Valuing gluten-free foods relates to health behaviors in young adults

In a new study featured in the Journal of the Academy of Nutrition and Dietetics, researchers found that among young adults valuing gluten-free foods could be indicative of an overall interest in health or nutrition. These young adults were more likely to engage in healthier behaviors including better dietary intake and also valued food production practices (e.g., organic, non-GMO, locally sourced). Of concern, they were also more likely to engage in unhealthy weight control behaviors and over-concern about weight.

Gluten-free food offerings have become more ubiquitous in the past decade, with proponents claiming they can help with everything from weight loss, to treating autoimmune disease, to improving your skin. Despite all the attention, little is known about the effect these beliefs have on the dietary habits of the general public.

Researchers from the University of Minnesota wanted to explore the sociodemographic and behavioral characteristics of young adults who value gluten-free as an important food attribute and investigate how this is associated with their dietary intake. The study looked at a sample of 1,819 young adults 25 to 36 years old from the Project EAT longitudinal cohort study. They measured whether they value gluten-free food, weight goals, weight control behaviors, food production values, eating behaviors, physical activity, and dietary intake.

Investigators found that approximately 13 percent of participants valued gluten-free food. These individuals were four to seven times more likely to value food production practices such as organic, locally-grown, non-GMO, and not processed. There was also an association between using Nutrition Facts and having a weight goal and valuing gluten-free foods.

Interestingly, valuing gluten-free food was also linked to both healthy eating behaviors like eating breakfast daily and consuming more fruits and vegetables, and unhealthy weight control behaviors such as smoking, using diet pills or purging. These data show that while eating gluten-free can be associated with an overall interest in maintaining a healthy lifestyle, it might also indicate a harmful preoccupation with weight loss and/or behaviors that are perceived to promote weight loss. Researchers found that valuing gluten-free food was three times higher for young adults engaging in unhealthy weight control behaviors.

“I have concerns about the increasing number of people who perceive that eating a gluten-free diet is a healthier way to eat. Of particular concern is the higher risk for those engaging in unhealthy weight control practices for perceiving a gluten-free diet as important, given that eating gluten-free, may be viewed as a ‘socially acceptable way’ to restrict intake that may not be beneficial for overall health,” noted lead investigator Dianne Neumark-Sztainer, PhD, MPH, RD, Professor and Head, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA. “If there is a need for eating gluten-free, then it is important to avoid foods with gluten. Otherwise, a dietary pattern that includes a variety of foods, with a large emphasis on fruits, vegetables, and whole grains, is recommended for optimal health.”

Gluten-free food offerings continue to gain a foothold in the marketplace. In 2015, gluten-free alternatives to traditional foods accounted for almost $1.6 billion in sales with most of the growth driven by consumers for whom being gluten-free is not medically necessary (e.g., Celiac disease). Other research shows that up to one third of consumers believe that gluten-free foods are healthier than their gluten counterparts. This is part of the “health halo” effect, belief by consumers that because a food lacks a certain ingredient or has a specific label, that food is automatically “healthy.”

“Products labeled as ‘low sodium,’ ‘natural,’ and ‘free from’ certain food components or characteristics may be interpreted by consumers as being healthier overall,” explained lead author Mary J. Christoph, PhD, MPH, postdoctoral fellow, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA. “The health halo effect can have unintended consequences on eating habits, such as people overconsuming because they believe they have chosen a healthier product.”

Investigators did find that individuals who valued gluten-free foods were more likely to eat a higher quality diet. Although dietary intake did not meet most guidelines, these participants were more in sync with the Dietary Guidelines for Americans, including consuming more fruits, vegetables, and fiber, less sodium, and a smaller proportion of calories from saturated fat. The data did show that there was no difference in whole grain intake between those who valued gluten-free foods and those who did not.

“This is one of the first population-based studies to describe sociodemographic and behavioral characteristics of young adults who value gluten-free food and to compare dietary intake for those who did and did not value gluten-free food,” concluded Dr. Christoph. “Nutrition professionals counseling gluten-free clientele should ask about the reasons underlying valuing and/or eating gluten-free food along with other behaviors, particularly weight control, to promote overall nutrition and health.”

------
The article is “Who Values Gluten-Free? Dietary Intake, Behaviors, and Sociodemographic Characteristics of Young Adults Who Value Gluten-Free Food,” Mary J. Christoph, PhD, MPH; Nicole Larson, PhD, MPH, RD; Katie C. Hootman, PhD, RD; Jonathan M. Miller, PhD; and Dianne Neumark-Sztainer, PhD, MPH, RD (http://dx.doi.org/10.1016/j.jand.2018.04.007). It will appear in the Journal of the Academy of Nutrition and Dietetics, volume 118, issue 8 (August 2018) published by Elsevier.

This study was supported by grant number R01HL116892 from the National Heart, Lung, and Blood Institute (Principal Investigator [PI]: Dianne Neumark-Sztainer). Mary J. Christoph is supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under National Research Service Award (NRSA) in Primary Medical Care, grant number T32HP22239 (PI: Iris Borowsky). Katie C. Hootman was supported by the NHLBI NRSA in Cardiovascular Disease Epidemiology and Prevention, grant number T32HL007779 (PI: Aaron Folsom). Jonathan M. Miller is supported by grant number T32CA163184 from the National Cancer Institute (PI: Michele Allen).

An accompanying video and information specifically for journalists are located at www.jandonline.org/content/podcast. Excerpts from the video may be reproduced by the media; contact Eileen Leahy to obtain permission.

About the Journal of the Academy of Nutrition and Dietetics 
The official journal of the Academy of Nutrition and Dietetics, the Journal of the Academy of Nutrition and Dietetics is the premier source for the practice and science of food, nutrition, and dietetics. The monthly, peer-reviewed journal presents original articles prepared by scholars and practitioners and is the most widely read professional publication in the field. The Journal focuses on advancing professional knowledge across the range of research and practice issues such as: nutritional science, medical nutrition therapy, public health nutrition, food science and biotechnology, food service systems, leadership and management and dietetics education. www.jandonline.org

About the Academy of Nutrition and Dietetics
The Academy of Nutrition and Dietetics is the world’s largest organization of food and nutrition professionals. The Academy is committed to improving the nation’s health and advancing the profession of dietetics through research, education, and advocacy. www.eatright.org

About Elsevier
Elsevier is a global information analytics business that helps institutions and professionals advance healthcare, open science and improve performance for the benefit of humanity. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support and professional education, including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, more than 38,000 e-book titles and many iconic reference works, including Gray’s Anatomy. Elsevier is part of RELX Group, a global provider of information and analytics for professionals and business customers across industries. www.elsevier.com