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Gluten-free diet – who should use it?

Gluten-free diet – who should use it?
A gluten-free diet is considered a diet with health benefits by many people. In the case of celiac disease, this thesis is absolutely correct, celiac disease is a disease that requires absolute avoidance of foods containing gluten. The use of a gluten-free diet is also justified in the case of non-celiac hypersensitivity to gluten. Otherwise dietary use is a controversial topic in terms of its health benefits.

dieta bezglutenowa: na obrazu są zdrowe warzywa: awokado, sałata, pomidory

What is gluten?

Gluten is a protein found in grains such as wheat, rye and barley. It is a storage protein for amino acids in the seed, allowing the plant to germinate and grow. The popularity of gluten in dishes is due to the fact that this protein increases the stickiness of the dough, which allows you to bake the desired flour foods.
Avoiding gluten in food is based on real health reasons when the consumption of gluten is not recommended (celiac disease). The popularity of a gluten-free diet, however, is not justified by dietary medical recommendations. In many cases, the choice of a gluten-free diet is caused by environmental pressure and erroneous premises resulting from the statements of “influencers” with low medical and dietary awareness.

Non-celiac hypersensitivity to gluten, placebo and nocebo

Non-celiac gluten hypersensitivity (NCGS) is a condition that causes symptoms when consuming gluten. Symptoms can be divided into digestive system symptoms: abdominal pain, flatulence, constipation, diarrhea or other systems: fatigue, headache, pain in muscles and joints, depressed mood.
The symptoms of consuming gluten in NCGS are most likely caused by an allergic reaction. Despite its name, NCGS does not necessarily result from consuming gluten. It is unclear whether the allergic reaction in the disease is not directed at other components of the cereal grains.

Medical diagnosis of non-celiac gluten hypersensitivity is difficult not only for technical reasons (lack of clear diagnostic criteria). The factors that disrupt reliable diagnostics are the effects of Placebo and Nocebo, strongly related to the topic of a gluten-free diet.
The nocebo effect, in the case of a gluten-free diet, consists in reporting complaints after consuming gluten due to the expected negative effects, regardless of the real complications of protein consumption. Placebo is the opposite, where you attribute positive health effects to stopping gluten consumption because of the expected effects.

The so-called The Salerno criteria, which are the basis for the diagnosis of NCGS, suggest that in addition to the symptoms described, perform a test limiting the impact of the psychological effect of consuming gluten. Using the double-blind method (neither the person performing the test, nor the respondent knows whether he or she is receiving the test dose of gluten) to some extent, it is possible to distinguish whether the negative effect of gluten consumption is not psychogenic. Such tests have limitations, they do not allow, among other things, to control whether the effect reported by the patient is not due to the presence of other components of the grains.

Reaching for a gluten-free diet, in many cases, results from dietary expectations, not from the clear effects of changing food intake. However, the symptoms associated with the consumption of gluten are not always due to the nocebo effect. You should be aware of the possibility of food allergy, allergy to gluten and NCGS. Symptoms should not be underestimated it is worth consulting a doctor.

The positive effects and risks associated with a gluten-free diet

Positive effects of the diet:

  • A gluten-free diet is the only treatment for celiac disease.
  • Better well-being among people without medical indications, resulting from the placebo effect.
  • The improvement in the functioning of children with autism spectrum disorders resulting from the use of a gluten-free diet is a controversial issue. Controversy arises from few credible studies confirming the effect and many studies negating the thesis. The effect of improving the functioning of children with autism requires further research.

Negative effects of diet:

  • A well-balanced gluten-free diet has no health risks. The negative effects most often result from low dietary awareness.
  • Micronutrient deficiencies. Gluten-free products often contain less calcium, iron, magnesium, vitamin D, B12, and folate compared to gluten-free products.
  • Fiber deficiencies. Avoiding grain-based foods can lead to constipation due to low fiber intake.
    Diabetic risk. Gluten-free products tend to have a higher glycemic index than gluten-containing products.
    A gluten-free diet is considered to be at risk of dietary errors, however, conscious selection of products minimizes the risk of any negative effects of the diet.

What about this diet? Who can gain?

Choosing a gluten-free diet is undoubtedly required among people with celiac disease. Diet is also recommended in cases of proven gluten allergy or hypersensitivity.
The use of a gluten-free diet among people without clear indications is controversial. In the case of a strong need to switch to a gluten-free diet, it is worth paying attention to the micronutrients contained in the products and selecting the consumed foods in such a way as to provide all nutrients in accordance with the needs.

Literature:

A. Diez-Sampedro, M Olenick, T Maltseva, Et. Al., Journal of Nutrition and Metabolism, 2019, A Gluten-Free Diet, Not an Appropriate Choice without a Medical Diagnosis

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