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Entity explores whether gluten intolerance really a thing.

You’re having your weekly Sunday brunch with your best friend at your favorite local eatery. Except this time, when the waiter comes to take your orders, your friend doesn’t order her usual pineapple pancakes. Instead, she asks, “Do you have a gluten-free menu? I’m gluten intolerant.” You’re stunned. Just last week, she inhaled whole-wheat pancakes like a competitive eater on a winning streak – and now she doesn’t do gluten? Has the gluten free trend devoured your best friend … and is gluten intolerance even a thing anyway?

It may seem like gluten-free is the new black. According to Jennifer Welsh at Science Alert, although only one percent of Americans have celiac disease – an autoimmune condition that requires a gluten-free diet – 30 percent of people want to eat less gluten and 18 percent of adults are buying gluten-free foods.

Some of these people avoiding gluten could have undiagnosed celiac disease; others could be fad dieters who believe that a gluten-free diet is healthier and more likely to promote weight loss. But what about those who claim to be gluten intolerant? Here are all the statistics, studies and stories you need to know to decide if gluten intolerance is fact or fiction.

What is gluten intolerance?

Try to imagine the full range of gluten-related diets on a kind of sliding scale. Fad dieters sit on the bottom because they typically follow a gluten-free diet due to preference while celiacs sit on the top because they need a gluten-free diet free of cross-contamination to survive. Gluten intolerants exists between these two extremes: They don’t have celiac disease, but often suffer intestinal or other negative symptoms when consuming gluten.

As the Huffington Post explains, symptoms of those who claim gluten intolerance can range form bloating to abdominal pain to brain fog to depression. Not only have some studies shown that these symptoms tend to decrease on a gluten-free diet for some people, but scientists have also connected non-celiac gluten sensitivity with other issues like autism, schizophrenia and ataxia.

How many people really have it?

To put it simply, gluten intolerance can be considered the gluten version of lactose intolerance. But how many people actually have gluten intolerance compared to how many people think they do? Luckily for us, we can turn to several recent studies for some answers:

  • According to U.S. News, a 2015 study in Digestion Journal found that 86 percent of those self-diagnosed with gluten sensitivity could tolerate gluten.
  • U.S. News also reports that a study by researchers from the University of L’Aquila in Italy involving 392 patients who believed they had gluten intolerance. This study found that, out of the 392 patients, 6.63 percent tested positive for celiac disease, 0.51 percent tested positive for wheat allergy and 6.88 percent percent showed signs of non-celiac gluten sensitivity. Based on these numbers, after accounting for those with celiac disease or a wheat allergy, 93 percent of those who believe they are gluten intolerant can tolerate gluten.
  • HealthLine points to an influential 2011 study of 59 Italians who claimed to have non-celiac gluten sensitivity. After observing the effects of participants receiving daily servings of rice protein (during a placebo phase) or gluten (during a study phase), three patients exhibited more negative symptoms during the gluten period. To Dr. Stefano Guandalini, founder and director of the University of Chicago Celiac Disease Center, this study shows that “a small, tiny, tiny, number” of people have gluten intolerance.
  • But it’s even more complicated that that. According to Forbes, Peter Gibson revisited his 2011 study that initially supported the existence of gluten intolerance. Two years later, however, he found that 37 self-identified gluten intolerants experienced the same symptoms – like pain, bloating, nausea and gas – on all given diets, including high-gluten, low-gluten and no-gluten. He blames a “nocebo” effect or the patients’ expectations to feel worse on the study diets, creating a self-fulfilling prophecy. Either way, Gibson concluded that “In contrast to our first study … we could find absolutely no specific response to gluten.”

Bottom line? According to U.S. News and Healthline, gluten intolerance only truly affects 0.06-6 percent of Americans. But more people than that seem to suffer when they eat gluten – and research is finding reasons other than gluten intolerance.

What else could be causing your symptoms?

Does this scenario sound familiar? Before lunch, your stomach is flaunting those baby abs you’ve been sweating over for months … but after eating your favorite sandwich and fruit cup from your office café, you look – and feel – like you’re eight months pregnant. A quick Google search may imply that “evil” gluten is your answer, but this probably isn’t the case.

As Healthline explains, there are several alternate answers than gluten intolerance. For instance, some people who claim of tummy troubles might have celiac disease, but are at such an early stage that the telltale signs haven’t emerged yet. Others, as already mentioned, could be allergic to wheat. An Australian 2013 study, however, found another possible trigger: FODMAPs, or fermentable oligo-, di- and monosaccharides and polyols.

For those who don’t have a biology degree, those are a certain kind of carbohydrates – including wheat, lentils and mushrooms – that can cause digestive issues in some people. The Australian researchers discovered that, when they reduced the amount of FODMAPs that the self-diagnosed gluten intolerants ate, participants who received gluten or a placebo reacted the same. As a result, the team concluded that many “gluten intolerants” are actually intolerant to FODMAPs. As long as their consumption of these carbs stays below a certain threshold, these people can eat gluten without a problem.

So now what?

So what should you do with all of this information? Use it to know that while gluten intolerance can exist in some people, it isn’t common. Instead, more people experience stomach issues and other symptoms due to celiac disease, an allergy to wheat or intolerance to FODMAPs. The next time you hear someone claim to be gluten intolerant, realize that this could be true … but you shouldn’t be free of a healthy dose of educated cynicism either.

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