This happens so regularly, you can almost set your watch by it.
What’s caused the fuss this time around? A study published in the BMJ, whose authors concluded, “the avoidance of gluten may result in reduced consumption of beneficial whole grains, which may affect cardiovascular risk. The promotion of gluten-free diets among people without celiac disease should not be encouraged.”
It’s becoming increasingly laughable that respected researchers are still arguing that some kind of harm might befall people without overt celiac disease who choose to avoid gluten anyway. Surely they’re aware of the growing body of evidence—not to mention several thousand patient case studies—demonstrating that one need not have their intestinal villi destroyed as the sole arbiter of intolerance to gluten. Sure, maybe that’s one of the most severe reactions to gluten in those who are sensitive to it, but let’s not negate its effects on the skin, its contribution to irritable bowel conditions, and its possible connection to schizophrenia. And that’s the short list! Gold-standard, placebo-controlled RCTs or not, healthcare professionals can no longer deny the list of nagging symptoms—some serious, others more mild—that patients report resolution of upon going gluten-free. Headaches, eczema, anxiety, lions, and tigers and bears, oh my! (Joking aside, you get the point.)
Let’s take a closer look at the BMJ study. It wasn’t “clinical” research; it was an epidemiological survey, based on food frequency questionnaires (FFQs), which are at best unreliable, and at worst, useless. This kind of data can be used to generate hypotheses, but not to prove cause and effect. In fact, in noting the poor quality of data from self-reported energy intake (EI) and physical activity energy expenditure (PAEE), researchers have written “that it is time to move from the common view that self-reports of EI and PAEE are imperfect, but nevertheless deserving of use, to a view commensurate with the evidence that self-reports of EI and PAEE are so poor that they are wholly unacceptable for scientific research on EI and PAEE.” Granted, they were writing in regard to caloric intake and physical activity, but there’s not much reason to believe self-reported food frequency should be any more reliable. FFQs are fraught with “systematic errors and biases in estimates.” Who consumed gluten? Who avoided it completely? Who ate only small amounts of it, and who ate wheat every chance they got? What else did they eat, and how much, how often? Can we ever really know what people eat unless they’re sequestered in a metabolic ward?