WORCESTER, Mass. — Gluten is the spongy complex of proteins found in wheat, barley and rye that allows dough to rise. As yeast ferments sugar and releases carbon dioxide, gluten inflates like a hot air balloon, giving breads and cakes their delectable texture.
According to USA Today, up to one-quarter of all consumers now want gluten-free food, even though only one person in 100 has celiac disease, the autoimmune disorder worsened by gluten ingestion. Going gluten-free seems somewhat faddish. The roster of celebrities who’ve gone temporarily or permanently off it includes Chelsea Clinton, Lady Gaga, Miley Cyrus, Drew Brees and Oprah Winfrey.
If only a small fraction of people have celiac disease, why do so many think they need gluten-free foods? It’s tempting to dismiss the phenomenon as the latest hysteria around an over-diagnosed problem. But there is a more nuanced perspective that is more constructive and less judgmental.
To understand the proper role of gluten-free diets requires untangling three separate and unrelated medical problems blamed on gluten: celiac disease, wheat allergy and gluten intolerance. Here’s the thing: The first problem is almost certainly underdiagnosed, but the latter two are likely to be overdiagnosed.