Does gluten intolerance lead to depression and disordered eating? That’s what researchers from Penn State are saying, after finding that women with celiac disease were at a higher risk for both depression and eating issues—regardless of whether they were on a gluten-free diet.
Celiac disease—a condition in which eating gluten triggers damage to the small intestine lining that prevents the body from properly absorbing nutrients—has previously been linked to depression. And it’s not just because the intestinal damage causes awful symptoms, like cramping, gas, vomiting and diarrhea; or because avoiding all wheat, barley and rye—all of which contain gluten—really sucks. No, the small intestine’s failure to absorb essential nutrients—like zinc, tryptophan and B vitamins—can actually trigger depression by halting production of neurochemicals like serotonin (food and mood are so linked!). A 1998 study found about one-third of those with celiac disease were also clinically depressed.
But if we accept all of that, than eating a gluten-free diet should eventually end a celiac patient’s depressive symptoms. Which—according to this new Penn State study—isn’t the case. The researchers looked at 177 women with celiac disease, most of whom did adhere to a gluten-free diet. Avoiding gluten was “related to increased vitality, lower stress, decreased depressive symptoms and greater overall emotional health,” said study co-author Josh Smyth.
“However, even those people who were managing their illness very well reported higher rates of stress, depression and a range of issues clustered around body image, weight and shape when compared to the general population.”
Now perhaps the increased depression rates can still be attributed to nutrient deficiencies—even after going on a gluten-free diet, it can take someone with celiac disease as long as two or three years to fully catch up, and the study doesn’t say how long participants had been eating gluten-free.
But how to explain the body-image and disordered eating issues? The researchers aren’t sure. Does the obsessive focus that avoiding all gluten requires trigger an unhealthy relationship to food? Are eating issues triggered by depression? Or can the higher depression rates—even in those on a gluten-free diet—be explained as a consequence of disordered eating?
“What we don’t know is what leads to what and under what circumstances,” Smyth said in a Penn State press release. “It’s likely that the disease, stress, weight, shape and eating issues, and depression are interconnected. But we don’t know if women with both higher stress and celiac disease are more likely to develop symptoms of disordered eating and then become depressed, or if women with celiac disease are depressed and then become stressed, which leads to disordered eating. In the future, we plan to investigate the temporal sequence of these symptoms.”