These days gluten is a mainstream word, although there is still a sizeable percentage of the population who don’t know what it is. More concerning, perhaps, is having wrong information about it. Below are 5 misconceptions about gluten that you will probably come across.
1. Gluten-free = healthy
This is one of the most common misconception about gluten and comes mainly courtesy of health claims on packaged products. The same “health halo” applies to words such as “organic”, “vegan”, “all natural” and “preservative free”. Bottom line, gluten-free products are not inherently healthy.
Exhibit A: Cheese-flavoured snack
- Ingredients: corn, vegetable oil, rice, milk powder, salt, cheese powder (1.0%), corn starch, flavour enhancers (621, 635), flavours, vegetable extract (corn), spice, natural colours (paprika extract, carotene), food acid (262), onion powder
- Energy per 100g: 2270 kJ
- Total fat per 100g: 34.2 g
- Saturated fat per 100g: 15.8 g
2. Coeliac Disease is a gluten allergy
Coeliac Disease (CD) is actually an autoimmune disease that affects multiple organs and is triggered by gluten (1).
3. Coeliac Disease can be diagnosed with a blood test, even in the absence of gluten intake
The scariest thing about this one is that there are doctors out there who think this way! The reality is that you need to consume gluten prior to blood or biopsy testing for the diagnosis to be valid. The recommended steps for diagnosis (1) are:
- Blood screening of antibodies (eating gluten) or HLA genotyping (not eating gluten)
- Small bowel biospy to confirm intestinal damage
- Go on a gluten-free diet, repeat biopsy to show recovery
4. Non-Coeliac gluten-sensitivity doesn’t exist
People who report symptoms after ingestion of gluten, but who do not have CD nor wheat allergy, are said to have Non-Coeliac Gluten Sensitivity (NCGS). There is controversy about the existence and prevalence of this condition, mainly because there is no objective diagnostic tool to date. Diagnosis, if any, is based on double-blinded gluten challenges (i.e. neither the doctor nor the patient know whether they are ingesting gluten or placebo). Some researchers think that these symptoms are caused by the nocebo effect (this is the opposite of placebo) or FODMAPs. In my opinion, NCGS does exist, but the aforementioned explanations are also plausible for a percentage of the suspected cases.
5. If I’m intolerant to gluten I won’t be able to eat/drink X again
If you are intolerant to a particular food or ingredient, you might be able to consume it in small quantities. Also, some food processing methods can lower the amount or effect of the problematic food. Finally, some food intolerances (and allergies) can be resolved with time, particularly if the sensitivity is caused by a compromised gut barrier.
Coeliac Australia’s website is a good resource for all things CD and gluten.
- Tye-Din J. Interpreting tests for coeliac disease. Australian Journal for General Practitioners. 2018;47:28-33.