"Gluten-free" is fast becoming the "low-carb" diet trend of the 21st century, although only 10 percent of the people buying its foods suffer from the celiac disease, wheat allergy or "gluten sensitivity" that make gluten avoidance a medical-must.
The burgeoning gluten-free marketplace has been a boon to men and women whose good health depends upon keeping gluten out of their gullets.
Today, gluten-free staples, frozen meals and snacks fill aisles of supermarkets that years ago might have stocked only a paltry collection of cardboard-y rice crackers and wheat-free cookies.
At Wrigley Field, home of the Chicago Cubs, baseball fans can wash down hot dogs on gluten-free buns with gluten-free beer.
Some churches provide gluten-free or very-low-gluten altar bread on communion trays, further attesting to the mainstreaming of gluten-free eating.
Last year, Americans spent $2.64 billion on foods and beverages without gluten, up from $210 million in 2001, according to Packaged Facts, a Rockville, Md.-based market research firm. The number of food and beverage packages with gluten-free package claims or tags rose from fewer than 1,000 at the end of 2006 to 2,600 by 2010.
The target market for sufferers of three types of gluten-related disorders is significant.
An estimated 3 million Americans have celiac disease, a life-threatening immune disorder triggered by the consumption of a protein found in wheat, rye and barley. Celiac disease is considered genetic, but can strike at any time of life when genetic and environmental influences intersect. Only about 200,000 Americans have been diagnosed.
Another 300,000 to 600,000 Americans have wheat allergies, which could kill them if they inadvertently ingested wheat products that swell their airways shut.
The biggest of these potential pools lies with those plagued by an emerging, but not fully delineated "gluten sensitivity" which Dr. Alessio Fasano, director of the Center for Celiac Research at the University of Maryland in Baltimore, in a study published in March, estimated could be as many as 20 million people.
Among that group is Maria Monteverde-Jackson, 40, of Arlington, Va. Only six weeks ago, she gave up gluten after becoming increasingly frustrated by doctors' inability to pinpoint the source of the stomach pain, tingling in her hands, headaches, brain fog and "a general unwell feeling" she'd had since December. Because she had a 3-year-old niece with celiac disease, she considered the possibility that celiac might be "somewhere in our DNA" and underwent blood tests and biopsies of her small intestine, which all proved negative for celiac.
After that, she said, "I felt like I needed to take control and do something to see if I couldn't make myself feel better."
She had a consultation with Fasano and was diagnosed with gluten sensitivity. When she stopped eating gluten, she said, "the mental fogginess and the headaches went away pretty quickly," which she described as "a great relief." The stomach pain has eased, too.
Gluten-Free Marketplace Has Changed With Growing Perception It's Somehow Healthier
Her sister-in-law showed her the ropes of shopping gluten-free. As the mother of two young sons who loves to cook from scratch, she found that some favorites, like risotto, were made with rice, which she can eat without reservation.
She doesn't want to interfere with the children's diet, so, for example, at dinner last Wednesday night, "I served bread for my boys and my husband and I just did without and that's fine."
She said her 5-year-old son is learning something from her new eating habits.
"My 5-year-old will say, 'Is an apple gluten-free?'" she said. "I'll say 'yes, that's gluten-free.' Then he'll turn around and offer me a pancake. He's still getting it."
Even though gluten-free diets initially were an accommodation to celiac disease and wheat allergies, the marketplace has changed.
Today, 90 percent of people whose eschew gluten do so "just as a food fad, or as a weight reduction thing," said Dr. Peter H.R. Green, director of Columbia University's Celiac Disease Center in New York. "Only 10 percent are doing it because they think it's helping their condition."
Many consumers feel that gluten-free foods are somehow better for them. Green said gluten-free diets can take off pounds if someone is cutting down on carbohydrate-rich pasta and bread, but they're no caloric bargain if they substitute gluten-free versions, typically containing more fat, sugar and a bigger caloric punch.
Avoiding gluten without a medical reason can put good health at risk in several ways.
Gluten-free flours and baked goods "aren't fortified with iron or B vitamins as wheat flour is; some people may become anemic because of lack of iron in their diet," Green said.
Flours, breads and other baked goods made from rice, potato and corn instead of flour often lack the fiber of their wheaten counterparts. As a result, they're higher on the glycemic index, more quickly raising glucose (blood sugar) levels in the blood and causing the pancreas to release more insulin.
That extra glycemic load can be a problem not just for someone prone to obesity or diabetes, but also to cancer patients trying to stick eat better to prevent secondary illnesses, said Dr. Mary Hardy, medical director of the Simms/Mann UCLA Center for Integrative Oncology.
In seeking to follow "the healthiest, cleanest diet," some misguided patients may buy into the notion that after rejecting higher-fat foods such as red meat and dairy, they've "got to take gluten out, too." Hardy said she becomes concerned when a patient "mindlessly" assumes gluten-free must be better. To show how over-the-top gluten-free claims can be, she described recently attending a natural products expo where she picked up "a bottle of plain water that was labeled as gluten-free!"
Celiac Disease, Wheat Allergy Require Vigilant Attention to Food Ingredients
Celiac disease, also called celiac sprue, affects an estimated 1 in 133 Americans, many of them unaware that they have a genetic disorder in which the body perceives gluten in their food as an alien invader and launches an immune system attack on the intestines and other organs. Symptoms can range from diarrhea, abdominal pain, fatigue and headaches to malnourishment, osteoporosis, neurological conditions and in some cases, infertility and cancer.
Celiac sufferers must strictly adhere to gluten-free eating. Even a stray crispy crouton in a salad could be enough to launch an internal immune system siege that can sicken them.
Like those with wheat allergy, which can trigger hives, congestion and potentially fatal anaphylaxis, celiac patients must be vigilant about the contents of everything they eat. Offending foods containing wheat products include such surprising items as salad dressings, cold cuts, egg substitutes, imitation crabmeat (surimi), some herbal teas and licorice.
In addition to wheat, rye and barley, gluten can be found in exotic grains like spelt, kamut, faro and triticale. Even some oat products may contain traces of gluten picked up in the field or during processing.
With the addition of people suffering from gluten sensitivity, the market for foods once considered in the dietary fringe is expected to grow further. Packaged Facts predicts it could approach $5.5 billion by 2015.