May is Celiac-Disease Awareness Month. Which might seem unnecessary, if the superfluity of “gluten free” labels and advertisements were any indication of people’s awareness of the disease.
Gastroenterologist Norelle Rizkalla Reilly believes it’s quite clearly not. She directs the Celiac Disease Center’s pediatric program at Columbia University. Her understanding of public misconceptions comes not just from daily immersion in the world of gluten-related immune disorder, but from a careful analysis of the true window into our souls: our Google histories.
She published the chart below in the Journal of Pediatrics:
In the medical journal, Reilly’s message is that physicians should be educating people that this is not okay. “You have the gluten-free industry speaking with a megaphone,” she said, “and we’re trying to do our part to put accurate information into circulation.”
It’s in that context that she addresses the many risks that come with taking on a gluten-free diet when it is not medically warranted. That includes studies that have found increased rates of metabolic syndrome among people who switch to a gluten-free diet, presumably due to poor nutritional quality of gluten-free replica products. Other studies have reported people developing deficiencies in folate, thiamine, and iron, which are added to grain products by law. When researchers in Spain compared 206 gluten-free food products to their traditional gluten-containing counterparts, the team found “marked differences” in the nutrient and caloric contents. “This may represent a nutritional concern for celiac patients,” the researchers concluded, “but it may also be a problem for non-celiacs who consume gluten-free rendered foods.”
Life is not gluten-free camp, though. In the real world, gluten-free versions of foods are most often more expensive than the standard formulations, as well. (An especially pointed factor for the 20 percent of households earning less than $30,000 annually and yet worrying about procuring gluten-free products.)
“We obviously have a lot of patients who need to be on a gluten-free diet,” Reilly added, “and I don’t mean to alarm those individuals.”
Given the disproportionate number of people who are eating this way without reason, though, there is cause for alarm. Especially among the many people who now mistakenly and blindly conflate “gluten free” and “healthy.” And among those who believe they may have celiac disease but do not get tested. Proper diagnosis is crucial not only to be certain that avoiding gluten and incurring the costs and risks above is truly necessary, but because other conditions sometimes go hand-in-hand with celiac. Those include the skin condition dermatitis herpetiformis, lymphoma, anemia, depression, liver disease, and osteopenia (weak bones). Having a proper diagnosis may inform future medical care not just for patients, but for their families.
As Reilly put it, resolutely but without alarm, “Anything that could potentially derail detection of this disease, including starting the diet on one’s own, should be avoided.”