Gluten Free Diet: Fad Diet or Legitimate Weight Loss Promotion?

Gluten.  This protein is being promoted and talked about everywhere lately.  Celebrities are endorsing it, claiming it will help people lose weight fast, give people more energy, and help people feel physically better overall.  An article stated approximately 30% of Americans are currently avoiding gluten containing foods or eliminating gluten from their diets all together  (1).  With that said it, is no wonder that the gluten free food industry is worth 2.6 billion dollars (2). However, what exactly is gluten and is there actually evidence to support these claims of benefits from adhering to a gluten free diet?

Gluten is a protein that is found in wheat, barley and rye.  It consists of glutenins and prolamins (3).  Currently, the common claims of eliminating this nutrient from the diet include possible prevention and also treatments of specific diseases including type 1 diabetes mellitus, obesity and insulin resistance (3).  Another source includes claims consisting of “better sleep, increased energy, thinner thighs, faster weight loss, clearer skin and improvement of medical conditions such as autism and rheumatoid arthritis” (2).

Evidence- Based Studies

In a recent study in the American Journal Of Clinical Nutrition, the diets and body compositions of celiac disease patients on a gluten free diet and healthy individuals were observed.  They assessed the individuals at the diagnosis of celiac disease and again in 6 months after complying to a gluten free diet.  The results of this study showed that there was a difference in macronutrient (carbohydrate, protein and fat) consumption, specifically that the celiac patients were consuming a higher percentage of fat and a lower percentage of carbohydrate than the control group.  But at the same time, the celiac patients were consuming less total daily energy or calories.  When it came to examining the body composition, the celiac patients had lower weight, BMI, lean body mass and fat mass (4).

Although these results seem promising, we must remember that they are celiac disease patients. Celiac disease is an autoimmune disorder in which consuming gluten will destroy the villi, or lining, of the small intestine, which decreases nutrient absorption. When eliminating gluten from their diet, they are increasing their nutrient absorption, which may lead to using their nutrients more efficiently (5).  Unfortunately at this time, there are not many studies on the effects of gluten free dieting that are not related to celiac disease.  As this issue becomes more and more popular, I do hope to see studies conducted using healthy individuals as participants.  However, one trend that is becoming more noticeable with healthy people starting these gluten free diets is that they are developing heart disease at a very young age.  This is related to the avoidance of heart healthy whole grains that are packed with fiber, which is associated with improving cardiovascular health.

Many studies have shown improvement of a variety of influences in weight of celiac patients.  Included is an increase in HDL cholesterol, which is the good cholesterol we want.  That same study also showed improvement in hypertension in celiac patients that adhered to a gluten free diet (6).  A different study that used obese rats as opposed to celiac disease patients concluded that the gluten free diet improved inflammation and insulin resistance, two factors that are highly prevalent in people with obesity (3).

How to Go Gluten Free

With all the benefits the previous two studies found through a gluten free diet, it made me wonder, could this one nutrient have this big of an influence on our bodies?  Could it possibly influence the rate we are oxidizing fat, which is the breaking down of fat into smaller molecules that can be used for energy, and fat storage as claimed by Soares (3)? But when looking through more research on gluten, I discovered that it is not the removal of gluten, it is how you remove that gluten from your diet that would result in health benefits, including weight loss.

There is a healthy, and a not so healthy way of cutting this protein from your diet.  Let us go over the unhealthy way first.  Simply by replacing your favorite brand of pretzels with a gluten free bag next to it, does not mean it is healthier.  You need to read labels!  These gluten free items are often higher in fat and sugar, to add the flavors and textures lost from the removal of the gluten.  These products are also lower in fiber, zinc, niacin, folate, and iron, all of which are typically added to foods that contain gluten (7).  So by switching to this food option, you are paying more money to get less nutrition.  And these products are expensive! As I mentioned in the beginning the gluten free food industry is worth 2.6 billion dollars because of the recent fad diet, and it certainly will continue to grow as celebrities and marketing companies continue to push the health benefits (2).

Now let me talk about the healthy way to switch to a gluten free diet, that won’t support the gluten free food industry or break the bank.  This includes removing processed foods like bagels, cereal and cookies with whole foods.  Fruits, vegetables, lean proteins and naturally gluten free grains like rice and quinoa resembles an ideal diet.  With this diet you are likely to have more energy, feel better and possibly lose weight.  Also increasing fruit and vegetable consumption may help decrease the risk of diseases associated with being overweight and obese such as hypertension, diabetes and insulin resistance, and cancer.  But is the weight loss an additional health benefits from the removal of gluten? Or is this more centered to the healthier diet that is born from reduced intake of processed foods.

Conclusion

In conclusion with the studies I have looked at, it is clear gluten has an effect on a wide array of metabolic, hormonal, and compositional factors that directly affect fat oxidation, insulin sensitivity and body composition.  I think that more research needs to be directed in this area. I also want to stress the importance of non- celiac research needed in this area.  I truly believe if it is showing normalization of many of these factors related to overweight and obese patients, it may be a possible treatment for weight loss.  I also want to stress that it is important how gluten is taken out of the diet.  Replacing processed foods with natural foods is an overall healthy lifestyle change that naturally will exclude gluten from the diet.  Taking a step in that direction, will more than likely result in weight loss, even if it is indirectly related to the lack of gluten in the diet.

References:

  1. Nash D, Slutzky A. Gluten sensitivity: new epidemic or myth? Baylor Univ Medical Center Proceedings. 2014. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed November 13, 2014.
  2. Marcason W. Is there evidence to support the claim that a gluten- free diet should be used for weight loss? American Dietetic Association.  2011.  Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed November 13, 2014.  doi: 10.1016/j.jada.2011.09.030
  3. Soares F, de Oliveira Matoso R, Alvarez-Leite J, et al. Gluten-free diet reduces adiposity, inflammation and insulin resistance associated with the induction of PPAR-alpha and PPAR-gamma expression. Journal Of Nutritional Biochemistry [serial online]. June 2013;24(6):1105-1111. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed November 13, 2014.
  4. Bardella M, Fredella C, Prampolini L, Molteni N, Giunta A, Bianchi P. Body composition and dietary intakes in adult celiac disease patients consuming a strict gluten-free diet. American Journal Of Clinical Nutrition [serial online]. October 2000;72(4):937-939. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed November 13, 2014
  5. Whitehead C. Obesity and coeliac disease: possible effects of the gluten- free diet. Gastrointestinal Nursing. 2013.  Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed November 13, 2014
  6. Norsa L, Shamir R, Zevit N. Gluten-free diet in celiac disease: protective or providing additive risk factors for the development of cardiovascular disease?. Nutritional Therapy & Metabolism [serial online]. 2012 Jan-Mar 2012;30(1):1-9. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed November 13, 2014.
  7. Enfield S. A sliding scale. Delicious Living.  2014. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed November 13, 2014

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