Do You Really Need To Go Gluten-Free?

Unless you actually have coeliac disease, it’s probably not gluten you have a problem with.

First things first: coeliac disease* is a real thing, where eating food containing gluten causes an adverse reaction.

Around 1% of people in the UK have coeliac disease, but many others go gluten-free for health reasons. There's a huge industry around gluten-free foods. The market is currently worth £175m and is expected to reach £561m by 2017.

In people with coeliac disease, the immune system mistakes substances found inside gluten as a threat to the body and attacks them. This damages the person's intestines and makes it hard for the body to absorb nutrients from food.

*or "celiac disease" if you're American and pedantic.

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Peter Gibson, a scientist at Monash University in Melbourne, Australia, was one of the authors on a key scientific paper that established evidence of non-coeliac gluten sensitivity in 2011.

But last year Gibson published a follow up paper based on a new, much more detailed and controlled, study that contradicts his previous findings.

That doesn't mean the symptoms people who think they're gluten intolerant are experiencing are all in their head. It just means it could be something other than gluten that's causing them.

"There are many people that feel that they have gluten sensitivity because when they go on a gluten-free diet they feel well, and when they eat wheat they feel poorly," Gibson told the Gastroenterology podcast last year. But the question is whether it's really the gluten or another part of wheat that is making people feel unwell.

Wheat has both protein and carbohydrate components, and either could be to blame.

Proteins other than gluten could be to blame for symptoms experienced by patients who think they're gluten sensitive.

Gluten breaks down into smaller proteins gliadin and glutenin when we digest it. It's gliadin that people with coeliac disease have a problem with. But these two also break down further into even smaller proteins, and these smaller ones could act like morphine or other opiates, possibly explaining the lethargy seen in people without coeliac disease.

Or it could even be carbohydrates – specifically a group of short-chain carbs called "FODMAPs" that are difficult to digest and poorly absorbed in the gut. These kinds of carbohydrates occur in lots of different types of food, so going gluten-free won't necessarily help if they are the problem.

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