Many people who are not Celiacs experience deleterious effects as a result of gluten consumption none the less. It's called gluten intolerance.
Awareness of how gluten can be the underlying cause of many subtle and low-grade health problems has only begun to spread in the past few years.
Labeling the sudden realization that gluten is something that A LOT of people shouldn't be eating as "hypochondria and mass hysteria" is ingnorant.
People should what makes them feel best. If low gluten does, more power to them. But doesn't anybody else find it so bizarre that people who were entirely asymptomatic for decades suddenly break out with a case of gluten intolerance. The anecdotal cases even in my own personal circles are absurd.
People who complain endlessly about immediate discomfort after eating gluten magically forget to notice these same symptoms when they eat foods they aren't aware has gluten or eat gluten free food and complain anyway because they heard that xyz has gluten in it When it doesn't.
Never underestimate the power of the mind in creating hypochondriac symptoms in people who have entirely asymptomatic medical histories.
Better yet folks who's mystery symptoms and strict diets change over the years at times that happen to coincide perfectly with changing pseudomedical food fads.
It creates so much noise that people who actually do have problems have trouble getting appropriate treatment.
In 5 years nobody will give 2 cents about gluten. the marketplace will simply have moved onto the next pseudomedical emergency involving millenia old food stuffs that don't seem to bother anybody outside of the country the xfree food is being sold in.
What is actually happening is that people are misLABELLING themselves as celiac when they are actually gluten intollerant. That does not take away from the validity of their choice, en mass, to avoid gluten in their diets. You have no right to be "insulted".
Just because someone thinks gluten affects them doesn't mean they're a 'supposed celiac'.
Even though there are a few, shoddy studies involving gluten intolerance, the science is weak, and there's no clear mechanism that would explain an "intolerance" that didn't carry the biochemical hallmarks of Celiac. Maybe that will change in the future, but the smart money is still on the bet that most of the people with "gluten intolerance" have nothing wrong with them at all.
No, the people who are skeptical are (in this case, and many others) following their own subjective feeling, helped by authority. But make no mistake, your skepticism -- unless you have access to primary data -- is nothing more than an appeal to authority.
I'm not saying you're wrong in your conclusion. (Not in this discussion, anyway), but your skepticism likely does not follow from logic, science or knowledge.
Unless, of course, you are working with primary data. I suspect you aren't, though, because I've had the misfortune to be in touch with leading authorities (who work with primary data) in the field recently, and most of them DO believe that gluten intolerance is real, prevalent and very serious.
(And yes, the irony that I'm appealing to authority does not escape me)
p.s.
> there's no clear mechanism that would explain an "intolerance" that didn't carry the biochemical hallmarks of Celiac.
That's definitely wrong. There is not agreement about the delayed allergy mechanisms work (mostly IgA and IgG) to the point that there is no standard lab test for them -- but there is definitely agreement that they are there, and that they can explain a lot of these things. I don't have time to verify the whole entry, but at least the symptoms section in http://en.wikipedia.org/wiki/Gluten_intolerance is decent.
You're just cherry-picking. All of the credible researchers in the field estimate the prevalence of "gluten intolerance" -- at the high end of the spectrum -- to be well under 10%. The guy at the U. Maryland center is on record for a prevalence of ~6%.
I'm sure there are a number of "expert" wackadoos who say that the number is higher, and are happy to sell you a book about it, too.
"There is not agreement about the delayed allergy mechanisms work (mostly IgA and IgG) to the point that there is no standard lab test for them"
Nonsense. There are well-established tests for immunoglobulins to gluten/gliadin, and they're so widely employed that they're in the Merck Manual as part of the diagnostic procedure for Celiac disease.
The situation here is that these test results don't correlate with the self-reported symptoms of people with "gluten intolerance". People who desperately want to blame their low-level health problems on gluten take this to mean that the tests are inadequate; the medical community concludes that the tests are fine, but the "intolerance" (if it exists at all), is not mechanistically related.
Finally, not that it will change your mind, but a Wikipedia article about a diet fad is not a reliable source of unbiased information. If that's your source of "primary data", then you need to find another source, because Wikipedia articles are notorious for cherry-picking extremely questionable, "fishing expedition" studies, and presenting them as consensus. Looking over the page you linked, I see a mess of incoherent speculation, but no one mechanism. Aside from the usual immunological markers of Celiac, there is nothing canonical.
5% prevalance is very prevalent, given that in the west, unless you make all your food starting with basic ingredients, you have to work very hard to avoid wheat. It's used everywhere as a cheap filler, including (but definitely not limited to) candy, soup, salads, protein supplements. And that's before considering that a significant part of western diet is wheat based.
The most recent guy I discussed this with (who heads one research department in a top tier medical school) estimates it as 5-10%, which seems to be in line with the U Maryland guy you quote. That's ridiculously high for a condition that many people disagree actually exists.
> Nonsense. There are well-established tests for immunoglobulins to gluten/gliadin, and they're so widely employed that they're in the Merck Manual as part of the diagnostic procedure for Celiac disease.
That is correct. I was talking about general delayed allergy mechanisms. There are some experimental tests that are supposed to figure out specific food intolerance (of which gluten is just one example), and there is no standard for those in general. Some reputable labs offer a panel of running IgA and IgG from blood against (say) 90 different foods and their metabolites. These tests have no standards and are not generally accepted (yet, anyway), despite the fact that it is undisputed that this is a mechanism of action that can cause a >24 hour delay of response.
