For some, a gluten-free diet is an essential medical treatment, but a number of people are turning to gluten-free products to lose weight or for sometimes unproven health benefits.
According to the Nielsen Co., gluten-free products are projected to become a $2.6 billion industry by 2012. There's gluten-free pasta, bread and pizza. There are full sections of gluten-free products in grocery stores. Even big-name companies such as General Mills, Campbell's and Frito-Lay have gluten-free product lines ranging from Betty Crocker Devil's Food cake mix to Cheetos Crunchy Cheese Flavored Snacks.
Amy Soergel, who owns Naturally Soergels, an organic, natural, gluten-free and allergen-free food store at Soergel's Orchards in Franklin Park, stocks more than 900 gluten-free food items. She said she's been amazed by the number of products that have entered the market since she opened the store in May 2009.
It's estimated that about 3 million American have celiac disease, an autoimmune disease in which ingesting gluten causes flattening of the villi in the small intestine, preventing the proper absorption of nutrients, but only about 10 percent have received a formal diagnosis. As many as 20 million people may have some milder form of gluten intolerance.
Gluten-sensitivity also has been associated with other conditions, including irritable bowel syndrome, attention deficit disorder and autism. There isn't a scientific consensus on whether removing gluten from the diet alleviates symptoms for any of these disorders, but some research has suggested that people diagnosed with autism may have a much higher likelihood of being gluten-intolerent than the general population.
But it's unlikely these groups alone could account for a reported 16 percent sales increase last year for products labeled gluten-free, as reported by Nielsen. What's driving it?
"I think there has definitely been a rise in using [a gluten-free diet] for weight loss," said Heather Mangieri, a Pittsburgh-based registered dietitian and spokeswoman for the American Dietetic Association.
Celebrities such as Gwyneth Paltrow, Jennifer Aniston and Oprah Winfrey have reported temporarily following gluten-free regimes to lose weight and to rejuvenate themselves.
New books like "The G-Free Diet: A Gluten-Free Survival Guide," by Elisabeth Hasselbeck, a host on ABC's "The View," also have played a role. Ms. Hasselbeck was diagnosed with celiac disease, but publicity material for the book consistently refers to the multiple benefits of going gluten-free, including weight loss. The back cover reads: "Whatever your motivation for going G-free -- whether you suffer from celiac disease, as Elisabeth does, or want to lose weight and maintain a healthier lifestyle -- the G-Free Diet is the key to reaching your goal!"
So could a gluten-free diet be the secret to slimming down?
The American Dietetics Association doesn't think so.
"The stance on that is the gluten-free diet is not ideal for weight loss, and it is not a weight-loss diet," said Ms. Mangieri. "There's nothing magical about eliminating gluten, unless of course you have an intolerance."
And if some people do lose weight on a gluten-free diet, she suspects that it's not related to the lack of gluten in their diet. "For some people, if they're starting on any diet, they're more conscientious about what they're eating, so it's more likely they are just taking in less calories and fat."
In fact, some people actually gain weight when eating gluten-free because products often compensate for removing wheat flour and other gluten-containing ingredients with added fat and sugar.
Gluten-free isn't the same as a low-carbohydrate diet, either. Some gluten-free pastas are actually higher in carbohydrates than regular pasta.
Julia Greer, a doctor in UPMC's Division of Gastroenterology, Hepatology and Nutrition, noted some other nutritional concerns, including difficulty getting enough fiber. Many gluten-free products also aren't fortified with the iron, folic acid and vitamin B that are added to most wheat-based products.
"Unless you have a problem with [gluten], I certainly wouldn't recommend that anyone do it for health reasons," she said.
Moreover, gluten-free products are often more expensive. And eating a gluten-free diet takes serious commitment. Not only does it require eliminating all wheat, barley and rye from the diet, but also it necessitates constant vigilance to avoid cross-contamination and unexpected encounters with gluten.
"Gluten is in crazy things you would never think of," said Dr. Greer. "Blue cheese -- they grow the cheese cultures on bread -- soup, canned beans."
She and Ms. Mangieri emphasized that whole foods should be the basis of a healthful, gluten-free diet. "We have a lot of really healthy, whole grains foods that don't contain gluten that should be central," Ms. Mangieri said. "This diet really has brought to life some of the other whole grains [like quinoa and buckwheat] that don't contain gluten, and those can be really beneficial to everyone."
"If you want to go gluten-free for health reasons, you need to take the processed foods out of your diets," said Dr. Greer, not "just go out and buy a bunch of gluten-free cookies."