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 **Figure 9:** Prevalence of people in the US with celiac disease compared to prevalence of people who did not have celiac disease but were avoiding gluten.<sup>[11]</sup>
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+Reasons for popularity increase may be attributed to endorsement by popular celebrities and figures. For example, actress Gwyneth Paltrow has adopted a gluten-free diet and has dedicated a book, It’s All Good, regarding tips that will make you “look good and feel great”. Popular recording artist, Miley Cyrus has also been known to advocate a gluten-free diet in her tweets stating that it will give amazing “change[s] in your skin, physical and mental health”.
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 **Figure 10:** Celebrities endorsing gluten-free diets
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-Reasons for popularity increase may be attributed to endorsement by popular celebrities and figures. For example, actress Gwyneth Paltrow has adopted a gluten-free diet and has dedicated a book, It’s All Good, regarding tips that will make you “look good and feel great”. Popular recording artist, Miley Cyrus has also been known to advocate a gluten-free diet in her tweets stating that it will give amazing “change[s] in your skin, physical and mental health”.
+The market for gluten-free foods have also grown substantially because of increased popularity. Sales of gluten-free foods have grown 34% to nearly one billion dollars in revenue over the last five years.<sup>[12]</sup> In a recent US survey by Packaged Facts in Fall 2010, only 8-12% of gluten-free consumers said they bought gluten-free products because they or a family member of their household has celiac disease or an intolerance to gluten.<sup>[12]</sup> Furthermore, the top reasons for buying gluten free foods were because consumers believe they were ‘generally healthier’ (46%) and that they would help in managing weight (30%).<sup>[12]</sup> Going gluten-free was especially popular among three groups who did not have a medical need for the diet: younger adults ages 20 to 39, females, and non-hispanic whites.<sup>[11]</sup>
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+===== Weight Loss Claims =====
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+Despite nearly one third of consumers adopting a gluten-free diet to lose weight, there is no scientific evidence supporting the alleged benefit that a gluten-free diet will promote weight loss. In fact, it may be associated with weight gain.
+In April 2006, the American Journal of Gastroenterology released a study following CD patients on a gluten-free diet for 2 years. At the end of the trial, 81% gained weight, and 82% of patients that were already overweight gained additional weight.<sup>[13]</sup> In 2010, similar results were found. Twenty one of eighty-eight (27%) of initially overweight CD patients had gained more weight while strictly adhering to a GFD. However, this may be due to improved intestinal function and more efficient nutrient absorption for those with celiac disease.<sup>[14]</sup> Another reason for weight gain may be due to the decreased consumption of fiber that often accompanies gluten-free diets. Fiber allows for increases in satiety (fullness). Consequently, a decrease in fiber may lead an individual to consume more food to feel satisfied.
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+===== Gluten-Free Products – Are they healthier? =====
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+**Figure 11:** Cost in euros/kg between-gluten free and gluten-containing foods across seven different food categories.<sup>[16]</sup>
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+Gluten-free (GF) products were evaluated by two studies done in Australia and Austria respectively. In comparison to the gluten-containing counterparts, gluten-free products were not found to offer any superior health effects. In fact, the studies have found that it was generally unhealthier than normal food products. Firstly, protein content was found to be around 31.9% lower in GF foods whereas saturated fats and sodium content were often higher.<sup>[15]</sup> Additionally, vitamins and minerals were also found to be significantly lower than gluten-containing products. For example, zinc content was lower by 82.1% on average (Missbach et al., 2015). Lastly, GF products generally costed a lot more – often 2-3 times as expensive (Figure 11).<sup>[16]</sup> Ultimately, GF products are often unhealthier than gluten-free products and rumored health benefits from GF foods is not only false, but the opposite from the truth.
