Here, you have my permission to enjoy a good loaf of bread

May is Celiac Awareness Month. Celiac disease can have very subtle manifestations, and its relatively non-specific and sometimes almost invisible symptoms make awareness of it critical. Awareness should make patients and physicians consider the possibility, and then diagnose it; or rule it out.

It doesn’t mean that everyone should avoid gluten, just in case.

It’s estimated that up to 1 percent of the American population has celiac, most of these people don’t yet know they have it. Others may have gluten sensitivity, a less clearly defined clinical entity. But there is now a widespread belief that gluten is just bad for your health, and the rise in gluten-free food adoption has been meteoric. A survey shows a third of Americans are trying to avoid gluten.

The anti-gluten movement has been greatly beneficial for the people whose health depends on gluten-free food – at last there are breads, grains flours and even restaurants that cater to their needs.

But the belief that gluten-free foods are better for the general population has many downsides.

The downside of the gluten-free fad

One of the obvious ones is that pointing at the wrong target makes you miss more important, more proven-to-harm ones.

Another downside is that by avoiding gluten you might actually be eating worse.

A new study just published in BMJ, that included about 6500 people who were followed up for more than 20 years, found that avoiding gluten not only didn’t improve heart hearth, it may have also increased their risk, as it led to reduced consumption of beneficial whole grains, known to reduce the odds of coronary artery disease.

Eating more gluten was associated with a lower risk of type 2 diabetes in a recent study presented at the American Heart Association meeting.

Another study, presented at the at the 50th Annual Congress of the European Society for Pediatric Gastroenterology Hepatology and Nutrition demonstrated what careful nutrition-label readers might have already suspected: Gluten-free foods often have more calories than their gluten-containing counterparts. The researchers gathered 655 gluten-free foods, and found that across the board, from pasta to cookies to ready meals, these foods had more fat and calories, and less protein than their 654 ordinary, gluten containing equivalents.

The authors warn that the gluten-free craze might be fueling obesity, as the gluten-free halo might be giving the impression that these highly-processed cookies and cereals are healthier than the wheat containing equivalents. In fact, those gluten-free products were even more energy-dense.

Bottom line

A gluten-free diet is essential for people who suffer from celiac, and might help people with gluten sensitivity.

As for the rest of us, we should be moderating our intake of all highly refined and highly processed grain-based foods -- not just gluten-containing ones. On the other hand, whole grains are foods that are good for our health, and there's no reason to deny ourselves the pleasure of a good whole-wheat or barley based bread in favor of one made with corn and tapioca starches.

Here, you have my permission to enjoy a good loaf of bread.

Dr. Ayala

“We should be moderating our intake of all highly refined and highly processed grain-based foods — not just gluten-containing ones.”