NPR

Look Who's Going Gluten-Free

French Laundry pastry chef Lena Kwak with the gluten-free flour she developed. (Thomas Keller Restaurant Group)

Gluten-free isn't just for natural foodies anymore. It's gone mainstream. So much so, it's even been embraced by restaurateur Thomas Keller, one of the nation's top chefs (he's the only one with three Michelin stars for two restaurants).

Keller and Lena Kwak, the research & development chef at his landmark French Laundry, have introduced a blend of rice flour, cornstarch and other ingredients sold under the label Cup4Cup. For a team as sophisticated as this, you may be surprised to hear Kwak's favorite recipe with this flour.

"To be honest, it's brownies!" she told me. "They're incredible." She also loves spiced apple muffins and danishes. Though you won't find gluten-free options listed on the menu, Keller now offers a gluten-free version of his famous Salmon Cornets by special request.

Get the recipes for gluten-free Spiced Apple Muffins and Danish.

Celebrities have helped propel gluten-free products into the mainstream: They're now a $2.6 billion a year industry. Scarlett Johansson has gone on the record as a fan of gluten-free cupcakes from the trendy, vegan Babycakes Bakery in New York. And Elisabeth Hasselback has tweeted about her gluten-free pizza outings. And, of course, there's Gwyneth Paltrow.

So why are so many people going out of their way to avoid gluten? Some have celiac disease. But many others avoid wheat and other grains because they're intolerant to to the gluey protein.

"There's been a number of studies over the last couple years, a small number, but convincingly done, that show there really is a phenomenon of what's now known as non-celiac gluten sensitivity," Harvard gastroenterologist Dan Leffler told me.

The medical establishment used to pooh-pooh the idea of wheat sensitivities. But Leffler says this is changing.

"These are people who clearly don't have celiac disease but at same time do have symptoms when they're exposed to gluten," says Leffler. Symptoms may include bloating, gas and other gastrointestinal problems.

Leffler says it's impossible to put a number on exactly how many people have some degree of gluten sensitivity. But he says it's likely that some portion of the millions of people diagnosed with irritable bowel syndrome don't tolerate gluten well.

"Gluten is a very difficult protein to digest, because it doesn't get broken down in the way many other proteins or sugars do," he says.

And for some people, this means the work of breaking it down is pretty much left up to the bacteria in the gut. "The bacteria create gas and acid," says Leffler. "And it's those byproducts of bacterial digestion of gluten that's causing the symptoms."

A survey by the market research group Packaged Facts finds that consumers have all sorts of motivations for experimenting with gluten-free diets. Some say they think it will help them shed a few pounds. They figure if they're giving up wheat, they're cutting carbs. But it usually doesn't work this way.

Leffler's research is finding that often times, people gain weight on gluten-free diets. Sometimes, if people are giving up pizza, they'll compensate by eating something extra — say, ice cream. "It's a common coping strategy," says Leffler.

"I think there's a perception that gluten-free equals health," Leffler told me. "It's just not the case." Just because there's no gluten in a food doesn't mean it's not loaded with calories, fat and sugar.

So his advice? If you think your body isn't tolerating gluten, get tested for celiac disease. Or try a gluten-free diet.

Copyright 2014 NPR. To see more, visit http://www.npr.org/.

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RENEE MONTAGNE, HOST:

Another dietary trend that's exploded in recent years is gluten-free products. You can now get everything from cupcakes to brownies to pizza with a gluten-free label. NPR's Allison Aubrey looks at whether there's any real health benefit for people who don't have celiac disease. That's the condition where people can't tolerate gluten.

ALLISON AUBREY, BYLINE: There was a time not too many years ago, before gluten-free was a $2.6 billion a year business, when wheat-free alternatives sat in a lonely corner of the health food store. Now when you walk through a market you can be inundated with options.

CHRIS HOGE: Our seafood alfresco is gluten-free. Our dips are all gluten-free. We make gluten-free crab cakes.

AUBREY: Chris Hoge has a booth at the Penn Quarter Fresh Farm Market in D.C. Market director Ann Yonkers says many more vendors are following suit.

ANN YONKERS: We've just had a lot more interest from bakers who are getting more sophisticated in terms of baking things that are gluten-free that are delicious.

AUBREY: So why are so many people going out of their way to avoid gluten? Well, some of them have celiac disease. They're bodies can't handle gluten, which is a protein found in wheat and other grains. It makes them sick. Now, researchers estimate that fewer than one percent of Americans have this disease. And Fresh Market shopper Elizabeth Malone is not among them. But she's chosen to go gluten-free anyway, and she says she feels better.

ELIZABETH MALONE: I find that I'm a lot healthier because of it. You know, we don't eat any processed food anymore. You can't call Domino's and order a pizza. It's just a much healthier way of being in a lot of ways.

AUBREY: Elizabeth started eating gluten-free because of her husband. She says he's got a wheat intolerance. Now experts in the medical community used to pooh-pooh the idea of wheat sensitivities. Some doctors thought if you didn't have celiac disease, any bad reaction to wheat was just in your imagination. But Dan Leffler, an assistant professor of medicine at Harvard, says this is changing.

DAN LEFFLER: There's a been a number of studies over the last couple years, a small number but convincingly done, that show that there really is a phenomenon of what's now known as non-celiac gluten sensitivity. These are people who clearly don't have celiac disease, but at same time do have symptoms when they're exposed to gluten.

AUBREY: Symptoms such as bloating, gas, and other GI problems. Leffler says it's impossible to put a number on exactly how many people have some degree of gluten sensitivity. But he says it's likely that some portion of the millions of people diagnosed with irritable bowel syndrome don't tolerate gluten well.

LEFFLER: Gluten is a very difficult protein to digest. It doesn't get broken down in the way many other proteins or sugars do.

AUBREY: And for some people that means the work of breaking it down is pretty much left up to the bacteria in the gut.

LEFFLER: And when that happens, the bacteria create gas and acid. And at least in a fair proportion of people, it's those byproducts of bacterial digestion of gluten that's causing the symptoms.

AUBREY: There are plenty of people out there who tolerate gluten just fine. But a recent survey by the market research firm Packaged Facts finds some of them have other motivations for buying gluten-free foods. Joel Warady works for a company called Enjoy Life Foods. They make lots of gluten-free sweets. He says people often think they're healthier.

JOEL WARADY: Because it's called gluten-free, people assume gluten must be bad, because why else would you want gluten-free?

AUBREY: And some people think it'll help them shed a few pounds. They figure if they're giving up wheat, they're giving up carbs, and hey, that's got to be good for the waistline. But here's why this thinking does not work: there are too many delicious, gluten-free goodies out there, like this one.

HOGE: We're going to let you taste a chocolate chip cookie and you're going to tell me whether or not you don't think it tastes like the best chocolate chip cookie you've ever had.

AUBREY: It's chocolate, so of course it tastes good. Harvard's Dan Leffler says his research shows that a lot of people actually gain weight on a gluten-free diet. He says by all means, try a gluten-free diet if you think your body doesn't handle it well, but don't be fooled into thinking that it's somehow healthier for everyone. Allison Aubrey, NPR News, Washington.

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MONTAGNE: You're listening to MORNING EDITION from NPR News. Transcript provided by NPR, Copyright NPR.

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