Is avoiding gluten recommended for anyone who suffers from digestive problems?

I bring here the answer of Roni Baruch, a senior dietitian at the Ichilov Gastro Institute, whom I have known and respected for many years.

"Over a decade ago, a market research company published that 1/3 of the adult population in the US avoids/reduces gluten consumption.

In recent years, the consumption of gluten-free food products has become popular among the general population, regardless of gluten sensitivity, for apparent health reasons and a desire to lose weight. Is this trend, which also involves additional financial expenditure, justified?

Disorders attributed to wheat include: wheat allergy, celiac disease, and gluten sensitivity, also called NCGS = Non Celiac Gluten Sensitivity.

Wheat allergy and celiac disease can be diagnosed by recognized tests. However, gluten sensitivity without celiac disease is a condition whose diagnosis is based solely on patient reporting, meaning - people who believe that eating products containing gluten causes them the above symptoms and that these disappear/reduce with the avoidance of products containing gluten.

It is characterized by a spectrum of clinical symptoms that include symptoms similar to irritable bowel syndrome (IBS) and include bloating, gas, diarrhea, abdominal pain, and symptoms outside the digestive system: fatigue, headaches, depression/anxiety.

The question arises: Is gluten the component that triggers the above symptoms?

Wheat contains additional proteins: ATIs and agglutinins that may trigger an immune response associated with a variety of symptoms inside and outside the digestive system.

Another important component that must be considered is the carbohydrates in the wheat kernel, which is 60-70%.

This ingredient includes a component called fructans, which is included in the group of indigestible carbohydrates called FODMAPs.

This group has been shown in studies to be a group that may cause the variety of symptoms in the digestive system in patients with sensitive intestines, so it is not clear whether gluten is the problem for the digestive system or the fructans mentioned above are the problem.

It is important to note that in examining food products from the carbohydrate group such as bread, rice, pasta, spelt bread, rye, corn, couscous, etc., it was found that the less gluten the foods contain, the less fructans they also contain.

Controlled studies published in the last decade dealing with the diagnosis of NCGS (gluten sensitivity) raise doubts that gluten is the "culprit" in most patients.

Additional work in healthy people who adopted a gluten-free diet showed changes in their microbiome in a way that compromised their good microbial profile, an undesirable situation.

In conclusion, avoiding gluten for reasons other than celiac disease/gluten allergy requires careful consideration and further understanding through the mediation of a qualified professional on the subject.

"It is important to remember that one should not adopt a blanket avoidance of gluten when it is not clearly required, from a health perspective."

Thanks to Roni Baruch M.Sc RD, Senior Dietitian, Nutrition Department, Gastroenterology Institute, Soursky Tel Aviv Medical Center, Co-Chair of the Gastroenterology Forum, Atid Association