnosed as having Crohn's disease but turned out to have celiac

disease, and his father, Jim, who is simply gluten intolerant. The

family says their efforts have paid off†" on their fruit- and

veggie-laden regime, grew more than an inch a few months after

he began the diet, and the whole family feels better than ever, says

Diane.

" It can be a very healthy diet, " says registered dietitian Dee

Sandquist. After all, substitute grains such as quinoa are filled with

more nutrients than white, refined flour. For some people without

celiac disease, a gluten-free diet may make them feel better through

the placebo effect, says Sandquist, and of course simply eating fewer

cookies and pies can contribute to feeling healthier overall. But

unlike foods made with wheat, many gluten-free products are not

fortified with B vitamins, so those people who avoid the protein may

want to take a multivitamin supplement.

For celiac suffers and gluten-free advocates alike, it's easier these

days to find a variety of food options. Restaurants such as Outback

and Carino's Italian are now offering items free of the protein. And

household-name manufacturers are jumping into the game. Hain-Celestial

markets a gluten-free line fortified with iron, folate, calcium and B

vitamins. Anheuser-Busch offers a barley-free, sorghum-containing beer

called Redbridge. And General Mills now sells gluten-free Rice Chex.

Food makers are eagerly awaiting an FDA rule on " gluten-free "

labeling. " Once that goes through, we will see some of the big boys

label gluten-free, " says the Gluten Intolerance Group's Kupper. FDA

spokesman Herndon says coming up with a final rule is an

" agency priority. "

Alternatives to avoiding wheat include genetically modifying it to

remove the genes responsible for the toxic fragments of gluten in it.

But historically Americans have been leery of so-called

" frankenfoods. " Another possibility: a vaccine. An Australian group is

working on one, but it is not in clinical trials. Researchers are also

working on a pill that people with celiac disease could take before

eating to help them digest gluten.

In the meantime, experts say the current gluten-free fad is unlikely

to hurt anyone's health. It is, of course, generally good to eat fewer

processed baked goods and more vegetables. Still, says Columbia's

Green, those without a celiac diagnosis should be cautious about

adopting the restrictive diet: " I don't think people should torture

their children unnecessarily. "

URL: http://www.newsweek.com/id/171953

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