I suppose we should perhaps be grateful that the Daily Mail didn’t claim that bread causes or cures cancer yesterday, but the news here that giving up bread ‘can make you fat’ and that ‘gluten is good for you’ nevertheless deserves a response.
The author Peta Bee is a terrific health journalist but this piece left me a bit unsatisfied.
Let’s start with this:
Coeliac disease is diagnosed by taking a biopsy of the intestine or via blood tests. Sufferers must be strict in avoiding gluten.
But this is different from so-called ‘gluten intolerance’, which is linked to IBS, headaches and mood swings.
CD is actually diagnosed by blood tests and then a biopsy, but no matter. The point here is that the writer is making a distinction between coeliac disease and gluten intolerance. But later:
Gluten intolerance was one of the ‘make-believe allergies’ highlighted by Portsmouth University researchers in January, in a study that showed a fifth of adults wrongly believe they have a problem with certain foods.
Bee is referring to the Wheat Hypersensitivity Report, which I wrote a lot about a few months ago. So gluten intolerance is make believe, is it? Not according to a BDA expert:
‘Gluten intolerance certainly exists,’ says Tanya Thomas, a dietitian and spokesperson for the British Dietetic association.
‘But we know that the amount of people who truly have coeliac-like symptoms is a lot less than the number of people who are cutting it out of their diets. A real intolerance to gluten can be diagnosed easily with the tests for coeliac disease ...’
By ‘A real intolerance to gluten’ does the speaker mean coeliac disease or gluten intolerance? It isn’t clear. Only coeliac disease can be diagnosed ‘with the tests for coeliac disease’, and if we’re talking about a non-coeliac gluten intolerance, then the only means of diagnosing that is via an elimination diet.
As for the argument that giving up bread can make you fat, this seems flawed to me. It’s not what you omit that makes you fat – it’s what you eat. And if you rely too much on processed foods – whether ‘free from’ or not – you’re likely to take in more calories than you need. If you do need to cut bread out for medical reasons, the key is to keep your diet largely wholesome and to continue cooking gluten-free meals from scratch.
But in the long-term, switching to a gluten-free diet, which involves replacing gluten products with those using flours made from rice, cornmeal and buckwheat, can lead to weight gain. It is not unusual to put on two to three stone.
This is true, but deserves explaining. Undiagnosed coeliac patients have gut damage and suffer from poor food absorption because of it. When diagnosed, and they eliminate gluten, the gut heals and absorption of food improves – as does calorific uptake as a consequence. This is why coeliac patients giving up gluten can put on weight. And I doubt the added difficulty of having to overhaul their diets helps either. Learning to exclude gluten strictly can be very stressful, and you can hardly blame some newly diagnosed patients for possibly comfort eating of gluten-free treats. This doesn't mean someone without CD giving up bread will suffer the same consequences...
As for gluten being good for you - which the title-writers at the Mail have apparently fabricated out of nothing – not especially. It’s just an averagely nutritious protein, as far as I understand it. Humans can’t digest it very well, but in people without coeliac disease the undigested parts just pass through the system and end up you know where. It’s possible that some people are more sensitive to this – wheat-related IBS, and so on – but generally most of us are fine with it.
So, no, giving up bread can’t make you fat per se, and gluten is fairly average for you. But that’s not quite as eye-catching a title is it?
Labels: coeliac disease, Daily Mail, Diagnosis (coeliac), gluten, Wheat Hypersensitivity Report