> People who desperately want to blame their low-level health problems on gluten take this to mean that the tests are inadequate; the medical community concludes that the tests are fine, but the "intolerance" (if it exists at all), is not mechanistically related.
Indeed, and that's correct, for the specific mechanism tested. But unfortunately, many also take this to mean no such thing as gluten intolerance exists. (similarly for other substances). That's not a valid position to take.
I have my own n=1 and enough of other anecdotal n=1 stories (and enough opinions from people I trust, and you would too given their credentials) to believe that wheat products -- not necessarily just wheat gluten, though it is probably the worst offender -- are bad for many.
I've gone through many elimination diets over the years trying to determine which foods aren't good for me - long before I heard of gluten intolerance. It might not be gluten at all, for all I know, but it has been consistent that removing stuff with "wheat" on the label from my diet makes me feel much better. (The most recent example was protein powder, which I figured was making me fill bad after 3 months or so -- and only then checked and realized that some wheat protein was among the components).
> Finally, not that it will change your mind, but a Wikipedia article about a diet fad is not a reliable source of unbiased information.
No, that's not reliable nor primary data. But Wikipedia is, more often than not, a good intro to a discussion, and some beginning pointers. I only referred to a couple of paragraphs as reasonable intro.
It's pretty analytical as well - they are comparing blood serums that have been stored over time to determine when it first showed up in the population.
My current approach is to simply ignore popular food science advice until it is 5-10 years old. If it sticks around that long, I figure it warrants further examination.
Other people can do whatever they like with their own diets. This is just me.
I am so tired of this quackery.
Here is a very recent study and write up:
http://www.ncbi.nlm.nih.gov/pubmed/22825366
http://celiacdisease.about.com/od/glutenintolerance/a/Gluten...
And here is a well-cited summary of the facts:
Symptoms of gluten sensitivity may include bloating, abdominal discomfort, pain, or diarrhea; or it may present with a variety of extraintestinal symptoms including headaches and migraines, lethargy and tiredness, attention-deficit disorder and hyperactivity, autism and schizophrenia, muscular disturbances as well as bone and joint pain. [1][2][3][4]
Whilst the research surrounding gluten sensitivity is still very much emerging, coeliac disease is a well-defined condition. It is a lifelong autoimmune condition characterised by the chronic inflammation of the intestine... In comparison, in a recent clinical paper, gluten sensitivity was defined as ‘one or more of a variety of immunological, morphological or symptomatic manifestations that may also be shared by coeliac disease and irritable bowel syndrome (IBS) [5]. In cases where there is reactivity to gluten, yet coeliac disease and wheat allergy are eliminated as possibilities, gluten sensitivity may be considered. Whilst the general clinical picture for gluten sensitivity is similar to coeliac disease in particular, it is usually less severe and neither anti-tissue transglutaminase antibodies nor autoimmune comorbidities are found. It is believed that approximately 40-50% of gluten sensitivity patients may have IgG or IgA anti-gliadin antibodies (AGA) [6][7]. There is also a study identifying approximately 50% of gluten sensitivity patients, few more than the general population, carry either HLA DQ 2 or 8 [8].
[1] Sapone A et al. Differential mucosal IL-17 expression in two gliadin-induced disorders: gluten sensitivity and the autoimmune enteropathy celiac disease. International Archives of Allergy and Immunology. 2010;152:75-80; Ford RP. The gluten syndrome. A neurological disease. Medical Hypotheses. 2009; 73 (3):438-440 [2] Elder JH et al. The gluten-free, casein-free diet in autism: results of a preliminary double-blind clinical trial. Journal of Autism and Developmental Disorders. 2006;36(3):413-420 [3] Dickerson F et al. Markers of gluten sensitivity and celiac disease in recent onset psychosis and multi-episode schizophrenia. Biological Psychiatry. 2010;68(1):100-104 [4] Hadjivassiliou M et al. Myopathy associated with gluten sensitivity. Muscle Nerve. 2007;35:443-450 [5] Verdu EF, Armstrong D, Murray JA. Between celiac disease and irritable bowel syndrome: The ‘No Man’s Land’ of Gluten Sensitivity. The American Journal of Gastroenterology. 2009;104(6):1587-1594 [6] Sapone A et al. (2010). Differential mucosal IL-17 expression in two gliadin-induced disorders: gluten sensitivity and the autoimmune enteropathy celiac disease. International Archives of Allergy & Immunology; 152: 75-80 [7] Bizzaro N et al. (2010) Cutting edge issues in celiac disease and in gluten intolerance. Clinical Reviews in Allergy & immunology. [8] Sapone A et al. (2010). Differential mucosal IL-17 expression in two gliadin-induced disorders: gluten sensitivity and the autoimmune enteropathy celiac disease. International Archives of Allergy & Immunology; 152: 75-80.
That's true, for instance with Someone=cmccabe.
Despite commonly held beliefs, the scientific method is not at all about proving things. It is about making testable hypothesis and being unable to refute them IN SPITE of testing.
Now, specifically about gluten intolerance, the claim that "if you are not celiac, gluten can't hurt you" can be disproved (as has been shown in the reference above).
Any qualifications in the area?