But while a gluten-free diet can be a godsend for people like Hoffman, Case is concerned about suggestions that everyone should embark on it.
“A whole lot of people following a gluten-free diet who don’t need it out of medical necessity. You’ve got the Miley Cyruses and the Lady Gagas of the world. All these celebrities are jumping on this for weight loss. There are many groups going on it claiming they feel so much better. In my mind a lot of these people who say they feel so much better may actually be undiagnosed celiac or sufferers of gluten sensitivity.”
She worries that people are embracing gluten-free as a magic bullet. Those undiagnosed celiacs who go on the diet before being tested are setting themselves up for problems, because it causes blood tests and biopsies to result in false negatives.
“They start to feel better and then they don’t go to the doctor and they don’t follow the diet as closely as they should — so they can still be doing damage to their small intestinal track and can be running into further complications like osteoporosis, cancer of the gut, or developing other autoimmune diseases like thyroid,” says Case.
By the time Hoffman asked her doctor to test her for celiac disease, she was told that because she had removed gluten from her diet the test results would be inconclusive. But since her symptoms were abating, Hoffman was advised to stay on the diet.
And a final irony: People who are neither celiac nor gluten sensitive who give up gluten may be in for a rude shock.
“It’s ironic that they are promoting it for weight loss when most people who go on a gluten-free diet gain weight,” Anka says, citing a recent study out of Ireland that found 80 per cent of patients who went gluten free gained weight within two years.
Moreover, many products such as gluten-free pasta, bread, cake and cookies are not enriched with iron and B vitamins as are regular wheat-based products.
And gluten helps give foods elasticity. To compensate many gluten-free products use more sugar and fat and are higher in calories and carbohydrates.
Bottom line: “A lot of gluten-free products are not very satisfying,” says Case. “There isn’t much fibre to them — there isn’t that oomph that makes you feel like you’ve eaten something, so you tend to eat a lot more. White rice pasta, for example, doesn’t stay with you very well.”
There is one way a gluten-free diet could help those who aren’t celiac or gluten sensitive lose weight and be healthier, says Case. “If they give up, say, bagels and pizza and pasta and cookies and crackers and pretzels and they start eating more fruits and vegetables with some lean chicken or fish.”
But you already knew that.