Gluten avoidance – trendy food fad, or insight into complex psycho-physiological interactions?

Research indicates that there has been an increase in the adoption of gluten-free diets despite modest estimates of disorders that require this restrictive diet. To date, little is known about what motivates people to engage in gluten avoidance without a medical diagnosis that requires them to do so. This research was developed to examine this population in detail, in order to determine whether individuals who avoid gluten belong to a homogenous group that differs from gluten consumers.
This thesis adopted a sequential qualitative-quantitative mixed methods design, allowing for the integration of multiple data types. Each phase of the research informed the next, where qualitative interviews highlighted significant factors that needed to be included for subsequent analyses. In the qualitative phase, participants reported heavily relying on self-diagnosis, which was complicated by a sense of dissatisfaction with GPs, and the high levels of perceived discrimination participants felt from those around them. This paved the way for two subsequent quantitative research phases.
The second phase utilised a representative sample to examine prevalence rates of gluten avoidance behaviors, and the demographic variables that characterise them. Twenty percent of the sample reported participating in non-prescribed gluten avoidance behaviors, and a further 2% reported strict avoidance due to diagnoses of coeliac disease/wheat allergy. Non-prescribed gluten avoidance was more likely to be reported by females, who were under 35 years of age. These findings established a need for deeper quantitative investigation to assess if they are able to be further distinguished by additional variables.
The final research phase examined the physiological and psychological characteristics that were reported by participants avoiding gluten. Gluten avoiders were found to have a non-specific physiological response to all foods, not just to gluten alone. These trends extended to avoidance behaviours, and food perceptions as well. Further investigation of psychological variables revealed that gluten avoiders may be experiencing sensory issues that genuinely manipulate the experience of physical sensations in the body.
The research identifies gluten avoiders as a homogenous group of people who are attending to more, sensing more, feeling more and responding more strongly to a range of foods and their effects. This research helps to establish the unique set of needs of this population, and the considerations that need to be given in future treatment models.