At age 40, Joyce Novak developed intestinal symptoms so severe she wound up in a Florida hospital. Doctors took X-rays and conducted bone marrow tests and barium studies, but still couldn't figure out why Novak was malnourished, her legs were painfully swollen and her weight had dropped to 80 pounds.
Then a young resident took a personal interest in her and began to investigate. He conducted a small-bowel biopsy, and Novak finally had her diagnosis: celiac disease, an autoimmune disorder in which the villi of the small intestine are damaged by specific peptides from wheat, rye and barley—collectively called gluten.
Novak cut bread, cake, pasta—anything that contained gluten—from her diet. She ate a lot of rice. She learned to make gluten-free bread that was "really dense. You had to toast it." Gradually, she regained her health.
That was more than 35 years ago, when hardly anybody had heard of celiac disease or gluten intolerance. Today, it's a different story. The whole world seems to be going gluten free. Celiac sufferers like Novak have dozens of books and websites, support groups and medical and educational resources, not to mention thousands of GF foods, drinks, ingredients, supplements and personal care to choose from.
Gluten free is big, and it's not just for celiacs. It's become the latest craze for everybody from the health-conscious to talk show hosts. Packaged Facts, a market-research firm based in Rockville, Md., put sales for all GF food and beverages at $1.6 billion last year, and projects the market will reach $2.6 billion by 2012.
Sales of GF products in natural foods stores totaled $921 million in 2008, up 16 percent from $791 million in 2006, according to SPINS, a Schaumburg, Ill.-based market-research firm. And those figures don't include sales at Austin, Texas-based giant Whole Foods, which probably account for another $250 million in revenue, estimates SPINS Director of Consumer Insights Mary Ellen Lynch.
The gluten-free consumer
Yet for all the attention to gluten-free living, celiac disease is "grossly underdiagnosed," says Shelley Case, a registered dietitian and the author of Gluten-Free Diet: A Comprehensive Resource Guide (Case Nutrition Consulting, 2008).
Of an estimated 2 million to 3 million celiacs in the United States, only about 5 percent are diagnosed, Case says. That's partly because symptoms of celiac disease mimic a number of other symptoms caused by gastrointestinal problems, allergies or anemia. In addition, Case says, people can have gluten intolerance—and suffer severe gastrointestinal symptoms as a result—but not have celiac disease. And then there are people who have wheat allergies but still can eat barley and rye.
Add to that a growing number of people who are going gluten free and switching to ancient grains like quinoa and amaranth as part of what they consider a healthy lifestyle, as well as those who jump on the latest bandwagon, and you have a full-blown trend.
Packaged Facts reports that 225 companies introduced 1,182 new GF food and beverage SKUs in the United States last year.
"The manufacturers are driving the gluten-free buzz," Case says. "The more we get diagnoses, the bigger the market."
A gluten-free smorgasbord
Pioneer manufacturers of natural, GF foods are seeing inroads from conventional food giants like General Mills. Choices abound, from brownies to frozen entrées. "Nowadays, I can even eat pizza," Novak says. "There are so many more products I can have."
Ukiah, Calif.-based Pamela's Products, founded in 1988 by Pamela Giusto-Sorrells, offers 30 GF products ranging from pancake mix to organic espresso-chocolate-chunk cookies. The company recently launched a line of cheesecakes, chocolate cake and coffee cake. "Sales have been growing significantly, in the 30 percent to 40 percent range over the last few years," says Stephanie Robbins, director of marketing. She says new GF entries, particularly by the large conventional manufacturers, "definitely push us," but because of the long-time credibility Pamela's has earned with its customers, "that level of competition works in our favor." (For more on Pamela's, winner of NFM's 2009 Industry Innovator Award, click here.)
While Pamela's Products are available online, at natural markets nationwide and at local independents, its biggest growth is in conventional supermarkets, Robbins says. Mass markets take up the lion's share of GF product sales—75 percent in 2008, according to SPINS. Yet the firm says growth is faster at naturals stores—up 20 percent last year versus a 15 percent increase in the conventional channel.
But that doesn't tell the whole story. Online sales are big with GF consumers, who often report that they can find a larger selection than at grocery stores. Specialty stores that sell only GF products also are popping up across the country, and Case said these markets are gaining in popularity. "Finding gluten-free products takes a lot of time. People go into larger stores and they don't know where to find things."
Like all trends, however, the gluten-free craze has its drawbacks.
"It is a myth that everyone should be on a gluten-free diet," Case says. People might see it as a solution for arthritis, attention-deficit disorder or weight loss, but "it's not a panacea." In addition, people who self-diagnose celiac disease and don't get the necessary blood tests and small-intestine biopsy might not be motivated to follow a strict GF diet, and could wind up with worse complications of the disease, she says.
For retailers and manufacturers, increases in diagnoses of celiac disease and heightened awareness of gluten might be good for business now, but counting on GF products to carry the bottom line is probably not a wise long-term plan, says Jay Jacobowitz, president of Retail Insights, a Brattleboro, Vt.-based consulting service.
"The potential audience for gluten free could arguably be the majority of Americans," Jacobowitz says. "It's driving sales for naturals stores. But go back to 2003 with low carb. Natural products stores were converting large sections of their stores to low carb. Where is that today?"
Because it costs conventional supermarket chains "virtually nothing" to increase space for shelf-stable GF products, he sees them overtaking natural products stores fairly soon. "I give it 18 to 24 months and you'll start to see a major shift in (gluten-free) availability through distribution channels."
The way Jacobowitz sees it: "There are a few small boats in the water. But there are big tankers coming up behind them."
Jane Hoback is a Denver-based freelancer.