The Healthy Skeptic: Supplements claim to break down gluten
Not long ago, almost nobody outside of a bakery ever gave a second thought to gluten, the protein in wheat and similar grains that makes bread dough firm, elastic and, well, doughy.
But lately gluten’s reputation has taken a sinister turn. Doctors warn that about 1 out of 100 people has celiac disease, a dangerous condition in which the body’s immune system attacks gluten proteins. For them, anything made with wheat flour can cause joint pain, gastrointestinal distress, anemia and even an early death.
Look around the Internet or do some reading at a health food store and you’ll find plenty of claims that the dangers of gluten go beyond celiac disease. Headaches, fatigue, fibromyalgia, autism — gluten has become a go-to explanation for all sorts of maladies.
Gluten fears have spawned a booming industry in gluten-free breads, pasta, cakes and cookies. They’re usually just pale imitations of the real things, a shortcoming that has spurred interest in another option: enzyme supplements that supposedly break down gluten before it has a chance to cause any trouble.
GlutenEase, a supplement from Enzymedica Inc., contains a blend of enzymes — including amylase, glucoamylase and dipeptidyl peptidase-4 (DDP-IV) — that are intended to digest both gluten and casein, a protein found in milk. Users are instructed to take at least one capsule with any meal that contains gluten or casein. It’s sold at many health food stores, but you can also buy it online directly from the company. Expect to pay about $30 for 60 capsules.
Gluten Defense, made by Enzymatic Therapy Inc., contains a similar blend of enzymes that includes DDP-IV, lactase and amylase. Users are instructed to “take two capsules with each meal or as directed by your healthcare practitioner.” A bottle of 120 capsules, available online and at many health food stores, costs about $30.
The claims
The website for GlutenEase says that the supplement can “support” people who have trouble digesting gluten. The site says that it is “not formulated” for people with celiac disease. But according to Dave Barton, director of education for Enzymedica, many people who say they have celiac disease feel better after taking the product, and some of them even manage to start eating wheat again. He cautions, however, that there’s “no way to guarantee that it would break down 100% of gluten proteins.”
Barton says that GlutenEase is especially popular among parents of autistic children.
The site for Gluten Defense says the product is “specifically formulated to defend against hidden gluten” that can cause gas, bloating and indigestion. Unlike GlutenEase, there are no specific claims that a person could knowingly eat gluten and get away with it. Enzymatic Therapy did not respond to requests for more information.
The bottom line
Over-the-counter enzymes may be able to break down a few molecules of gluten here and there, but it would be downright dangerous for anyone with celiac disease to think that a supplement would make it possible for them to eat gluten again, says Dr. Stefano Guandalini, a professor of pediatrics and director of the University of Chicago Celiac Disease Center. “The amount of gluten that these would be able to digest is ridiculously low,” he says. “For people with celiac disease, these are something to completely avoid.”
Dr. Peter Green, director of the Celiac Disease Center at Columbia University in New York City, agrees that current enzyme supplements would digest only a small percentage of gluten molecules. But, he adds, the basic concept isn’t completely far-fetched. Pharmaceutical companies are currently spending hundreds of millions of dollars to develop an enzyme-based drug that could allow people with celiac disease to eat gluten. However, he adds, if over-the-counter products already did the job, companies wouldn’t be investing such big bucks to reinvent the wheel.
Green is baffled that so many people want to avoid gluten in the first place. If a person doesn’t have celiac disease, he explains, there’s no evidence that the protein can do any lasting harm. “A gluten-free diet isn’t necessarily a healthy diet,” he adds. He points out that gluten-free products made with rice flour or potato flour tend to be relatively low in iron, B vitamins, folic acid and other nutrients often found in fortified grains.
According to Guandalini, a small number of people — perhaps 1 out of 200, although no one knows for sure — may still be “gluten sensitive” even though they don’t have celiac disease. There’s currently no scan or blood test that can detect anything amiss, but it does seem that these people are more likely to suffer from headaches, indigestion or other problems after eating gluten, he says. Even for them, he adds, an enzyme supplement wouldn’t break down enough gluten to do any good.
For everyone else — the vast majority of Americans — there’s no reason to avoid gluten, Guandalini says. “A lot of people are on a gluten-free diet who don’t need to be,” he says.
Guandalini is particularly exasperated by the many parents who believe that a gluten-free diet is an effective treatment for children with autism. “That’s just one more burden on a child, and there’s no evidence whatsoever that it has any benefits,” he says.
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