The supermarkets are now full of products without gluten. Many of my friends who do not suffer from celiac disease have started to buy and prepare them for the whole family. I wonder whether non-celiacs eating grains without gluten or a reduced amount of gluten could be harmful. B.F., Tel Aviv, Israel
Judy Siegel-Itzkovich replies:
Indeed, just a few years ago there was very little gluten-free food sold, and whatever was sold was much more expensive, even through the raw materials were no more expensive and often much cheaper than ordinary products. Now, gluten-free products are now cheaper and easily available.
An increasing number of people choose a low-gluten diet even though they are not allergic to gluten, which is a general name for the proteins found in wheat, barley, rye, barley and other grains. Gluten helps foods maintain their shape, acting as a glue.
This trend has sparked public debate about whether or not low-gluten diets are recommendable for people without allergies. Most nutritionists do not recommend that non-celiacs abandon gluten completely.
Now, Danish researchers from the University of Copenhagen and colleagues have investigated the matter and recently published their findings in the prestigious journal Nature Communications.
They found that a low-gluten but fiber-rich diet changes the community of bacteria in the esophagus, stomach and small intestine and decreases gastrointestinal discomfort such as bloating and is linked to a small weight loss. The changes in intestinal comfort and body weight are caused by changes in gut bacteria composition and function.
“We demonstrate that, in comparison with a high-gluten diet, a low-gluten, fiber-rich diet induces changes in the structure and function of the complex intestinal ecosystem of bacteria, reduces hydrogen exhalation and leads to improvements in self-reported bloating. Moreover, we observed a modest weight loss, likely due to increased body combustion triggered by the altered gut bacterial functions,” explained Prof. Oluf Pedersen, the leading principal investigator of the study.
The researchers undertook a randomized, controlled, cross-over trial involving 60 middle-aged healthy Danish adults with two eight week interventions comparing a low-gluten diet (2 grams gluten per day) and a high-gluten diet (18 grams daily), separated by a “washout period” of at least six weeks with an ordinary diet (12 grams of gluten per day).
The two diets were balanced in the number of calories and amount of nutrients including the same amount of dietary fibers, but the composition of fibers differed significantly between the two diets.
Based on their observations of altered food fermentation patterns of the gut bacteria, the researchers conclude that the effects of low-gluten dieting in healthy people may not be mainly due to reduced intake of gluten itself but instead to a change in dietary-fiber composition by reducing fibers from wheat and rye and replacing them with fibers from vegetables, brown rice, corn, oats and quinoa.
A low-gluten diet has previously been proposed to reduce gastrointestinal symptoms in patients with inflammatory bowel diseases and irritable bowel syndromes, which occur in up to a fifth of the general Western population.
The Danish study suggests that even some healthy individuals may prefer a low-gluten diet to combat intestinal discomfort or excess body weight. The authors declared that more long-term studies are definitely needed before any public health advice can be given to the general population – “especially, because we find dietary fibers, not the absence of gluten alone, to be the primary cause of the changes in intestinal discomfort and body weight.”
However, the Danish researchers said their study was a “a wake-up call to the food industry. Gluten-free may not necessarily be the healthy choice many people think it is. Most gluten-free food items available on the market today are massively deprived of dietary fibers and natural nutritional ingredients. Therefore, there is an obvious need for availability of fiber-enriched, nutritionally high-quality gluten-free food items that are fresh or minimally processed to consumers who prefer a low-gluten diet.”
But a low-gluten diet may turn out to be key for alleviating gastro-intestinal discomfort and helping to control weight in the general population by changing the bacteria in the gut, Pedersen concluded.
My husband and four teenage children are so different in their eating habits. Some prefer to eat a lot in the morning and for lunch, while others prefer to gorge food at night. Why is this, and is there anything I can do to change their biological/hunger clocks? S.S., Toronto, Canada
Dr. Olga Raz, head of clinical nutrition in the nutrition sciences department at Ariel University in Samaria, Israel, comments:
People differ in countless things from appearance, character traits and even the eating style and timing. I have found that people can be classified into different types according to how, when and what they eat.
Some “breakfast eaters” eat most of their food by noon; “evening eaters” who don’t mind eating little during the day, but when evening comes, they become hungry and eat whatever they can. Some people eat late into the night. Others insist on having a hot meal at lunchtime; otherwise they are not satisfied.
It is recommended eating every two to three hours during your “hunger hours” and every four hours at other times. You will then feel satisfied at all hours of the day and prevent gorging yourself.
It is also important to eat even if you are not hungry; otherwise, when you are really hungry, you will compensate yourself by eating too much. This will probably result in weight gain, a feeling of heaviness, heartburn and even stomach and chest pain. Small meals like crackers, a slice of light bread with a spread, natural yogurt and the like can be enough. It is advisable to plan in advance the hours of eating and prepare the necessary food in advance.
Night eaters with a problem are divided into two types. The first have “night-eating syndrome,” an eating disorder characterized by a change in the sleep cycle. Unlike those who binge (overeat) at night, such night eaters do not eat very much and don’t lose control. This disorder does have side effects such as a lack of appetite in the morning, an intense need to eat late, a belief that eating will help them to fall asleep again, depression, anxiety and/or sleep problems. This syndrome is found in both women and men and accounts for 1% to 2% of the general population and about 10% of the population suffering from obesity.
Binge eating is different and characterized by very large amounts of food, loss of control over eating to the point of forgetfulness of what is eaten at night. Women are the majority with such a syndrome.
Clinical dietitians have one recommendation in both cases: Eat in the evening and just before bedtime meals a sandwich with a spread, oatmeal or any other porridge – preferably not sweetened with sugar — baked sweet potatoes, legumes or any other complex carbohydrate. Keep next to your bed a few crackers, sandwich, banana and so on – foods that can be eaten without getting out of bed.
Both night-eating groups are advised to consume complex carbohydrates, some for small meals every three to four hours. Eating like this reduces the desire for sweetness and allows it to be controlled. Keep irresistible sweet foods out of the home. Don’t use the excuses that the treats are for guests and children; it is clear that most sweets are eaten by you. If you want something sweet, eat outside the house – in a coffee shop or even in the nearest pizzeria.
It is important to understand that all snacks are food for all intents and purposes and often also fattening. Plan meals as you plan other things in life, money and work for example. Internalize that snacks contain a lot of salt and/or sugar and lots of calories.
If you identified have identified you family members as these types of eaters, it was an achievement. They can now start changing. No matter what type of eaters you are, if eating poses a problem for you, there is a solution and everything in your hands. I hope I gave you some food for thought.
If you want an Israeli expert to answer your medical questions, write to Breaking Israel News health and science senior reporter Judy Siegel-Itzkovich at judy@israel365.com with your initials, age, gender and place of residence and details of the medical condition, if any.
