Anytime I work at my sushi restaurant, I am always brought up this one question by customers; “do you have gluten-free options?” I have had few customers tell me straight that they have Celiac to make me aware that they absolutely cannot eat it. However, many other customers simply prefer a gluten-free option. Frequently, I have had customers who want a gluten-free dish but are okay to ingest soy sauce which has gluten in it. With these interactions and the many restaurants that are coming with gluten-free options, I wondered if there is any health benefit to a gluten-free diet (GFD) if one does not have Celiac.
Turns out, from a paper review, that the evidence that supports a GFD for symptoms other than an immune-mediated response is not that strong and there is potential harm in patients who do not have gluten-related diseases (Niland and Cash, 2018). One study did show that non-Celiac patients on a GFD had benefited in terms of weight management, but there was no significance in risk for metabolic syndrome or cardiovascular risk (Kim et al., 2017). It is also worth mentioning that only 1.3% of the participants in this study reported that they adhered to the GFD. While weight-loss sounds like an appealing result for most of us, it might not be all that healthy. A study performed in Australia evaluated the nutritional quality of gluten-free foods (GF) and non-gluten free foods (non-GF). The results significantly showed that GF foods had consistently lower average protein content when compared to their non-GF counterparts (Wu et al., 2015). This implies that there is not really any health benefit to a GFD unless one is seriously intolerant to it and you could potentially be missing out on necessary nutrients. Despite the evidence given, GF options are everywhere which is great for those who have Celiac, but also not so much when it is more expensive compared to non-GF products. A past study showed that GF products were, on average, 242% more expensive than regular products (Stevens and Rashid, 2008).
To me, it sounds like a GFD is not healthy unless you are seriously intolerant to it. However, GF options and restaurants are everywhere and being branded as a healthy diet. In reality, it might be more harmful to us in terms of lack of nutrients and for us to pay more for such product.
References:
Kim, H., Demyen, M. F., Mathew, J., Kothari, N., Feurdean,
M., & Ahlawat, S. K. (2017). Obesity, Metabolic Syndrome, and
Cardiovascular Risk in Gluten-Free Followers Without Celiac Disease in the
United States: Results from the National Health and Nutrition Examination
Survey 2009–2014. Digestive Diseases and Sciences, 62(9),
2440-2448.
Niland, B., & Cash, B. D. (2018). Health Benefits and
Adverse Effects of a Gluten-Free Diet in Non-Celiac Disease Patients. Gastroenterology &
hepatology, 14(2), 82–91.
Stevens, L., & Rashid, M. (2008). Gluten-Free and
Regular Foods: A Cost Comparison. Canadian Journal of Dietetic Practice and
Research, 69(3), 147-150.
Wu, J. H., Neal, B., Trevena, H., Crino, M., Stuart-Smith,
W., Faulkner-Hogg, K., Louie, J. CY., Dunford, E. (2015). Are gluten-free foods
healthier than non-gluten-free foods? An evaluation of supermarket products in
Australia. British Journal of Nutrition, 114(3), 448-454.
After reading your post about the pros and cons of a gluten free diet and how choosing to eat a gluten free diet without having Celiac is unhealthy, I began to wonder if the same was true for a vegan diet. Some studies have proven that a vegan diet can be beneficial for people with Chronic Kidney disease, bipolar disorder, and other health conditions (Gluba‐Brzózka, Franczyk, & Rysz, 2017). However, choosing to eat vegan has become highly popular for people who do not have preexisting health conditions. Although a vegan based diet can be beneficial for lowering rate of heart disease, diabetes, obesity and high blood pressure, there is still debate about the longer term effects of this diet (Tuso, Ismail, Ha, & Bartolotto, 2013). It has been found that people who have a plant-based diet or are vegan generally have lower iron stores and are more likely to have B12 and omega-3 deficiencies (Tuso et al., 2013). From the studies I found there were no clear answer whether vegan eating is more unhealthy than beneficial, but they did all come to the conclusion that it depends on the person and is not a “all-or-nothing program” (Tuso et al., 2013). This means that people really should be focusing on eating a “healthy” diet that provides all the necessary vitamins and nutrients rather than focusing on one kind of diet that eliminates food groups all-together. I also believe that more research needs to be done on vegan and other fade diets in order to provide knowledge about the effects of these diets, allowing individuals to make their own decision (autonomy). I also think it is a physicians responsibility to be educated on fade diets like going vegan or gluten free, in an effort to properly advise their patients about these diets (beneficence and nonmaleficence).
ReplyDeleteGluba‐Brzózka, A., Franczyk, B., & Rysz, J. (2017). Vegetarian diet in chronic kidney disease—A friend or foe. Nutrients, 9(4), 1–15. https://doi.org/10.3390/nu9040374
Tuso, P. J., Ismail, M. H., Ha, B. P., & Bartolotto, C. (2013). Nutritional update for physicians: plant-based diets. The Permanente Journal, 17(2), 61–66. https://doi.org/10.7812/TPP/12-085