For the estimated 1% of the population with celiac disease, gluten is a kryptonite that can trigger digestive distress and cause long-term health problems. (It's also problematic for a slice with less severe gluten sensitivity, though there are no solid numbers on its prevalence.) But for the vast majority of us, gluten is a harmless protein found in grains like wheat, rye and barley that is best known for giving bread its fluffiness.
Nonetheless, "gluten free" has become a major selling point, as if it were a synonym for "low carb." Gluten-free Betty Crocker cake mix and gluten-free beer now line grocery-store shelves. There are gluten-free menus, gluten-free Communion wafers and gluten-free lifestyle tips from the likes of Gwyneth Paltrow. Americans spent a record $2.6 billion last year to banish gluten from their lives, about the same amount they spent on cat food.
But it is the trend followers rather than the celiac sufferers who are doing the bulk of the buying. A recent survey by market-research firm Packaged Facts showed that only 8% to 12% of people who purchased gluten-free products did so because of gluten intolerance. Most simply thought these products were healthier or of higher quality or could help them manage their weight.
"It's becoming extremely fashionable to the point that it's almost alarming," says Dr. Stefano Guandalini, founder and director of the Celiac Disease Center at the University of Chicago. He and other gluten gurus say most people on gluten-free diets don't actually need to be: they've either jumped on the bandwagon or misdiagnosed themselves as gluten-sensitive, a condition that can't be tested for and is treated only by changes in diet.
Food manufacturers are rushing to get a slice of the market, but the Food and Drug Administration has yet to set a standard for gluten-free labeling. That's hardly dire for people avoiding gluten for nonmedical reasons, but for those with celiac disease, a tiny amount can cause a severe autoimmune reaction. And without regulation, the risk of that happening increases. "Vendors or restaurants will feel it's just a fad, it's another crazy diet and it doesn't matter what we feed to these people," says Tiara Rogers, 34, who has a close friend with celiac disease.
Rogers recently gathered with other activists in Washington to pressure the FDA (and to garner attention by building a 11-foot, 64-layer gluten-free cake). One event fresh on their minds was a mislabeling case in North Carolina, where a con man slapped "gluten free" on regular bread, making dozens sick. He was given an 11-year prison sentence last month.
Many health experts stress that gluten is not a dietary evil. "Think of all the populations on the globe that have existed on wheat or other products that have gluten in them," says Barry Popkin, a nutrition professor at the University of North Carolina. As for supposed weight-loss benefits, a gluten-free pretzel is not going to take off pounds any faster than a regular pretzel. In fact, if you avoid only gluten, rather than the carb-packed foods it's typically in, you will likely be getting more calories with fewer nutrients, says Guandalini, because many substitutes end up being high in surrogate carbs and low in fiber. That's why celiac patients who go on prescribed gluten-free diets often see their body mass indexes increase, not decrease.
Of course, people are free to eat what they wish, but "a gluten-free diet is not necessarily a healthy diet," says Dr. Peter Green of Columbia University's Celiac Disease Center. "It's something people seem to take on without being aware of the effects."