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+===== Negative Health Implications of Gluten-Free Diets =====
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+There are quite a few disadvantages to consuming a gluten free diet. The big one being is that you miss out on consuming whole grains (since most of them contain gluten). A meta-analysis of 45 cohort studies and 21 randomized control trials found that whole grain consumption was associated with lower risks of type 2 diabetes, cardiovascular disease and obesity.<sup>[17]</sup> Furthermore, whole-grain interventions were shown to have favorable effects on glycemic control, immune function and blood lipids (ie. triglyceride levels). <sup>[18]</sup> Research has shown that adherence to the gluten-free dietary pattern may actually result in a diet that is low in carbohydrates, iron, folate, niacin, zinc, and fiber.<sup>[14]</sup>
+It has also been shown that gluten free diets can adversely affect your gut flora (or bacterial intestinal health) if you don’t have celiac disease.<sup>[19]</sup> A month on a gluten free diet can drastically decrease numbers of healthy gut bacteria and increase numbers of unhealthy bacteria in your intestines. This imbalance of gut flora can lead to chronic constipation, bloating, diarrhea, irritable bowel disease, and anemia.<sup>[19]</sup>
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+====== Conclusion ======
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+Celiac disease is a very rare disease with no cure and with several symptoms and negative long term implications. The only management for these individuals are gluten-free diets and unfortunately, the media has exploited the use of these diets to make a large market and profit.
+Ultimately, unless someone has celiac disease or a wheat allergy, there’s no reason to really adopt this diet. It has been shown that to the general population, adopting gluten-free diets may be detrimental to one’s health. Gluten is widely misunderstood, naturally occurring wheat protein, but fad diets exploit peoples’ imaginative tendencies to demonize what they don’t understand.
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 ====== References ======
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 [10] Mooney, P. D., Hadjivassiliou, M., & Sanders, D. S. (2014). Coeliac disease. Bmj, 348(Mar03 6). doi:10.1136/bmj.g1561
+[11] Kim, H.-S., Patel, K. G., Orosz, E., Kothari, N., Demyen, M. F., Pyrsopoulos, N., & Ahlawat, S. K. (2016). Time Trends in the Prevalence of Celiac Disease and Gluten-Free Diet in the US Population: Results From the National Health and Nutrition Examination Surveys 2009-2014. JAMA Internal Medicine, 176(11), 1716–1717. https://doi.org/10.1001/jamainternmed.2016.5254
+[12] Daniel Granderson. (2016). Gluten-Free Foods in the U.S., 6th Edition (No. LA15012937). Packaged Facts. Retrieved from https://www.packagedfacts.com/Gluten-Free-Foods-10378213/
+[13] Dickey, W., & Kearney, N. (2006). Overweight in celiac disease: prevalence, clinical characteristics, and effect of a gluten-free diet. The American Journal of Gastroenterology, 101(10), 2356–2359. https://doi.org/10.1111/j.1572-0241.2006.00750.x
+[14] Gaesser, G. A., & Angadi, S. S. (2012). Gluten-free diet: imprudent dietary advice for the general population? Journal of the Academy of Nutrition and Dietetics, 112(9), 1330–1333. https://doi.org/10.1016/j.jand.2012.06.009
+[15] Wu, J. H. Y., Neal, B., Trevena, H., Crino, M., Stuart-Smith, W., Faulkner-Hogg, K., … Dunford, E. (2015). Are gluten-free foods healthier than non-gluten-free foods? An evaluation of supermarket products in Australia. The British Journal of Nutrition, 114(3), 448–454. https://doi.org/10.1017/S0007114515002056
+[16] Missbach, B., Schwingshackl, L., Billmann, A., Mystek, A., Hickelsberger, M., Bauer, G., & König, J. (2015). Gluten-free food database: the nutritional quality and cost of packaged gluten-free foods. PeerJ, 3. https://doi.org/10.7717/peerj.1337
+[17] Ye, E. Q., Chacko, S. A., Chou, E. L., Kugizaki, M., & Liu, S. (2012). Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain. The Journal of Nutrition, 142(7), 1304–1313. https://doi.org/10.3945/jn.111.155325
+[18] Slavin, J. (2004). Whole grains and human health. Nutrition Research Reviews, 17(1), 99–110. https://doi.org/10.1079/NRR200374
+[19] Sanz, Y. (2010). Effects of a gluten-free diet on gut microbiota and immune function in healthy adult humans. Gut Microbes, 1(3), 135–137. https://doi.org/10.4161/gmic.1.3.11868

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