The gluten-free diet? You know that it’s fashionable when Oprah Winfrey does it. In 2008, the media mogul temporarily gave up gluten as part of a 21-day “cleanse diet.”
Over the past decade, going gluten-free has been touted as a way to boost health and energy, lose weight, or cope better with ADHD, autism, headaches, and other conditions.
But who really needs this diet?
Long before its newfound popularity, the gluten-free diet was a medical staple -- a proven treatment for celiac disease. Perhaps someday, new scientific findings will show that gluten-free diets benefit other health problems, too.
But for now, people need a gluten-free diet only if they have celiac disease or gluten sensitivity, a condition that doctors once dismissed, but now are recognizing as legitimate. That's the advice of Stefano Guandalini, MD, director of the University of Chicago Celiac Disease Center.
“People think that gluten-free diets are more healthy,” Guandalini says. “This is, of course, not the case.” In fact, the diet is hard to follow and may pose nutritional drawbacks when people have no medical reason to be on it.
Make no mistake: Going gluten-free is essential for patients with celiac disease, such as Susan Eliot. “I was a very typical, undiagnosed, malnourished celiac child. I was very sickly,” says the 67-year-old resident of Sequim, Wash.
Celiac disease is an autoimmune disease in which a person can’t tolerate gluten, a protein in wheat, rye, and barley. Gluten shows up in bread and pasta, but may also hide in many other foods, such as cold cuts, salad dressings, beer, and even licorice.
If a person with celiac disease eats gluten, the lining of their small intestine becomes inflamed and damaged. That hampers the absorption of nutrients and can lead to malnutrition and weight loss. Celiac patients also struggle with distressing symptoms, such as diarrhea, stomach upset, abdominal pain, and bloating.
In some cases, celiac disease may take years to diagnose because doctors mistake it for irritable bowel syndrome or other diseases.
Eliot described herself as "wasting away,” dropping weight and suffering from chronic poor health until doctors finally diagnosed her with celiac disease at age 27. Years of poor calcium absorption had left her with joint and tooth problems. Celiac disease may have also been the culprit in delayed menstruation; she didn’t start having periods until she was 18.
Since her diagnosis 40 years ago, Eliot has followed a strict, gluten-free diet, the only treatment for celiac disease. After she stopped eating gluten, her intestine repaired itself, a recovery that’s typical for celiac patients. Eliot credits gluten-free eating with restoring her health. “It may be a fad diet, but it’s not a fad disease,” she says.