CD and wheat allergy, there are cases of gluten reactions in which neither allergic nor autoimmune mechanisms are involved. These are generally defined as gluten sensitivity (GS), a condition in which symptoms are triggered by gluten ingestion, in the absence of celiac‐specific antibodies and classical celiac villous atrophy, with variable human leukocyte antigen status and variable presence of first‐generation anti‐gliadin antibodies.
The overall prevalence of GS in the general population is still unknown, because there is not yet a consensus on precisely what is meant by ‘gluten sensitivity’. Therefore, on one hand, it is still unknown whether gluten represents the trigger of GS and, on the other, many patients are currently self‐diagnosed and start a GFD without medical advice or consultation.
To summarize, GF products are used by either clinically diagnosed CD patients or patients with a variegate series of conditions, not including CD, but leading to remove gluten from the diet. At the same time, undiagnosed CD patients still follow a normal diet inclusive of gluten without overt clinical symptoms. The overall cost/benefit ratio of this distribution on population health in the long term is still unknown.
As a matter of fact, since the demand for GF products is continuously increasing, extensive research has been carried out to produce GF bakery products with sensory and nutritive characteristics suitable for replacing, at least partially, traditional cereal‐based products. In the production of such foods, mechanical and sensory challenges have to be solved, since a dough without gluten has a weak structure, is technologically hard to work and often has a low mouthfeel. Therefore a large number of flours and starches as well as many ingredients such as enzymes, proteins and hydrocolloids have been used in order to mimic the viscoelastic properties of gluten, thus improving the structural acceptability of GF products. As a consequence, the different mixtures of these ingredients bring a wide difference in the nutritional composition of GF foods with respect to gluten‐containing counterparts and, in turn, affect the nutritional quality of these products.
Also, there is no scientific evidence supporting the alleged benefit that a gluten-free diet will promote weight loss. Research has shown that adherence to the gluten-free dietary pattern may actually result in a diet that is low in carbohydrates, iron, folate, niacin, zinc, and fiber. There is nothing special about a gluten-free diet that can help a person lose weight. Could it be that some people lose weight because of the limited foods available? And could a person actually gain weight on a gluten-free diet? Gluten-free products do not mean fat-free or calorie free.
Comparing a serving of pretzels, regular pretzels provide 108 calories and 1 gram of fat and gluten-free pretzels contain 140 calories and 6 grams of fat. In fact, some research has confirmed weight gain in celiac patients when they start a gluten-free diet. This could be due to improved gastrointestinal absorption, a diet with higher portions of fats and proteins, or some of the new (higher calorie) gluten-free product.The bottom line is that evidence-based research is needed to confirm the benefits of a gluten-free diet beyond its use for celiac disease.
References
1.
https://jandonline.org/article/S0002-8223(11)01572-0/pdf
2. Pellegrini, N., & Agostoni, C. (2015). Nutritional aspects of gluten‐free products.
Journal of the Science of Food and Agriculture,
95(12), 2380-2385.
