‘Pie hole’, colloquial for one’s mouth, is believed to have evolved in the USA in the 1980s from the British expression ‘cake hole’ (coined in the mid 20th century). Pie hole refers to a mouth, as in: Shut your pie hole or, in this case: Put less in your pie hole.

Thursday, January 21, 2016

Gluten-Free: Not Guilt-Free

It's no longer the season to overeat and be merry. But many people have this problem year-round, followed by the oh-so familiar guilty feeling. That's when folks turn to fancy advertising claims to make themselves feel better. What am I talking about? The crowd buying into the "fat-free", "sugar-free", "gluten-free", "wheat-free", "all natural", "science-free" jibber jabber.

new study found that a significant number of people believed that a product with a "free-from" claim on it (especially "gluten-free") was healthier than the conventional counterpart that sported no such claims. That's good news for no one, unless of course you're the company pocketing the (gluten-free) dough... Get it? You know you chuckled.

People who "identified" as gluten intolerant, or unsure about gluten intolerance, were significantly more likely to choose the "gluten-free" product and rate it "healthier" than the conventional alternative. So, by that logic the "gluten-free" chocolate chip cookies are healthier than regular chocolate chip cookies. Same, I guess with gluten-free chips, pretzels, or lard...

There are really two issues here: The psychology behind people making these choices, and the people who "identified" as gluten-free. Let's discuss the latter.

"Identifying" as gluten free
This statement in and of itself is flawed. One does not "identify" as having Parkinson's or dementia or cancer until one is actually diagnosed with it. Celiac disease is no different. But many "identify" (AKA they self-diagnosed themselves) as gluten intolerant.

Gluten intolerance is yet to have a clinical definition or clinical diagnosis (1, 2, 3). But Celiac disease (aka someone who MUST be gluten free) does have a definition (read more here and here).

"Gluten intolerance", or non-celiac gluten sensitivity (NCGS) is a relatively new condition. And since there's no diagnostic criteria, it's currently diagnosed based on excluding other illnesses/condition like wheat allergy or actual celiac disease. This is because NCGS has a lack of viable biomarkers (things that show up on blood tests) to accurately determine a person has NCGS (1, 2, 3, 4, 5, 6).

But no. You shouldn't use this as an excuse to say that you have NCGS and therefore need to follow a gluten free diet. That remains controversial in the scientific community due to insufficient evidence that a gluten free diet is effective (1, 2.)
In fact, one study found that NCGS patients significantly decreased their gastrointestinal (GI) symptoms when put on a low FODMAPs* diet. Further, when gluten was introduced it only caused GI upset in 8% of participants. Another study also found that FODMAPs, rather than gluten, were the cause of GI symptoms in NCGS patients.

* What's a FODMAP? That's a whole other article. In the meantime, you can read about it here and here.
What did we learn?
  • A self-diagnosis (or non-medical diagnosis) doesn't make you gluten intolerant
  • Buying a product that touts itself as gluten free or free from other things, doesn't make it healthier than the conventional version... Just more expensive

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